Sexual Health

Assessment of prementstrual syndrome in HIV-positive adolescents

Sub-study of: Reproductive health in HIV-infected adolescents.
Status: Closed 2015
Target/Enrolled: 200/164

BV in HIV+ IUD users: Prevalence of bacterial vaginosis in HIV-positive copper intrauterine device users

Study ID: HIV-NAT199
This is a cross-sectional study that will assess and compare the prevalence of BV and intermediate vaginal flora in women or reproductive age in four groups: HIV-positive Thai women with Cu-IUD, : HIV-positive women without IUD; HIV-negative women with and HIV-negative without Cu-IUD.
Status: Closed 2016
Target/Enrolled: 182/137

HIV-1 in menopausal women: Viral shedding and disease progression in HIV-positive menopausal women.

Study ID: HIV-NAT206
This is an observational prospective study that will assess the changes in viral load in the genital secretions before and after menopause in women infected with HIV. This study will also measure and compare inflammatory markers among HIV-positive premenopausal and menopause women. Then these results will be compared to HIV-positive men in the same age as well as HIV-negative HIV-negative menopausal women.
Status: Closed 2016
Target/Enrolled: 50/17

Intervention to Promote Sexual Health of Adolescents and Young Adults with HIV in Thailand

Study ID: HIV-NAT180
This is a qualitative study assessing the efficacy of a proposed model to promote sexual health in adolescents.
Status: Close April 2014. Additional information can be obtained from section entitled, “Summary report of the activities for HIV-infected children and parents at the Thai Red Cross AIDS Research Centre”.
Target/Enrolled: 56/56 from 4 sites
Collaborator: Infectious Disease Division, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Srinagarind Hospital; Phachomklao Phetchaburi Hospital, Phetchaburi Province; Children and Youth Program, SEARCH, Thai Red Cross AIDS Research Centre, Bangkok; the AIDS ACCESS Foundation – Chiang Rai; Phrayanasangwarn Wiangchai Hospital, Mae Chan Hospital and Pharn Hospital

Metabolic changes in HIV + female adolescents on ART with hormonal contraception

Sub-study of: Reproductive health in HIV-infected adolescents.
Status: Closed. Manuscript writing.
Target/Enrolled: 80/51

Reproductive health in HIV-infected adolescents.

Study ID: HIV-NAT176
Optimization of reproductive health care for female adolescents living with HIV. This is a prospective cohort study that will be used to create a model of reproductive health services for HIV-positive female adolescents in Asia.
Status: Closed Sept 2015. Manuscript writing
Target/Enrolled: 100/77
Result: Young HIV+ people are sexually active or anticipate becoming so in the future. Need of comprehensive and individually tailored RH service. There is substantial, and continuously growing, scientific knowledge on RH issues; however, the medical model alone cannot answer the complex needs of this target group. Need of integration of service – clinical care + RH service + psychosocial support. In about 20 years the number of HIV+ adolescents is expected to start declining. Low number of HIV+ adolescents/health facility. Health education on RH issues and safe sex practices at the pediatric department with standardized tools is very much appreciated. The service can be improved by using better the existing structure of family planning clinics in Thailand; improve communication between pediatric and FP departments. Long acting reversible contraception together with condoms seems to provide the most reliable protection from unintended pregnancy and STI/HIV transmission.

Serodiscordant Couple

Study ID: HIV-NAT168
Reproductive health and HIV – Characterize HIV serodiscordance in heterosexual couples. This is a cross-sectional study to gather data on the marital status or engagement in a heterosexual stable relationship (more than six months) for all clients of the HIV-NAT 006 cohort, and of the MTCT-Plus program of the Thai Red Cross Anonymous Clinic, as well as on whether they are aware of the HIV status of their partner.
Status: Closed March 2014
Target/Enrolled: 500/298
Collaborator: The Thai Red Cross Anonymous Clinic
Result: We found zero HIV prevalence among non-index heterosexual partners after a median 10 years of HIV-serodiscordant relationships (all but two index partners were on successful ART), and a low HIV testing rate. The latter was substantiated and explained by the qualitative outcome of the study, suggesting relation to stigma against HIV-positive people Our results support the WHO recommendation for starting ART for treatment and prevention in HIV-serodiscordant couples at any CD4 count. Furthermore, we recommend the dissemination of data showing that no HIV transmission in heterosexual couples through sex practice has been observed provided VL is suppressed. This could be a powerful tool for effective fight against stigma and self-stigma in people living with HIV. While safe sex and HIV testing should continue to be promoted, it is important to reassure the public and the HIV-positive community of extremely low HIV transmission risk with successful ART.
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