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Control of acquired immunodeficiency syndrome: recent developments

Ilina I

Family Physician, 1993;5:37-41.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Distal renal tubular acidosis in HIV/AIDS patient

Isa WY, Daud KM

Intern. Med., 2011;50(16):1765-8.
PMID: 21841342

We report a case of renal tubular acidosis (RTA) in a patient with HIV infection and AIDS. A 33-year-old HIV-positive man with Hepatitis C and tuberculous lymphadenitis was admitted due to deep venous thrombosis and generalized muscle weakness. He had never received anti-retroviral medication. The blood gases and serum electrolytes showed hyperchloremic normal anion gap metabolic acidosis with severe hypokalemia and alkaline urine. Diagnosis of distal RTA was made. His renal function and serum globulin level remained within normal range throughout his illness. Clinicians should be alert to renal tubular disorders in HIV/AIDS patients even in the absence of anti-retroviral therapy or hypergammaglobulinemic state.

Matched MeSH terms: Acquired Immunodeficiency Syndrome/complications; Acquired Immunodeficiency Syndrome/diagnosis
An Islamic Microfinance Approach to Scaling up the Economic Life of Vulnerable People with HIV/AIDS in the Muslim Society

Islam R, Ahmad R, Ghailan K, Hoque KE

J Relig Health, 2020 Jun;59(3):1327-1343.
PMID: 31134517 DOI: 10.1007/s10943-019-00832-8

People with HIV/AIDS (PLWHA) commonly pose problems to their family as well as to society because of their vulnerable health and economic conditions. Contrarily, PLWHA encounter social discrimination and adverse realities while finding it difficult to continue in their jobs. These complex phenomena interact to push them into a low economic status. A microfinance program can hopefully assist poor patients to cope with the negative economic consequences of this disease. But the conventional market-oriented microfinance institutions show reluctance to serve this group of people due to the possibilities of having credit risk. In this paper, we propose an alternative microfinancing technique that can provide a better economic life of the PLWHA while absorbing the credit risks. A comprehensive model is designed using specific Islamic financial instruments in conjugation with household economic portfolio theory. Critical realism method was adopted to construct this model. We concluded that the application of Islamic microfinance can enhance income of HIV patients while reducing the productivity-loss. This model can be useful to the microfinance practitioners and policymakers for addressing a different market segment, diversifying products, and formulating policy.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
HIV/AIDS in Malaysia

Ismail R

AIDS, 1998;12 Suppl B:S33-41.
PMID: 9679627
Matched MeSH terms: Acquired Immunodeficiency Syndrome/epidemiology*; Acquired Immunodeficiency Syndrome/prevention & control
Sexually transmitted disease (STD) and acquired immunodeficiency syndrome (AIDS) in South East Asia

Ismail R

Clin Dermatol, 1999 5 20;17(2):127-35; discussion 105-6.
PMID: 10330595 DOI: 10.1016/s0738-081x(99)00005-x
Matched MeSH terms: Acquired Immunodeficiency Syndrome/economics; Acquired Immunodeficiency Syndrome/epidemiology*; Acquired Immunodeficiency Syndrome/transmission
The Socioeconomic Implications among People Living with HIV/AIDS in Sudan: Challenges and Coping Strategies

Ismail SM, Kari F, Kamarulzaman A

J Int Assoc Provid AIDS Care, 2015 12 28;16(5):446-454.
PMID: 26715489 DOI: 10.1177/2325957415622449

To determine the socioeconomic impacts among HIV-infected persons in Sudan and examine whether there are significant variations in coping strategies between infected men and women, a primary survey was conducted among infected persons (n = 555). Discriminant function was used to analyze the data. We found significant variation in the coping strategies (

Matched MeSH terms: Acquired Immunodeficiency Syndrome/economics; Acquired Immunodeficiency Syndrome/psychology
Fulltext Improvements of knowledge and perception towards HIV/AIDS among secondary school students after two hours talk

