9^th World Congress on Control and Prevention of HIV/AIDS, STDs & STIs August 23-24, 2021 Vienna, Austria

Biography:

Debjit Chakraborty is an expert in the field of epidemiology and public health working in the field of HIV and other communicable disease for last 13 years. He has basic education in Medicine and master in public health (epidemiology) from Kolkata, India. He has worked in the field of HIV, Cancer, Vector Borne Disease and Antimicrobial Resistance till date and has more than 40 publication in many national and international journals and conferences. He is presently working as Scientist D, in the division of Epidemiology in ICMR- National Institute of Cholera and Enteric Diseases in India.

Abstract:

Statement of the Problem: Prevention of parent to child transmission (PPTCT) of HIV approaches towards early detection of HIV status and to provide cascades of services including Anti Retroviral Treatment (ART) for both maternal health benefit and to prevent vertical transmission. In India the major intervention adopted initially was intrapartum single dose nevirapine to mother baby pair. However to achieve global goal of elimination of pediatric HIV since 2014-16 WHO adopted multidrug ART regimen to antenatal HIV positive mother coupled with extended nevirapine prophylaxis to HIV exposed infants (6-12 weeks). Our study compared the effectiveness across this two regiemens keeping ARV naïve as reference.

Findings: We conducted a series of retrospective cohort studies in West Bengal, India (since 2013-2020) where we observed a mother to child transmission rate of around 27% in absence of any prophylaxis. This was reduced to 10% and 3% respectively with administration of single dose nevirapine and multidrug ART regimen. Protective effectiveness of multidrug ART was 88% as compared to 62% for single dose nevirapine. Moreover, ART in pregnant mother was found 94% effective in reducing still birth rate in HIV infected pregnant women in India. Also we observed when ART is in place, the role of other factors such as maternal age, CD4, duration of ART, time of HIV detection, mode of delivery etc becomes insignificant.

Conclusion & Significance: It can be concluded from our studies that incorporation of multidrug ART in PPTCT is really a paradigm shift as it remarkably reduces HIV transmission rates from mother to child and also reduces a drastic reduction in adverse obstetric outcomes. Test and Treat policy of HIV since 2014 in India also enabled early ART initiation which showed the potential of elimination of Pediatric HIV

Biography:

Nina Olivia Rugambwa is a lecturer in the Department of Library and Information Science at Kyambogo University in Kampala Uganda. She is both an educationist and Information scientist. Nina has 11 years of University teaching experience. She is passionate about teaching and her research interests are information seeking behavior, Indigenous Knowledge systems management, knowledge Management, curriculum design and development, collection-development and health information. She is also a student mentor with MasterCard Foundation where she mentors University students.

Abstract:

Problem: Over 80% of rural African people’s primary health care needs are dependent on Indigenous Knowledge (IK) health systems. Uganda is one of the countries that have been greatly affected by HIV/AIDS with young people driving new infections. Lack of comprehensive HIV information has been recognized as a challenge. Minimal studies have been conducted to map out where adolescents access IK for HIV prevention. Knowing IK information sources will assist in provision of targeted and accurate information. This paper presents study findings on where adolescents access IK for HIV prevention.

Materials and Methods: Using a survey research design, 399 secondary school students in Kampala were studied. Data on information sources and access was collected using a questionnaire. Documentary review was also employed. Data was analysed by use of descriptive statistics and content analysis.

Results: Adolescents receive information mainly from family, school and mass media. The information sources from family were mothers (43%) and fathers (21%); from school senior women teachers (35%) and senior men teachers (17%) and from mass media internet (14%) and TV (13). Only 28% of respondents interacted very frequently with their teachers on IK and HIV prevention. 39% of respondents accessed IK from PIASCY the national strategy for increasing HIV information to learners.

Conclusion and Significance: Mothers, fathers, senior teachers, internet and TV are the key information sources on IK for HIV prevention. IK is rarely disseminated to learners by teachers. The influence of PIASCY is limited by its minimal focus on IK. Given the centrality of teachers in learning process, this is a lost opportunity for adolescents’ access to comprehensive information.

