4^th International Conference on HIV/AIDS, STDs and STIs October 03-05, 2016 Orlando, Florida, USA

Background: The CDC estimates that 1.2 million individuals aged 13 years and older are living with HIV infection in the US, 14 percent of which are undiagnosed. Over the past decade, as the pace of new infections has continued to increase, reimbursement and lack of trained physicians have been cited as major challenges in the battle against HIV. Recently, a less than optimal fellowship match rate is raising concerns for an increased need for specialists in Infectious Diseases (ID). Although there is a general perception that a mismatch exists with regards to the prevalence of HIV and the geographical spread of ID physicians, little data is available.rnrnMethods: De identified data about the number of board certified ID physicians by zip code was obtained from the Doximity physician database which is up to date and refreshed monthly. The location of current Infectious Disease fellowships was obtained from the NRMP public data. These were mapped using Google fusion tables and the results compared to several CDC databases, mainly: Number of HIV diagnoses, number of AIDS diagnoses, death rates (per 100,000), survival rates, federal HIV/AIDS grant funding and GDP as a parameter to assess the financial health of various parts of the US.rnrnResults: A total of 7129 ID physicians and 147 fellowship programs were identified. Our results indicate that ID specialists and fellowship programs tend to be more concentrated in the Northeast and metropolitan areas in the Western regions of the US, which parallel similar patterns noted in other specialties. Survival rates for HIV were also noted to be higher in these locations. HIV prevalence and mortality rates tended to be higher in the Southwestern belt of the US, which correlated with fewer fellowships and physicians along with lower GDP.rnrnConclusion: The use of this novel social network mapping approach to assess the Infectious Disease physician workforce has the potential of providing real time data regarding their geographical spread. The discrepancies between supply and demand could be addressed by targeted rebalancing interventions that may include additional fellowship spots in ‘underserved’ areas as well as financial and practice incentives.rn

Chandrika Johnson is an Assistant Professor of Health Education in the Department of Middle Grades, Secondary and Specialized Subjects at Fayetteville State University. She has received her Bachelor of Science degree in Community Health Education from University of North Carolina at Pembroke, Master of Public Health degree in Community Health Education from the University of Tennessee at Knoxville and PhD in Health Education from Southern Illinois University at Carbondale. Her research interest includes diabetes education, women\'s health and cancer screening. She has published and made numerous presentations on those topics.

Although HPV issues have focused primarily on females, it is important to give attention to males given that sexual transmission is the primary mode of spread to women. The development of the HPV vaccine has spurred controversy over whether or not males as well as females should obtain the vaccine. This study examined male college students’ intention to be HPV vaccinated, their HPV knowledge, attitudes, subjective norms and perceived behavioral control towards vaccination. A descriptive, correlational, cross-sectional research design was employed. Two hundred and eight male college students at a mid-sized public university completed an in-class questionnaire for the study. Results showed that, on average, the majority of participants responded correctly to less than half of the 15 HPV knowledge questions. Respondents had positive attitudes towards HPV vaccination, greater sense of control over being HPV vaccinated and favorable intention to be HPV vaccinated. Subjective norms and perceived behavioral control were significant predictors of participants’ behavioral intention to be HPV vaccinated. Subjective norms and perceived behavioral control had a positive influence on male college students’ behavioral intention to be HPV vaccinated. Lastly, male college students’ level of HPV knowledge was not significantly correlated to their behavioral intention to be HPV vaccinated.

Minet Tesfai Hadish is a Master’s student from School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. He has graduated his Bachelor Science in Nursing (BSN) from School of Nursing, Asmara College of Health Sciences, Asmara, Eritrea in 2010 and won Gold Medal. He has worked in the same college for six years as an Assistant Lecturer, as Member of the executive committee for research coordination of the school of nursing and the college and in close association with BDHO; the Eritrean National HIV/AIDS Association as Trainer and Consultant.

