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We aimed to investigate the prevalence and correlates of smoking in people living with HIV (PLWHIV) in Germany and Austria and their readiness to quit. A total of 447 consecutive patients with confirmed positive HIV status who were treated in different outpatient HIV centres in Austria and Germany were included. Nicotine dependence and stages of change were assessed by standardized questionnaires, and this was confirmed by measuring exhaled carbon monoxide. Prevalence of smoking was 49.4%. According to a multivariate logistic regression analysis, higher age (for each year of life OR = 0.96; 95% CI 0.92-1.00) and tertiary education level (OR = 0.43; 95% CI 0.15-0.79) were associated with a lower chance, and occasional (OR = 3.75; 95% CI 1.74-8.07) and daily smoking of the partner (OR 8.78; 95% CI 4.49-17.17) were significantly associated with a higher chance of smoking. Moderate (OR = 3.41; 95% CI = 1.30-9.05) and higher nicotine dependency level (OR = 3.40; 95% CI 1.46-7.94), were significantly associated with higher chance, and older age (for each year of life OR = 0.95; 95% CI = 0.91-0.99), with lower chance for readiness to quit smoking. Those results may be used to address preventive measures to quit smoking aimed at PLWHIV and the importance of addressing smoking habits.

We aimed to determine the prevalence of drug and polydrug use in people living with HIV in Austria for the first time for which a two center cross-sectional study was performed. Participants were recruited from consecutive patients during their regularly scheduled visits. In total 438 participants were included in the analysis. For this study we used paper-pencil and online-based questionnaires. The prevalence of illicit drug use was 60.5%; with cannabis use at 31.5%, nitrates at 31.5%, sildenafil/tadalafil at 24% and cocaine at 14%, being the most used substances. Use of more than one substance (polydrug) in drug users was 69.4% or 42.0% in the total study population. Younger age, male gender, and living in an urban area were associated with drug use. Moreover, drug use during clubbing and sex, HIV therapy non-adherence and younger age were associated with polydrug use. Drug users reported condomless sex in 42.4% and performing sexual acts they would not do sober in 44.1%. Results indicate a high prevalence of illicit drug use in PLWHIV in Austria. New research focusing on illicit drug use in PLWHIV should focus on the use of substances during sex and surrounding practices.

ObjectivesUnderstanding the public health impact of lymphogranuloma venereum (LGV) in Europe is hampered by inadequate diagnostics and surveillance systems in many European countries. We developed and piloted LGV surveillance in three European countries without existing systems and performed a preliminary investigation of LGV epidemiology, where little evidence currently exists.MethodsWe recruited STI or dermatovenereology clinics and associated laboratories serving men who have sex with men (MSM) in Austria, Croatia and Slovenia, using the UK for comparison. We undertook centralised LGV testing of Chlamydia trachomatis (CT)-positive rectal swabs collected between October 2016 and May 2017 from MSM attending these clinics. Stored specimens from Austria (2015–2016) and Croatia (2014) were also tested. Clinical and sociodemographic data were collected using a standardised proforma. The ompA gene of LGV-positive specimens was sequenced.ResultsIn total, 500 specimens from CT-positive MSM were tested, and LGV positivity was 25.6% (128/500; 95% CI 22.0% to 29.6%) overall, and 47.6% (79/166; 40.1% to 55.2%) in Austria, 20.0% (3/15; 7.1% to 45.2%) in Croatia, 16.7% (1/6; 3.0% to 56.4%) in Slovenia and 14.4% (45/313; 10.9% to 18.7 %) in the UK. Proformas were completed for cases in Croatia, Slovenia and in the UK; proformas could not be completed for Austrian cases, but limited data were available from line listings. Where recorded, 83.9% (78/93) of LGV-CT cases were HIV-positive compared with 65.4% (149/228) of non-LGV-CT cases; MSM with LGV-CT were more likely to have proctitis (Austria, 91.8% vs 40.5%, p<0.001; Croatia, 100% vs 25%, p=0.04; UK, 52.4% vs 11.7%, p<0.001) than those with non-LGV-CT. Six different ompA sequences were identified, including three new variants; the L2 ompA sequence predominated (58.6%, 51/87).ConclusionsLGV is substantially underdiagnosed in MSM across Europe. Unified efforts are needed to overcome barriers to testing, establish effective surveillance, and optimise diagnosis, treatment and prevention.

