Renal cell carcinoma is well-known for its propensity to present in unusual ways, and renal cell carcinoma presenting as pleural effusion is extremely rare. Pleural effusion secondary to renal cell ...carcinoma constitutes only about 1% to 2% of all malignant pleural effusions. We report the case of a 34-year-old man with no significant past medical or surgical history who presented in the Emergency Department with dyspnea. Chest x-ray demonstrated right-sided pleural effusion; computed tomography (CT) reported right-sided effusion in the pleura with suspicious mass in the upper border of left kidney. CT-guided pleural tap was performed and cytology was positive for vimentin and common acute lymphocytic leukemia antigen (CD10), leading to the diagnosis of primary renal cell carcinoma presenting as unilateral pleural effusion. While lungs are the common site of metastasis, the presentation of renal cell carcinoma as pleural effusion or pleural metastasis without lung involvement is rare.
Non-disclosure of positive HIV status in population-based surveys causes underestimation of national HIV diagnosis and biases inferences about engagement in the care continuum. This study ...investigated individual and household factors associated with HIV non-disclosure to survey interviewers in Nigeria.
Secondary analysis of a cross sectional population-based household HIV survey.
We analyzed data from adults aged 15-64 years who tested positive for HIV and had antiretroviral drugs (ARVs) in their blood from a nationally representative HIV sero-survey conducted in Nigeria in 2018. We considered ARV use as a proxy for knowledge of HIV diagnosis; thus, respondents who self-reported to be unaware of their HIV status were classified as non-disclosers. We estimated the associations between non-disclosure and various sociodemographic, clinical, and household characteristics using weighted logistic regression.
Among 1266 respondents living with HIV who were taking ARVs, 503 (40%) did not disclose their HIV status to interviewers. In multivariable statistical analyses, the adjusted odds of non-disclosure were highest among respondents aged 15-24 years, those with less than a primary school education, and those who were the only person living with HIV in their household.
Non-disclosure of positive HIV status to survey personnel is common among adults who are receiving treatment in Nigeria. These findings highlight the importance of validating self-reported HIV status in surveys using biomarkers of ARV use. Meanwhile, it is crucial to improve disclosure by strengthening interview procedures and tailoring strategies towards groups that are disproportionately likely to underreport HIV diagnoses.
We utilized data from the 2012 Crane Survey in Kampala, Uganda to estimate prevalence of rape among female sex workers (FSWs) and to identify risk factors for and prevalence of client-initiated ...gender-based violence (GBV) among FSWs. Participants were recruited using respondent-driven sampling. Analyses were weighted using RDSAT-generated individualized weights for each of the five dependent GBV outcomes. Analyses were conducted utilizing SAS 9.3. Among 1,467 FSWs who were interviewed, 82 % (95 % CI: 79–84) experienced client-initiated GBV and 49 % (95 % CI: 47–53) had been raped at least once in their lifetime. GBV risk increased with increasing frequency of client demands for unprotected sex, length of time engaged in sex work, and FSW alcohol consumption. Risk decreased when sex with clients occurred at the FSW’s or client’s house or a hotel compared to when sex occurred in open spaces. Our findings demonstrate a high prevalence of GBV among FSWs. This research reinforces the urgent need for GBV prevention and response strategies to be integrated into FSW programming and the continuing need for GBV research among key populations.
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