Background: HIV was added to the British Columbia list of reportable diseases on 1 May 2003 which included enhanced contact tracing by public health. A sensitive/less-sensitive (S/LS) algorithm using a modified EIA anti-HIV assay was employed to evaluate enhanced partner notification by comparing the proportion of newly diagnosed cases of HIV presenting within 6 months of becoming infected before and after HIV Reporting. Methods: Banked HIV positive samples, collected between 1 Jan 2000– 30 Apr 2003 (pre-reporting group) and 1 May 2003 – 23 Aug 2006 (post-reporting group) were re-tested using the bioMérieux Vironostika HIV-1-S/LS tests. Samples were classified by the S/LS EIA (detuned test) as a recent seroconversion (RSC) (infected for <170 days) or established infection (>170 days). Data was linked to the BC HIV Surveillance and AIDS databases. The proportion of RSC in the pre-reporting group was compared to the proportion of RSC in the post-reporting group using a 2-sided z-test of independent proportions. Similarly, the proportion of new cases of HIV presenting with AIDS was compared between groups. A Kappa statistic was calculated to determine the level of agreement between clinical assessment of HIV staging was compared and the detuned test results. Finally, characteristics of RSC were examined. Results: Serum was available for 1111 newly positive HIV cases in the pre-reporting group and 470 in the post-reporting group. RSC in the pre and post reporting group were 311 (28%; CI: 25.36%, 30.73%) and 136 (29%; CI: 24.87%, 33.27%) respectively (p= 0.70). There was no significant difference in the proportion of cases presenting with AIDS between groups (pre-reporting: 6.7% [CI: 5.4%, 8.1%]; post-reporting: 7.6% [CI: 6.3%, 9.1%]) (p=0.31). Sex work is independently associated with being RSC (AOR 1.78 [CI:1.09, 2.91]). There is an inverse association between being 41-60 yrs old, Asian and/or mixed ethnicity and RSC. Conclusions: The bioMérieux Vironostika HIV-1-S/LS test is an effective tool to objectively evaluate public health interventions and in identifying sub-populations likely to be RSC. This underpowered study demonstrated a slight increase in RSC post reporting which was not statistically significant. Similarly there was no difference in the proportion of cases presenting with AIDS.

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 2007. / A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.

Thesis (Ph. D.)--University of Virginia, 1993. / Includes bibliographical references (leaves 201-216). Also available online through Digital Dissertations.

Background: HIV was added to the British Columbia list of reportable diseases on 1 May 2003 which included enhanced contact tracing by public health. A sensitive/less-sensitive (S/LS) algorithm using a modified EIA anti-HIV assay was employed to evaluate enhanced partner notification by comparing the proportion of newly diagnosed cases of HIV presenting within 6 months of becoming infected before and after HIV Reporting. Methods: Banked HIV positive samples, collected between 1 Jan 2000– 30 Apr 2003 (pre-reporting group) and 1 May 2003 – 23 Aug 2006 (post-reporting group) were re-tested using the bioMérieux Vironostika HIV-1-S/LS tests. Samples were classified by the S/LS EIA (detuned test) as a recent seroconversion (RSC) (infected for <170 days) or established infection (>170 days). Data was linked to the BC HIV Surveillance and AIDS databases. The proportion of RSC in the pre-reporting group was compared to the proportion of RSC in the post-reporting group using a 2-sided z-test of independent proportions. Similarly, the proportion of new cases of HIV presenting with AIDS was compared between groups. A Kappa statistic was calculated to determine the level of agreement between clinical assessment of HIV staging was compared and the detuned test results. Finally, characteristics of RSC were examined. Results: Serum was available for 1111 newly positive HIV cases in the pre-reporting group and 470 in the post-reporting group. RSC in the pre and post reporting group were 311 (28%; CI: 25.36%, 30.73%) and 136 (29%; CI: 24.87%, 33.27%) respectively (p= 0.70). There was no significant difference in the proportion of cases presenting with AIDS between groups (pre-reporting: 6.7% [CI: 5.4%, 8.1%]; post-reporting: 7.6% [CI: 6.3%, 9.1%]) (p=0.31). Sex work is independently associated with being RSC (AOR 1.78 [CI:1.09, 2.91]). There is an inverse association between being 41-60 yrs old, Asian and/or mixed ethnicity and RSC. Conclusions: The bioMérieux Vironostika HIV-1-S/LS test is an effective tool to objectively evaluate public health interventions and in identifying sub-populations likely to be RSC. This underpowered study demonstrated a slight increase in RSC post reporting which was not statistically significant. Similarly there was no difference in the proportion of cases presenting with AIDS. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Background: HIV prevalence is increasing and more people are being infected despite the messages and the advertising.1 Namibia has one of the highest HIV/AIDS prevalence rates in the world of 21.3% as at end of 2002. Two hundred and ten thousand people were estimated to be living with HIV/AIDS, more than one in five adults.2 Disclosure is very important for the prevention and control of HIV infection and is an essential part of behaviour modification, access and adherence to treatment. Aim: To determine knowledge, attitudes, and practices of HIV positive patients regarding disclosure of HIV results at Betesda clinic in Namibia. Objectives: To determine the participant profile, reasons for disclosure and non disclosure, to explore attitudes, knowledge and to understand practices of HIV positive patients with regard to disclosure of HIV results. Methods: This was a cross-sectional descriptive study done at Betesda clinic a private clinic in Katutura a high density suburb of Windhoek. Two hundred and sixty three HIV positive patients tested after 2004 were entered into the study. Convenience sampling of all willing HIV positive patients was done. A questionnaire was used; a professional interpreter and a counsellor were available. Permission to conduct the study was obtained from Betesda management; ethical clearance was obtained from the Post Graduate Committee and Human Research Committee of the University of the Witwatersrand. Epi Info statistical software package version 3.4.1 July 3 2007 was used to analyze data. An expert statistician was utilized to assist with analyzing data. Results: Two hundred and sixty three respondents were entered into the study. Sixty four percent were males, 41% were married, 28% were single, and 27% were cohabitating. 68% responded positively to what they thought about disclosure. Reasons for disclosure were 32% needed help, 25% partner to go for testing and 20% to let relatives know. Reasons for non disclosure were mainly fear of gossiping 79%. Seventy three percent had disclosed 60% within one week of knowing the results. Seventy three percent had disclosed to their partners, 23% had disclosed to more than one person. People’s reactions were 43% supportive, 29% understood, 9% accepted and 6% angry. Upon disclosure 40% received help, 24% partners were tested, 23% received psychological support and 5% were stigmatized. Disclosure was found to be higher among the married and cohabitating. Conclusion: Knowledge of disclosure was positive; most thought disclosure was important and good. Attitudes and practices towards disclosure were encouraging; people were disclosing but to trusted individuals in the society and fear of stigma was still there but actual stigma was very low.

No description available.

Thesis (Ph. D.)--School of Public Policy, Georgia Institute of Technology, 2004. Directed by Paul G. Farnham. / Includes bibliographical references (leaf 127).

Thesis (Ph. D.)--University of Sydney, 2009. / Title from title screen (viewed 31 March 2009). Submitted in fulfilment of the of the requirements for the degree of Doctor of Philosophy to the Discipline of Medicine, Faculty of Medicine. Degree awarded 2009; thesis submitted 2008. Includes bibliographical references. Also available in print form.

Thesis (D.P.H.)--University of Michigan, 1993.

Thesis (D.P.H.)--University of Michigan, 1997. / Includes bibliographical references.