Jahanfar S, Lim AW, Loh MA, Yeoh AG, Charles A

Med J Malaysia, 2008 Oct;63(4):288-92.
PMID: 19385486 MyJurnal

Malaysia is confronted with an increasing incidence of HIV and AIDS among adolescents and young adults. The effectiveness of various programs offered to school going teenagers is unknown. The objective of this study is to measure the effectiveness of two hours talk on sex education offered by a non governmental organization (NGO) in improving youngsters' knowledge and perception towards HIV and AIDS. A cross sectional study was conducted among the adolescent students from a secondary school in Ipoh, Perak, a province of Malaysia. A total of 182 students participated in the study. A standard questionnaire consisting of demographic data, knowledge and perception towards HIV/ADIS were distributed before (pre-test) and after the intervention (post-test). Performance of participants was compared to establish the effectiveness of the intervention. Our findings suggests that there was a significant increase in participants' knowledge and perception after the intervention (p = 0.000). Knowledge improvement was found in both genders however, improvement in perception was higher among female students. Interestingly, 80% of participants disagree that sexual education will encourage sex among youngsters. NGOs are playing a supplementary role in providing sex education programs in schools. This program although of short duration but it is effective in enhancing adolescence awareness about HIV/AIDS.

Matched MeSH terms: Acquired Immunodeficiency Syndrome/prevention & control*
Fulltext A randomised controlled trial of peer-adult-led intervention on improvement of knowledge, attitudes and behaviour of university students regarding HIV/AIDS in Malaysia

Jahanfar S, Lye MS, Rampal L

Singapore Med J, 2009 Feb;50(2):173-80.
PMID: 19296033

INTRODUCTION: The aim of this study was to investigate the knowledge, attitudes and behaviour of university students regarding acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV).
METHODS: A randomised controlled trial of 530 university students was done using peer-adult facilitators. Participants completed a questionnaire before and after the intervention, which was a four-hour group session. A prevention programme was developed by local experts, health educators and peer facilitators. The peer-adult-led programme was designed to provide a conceptual model of HIV risk reduction through information, motivational and behavioural skills, a harm reduction module and health promotion theme.
RESULTS: The main outcome measured was the level of knowledge, attitudes and behaviour scores. The results suggest that relative to the control group, participants in the intervention group had higher levels of knowledge (30.37 vs. 25.40; p-value is 0.001) and a better attitude (12.27 vs. 10.84; p-value is 0.001). However, there was no difference in the behavioural score (9.47 vs. 9.41; p-value is 0.530). The correlation between the level of knowledge and age and the level of education was found in the intervention group, but not in the control group (p-value is 0.01). Attitude and gender were found to be correlated in the intervention group only (p-value is 0.01).
CONCLUSION: Our programme was successful in increasing knowledge and improving attitudes towards AIDS and HIV. However, it did not improve risk-taking behaviour. Peer-adult-led educational programmes for youth using various interactional activities, such as small group discussions, poster activity and empathy exercises, can be successful in changing the prevailing youth perceptions of AIDS and HIV.

Matched MeSH terms: Acquired Immunodeficiency Syndrome/prevention & control*
Fulltext Pneumocystis carinii (jirovecii) pneumonia (PCP): the most common opportunistic infection observed in HIV/AIDS cases at the University Malaya Medical Centre, Kuala Lumpur, Malaysia

Jamaiah I, Rohela M, Tok EL, Tan CL, Tan WH, Teo WS, et al.

Southeast Asian J. Trop. Med. Public Health, 2012 Jul;43(4):825-31.
PMID: 23077803

