Abubaker Ibrahim Elbur

Background: Overall progress in getting to zero new HIV infections in San Francisco has been made since 2012. However, among people who inject drugs (PWID), there has been no clear downward trend in new HIV infections in recent years. Direct measures of the rate of HIV acquisition and characterization of factors associated with higher rates among PWID are needed to help achieve HIV elimination. Methods: This study is a secondary analysis of the National HIV Behavioral Surveillance survey of PWID in San Francisco in 2022. HIV incidence is estimated using age of first injection drug use and date of first HIV-positive test or interview date as the exposure period. Factors associated with HIV seroconversion were identified by Cox regression. Results: Of 518 PWID, 12 newly tested HIV positive in the survey and 38 reported a prior positive test. HIV incidence was calculated as 0.46 per 100 person-years (95% confidence interval [CI]: 0.35 to 0.61). HIV incidence rates were significantly higher among PWID who were men who have sex with men (adjusted hazard ratio [aHR] 15.98, 95% Cl 7.77 to 32.87, P < 0.001), transgender (aHR 8.64, 95% Cl 2.76 to 27.08, P < 0.001), and Hispanic (aHR 2.85, 95% Cl 1.23 to 6.63, P < 0.001). Conclusions: We found a moderate HIV incidence of ∼5 per 1000 person-years among PWID in San Francisco, with significantly higher rates among sexual, gender, and ethnic minority groups of PWID. Further progress in getting to zero new HIV infections will require more vigorous scale-up of effective prevention interventions, such as PrEP, specifically reaching vulnerable groups of PWID.

Background: Polypharmacy, using five or more medications, may increase the risk of nonadherence to prescribed treatment. We aimed to identify the interrelationship between trajectories of adherence to antiretroviral therapy (ART) and polypharmacy. Methods: We included women with HIV (aged ≥ 18) enrolled in the Women’s Interagency HIV Study in the United States from 2014 to 2019. We used group-based trajectory modeling (GBTM) to identify trajectories of adherence to ART and polypharmacy and the dual GBTM to identify the interrelationship between adherence and polypharmacy. Results: Overall, 1,538 were eligible (median age of 49 years). GBTM analysis revealed five latent trajectories of adherence with 42% of women grouped in the consistently moderate trajectory. GBTM identified four polypharmacy trajectories with 45% categorized in the consistently low group. Conclusions: The joint model did not reveal any interrelationship between ART adherence and polypharmacy trajectories. Future research should consider examining the interrelationship between both variables using objective measures of adherence.

Background: Women with HIV (WHIV) in the United States face many challenges with adherence to antiretroviral therapy (ART), and suboptimal adherence often leads to virologic failure. This study aimed to determine the association between ART adherence trajectories and the risk of virologic failure. Methods: We included WHIV (aged 18 years or older) enrolled in the Women's Interagency HIV Study in the United States from April 2014 to September 2019 who had at least 2 consecutive measurements of HIV RNA and ≥3 measurements of self-reported adherence. Group-based trajectory modeling was used to identify adherence trajectories. Cox proportional hazard ratios were used to measure the association. Main Outcome Measure: Virologic failure was defined as HIV RNA ≥200 copies/mL at 2 consecutive visits. Results: We included 1437 WHIV (median age 49 years). Of all women, 173 (12.0%) experienced virologic failure. Four adherence trajectories were identified, namely “consistently high” (26.3%), “moderate increasing” (9.5%), “moderate decreasing” (30.6%), and “consistently low” (33.5%). Women in the consistently low adherence group consumed alcohol and experienced depression more than other groups. Compared with the “consistently high” trajectory, the risk of virologic failure was higher among women with “consistently low” [adjusted hazard ratio (aHR) 2.8; 95% confidence interval (CI): 1.6 to 4.9; P < 0.001] and “moderate decreasing” adherence trajectories (aHR 1.8; 95% CI: 1.0 to 3.2; P = 0.04), but it was similar to those with “moderate increasing” adherence trajectory (aHR 1.0; 95% CI: 0.4 to 2.5; P = 0.94). Conclusions: Adherence to ART remains a challenge among WHIV. Multilevel behavioral interventions to address poor adherence, alcohol consumption, and depression are needed.

Background Polypharmacy, using five or more medications, may increase the risk of nonadherence to prescribed treatment. We aimed to identify the interrelationship between trajectories of adherence to antiretroviral therapy (ART) and polypharmacy. Methods We included women with HIV (aged ≥ 18) enrolled in the Women's Interagency HIV Study in the United States from 2014 to 2019. We used group-based trajectory modeling (GBTM) to identify trajectories of adherence to ART and polypharmacy and the dual GBTM to identify the interrelationship between adherence and polypharmacy. Results Overall, 1,538 were eligible (median age of 49 years). GBTM analysis revealed five latent trajectories of adherence with 42% of women grouped in the consistently moderate trajectory. GBTM identified four polypharmacy trajectories with 45% categorized in the consistently low group. Conclusions The joint model did not reveal any interrelationship between ART adherence and polypharmacy trajectories. Future research should consider examining the interrelationship between both variables using objective measures of adherence.

