Browsing by Subject "HIV-positive"

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    Open Access
    Health care provider perspectives on pregnancy and parenting in HIV-positive individuals in South Africa
    (BioMed Central, 2014-09-12) Moodley, Jennifer; Cooper, Diane; Mantell, Joanne E; Stern, Erin
    Background: Within the health system, limited attention is given to supporting the fertility and parenting desires on HIV-positive people. In this study, we explore health care providers’ knowledge and perspectives on safer conception and alternate parenting strategies for HIV-positive people. Methods Between November 2007 and January 2008, in-depth interviews were conducted with 28 health care workers involved in providing HIV and/or antiretroviral services at public sector clinics in Cape Town, South Africa. Views on sexual and reproductive health services, pregnancy, childbearing and parenting in HIV-positive men and women were explored using a semi-structured interview guide. Data were analyzed using a thematic approach. Results: Providers recognized the sexual and reproductive rights of HIV-positive individuals, but struggled with the tension between supporting these rights and concerns about spreading infection. Limited knowledge of safer conception methods constrained their ability to counsel and support clients in realizing fertility desires. Providers believed that parenting alternatives that do not maintain biological and cultural linkage are unlikely to be acceptable options. Conclusions: Health care provider training and support is critical to providing comprehensive sexual and reproductive health care and meeting the fertility desires of HIV-positive people.
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    Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
    (2024) Mabizela, Nosipho; Dandara, Collet. Soko, Nyarai; Naidoo, Richard
    Despite the use of antiretroviral therapy, cervical cancer remains a leading malignancy in women with HIV, who face a six-fold increased risk. Infection with HIV and HPV has been linked to accelerated cervical cancer development. However, there are limited studies on the role of host somatic variations in HIV-positive and HIV-negative women on cervical cancer. Understanding these variations may help identify potential genetic factors that contribute to accelerated cervical cancer development and differential response to treatment. This knowledge is important in targeting interventions and improving outcomes for women with HIV and cervical cancer. Therefore, this study aims to investigate host somatic genetic variation between cervical biopsies obtained from HIV-positive or HIV-negative women with histologically confirmed CIN3 to determine potential differences in genomic landscapes and HPV infection between HIV-positive and HIV-negative women. The matched case-control study utilized archived cervical biopsies from 88 women (44 HIV positive, 44 HIV-negative) attending Groote Schuur Hospital Cancer Clinic between 2020 and 2022. The cases and controls were carefully age matched. HPV infection and type were confirmed using the Anyplex™ II HPV28 Detection kit. In cervical cancer, six hotspot regions in the four commonly mutated genes (TP53, PIK3CA, PTEN, and EGFR) were genotyped using Polymerase Chain Reaction and validated using Sanger Sequencing. Missense variant pathogenicity was assessed using SIFT, Polyphen-2, and ClinVar tools. The median age was [37 years (IQR:34-41)] for HIV-positive women and [35 years (IQR:32- 43)] for HIV-negative women. In the HIV-negative cohort the women reported tobacco smoking (p<0.0001), menstruation irregularities (p=0.005), and contraception usage (p=0.019). These parameters were statistically significant when compared to HIV-positive cohort. Common HPV types identified were HPV 16 (43/88, 49%), 35 (12/88, 14%), and 58 (10/88, 11%). A total of 232 genetic variants were identified, with HIV-positive women having a significantly higher burden of pathogenic variants (31%) compared to 15% among the HIV-negative (p=0.0406). Identified mutations included stop-gain, missense, synonymous, and intron variants. The genes TP53 and PIK3CA had more stop-gain variants among HIV-positive women (4/5) compared to HIV-negative women with 1/5 of the 5 mutations. These damaging variants were more prevalent in women under 50 in both cohorts. In conclusion, younger women (<50 years) showed predominantly damaging variants, indicating more aggressive cancer, and a possible reason for early onset in the younger cohort. HIV-positive women displayed a higher mutation burden in PIK3CA and pathogenic variants in TP53, emphasizing the need to further explore these genes in gene expression studies.