Recommendation: Joint community-school sexuality and HIV prevention activities need to be scaled up in schools. PIASCY books need to be enriched with more IK on sexuality and HIV prevention and IK should be mainstreamed in school curriculum.

Biography:

Ilongo Fritz Ngale has his expertise in psychology of education and counselling. He is also a creative writer and his research interests include; philosophies of education, workplace bullying, dispute management and conflict resolution, gender based violence, and African counselling approaches.

Abstract:

Statement of the Problem: The advent of the COVID – 19 pandemic has seemingly created ‘selective amnesia’ in relation to disease perception, in which case the former has ‘suppressed in collective consciousness’ the still dire ravages of HIV & AIDS, with the latter being reduced to ‘second fiddle status in the game of death.’ The systematic marginalization of HIV & AIDS during the COVID – 19 pandemic is glaringly noticed through ‘information and statistics overload’ skewed towards the latter, thereby creating a cognitive distortion of ‘magnification of COVID – 19, and a minimization of HIV & AIDS.’ The purpose of this concept paper is to describe the phenomenon of percepticide during the ongoing COVID – 19 pandemic, in which people are frightened by ‘infobesity and successive and devastating waves’ of the pandemic into not seeing, not hearing, and not talking about the still ever present ravages of HIV & AIDS.

Methodology & Theoretical Orientation: The methodology was basic research and the theoretical framework was Critical Theoretical Analyses articulated around cognitive psychology, psychodynamic theory, and behaviorism.

Findings: Percepticide during the ongoing COVID – 19 pandemic is characterized by cognitive distortions, negative defense mechanisms, de-memorization, de-sensitization, accommodation, indifference, and pseudofearlessness in relation to HIV & AIDS, with the likelihood of rising irresponsible sexual behaviors and still to be documented rising prevalence.

Conclusion & Significance: This concept paper postulates that percepticide in relation to HIV & AIDS ravages during the COVID – 19 pandemic will not ‘magically shoo away’ the former, which still remains contextual, topical and as current as the latter. Recommendations are made for ‘psychological or perceptual reintegration’ of HIV & AIDS alongside the COVID – 19 pandemic, as two pandemics which humankind is concomitantly experiencing.

Biography:

Javier Gomez Castella is a physician and Clinical Microbiology specialist, currently working in STI prevention and control area as a career civil servant in the National Plan against AIDS in the Public Health Directorate of the Ministry of Health of Spain. In the mainframe of the new strategic plan for prevention and control of HIV and other STI 2021 – 2030, the main lines of action on STI Javier is working on are the development of a new tool for addressing STI resources and provide information for further actions on STI prevention and innovation on early STI diagnosis, with special focus on self-sampling and community testing, as well as epidemiological research and surveillance on STI and gonococcal antimicrobial resistance.

Abstract:

COVID-19 pandemic has pointed out the necessity for improvement in healthcare in several countries across the globe. It is widely known that after global health and political crisis such as world wars I and II, there are marked increases of STIs in the general population due to different factors. This foreseen STI increase in a post-pandemic stage provides an opportunity to identify several challenges in prevention and control of STIs. First of all, strengthening of the healthcare systems and services which provide STI attention is mandatory, where different strategies such as decentralization or STI service provision integration with other diseases such as HIV or viral hepatitis, along with a thorough knowledge of the available resources are different strategies opened to debate. COVID-19 pandemic has also provided valuable experience and new scenarios of healthcare delivery are being considered, which are more patient-centered and with a special focus on the usage of new technologies. In this new setting, STI self-sampling, self-diagnosis and virtual assistance through apps, minimizing the contact with the traditional healthcare facilities, are being positioned as a key element for the future of STI prevention and control.

This approach to STI prevention has several advantages compared to traditional STI diagnostic methods, such as resource optimization and developing patient’s autonomy regarding sexual health, contributing enormously to access outreach key populations. However, there are still several technical and regulatory barriers across the countries that hinder this progress, along with different issues concerning epidemiological data gathering and acceptability of these new diagnostic tools among general population. A combined effort within the different countries is mandatory to improve STI prevention and control after COVID-19 pandemic, where focusing on strengthening healthcare systems and improving STI diagnosis play a key role in the future of STI prevention and control.

