scholarly journals The case for expanding the definition of ‘key populations’ to include high-risk groups in the general population to improve targeted HIV prevention efforts

2015 ◽  
Vol 105 (8) ◽  
pp. 664 ◽  
Author(s):  
Olive Shisana ◽  
Numpumelelo Zungu ◽  
Meredith Evans ◽  
Kathryn Risher ◽  
Thomas Rehle ◽  
...  
Keyword(s):  
High Risk ◽  
General Population ◽  
Hiv Prevention ◽  
Risk Groups ◽  
Key Populations ◽  
Definition Of

scholarly journals Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Jing Liao ◽  
Na He ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Hiv Prevention ◽  
Meta Analysis ◽  
Peer Education ◽  
Risk Groups

HIV non-occupational postexposure prophylaxis (nPEP) usage among five key populations in China

2021 ◽  
pp. sextrans-2020-054791
Author(s):  
Haochu Li ◽  
Ran Wei ◽  
Eduardo Piqueiras ◽  
Eric P F Chow ◽  
Kedi Jiao ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Prevention ◽  
Sex Workers ◽  
People Who Use Drugs ◽  
Key Populations ◽  
Multiple Use ◽  
Postexposure Prophylaxis ◽  
Cross Sectional ◽  
Prevention Services ◽  
Behavioural Factors

ObjectivesTo examine the feasibility of non-occupational postexposure prophylaxis (nPEP) as a national strategy for HIV prevention in China, we investigated nPEP usage and related sociodemographic and behavioural factors among five key populations at high risk of contracting HIV.MethodsWe conducted a cross-sectional study among five key populations from November 2018 to September 2019 in China using convenience sampling to recruit participants aged ≥18 years, self-reporting HIV status as either negative or unknown and providing written informed consent. Univariable and multivariable logistic regression models were fitted.ResultsOur analysis included data from 2022 participants with a mean age of 35 years (SD=11.62). Only 57 (2.82%) participants had ever used nPEP. Sociodemographic and behavioural factors related to nPEP usage included populations (p<0.0001), age (p<0.05), education (p<0.05), nPEP knowledge (p<0.01), receiving conventional HIV prevention services (p<0.05) and HIV testing (p<0.05). A significant percentage (26%) of nPEP users used nPEP medication more than once. Challenges and concerns, such as multiple use of nPEP and syndemic conditions, were emerging.ConclusionsKey populations in China had low nPEP usage rates. Female sex workers, people who use drugs, older and illiterate individuals with poor nPEP knowledge, not using HIV prevention services or never tested for HIV should be emphasised. Implementing nPEP services would be an important way to access high-risk individuals for intensive and tailored HIV prevention and intervention. Challenges of providing nPEP services and future study foci are highlighted.

Social network strategy as a promising intervention to better reach key populations for promoting HIV prevention: a systematic review and meta-analysis

2020 ◽  
Vol 96 (7) ◽  
pp. 485-491
Author(s):  
Xing Yang ◽  
Ting Fang ◽  
Siam AI Mobarak ◽  
Jing Wang ◽  
Can Wang ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
High Risk ◽  
Hiv Prevention ◽  
Risk Behaviour ◽  
Control Methods ◽  
Key Populations ◽  
Hiv Interventions ◽  
Hiv Seroconversion ◽  
Testing Uptake

IntroductionKey populations such as men who have sex with men (MSM), drug users and sex workers are at high risk of HIV infection, but they are marginalised and hidden. Social network strategy (SNS) is purposeful to use social networks to generate social influence, accelerate behaviour change and achieve desirable outcomes among individuals or communities and have been increasingly used for HIV interventions. This study aims to investigate the effects of SNS on HIV prevention among key populations.MethodsWe searched six databases, including PubMed, Web of Science, Embase, Cochrane Library, ScienceDirect and Wiley for randomised controlled trials published between January 1999 and May 2019. Eligibility criteria included SNS conducted among key populations for HIV interventions, with a comparator group. Outcomes included changes in HIV high-risk behaviour, HIV seroconversion and other HIV outcomes. We used the risk ratio (RR) or mean difference with associated 95% confidence interval (CI) to assess the comparative efficacy between SNS and control methods on the selected outcomes. The GRADE system was used to assess the quality of evidence for the studies.ResultsOf 2818 citations identified, 28 trails from 24 papers met the inclusion criteria. The results showed that SNS was associated with less unprotected intercourse (RR 0.79, 95% CI 0.72 to 0.86) and sex with multiple partners (0.46, 95% CI 0.33 to 0.65). Additionally, relative to the control methods, SNS significantly reduced HIV seroconversion (0.65, 95% CI 0.53 to 0.81), improved HIV testing uptake (1.11, 95% CI 1.07 to 1.15) and promoted participant retention (1.03, 95% CI 1.00 to 1.06) among key populations. The Grading of Recommendations Assessment, Development and Evaluation system showed that trails were of moderate quality.ConclusionsThis review provides evidence that SNS can reach key populations who are currently not being reached by existing programmes and deliver HIV interventions through social networks, which decreases HIV sexual risk behaviour and HIV incidence and increases HIV testing uptake and participant retention.Trial registration numberCRD42019140533.