Background: The prognosis for people living with HIV (PLWHIV) has improved tremendously in the past years, and life expectancy in PLWHIV is almost the same as in the general population. HIV now is regarded as chronic condition, and as PLWHIV age, additional age-related problems emerge. These seem to occur more often and earlier compared to the general population, due to the virus itself, due to antiretroviral therapy, or due to lifestyle factors. Among these problems are biological factors such as chronic non-communicable diseases, other communicable diseases, and frailty, mental factors like common mental disorders and substance use, as well as social factors like stigma, discrimination, prejudices, work disability and unemployment, and having no partner. It was the aim of this study to monitor medical health burdens in a cohort of PLWHIW over time with an emphasis on cardio-vascular risk factors in order to design a comprehensive, integrated, person-centred care model around the antiretroviral therapy. The study was carried out by researchers and caregivers together with PLWHIV, and supported by a pharmaceutical company. Methods: PLWHIV participated in a baseline study (2013) in an HIV treatment centre and in a follow-up study (2021). At baseline the study population comprised of consecutive patients with HIV, who visited their treating physicians for routine checks. Inclusion criteria were age >= 18 years, documented HIV-Infection and written informed consent. Risk factors were recorded as either having a corresponding diagnosis in the patient´s charts OR being treated with specific drugs, OR having laboratory values outside the normal range. Results: From the initially included 450 participants, 360 (80%) patients participated in the follow-up. The mean age at baseline was 41.4 years, 5.3% were female. 10.8% were affected by hypertension at baseline, and 19.6% at follow-up (P<0.001). Prevalence of type 2 diabetes mellitus was 3.1% at baseline and 5.3% at follow-up (P=0.039), and of dyslipidaemia 76.9% at baseline and 71.4% at follow-up (P=0.042). The proportion of smokers decreased from 42.6% a baseline to 37.1% a follow-up (P=0.007). Prevalence of overweight was 36.6% and of obesity 8.9% at follow-up (no baseline data available). Learnings and next steps: PLWHIV have a high prevalence of cardio-vascular risk factors in an early age, which will increase health problems as this population is ageing. Most cardio-vascular risk factors increased rapidly in PLWHIV and therefore they are a major challenge for comprehensive and integrated care. As an important next step not only medical, but also psycho-social, sexual, spiritual and lifestyle-related health burdens as well as health resources need to be assessed and monitored to ensure care for PLWHIV is truly person-centered. Furthermore, PLWHIV want to be perceived as a partner in their treatment and this needs to become an integral part of routine care.  

Purpose To report on the global quality of life (QOL) in people living with HIV (PLWHIV) and how a smoking cessation intervention influences the changes in QOL. Methods Participants were asked to fill out a questionnaire during visits to their HIV outpatient clinic consisting of sociodemographic information, general health data and the WHOQOL HIV-Bref. Exhaled carbon monoxide measurements were used to confirm the smoking status, based on which participants classified as smokers received a short 5 min structured intervention and were offered participation in a full smoking cessation programme consisting of five sessions. Follow-up was done 8 months after the baseline. Results Overall 447 (mean age = 45.5) participants took part with 221 being classified as smokers. A total of 165 (74.6%) participants received a short intervention and 63 (29.4%) agreed to participate in the full program. At baseline, differences in QoL were observed, where smokers had lower QoL in domains of physical (M = 16.1 vs. 15.3, p = 0.009) and psychological (M = 15.3 vs. 14.6, p = 0.021) well-being, independency level (M = 16.1 vs. 15.2, p = 0.003) and environment (M = 16.5 vs. 16.0, p = 0.036). At study end, 27 (12.2%) participants quit smoking; 12 (19.0%) participants of the full programme and 15 (14.7%) that received the short intervention. There were no significant differences in QoL between those that continued to smoke and quitters at follow-up. Conclusion Quality of life results may be used to better understand the underlying motivation of PLWHIV who start cessation programs. In order to reduce the high prevalence and health burden that smoking causes in PLWHIV, it is necessary to introduce effective interventions that can be used in the clinical settings.