Pharmacy Practice is a free full-text journal with a scope on the practice of pharmacy. Pharmacy Practice covers pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology

Hepatitis B Virus (HBV) infection is an important and serious global health problem. Despite the fact that there is a decrease in the prevalence rate of HBV infection in Saudi Arabia, but still it causes significant morbidity and mortality. This study was conducted to measure the level of knowledge and to identify attitude and practice on HBV. A cross-sectional study was conducted in Taif Area; Saudi Arabia during the period of 1st June - 30th July 2016. Adult (18 years and above) Saudi and Non-Saudi (Arabic speaking) people were included.

Satisfaction with and adherence to oral anticoagulant treatment are important measures that decrease morbidity and mortality. Higher satisfaction and adherence to warfarin therapy was found to be associated among other factors with good International Normalized Ratio (INR) control. To assess patient satisfaction with and adherence to oral anticoagulant therapy and to identify predictors of the two studied domains. A cross-sectional study was conducted at the Cardiothoracic Clinic in Alshaab Teaching Hospital; Khartoum; Sudan during March-April 2015. A representative sample of patients on oral anticoagulant treatment was recruited. Data was collected through face-to-face interview method using oral Anti-Clot Treatment Scale (ATCS) to measure satisfaction and the 4-items Morisky Scale to measure adherence to therapy. Data was processed using SPSS. Logistic regression analysis was performed. P value <0.05 was considered statistically significant. A total of 93 patients was included, of them 46 were males. Overall, 47 (50.5%) were classified as satisfied with anti-clot treatment. Patients attained secondary and above educational level were approximately 8 times more satisfied with their anti-clot treatment, compared to those educated below this level, [OR 7.9 (2.9-21.7), P < 0.001]. Similarly, patients currently working were found to be approximately 3 times more satisfied with warfarin therapy, compared those who had no jobs, [OR 2.9 (1.1-7.6), P = 0.035]. Overall, 5.4% of the patients were found to be adherent to warfarin therapy. No definite background characteristic variable was found to be associated with adherence to treatment. No association was found between patient satisfaction and adherence to treatment, (P = 0.490). Ensuring health education on warfarin together with continuous patients motivation are needed, specifically among patients with low educational level. Efficient multidisciplinary effort from all healthcare providers is needed to make warfarin treatment more successful.

Parents’ false beliefs about signs and symptoms associated with teething have been documented in many studies around the world. This study was conducted to assess parental knowledge on infant teething process and to investigate parents’ practices used to alleviate teething disturbances. A cross-sectional survey was conducted among parents of children of 6 months–5 years old in Taif, Saudi Arabia during April 2013. Convenience method of sampling was adopted and the data was collected by mean of a structured-questionnaire. Data was processed by SPPS. Logistic regression analysis was performed. P value <0.05 was considered statistically significant. Overall, of 493 participants were included in the final analysis with mean age 35 years. Females constituted more than two-third. All the parents attributed one or more of the listed signs and symptoms to teething process. Desire to bite, fever, gum irritation, increased salivation and diarrhea were the most reported signs and symptoms of teething by 459 (93.1 %), 429 (87 %), 415 (84.2 %), 414 (84 %) and 409 (83 %) of the parents respectively. The only predictor of ascribing fever as a sign of infant teething was female gender (P = 0.001). However, female gender (P < 0.001), residence (P = 0.039) and educational level (P = 0.006) were found to be significantly associated with ascribing diarrhea as one of the teething symptoms. Only 91 (18.5 %) of the parents responded correctly to all questions designed to assess their knowledge on teething process. Wide gaps in parents’ knowledge and practices related infant teething was identified. Educational interventions are needed to upgrade parents’ knowledge and improve their practices regarding infant teething process.

Background Antibiotic prophylaxis is effective at reducing the risk of postoperative infection for nearly all types of surgery. Objective To audit the use of prophylactic antibiotics for elective surgery. Setting Khartoum Teaching Hospital, Sudan, a 1,000 bed tertiary level hospital. Method A prospective study was conducted over a 9 month period; patients admitted for elective surgery were included consecutively. Main outcome measure The use and administration of prophylactic antibiotics for elective surgery. Results A total of 1,768 patients with mean age 37.8 ± 14 years were recruited (females, 83.3 % of total) who underwent 1,814 surgical interventions. Of these 1,277 (70.4 %) of procedures were clean-contaminated. A total of 1,758 patients (99.4 % of total) received antibiotics for prophylaxis; 1,730 patients (97.9 %) were given antibiotics in the operating room; for 1,288 (74.5 %) of cases the antibiotics were considered ‘recommended’, while for 442 (25.5 %) they were not. Out of the patients for whom prophylaxis was recommended and was given, 725 (56.3 %) of patients received a broad spectrum antibiotic or unnecessary combination, 913 (70.9 %) received a sub-therapeutic dose, 120 (9.3 %) were given the first preoperative dose within the proper time window, and 1,250 (97 %) of patients had an extended duration of prophylaxis. Compliance with all stated criteria was achieved in only 47 (2.7 %) of observed prescriptions. Conclusion This audit showed a wide gap between international standards and local practices; the authors call for urgent action to correct this situation through the development and implementation of local clinical guidelines.