Risk Of Solid Subsequent Malignant Neoplasms (SMNs) With Extended Follow-Up Of Childhood Hodgkin Lymphoma (HL) Survivors Is Comparable To The Risk In Known High-Risk Groups Within The General Population: Report From The Late Effects Study Group (LESG)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2992-2992
Author(s):  
Smita Bhatia ◽  
Cor van den Bos ◽  
Can-Lan Sun ◽  
Jillian Birch ◽  
Lisa Diller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Lung Cancer ◽  
High Risk ◽  
General Population ◽  
Clin Oncol ◽  
Cumulative Incidence ◽  
Risk Groups ◽  
Increased Risk

Abstract Background We describe the pattern and incidence of SMNs with 10 additional years of follow-up of an international cohort (Bhatia, N Engl J Med, 1996; Bhatia, J Clin Oncol, 2003) of children with HL diagnosed between 1955 and 1986 at age 16 y or younger. Methods Medical record review was used to identify SMNs, define vital status and describe therapeutic exposures. Pathology reports served to validate SMNs. Cumulative incidence (CI) utilized competing risk methods. Standardized incidence ratio (SIR) and absolute excess risk (AER/10,000 p-y) utilized age-, gender- and year-matched rates in the general population. Cox regression techniques (using calendar time as time scale) identified predictors of SMN risk. Results The cohort included 1023 patients diagnosed with HL at a median age of 11 y, and followed for a median of 26.8 y (IQR, 16.4-33.7). Eighty-nine percent had received radiation, either alone (22%), or in combination with chemotherapy (67%). Alkylating agent (AA) score was defined as follows: 1 AA for 6 m = AA score of 1; 2 AA for 6 m or 1 AA for 12 m = AA score of 2, etc. The AA score was 1-2 for 54% and 3+ for 16%; 30% did not receive AA. A total of 188 solid SMNs developed in 139 patients (breast [54], thyroid [24], lung [11], colorectal [11], bone [8], other malignancies [80]. Table summarizes SIR (95%CI), CI, and AER by attained age. The cohort was at an 11.1-fold increased risk of developing solid SMNs (excluding non-melanoma skin cancers) compared with the general population (95% CI, 9.4-13.0). CI of solid SMNs was 25.2% at 40 y from HL diagnosis (Fig 1). Among patients aged ≥40 y, 79% of total AER was attributable to breast, thyroid, colorectal and lung SMNs (Table). Thirty-seven patients developed >1 solid SMN; the cumulative incidence of the 2nd SMN was 19.6% at 10 years from diagnosis of the 1st SMN. Breast Cancer: Females (n=41) had a 20.9-fold increased risk, and males (n=3) a 45.8-fold increased risk c/w general population. Age at HL of 10-16 y vs. <10 y (RR=9.7, 95%CI, 2.3-40.6, p=0.002), and exposure to chest radiation (RR=5.9, 95%CI, 1.4-25.9) were associated with increased risk. Among females aged 10-16 y at chest radiation, cumulative incidence was 24.3% by age 45 y, as opposed to 2.6% for those <10 y, p=0.001 (Fig 2). Exposure to AA was associated with a lower risk (RR=0.4, p=0.002). Diagnosis of HL after 1975 was associated with decreased risk (RR=0.25, 95%CI 0.12-0.53), explained, in part by the increasing use of AA after 1975 (78%) vs. before 1975 (61%). By age 40 y, the risk of breast cancer among females exposed to chest radiation at age 10-16 y (18.2%) was comparable to the risk for BRCA1 mutation carriers (15%-20% by age 40 y; Chen, J Clin Oncol, 2007). Lung cancer: Ten of 11 lung cancer cases were diagnosed in males (males: SIR=24.7; females: SIR=3.2, p=0.05); all had received neck/chest radiation. The CI of lung cancer among males was 3.8% by age 50 y, comparable to the risk among male smokers (2% by age 50 y, Bilello, Clinics Chest Med, 2002). Colorectal cancer: There was a 11.5-fold increased risk c/w general population. The CI among those with abdominal/pelvic radiation was 4.1% by age 50 y ; this risk is higher than that observed in individuals with ≥2 first degree relatives affected with colorectal cancer (1.2% by age 50 y, Butterworth, Eur J Cancer, 2006). Thyroid cancer: Survivors had a 22.2-fold increased risk; all developed within radiation field. Females (RR=4.3, 95%CI 1.8-10.4) were at increased risk. Conclusion In this cohort of HL survivors with 20,344 p-y of follow-up, the greatest excess risk of SMNs among those > 40 y was attributable to breast, thyroid, colorectal and lung SMNs. Observed risks for the most common SMNs were comparable to or greater than known high-risk groups within the general population. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e015069 ◽  
Author(s):  
Samar Abd ElHafeez ◽  
Davide Bolignano ◽  
Graziella D’Arrigo ◽  
Evangelia Dounousi ◽  
Giovanni Tripepi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
General Population ◽  
Risk Groups