This retrospective study was conducted among 59 HIV/AIDS patients with opportunistic infections admitted to the University Malaya Medical Centre between 2000 and 2009. Fifty-five point nine percent of cases were Chinese, 25.4% were Malays, 11.9% were Indians and 6.8% were of unknown ethnic origin. The male:female ratio was 2.9:1 (44 males and 15 females). The highest prevalence (38.9%) occurred in the 30-39 year old age group. Men comprised 47.7% and women 53.3%; the majority of both were married. The majority of cases were Malaysians (89.8%) and the rest (10.2%) were immigrants. Most of the patients (18.6%) were non-laborers, followed by laborers (11.9%), the unemployed (5.1%) and housewives (3.4%). The most common risk factor was unprotected sexual activity (20.3%). The two most common HIV/AIDS related opportunistic infections were Pneumocystis carinii (jirovecii) pneumonia (PCP) (62.7%) and toxoplasmosis (28.8%). Seventy-two point nine percent of patients had a CD4 count <200 cells/microl and 5.1% had a CD4 count >500 cells/microl. Eleven point nine percent of cases died during study period. A low CD4 count had a greater association with opportunistic infections. Most of the patients presented with fever (44.1%), cough (42.4%) and shortness of breath (28.8%). Detection of the etiologic pathogens aids clinicians in choosing appropriate management strategies.

Matched MeSH terms: Acquired Immunodeficiency Syndrome/epidemiology
Responding to local needs. Self-help groups

Jayaseelan J

AIDS Action, 1993 Mar-May;[nil](20):4.
PMID: 12288933

PIP: Pink Triangle, the only community-based group in Malaysia which works with men who have sex with men, took initial steps in August 1992 to establish a self-help project for people who are HIV-seropositive. Supporting people who are HIV-positive and fighting for their rights is new in Malaysia. The group has thus far been publicized through its public education events, hospitals, and other nongovernmental organizations. For the first time, information is being published specifically by and for people living with HIV/AIDS. The project also has a phone line to allow people to speak anonymously with someone who shares their experience. Many callers are men who have sex with men in the social context of intense prejudice and discrimination. Afraid to openly acknowledge their sexuality with strangers, the callers have yet to accede to meeting each other face-to-face in a group setting. The author notes in closing that Pink Triangle must be realistic about what can be achieved in Malaysia and allow the group to develop according to people's needs and not on the basis of a model imported from outside of the country.

Matched MeSH terms: Acquired Immunodeficiency Syndrome*
AIDS in Asia and the Pacific

Karel SG, Robey B

Asian Pac Cens Forum, 1988 Sep;2(1-2):1-4, 18-30.
PMID: 12342138
Matched MeSH terms: Acquired Immunodeficiency Syndrome*
Fulltext Cytomegalovirus retinitis associated with high CD4 counts and DHEA abuse

Keat GY, Ahmad SS, Subramaniam S, Ghani SA, Samsudin A

Indian J Sex Transm Dis AIDS, 2020 06 18;41(1):119-122.
PMID: 33062999 DOI: 10.4103/ijstd.IJSTD_90_15

The most frequent ocular manifestation of acquired immunodeficiency syndrome (AIDS) is cytomegalovirus retinitis (CMVR). This infection is reportedly inversely proportional to the CD4 counts. Usually CMVR develops once the CD4 counts fall below 50/mm3. Our case report documents an AIDS patient who developed CMVR despite CD4 counts being persistently >200/mm3. The patient was self-administering dehydroepiandrosterone, high dose Vitamin C, testosterone and hydrocortisone. This case report describes a unique case of pharmacologically induced elevated CD4 counts, which however, did not prevent the development of CMVR in the patient.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext Adverse Drug Reactions in HIV/AIDS Patients at a Tertiary Care Hospital in Penang, Malaysia

Khan K, Khan AH, Sulaiman SA, Soo CT, Akhtar A

Jpn J Infect Dis, 2016;69(1):56-9.
PMID: 26073728 DOI: 10.7883/yoken.JJID.2014.246