Biography:

Lekshmi Suresh Babu is a junior doctor working in Mid Cheshire Hospitals, United Kingdom. She had graduated medicine from one of the highest ranked medical schools of India. She has special interest in studying infectious diseases, particularly HIV. She is currently involved in the biggest COVID research in the United Kingdom, The Recovery Trial.

Abstract:

The elimination of HIV transmission in the UK is now an achievable goal, according to Public Health England. The two key components that make this aim achievable are prompt HIV testing and efficient and timely Anti-Retroviral Therapy. We conducted an audit on HIV testing in an NHS Hospital in the UK. The standards used were British HIV association standards for HIV testing, which states that every patient presenting with a Clinical indicator condition should receive an HIV test.

However, various factor such as lack of awareness among non- HIV clinicians about when to test for HIV, stigma, fear of outcome and barriers of communication are major hurdles when ordering for an HIV test. The audit was carried out using data collected from patients admitted over a 3-year period (2018-2020) at our hospital. The clinical indicator condition that we audited for was Community Acquired Pneumonia. According to BHIVA, every patient admitted with the diagnosis should receive an HIV test. However, only 16.6% of patients admitted to critical care with severe pneumonia received an HIV test. While in patients receiving ward-based care, only 7.4% were tested for HIV. This is a very low figure. The audit also uncovers some interesting biases, that we as clinicians may have while clinical decision making. In Critical Care, more than 75% of patients who ended up receiving an HIV test were under the age of 65 and more than 80% of patients who received the tests were those who identified themselves as belonging to the male gender. The BHIVA guidelines do not use the criteria of age or gender, but rather warranties an HIV test to anyone presenting with a community acquired pneumonia. Also, more than 50% of the patients received a test on the day of their admission to hospital and the probability of receiving a test significantly dropped thereafter, even if they did not show any improvement in their condition. This was quiet contrary to what would have otherwise been expected.

Looking at the data published by Public Health England, 50% of patients diagnosed with HIV in the Midlands are late diagnoses, thereby significantly impacting the lives of those affected, by reducing life expectancy and quality of life. To allow for early diagnosis, BHIVA published a list of Clinical Indicator Conditions in this guideline. However, the awareness regarding these indicator conditions is low among healthcare workers and many cases of HIV are late diagnoses or remain undiagnosed.

Increasing awareness, by disseminating such findings and educating clinical decision makers is the way forward to improve HIV testing in clinical practice.

Biography:

Igor M Rouzine, has done his PhD in Theoretical Physics, has been working in virological departments for 25 years developing models of virus evolution, host-virus interaction, and immune response. He has pioneered the analytic method of traveling wave predicting the asexual evolution of a large number of linked loci and the evolution with rare recombination, as well as the immune models with the dual response to helper cells and infected cells.

Abstract:

Statement of the Problem: After 37 years of HIV studies, we still do not understand why most HIV patients cannot clear infection, why a small fraction of individuals can control HIV infection spontaneously or posttreatment, and why some of these lucky individuals maintain control longer than the others. All we know is the empiric statistical correlation of control with some HLA subtypes.

Methodology & Theoretical Orientation: To shed light on this enigma, based on the available data in the literature, I have developed a model of the adaptive immune response that explains the diverse outcome of HIV infection from the variation in a few critical immunological parameters that can be measured in advance in an individual. The model includes 5 compartments of immune cells and the dual activation of CD8 T cells directly by antigen in MHC-I context and by helper cells.

Findings: The outcome of infection in an individual is decided by the arms race between the proliferation of helper CD4 Th1 cells enabling effective control of the virus and the virus infecting CD4 T cells and employing CD8 T cells to suppress the helper cells. Computer simulation predicts four parameter regions in the plane of the functional avidities of CD8 T cells and CD4 T cells, which correspond to the cohorts of patients with high viremia, spontaneous control, long-term post-treatment control, and short-term control. The model predicts that CD4 T cells in controllers must be very avid, while the avidity of CD8 T cells should be modest, which predictions agree with the clinical observations. Whether a patient maintains a spontaneous of posttreatment control is decided by the infectivity ratio between the target CD4 T cells and their virus-specific activated subset. Simulation predicts a broad region of transient control is discovered, which explains the variable stability of HIV control in different controllers. The predictions are fit to the available data on CD4 T cell avidity to demonstrate the segregation between patient cohorts.