Ivory Coast, Cameroon and Gabon are the highly HIV/AIDS prevalent West African countries. However, studies show that nationally representative or comparative studies had never been done. Hence, this study was focused on associates of comprehensive HIV/AIDS knowledge and acceptance attitude towards people living with HIV/AIDS (PLHA) among male youth of the three countries and comparison among them. We utilized nationally representative datasets from Demographic and Health Surveys (DHS) of Ivory Coast 2011-12, Cameroon 2011 and Gabon 2012. A total of 6576 youth; 1811 (27.5%) Ivorian, 2803 (42.6%) Cameroonian and 1962 (29.8%) Gabonese was taken. We used IBM SPSS version 22 to run multivariate logistic regression taking p-values less than 0.05 as significant. The comprehensive knowledge of HIV/AIDS and acceptance attitude in all the three countries were nearly below average; especially knowledge in Ivory Coast (39.1%) and attitude in Gabon (21%) were very low. On multivariate analysis, only age, residence, educational level and wealth index were significant associates of comprehensive HIV/AIDS knowledge. On the other hand, age, religion, educational level and wealth index were significant associates of acceptance attitude. On comparison, Gabonese were 1.5 times more likely to have comprehensive HIV/AIDS knowledge than Ivorians (AOR=1.50, P<0.001). However, Ivorians 1.18 (AOR=0.85, P=0.032) and Cameroonians 1.26 (AOR=1.26, P=0.001) times more likely to have acceptance attitude than Gabonese. Comprehensive HIV/AIDS knowledge and acceptance attitude towards PLHA in the three countries and specifically, acceptance attitude in Gabon was considerably low. Hence, it is crucial to give emphasis of planning policy of transmitting information to youth in a contextually applicable to socio-cultural differences.

Dr. Carmack received Post-Doc from Pennsylvania State University, 2010. And Ph.D. in Community Psychology Wichita State University, 2007. She is a community psychologist with a specialty in statistics and methodology. Dr. Carmack\'s research focuses on the HIV health disparity in African American communities, young adult HIV risk-related behaviors, (CBPR) evaluation, and risk reduction intervention strategies. Currently she is an Assistant Professor, Department of Psychological Health and Learning Sciences, University of Houston

African Americans account for approximately half of new HIV infections each year (CDC, 2013). African American college students have reported sexual risk factors at a higher rate than their counterparts (ACHA-NCHA, 2012). Sexual risk behaviors such as lack of condom use is a predominate cause of HIV and other STI infection among African American young adults. The present study investigated partner communication self-efficacy (PCSE) about condom use, partner perceptions about condom use and attitude about condom use to model condom use behavior. Students (N=255) from a major historically Black university (HBCU), ages 17 to 25, were surveyed about their sexual perceptions, intimate partner communication and condom use behavior (at follow-up). Regression analyses were conducted separately for males and females to model the significance of PCSE and perceived partner perceptions about condom use on subsequent condom use. For males, PCSE and partner perceptions were significantly associated with condom use (p<.05). An interaction effect was found in that partner’s perception was associated with condom use only when attitudes toward condom use was low (unfavorable) (p=0.01). For females, a significant relationship was found between attitude toward condom use and PCSE only (p=.01) in predicting condom use. The final models accounted for 33% and 27% of the variance in condom use for males and females, respectively; a medium effect. Programs and initiatives focused on increasing condom use communication and favorable attitudes toward condom use could positively impact condom use among African American college students and subsequently reduce the HIV/STI incidence in this population.

Dr. Nibedita Das is a specialist (microbiology), at Institute of serology, kolkata, India. She has experienced in working in different viral diseases and special interest in antimicrobial resistance. She also loves to read, listen to music and surf the Net.