scholarly journals Screening for celiac disease in the general population and in high‐risk groups

2015 ◽  
Vol 3 (2) ◽  
pp. 106-120 ◽  
Author(s):  
Jonas F Ludvigsson ◽  
Timothy R Card ◽  
Katri Kaukinen ◽  
Julio Bai ◽  
Fabiana Zingone ◽  
...  
Keyword(s):  
Celiac Disease ◽  
High Risk ◽  
General Population ◽  
Risk Groups

scholarly journals Prevalence of hepatitis C infection among the general population and high-risk groups in the EU/EEA: A systematic review update

2019 ◽  
Author(s):  
Ru HAN ◽  
Junwen ZHOU ◽  
Clément François N ◽  
Mondher Toumi
Keyword(s):  
Hepatitis C ◽  
High Risk ◽  
General Population ◽  
Risk Groups ◽  
Epidemiological Studies ◽  
Resource Utilisation ◽  
European Economic Area ◽  
The European Union ◽  
Hepatitis C Infection ◽  
Healthcare Resource Utilisation

Abstract Background: Although significant improvement in efficacy measured by a sustained virological response, the high acquisition costs of direct-acting antivirals limit the access for patients and influence the costs of healthcare resource utilisation in hepatitis C. It is important to have the latest estimates of prevalence, especially in high-risk groups, for cost of illness, cost-effectiveness and budget impact studies. Methods: Original studies on the estimates of the prevalence among general and high-risk populations in the European Union/European Economic Area (EU/EEA) were retrieved from Medline and Embase for the period from 2015 to 2018. All included studies were evaluated for risk of selection bias and summarised together in a narrative form. Results from previous reviews and updated searches were compared per country among different populations, respectively. Results: Among the 3871 studies identified, 46 studies were included: 20 studies were used for the estimate of the general population; 3 for men who have sex with men (MSM); 6 for prisoners; and 17 for people who inject drugs (PWID). Compared with the results reported in previous systematic reviews, the updated estimates were lower than previously in most available countries. Anti-HCV general population prevalence estimates ranged from 0.54% to 1.50% by country. The highest prevalence of anti-HCV was found among PWID (range of 7.90% - 82.00%), followed by prisoners (7.00% - 41.00%), HIV-positive MSM (1.80% - 7.10%), HIV-negative MSM (0.20% - 1.80%), pregnant women (0.10% - 1.32%) and first-time blood donors (0.03% - 0.09%). Conclusions: Our study highlights the heterogeneity in anti-HCV prevalence across different population groups in EU/EEA. The prevalence also varies widely between European countries. There are many countries that are not represented in our results, highlighting the need for the development of robust epidemiological studies.

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