In the current study we explored the occurrence of adverse drug reactions (ADRs) to antiretroviral therapy among human immune-deficiency virus (HIV)/AIDS patients. We concluded an observational retrospective study in all patients who were diagnosed with HIV infection and were receiving highly active antiviral therapy from Jan. 2007 to Dec. 2012 at Hospital Pulau Pinang, Malaysia. Patient socio-demographic details along with clinical features and susceptible ADRs were observed during the study period. Out of 743 patients, 571 (76.9%) were men, and 172 (23.1%) were women. Overall 314 (42.2%) patients experienced ADRs. A total of 425 ADRs were reported, with 311 (73.1%) occurring in men and 114 (26.8%) in women, with a significant statistical relationship (P value (P) = 0.02, OR = 1.21). Overall 239 (56.2%) ADRs were recorded among Chinese, 94 (22.1%) in Malay, and 71 (16.7%) in Indian patients, which had a statistically significant association with ADRs (P = 0.05, OR = 1.50). Out of a total 425 among ADRs, lipodystrophy was recorded in 151 (35.5%) followed by skin rashes in 80 (18.8%), anemia in 74 (17.4%), and peripheral neuropathy in 27 (6.3%) patients. These findings suggest a need of intensive monitoring of ADRs in HIV treatment centres across Malaysia.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext Chylothorax and central vein thrombosis, an under-recognized association: a case series

Kho SS, Tie ST, Chan SK, Yong MC, Chai SL, Voon PJ

Respirol Case Rep, 2017 May;5(3):e00221.
PMID: 28250931 DOI: 10.1002/rcr2.221

Chylothorax is defined as the presence of chyle in the pleural cavity. Central vein thrombosis is an under-recognized cause of chylothorax in the adult population and is commonly related to central venous catheterization. Case 1 illustrates a patient with AIDS and disseminated tuberculosis with left chylothorax and central vein thrombosis after a month of antituberculosis therapy. Case 2 was a patient with advanced seminoma who presented with left chylothorax and central vein thrombosis while on chemotherapy. Chylothorax resolved with anticoagulation for both cases. Case 3 was a lymphoma patient with central vein thrombosis who developed chylothorax during chemotherapy. Chylothorax resolved with the continuation of anticoagulation and did not recur despite his progressive underlying lymphoma. There was no central venous catheterization in any of these three cases. These cases illustrate the unique association of central vein thrombosis and chylothorax and the importance of anticoagulation in its management.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext A review of HIV/AIDS research in Malaysia

Koh KC

Med J Malaysia, 2014 Aug;69 Suppl A:68-81.
PMID: 25417954 MyJurnal

Two hundred fifty seven articles related to HIV/AIDS were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. One hundred seventy one articles were selected and reviewed on the basis of clinical relevance and future research implications. This review of literature has been divided into six sections, namely, epidemiology, risk behaviour, clinical features and opportunistic infections, management, diagnosis and discussion. Wherever possible, the reviewed articles have been presented in a chronological order to provide a historical perspective to the reader as many of the results of earlier publications, which are common knowledge now, were relatively unknown then. Since the early days of the HIV epidemic in Malaysia, there have been rapid advances in the understanding and the management of the epidemic in Malaysia based on the insights derived from the results of these research. These insights are invaluable tools for policy makers, advocators, healthcare providers, researchers and everyone and anyone who are involved in the care of individuals with HIV/AIDS. Attempts have been made to identify gaps in certain research areas with the hope of providing directions for future research in HIV/AIDS in Malaysia.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext AIDS presenting as unresolved pneumonia in a 9 year old boy

Lee JK

Med J Malaysia, 1993 Mar;48(1):93-4.
PMID: 8341180
Matched MeSH terms: Acquired Immunodeficiency Syndrome/complications; Acquired Immunodeficiency Syndrome/diagnosis
Factors Affecting Voluntary HIV Testing Among General Adult Population: A Cross-Sectional Study in Sarawak, Malaysia