Introduction: India is witnessing an unprecedented epidemiological and demographic transition with increased chronic disease burden on the one hand and declining mortality and fertility rates on the other. It is responsible for major ill health throughout the world. RTI/STIs have a profound impact on sexual and reproductive health worldwide and rank among the top five disease categories for which adults seek health care. The present study was conducted to estimate the current prevalence of RTIs based on a syndromic approach among women between 15 to 49 years of age, supported by both laboratory and clinical diagnosis to measure the actual magnitude of morbidity associated with RTIs among the study population.rnrnObjectives: To study the prevalence of reproductive tract infection among the women of reproductive age group (15-49 years) and the socio-demographic factors influencing the occurrence of the disease.rnrnMethodology: A cross-sectional study was done using a simple random sampling technique using a pre-designed pre-tested semi-structured schedule for data collection from 312 women of 15-45 years, residing in the field practice area. This was followed by clinical examination and collection of samples for laboratory tests in Urban Health Centre, attached to All India Institute of Hygiene and Public Health, Kolkata, West Bengal.rnrnResults: The prevalence of RTIs among the reproductive age group women was 43.6% based on their symptoms of RTI with majority having abnormal vaginal discharge. According to laboratory investigations the most common cause of RTI was bacterial vaginosis. It was 67.4% (using Amsel’s criteria) and 31.7% (as per Nugent’s score), followed by Vulvovaginal candidiasis which was found in 12.4%. The influence of socio-demographic factors like younger age, increased parity, poor socio-economic conditions, early age at marriage, poor personal and menstrual hygiene practices had direct effect on occurrence of RTI in the community.rnrnConclusion: RTI among women of reproductive age is quite a common morbidity with significant predictive, contextual and direct covariates and wherever possible both clinical and laboratory findings should corroborate self reported morbidity to know the exact prevalence of any disease in the community.rn

Jean-Daniel Ndikumana. I am from Burundi. I left Burundi for Belgium where I got because of my sexual orientation and gender identity my refugee status.\r\nCurrently, I work in an association whose objective is the defense, promotion and structuring of secularism in Belgium: the Lay Action Center of the Province of Luxembourg (CAL/Luxembourg). I am committed as leader and I am also in charge of a project aimed at asylum seekers LGBTQI set up by the service Maison Arc-en-Ciel of Lay Action Center of the Province of Luxembourg.\r\nLGBTQI activist in Burundi since 2009, I am a representative of MSM in East Africa AFYA MINORITY and defender of human rights in East Africa and the Horn of Africa.\r\n

Immigrants and LGBTI refugees account for a growing proportion of people living with HIV worldwide. This highlights the need to establish equitable services in prevention awareness, treatment and support to immigrants and refugees infected and affected by HIV. Immigrants and LGBTI refugees living with HIV face complex barriers that have a significant impact on their health and well-being as well as their ability to become full citizens. Immigrants and LGBTI refugees living with HIV face complex challenges like trauma inherent in the course of any immigrant; the complexity of the immigration system in the host country; the difficulties of adapting to a new culture; accessibility problems in housing and employment and prejudice and discrimination both within their own cultural community and in society in general. These people also face barriers in terms of access to HIV information, treatment and support; these obstacles are caused by language barriers and other cultural divisions and the lack of medical knowledge and systemic discrimination. All these constraints and obstacles have considerable impact on the health and welfare of these people, as well as their ability to become full citizens. People living with HIV are very afraid that their application be rejected, especially since the HIV test is mandatory for all new entrants who apply for immigration.

Dominique Savio Habimana has completed his MBChB in 2013 from National University of Rwanda, since then he has been appointed in Internal Medicine Department as the Head of Department of HIV and other STIs.

Alpha-fetoprotein (AFP) is a serum glycoprotein secreted by the liver in fetal life and by liver tumors, even though not very specific but being the most available and affordable in our settings, it has been used as a predictor of cirrhosis and hepatocellular carcinoma in HIV and HBV co-infected versus solely HBV infected patients. This study was aiming at assessing the real impact of HIV on the prognosis of HBV infected patients. A random study with neither sex nor age selection was conducted for 50 HIV and HBV co-infected and 50 solely HBV infected patients attending our Internal Medicine Clinic. The findings were: For all co-infected patients, the level of AFP was considerably higher, 6 times than the solely HBV infected patients: 36 HBV and HIV co-infected patients were with remarkably increased AFP level with worse clinical manifestations whereas for the solely HBV infected, only 6 showed AFP level that was above the upper limit with relatively light clinical manifestations; among HIV and HBV co-infected patients, only 4 cleared the HBV infection while for the other part 20 of them cleared.The remaining ones were with dormant, non-active infection. In conclusion; HIV is an accelerator of HBV infection towards hepatocellurar carcinoma as well as liver cirrhosis and bad prognosis in general.