Conclusion & Significance: The number of potential post-treatment patients may be much larger than currently observed. The broad region of transient controllers predicted by the model explains why some patients maintain control longer than the others. The present study offers a mathematical model of the helperdependent immune response that explains the differences between the HIV patient cohorts from the variation in several critical immunological parameters of the adaptive response.

Biography:

Debjit Chakraborty is an expert in the field of epidemiology and public health working in the field of HIV and other communicable disease for last 13 years. He has basic education in Medicine and master in public health (epidemiology) from Kolkata, India. He has worked in the field of HIV, Cancer, Vector Borne Disease and Antimicrobial Resistance till date and has more than 40 publications in many national and international journals and conferences. He is presently working as Scientist D, in the division of Epidemiology in ICMR- National Institute of Cholera and Enteric Diseases in India.https://globalhiv-aids-std.infectiousconferences.com/

Abstract:

Statement of the Problem: India is committed to Elimination of mother to child transmission of HIV through achieveing the target of 95 -95 -95.ANC HIV testing and inititation of ART is still a challenge along with emergence of Adolescent HIV who are getting pregnant to complete the life cycle.

Findings: In India still 66% of estimated pregnant women know their HIV status and 61% were alive on ART. Two third of the new adolescent HIV infections are among adolescent girls. Vulnerability in adolescence is further enhanced due to HIV. Eight percent Women age 15-19 years who were already mothers or pregnant at the time of the survey (%) and Adolescent age group comprised of 12% new HIV infection.

Conclusion & Significance: The ambit of the PPTCT program needs to be expanded to encompass the life cycle of a woman from adolescent age group to pregnancy and child birth. Cascade of intervention needs to be introduced in a culturally acceptable and affordable manner to prevent adolescent HIV as well as teenage pregnancy which will ultimately contribute to the global goal of EMTCT and elimination of pediatric HIV.

Biography:

Nina Olivia Rugambwa is a lecturer in the Department of Library and Information Science at Kyambogo University in Kampala Uganda. She is both an educationist and Information scientist. Nina has 11 years of University teaching experience. She is passionate about teaching and her research interests are information seeking behavior, Indigenous Knowledge systems management, knowledge Management, curriculum design and development, collection-development and health information. She is also a student mentor with MasterCard Foundation where she mentors University students.

Abstract:

Problem: HIV/AIDS is still a major killer disease among adolescents in sub- Saharan Africa and Uganda in particular. In the consecutive years of 2015 to 2019 HIV infections among adolescents aged 10-19 have been persistently high. Several researchers have attributed the high HIV infections to multiple sexual partners, low condom use, those born with HIV and poverty. However, minimal studies have been conducted on the role of Indigenous Knowledge (IK) health information and high HIV infections among adolescents in Uganda. Indigenous information on HIV prevention also remains under documented. Yet, indigenous knowledge is a major critical information source adolescents depend on for health choices on HIV prevention in Uganda.

Materials and Methods: Using a qualitative Case study research design, students in ten secondary schools in Kampala District were studied. Focus Group Discussions and key informant interviews were conducted with teachers, students, students’ aunties and uncles to find out their indigenous representations of HIV/AIDS, causes of HIV infections and ways of preventing HIV infections.

Results: Adolescents are vulnerable to HIV infections because they have a lot of misinformation emanating from some of the indigenous beliefs on HIV/AIDS. Undocumented IK on HIV/AIDS resides in people’s minds and there are conflicts between biomedical and traditional practices on HIV prevention.

Conclusion and Significance: IK informs health interventions for HIV prevention among young people in many African communities and is relied on for making health choices. This paper adds voice to scholars who have emphasized that successful HIV/AIDS programs must combine biomedical and indigenous representations to be effective.

Recommendation: Adolescents have a lot of misinformation emanating from some indigenous beliefs associated with HIV/AIDS, and the knowledge is still under documented. This study recommends that this IK is identified, processed and repackaged in appropriate formats to empower adolescents to be able to make timely health choices based on accurate information on HIV prevention.