Introduction Due to the interaction between smoking and the virus and the antiretroviral therapy, the excess health hazard due to smoking is higher in HIV+ patients than in the general population. International studies suggest a higher prevalence of smoking in HIV+ subjects compared to the general population. It was the aim of the study to assess prevalence of smoking, to analyze determinants of smoking, and to evaluate readiness to quit in HIV+ patients in Germany and Austria. Material and Methods Consecutive patients with positive tested HIV status, smokers and non‐smokers, who are treated in seven different HIV care centres in Austria and Germany were included. Nicotine dependence was assessed with the Fagerström Test for Nicotine Dependency (FTND), and stages of change by a standardized readiness to quit questionnaire. Self‐reported smoking status was objectified by measuring exhaled carbon monoxide levels. Smokers who wanted to quit were offered a structured smoking cessation programme, and those who did not want to quit received a 1‐minute consultation. After six months, the smoking status of all included subjects was reassessed. Results A total of 447 patients were included; the response rate was 92%. Prevalence of smoking was 49.4%. According to a multivariate logistic regression analysis, lower age, male sex, lower educational level, and smoking of the partner were significantly associated with the smoking status. According to the FTND, 25.3% showed a low (0–2 points), 27.6 a moderate (3–4 points) and 47.1% a high (5–10 points) dependency. Regarding stages of change, 15.4% of the smokers were in the stadium precontemplation, 48.4 in contemplation, 15.4 in preparation and 10.0 in the stadium action. 11.0% were not assignable in any stadium. Higher education level and lower grade of dependency were significantly associated with the wish to quit smoking. Six months after the baseline examination, smoking cessation visits (at least one session) was performed in 28.5% of the smokers. 13% of the smokers have quit smoking, 23% have reduced smoking and 63% did not change smoking habits positively 6 months after the first visit. Conclusions Prevalence rates for smoking in HIV+ subjects are higher than in the general population. Readiness to quit is, however, high, and 13% of smokers who have quit smoking after six months is a remarkable short‐term success. This observation underlines the importance and feasibility of addressing smoking habits in HIV care.

A brain-computer interface (BCI) can provide a non-muscular communication channel to severely disabled people. One particular realization of a BCI is the P300 matrix speller that was originally described by Farwell and Donchin (1988). This speller uses event-related potentials (ERPs) that include the P300 ERP. All previous online studies of the P300 matrix speller used scalp-recorded electroencephalography (EEG) and were limited in their communication performance to only a few characters per minute. In our study, we investigated the feasibility of using electrocorticographic (ECoG) signals for online operation of the matrix speller, and determined associated spelling rates. We used the matrix speller that is implemented in the BCI2000 system. This speller used ECoG signals that were recorded from frontal, parietal, and occipital areas in one subject. This subject spelled a total of 444 characters in online experiments. The results showed that the subject sustained a rate of 17 characters/min (i.e., 69 bits/min), and achieved a peak rate of 22 characters/min (i.e., 113 bits/min). Detailed analysis of the results suggests that ERPs over visual areas (i.e., visual evoked potentials) contribute significantly to the performance of the matrix speller BCI system. Our results also point to potential reasons for the apparent advantages in spelling performance of ECoG compared to EEG. Thus, with additional verification in more subjects, these results may further extend the communication options for people with serious neuromuscular disabilities.