Lemin AS, Rahman MM, Pangarah CA, Kiyu A

J Family Reprod Health, 2020 Mar;14(1):45-51.
PMID: 32863838

Objective: Voluntary HIV testing is one of the key strategies in the HIV/AIDS prevention and control program. New National Strategic Plan for 2016-2030 in Malaysia, adapt three zeros viz. 'zero new infections of HIV/AIDS, zero discrimination and zero AIDS-related deaths'. This study aimed to determine the predictors of voluntary HIV testing in Sarawak. Materials and methods: A cross-sectional study was conducted with a total of 900 respondents (450 males and 450 females) from the state of Sarawak, aged 18 years and above, who were selected by gender-stratified multistage cluster sampling. Data were obtained by face-to-face interview using a pretested questionnaire. Binary logistic regression analysis was done to determine the potential predictors for voluntary HIV testing. Results: The prevalence of HIV testing was higher among female respondents (26%) compared to male respondents (14.2%), and the difference was statistically significant (p < 0.001). Binary logistic regression analysis revealed that household income more than MYR 1501 (p = 0.009), not living with a partner (p < 0.001) and discussion on HIV/AIDS (p = 0.019) appeared to be predictors for the male respondents, while, ethnicity was statistically significant for female respondents (p < 0.001). Conclusion: The utilisation of HIV testing was low in both males and females. Thus, the finding of this study could be considered when designing HIV education and screening program in Sarawak.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext Epilepsy stigma in Asia: the meaning and impact of stigma

Lim, Kheng-Seang, Tan, Chong-Tin

Neurology Asia, 2014;19(1):1-10.
MyJurnal

Stigma is conceptually broad and culturally variable. Understanding stigma from the conceptual theories, culturally application based on the word stigma in other languages, the definition of stigma and its synonyms, as well as the medical implications in other stigmatized disease such as AIDS, will help us to understand the complexity of stigma in epilepsy. This review investigated the meaning and types of stigma from different perspectives, leading to staging stigma into 5 levels, i.e. social identity, stereotype, prejudice, discrimination and social disability. In addition to the conventional categorization of stigma into social, felt, self-perceived or internalized stigma, new categories of stigma i.e. personal and general attitudes towards epilepsy based on a newly developed Public Attitudes Toward Epilepsy (PATE) scale was introduced. Courtesy stigma was further elaborated in related to Asian culture. Based on well-established and recently developed theories, the causation and impact of epilepsy stigma was discussed in an Asian context, especially from the aspects of language and society values which are culturally specific. Integrating these theories of causation, illness and stereotype perceptions were proposed to be the mediating mechanism of stigma, which led to the development of a practical and multi-dimensional stigmatization model, aiming to guide, widen and deepen the scope of future stigma research in epilepsy. Using the established model, together with review of related studies, research priorities in epilepsy stigma research especially in Asia focusing on five aspects, i.e. expanding population studies especially on significant others, understanding stigma from personal attitude perspective, investigating the cultural and social causation of stigma, and the impacts of stigma on patients as well as the family members, were proposed.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext Malaysian youth sexuality: issues and challenges

Low, W.Y.

JUMMEC, 2009;12(1):3-14.
MyJurnal

Youth sexuality is a great concern for many. Sexual health issues facing our youths are: premarital sexual intercourse, sexually transmitted diseases, unwanted and unsafe pregnancies and abortions, sexual diversity, HIV/AIDS, and cybersex. Various factors lead to risky sexual and reproductive health behavior, particularly among those unmarried youths: lack of sexual and reproductive health information and skills in negotiating sexual relationships and the inaccessibility of youth-friendly sexual and reproductive health services. Growing peer pressure of pre-marital sex plays a major role in sexual and reproductive health related decision-making among youths. Another factor is the issue of sexuality education which is still considered a sensitive topic and thus impinging on its implementation, due to cultural and religious constraints. Misunderstanding and a lack of information on sexual diversity have caused a concern for many, as there is a tendency for judgments, stereotypes, discriminations and prejudices towards homosexuality in the society. Online sexual activities or cybersex have become the next sexual revolution. Negative consequences are shown for those hooked on cybersex. Healthy youths are fundamental to the prevention initiatives. Promoting the sexual and reproductive needs and rights of our youths is warranted.

Matched MeSH terms: Acquired Immunodeficiency Syndrome
Fulltext Sun, sea and sex: a review of the sex tourism literature

Lu TS, Holmes A, Noone C, Flaherty GT

Trop Dis Travel Med Vaccines, 2020 Nov 27;6(1):24.
PMID: 33292661 DOI: 10.1186/s40794-020-00124-0

BACKGROUND: Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism.
METHODS: The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles.
RESULTS: With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad.
CONCLUSIONS: Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.

Matched MeSH terms: Acquired Immunodeficiency Syndrome

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