Moges Amare Ambaw has completed his degree in Midwifery from Addis Ababa University and he is currently pursuing Clinical Internship. He was the Head of MNCH Department in St. Peter Hospital. He is also a Lecturer in Menilik II Health Science College and Trainer on PMTCT, Basic Emergency Obstetric and Newborn Care (BEmONC) and Family Planning.

The HIV/AIDS pandemic has succumbed millions of people throughout the world since it was first described in the early 1980s. In the past three decades the world has learned that HIV/AIDS is not only a health problem that can be addressed solely by the health sector but it is a social, economic, development and security issue that needs the united endeavors of all sectors including the public, private, religious, social and cultural structures of nations. This problem is worse in non-developed countries like Ethiopia. The prevalence of HIV at PMTCT site has shown a four-fold decrease during the five years period. The studies shows only 53% of known HIV positive mothers and 48% of known HIV exposed infants have received ARV prophylaxis. The estimated ARV coverage was found to be 11.6% for HIV positive mothers and 8.4% for their babies. Transmission of HIV from mother to child is mainly during pregnancy (Labor & delivery and during breast feeding). To prevent the transmission the four prongs must be implemented: Primary prevention of HIV infection; Prevention of unintended pregnancies among HIV-infected women; Prevention of HIV transmission from HIV-infected women to their offspring; and Provision of care and support to women infected with HIV, their infants, and their families. So integrating PMTCT service in all health system or sectors should be enhanced and need all stakeholders’ involvement.

Nahom Tesfaluul Negassi is currently an Assistant Lecturer as well as Member of Research and Postgraduate Program in Asmara College of Health Sciences, Asmara Eritrea since 4 years. He is currently pursuing Masters in Clinical Laboratory Diagnostics, Department of Laboratory Medicine in The First Affiliated Hospital of Zhengzhou University, China.

Background: In resource poor countries like Ethiopia the survival of patients treated with ART depends on a variety of factors, which might vary greatly with economic, demographic, behavioral and health risk factors. However, factors affecting survival in Ethiopia are poorly understood. The aim of this study is to determine causes of mortality in adult HIV-positive patients receiving highly active anti retroviral treatment (HAART) in Dilla Referral Hospital.\r\n\r\nMethods: The medical records of 1391 ART patients who enrolled at Dilla Hospital between 2010 and 2014 were reviewed and socio-demographic, clinical, behavioral and immunological data were collected. Multivariable Cox proportional hazards regression model was used to measure risk of death and identify the independent predictors of mortality.\r\n\r\nResult: Out of 1391 cohorts of adults ART patients 1081 (77.7%) were alive and continued their treatment in the hospital, 128 (9.2%) were reported dead, 111 (8%) were transfer out and 71 (5.1%) were lost follow up. The probability of remaining alive and on treatment after 60 months of follow up was 89.3% for TB/HIV patients and 91.1% for HIV only infected patients. HIV patients who developed TB had shorter survival time than not developed TB. Death occurred 26% and 52% in the first 3 and 12 months of ART initiation respectively. The overall incidence rate of mortality during ART treatment was 3.5 per 100 person year observations (PYO). In multivariate analysis low body weight BMI <18.5 kg/m2 (HR 3.12, 95% CI 1.39-7.76, P<0.0001), CD4 count less than 50 cells/mm3 (HR 4.55, 95% CI 1.19-8.44, p<0.002), anemia, WHO clinical stage III and IV, drug addiction and presence of active TB infection were predictor of survival and statistically significant association with mortality in HIV patients under ART follow up.\r\n\r\nConclusion: The presence of lower baseline CD4-cell, TB infection, WHO clinical stage III and IV, lower body weight, anemia and drug addiction were factors associated with mortality among ART clients. Improving nutritional status, prevention and control of TB and other opportunistic infections were the recalled recommendations to decrease AIDS-related morality. These determinants should be taken into account by health care providers to enhance better clinical outcomes of ART attendees.\r\n