Copyright © 2024 The Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use

¹Department of Medical Laboratory Science, Kampala International University, Uganda,

Article Info:

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Article History:

Received 27 December 2023

Reviewed 29 January 2024

Accepted 22 February 2024

Published 15 March 2024

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Cite this article as:

Obeagu EI, Obeagu GU, Mental Health and Psychosocial Effects of natural disaster on HIV Patients, Asian Journal of Dental and Health Sciences. 2024; 4(1):38-44

DOI: http://dx.doi.org/10.22270/ajdhs.v4i1.63 _____________________________________________

*Address for Correspondence:

Emmanuel Ifeanyi Obeagu,Department of Medical Laboratory Science, Kampala International University, Uganda, 0000-0002-4538-0161

Abstract

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Natural disasters pose unique challenges to individuals living with HIV/AIDS, impacting their mental health and psychosocial well-being. This review explores the complex interplay between natural disasters and the mental health implications for HIV patients. Disruptions in healthcare infrastructure, medication access, and treatment continuity during disasters significantly affect disease management, leading to heightened stress, anxiety, and trauma among this vulnerable population. Social support networks, crucial for those with HIV, often suffer severe setbacks, exacerbating mental health issues. The aftermath of disasters may induce long-term psychological effects, including post-traumatic stress disorder (PTSD) and depression. Understanding these multifaceted impacts is critical in developing tailored interventions and support systems to mitigate the mental health consequences experienced by individuals living with HIV in the wake of natural disasters. Further research and targeted interventions are essential to address the specific needs of this population and promote resilience in the face of such calamities.

Keywords: mental health, psychosocial effect, natural disaster, HIV, AIDS, emergency

Natural disasters, ranging from hurricanes and earthquakes to floods and wildfires, present multifaceted challenges that extend beyond immediate physical devastation. Amidst the chaos and upheaval caused by these catastrophic events, individuals living with HIV/AIDS constitute a particularly vulnerable population facing unique mental health and psychosocial ramifications. The intersection of natural disasters and the complex landscape of HIV care introduces intricate challenges, disrupting access to crucial healthcare services, medication adherence, and psychosocial support networks.^1-11The impact of natural disasters on the mental health of HIV patients is a topic of increasing concern and study.¹² Disruptions in healthcare infrastructure, exacerbated by the chaos following disasters, disrupt the continuity of care essential for managing HIV. This disruption not only amplifies the existing stressors but also triggers heightened levels of anxiety, fear, and uncertainty among individuals grappling with the dual burden of a chronic illness and the aftermath of a disaster.^13-19

Moreover, the erosion of social support networks - a cornerstone of coping mechanisms for those living with HIV - during and after a natural disaster intensifies the psychosocial strain.²⁰ Loss of familial ties, community structures, or access to essential support services compounds the challenges faced by HIV-positive individuals, often leading to profound isolation and exacerbating mental health vulnerabilities.^21-28While immediate relief efforts focus on addressing physical needs and infrastructural rehabilitation post-disaster, the long-term mental health implications for individuals living with HIV often remain overlooked. Understanding the intricate interplay between natural disasters and mental health outcomes in this population is pivotal in devising targeted interventions and support systems that cater to their specific needs.This paper aims to delve into the nuanced dynamics of how natural disasters impact the mental health and psychosocial well-being of individuals living with HIV/AIDS. By synthesizing existing literature and highlighting key challenges, it seeks to underscore the urgency of addressing the mental health repercussions of disasters among this vulnerable demographic. Ultimately, this exploration underscores the importance of tailored interventions and comprehensive support frameworks to mitigate the mental health burden experienced by HIV patients in the wake of natural disasters.

Disruption of healthcare services due to natural disasters presents a critical challenge for individuals living with HIV/AIDS.²⁹ The aftermath of such calamities often leads to severe disruptions in healthcare infrastructure, hindering access to essential medical care, medications, and ongoing treatment for HIV-positive individuals.^30-34Natural disasters, whether hurricanes, earthquakes, or floods, can damage healthcare facilities, compromise supply chains, and displace healthcare providers.³⁵ This disruption not only limits the immediate availability of medical care but also impedes the continuity of treatment essential for managing HIV/AIDS. Interruptions in the supply of antiretroviral therapy (ART) and other necessary medications can have dire consequences, leading to treatment interruptions, viral resistance, disease progression, and increased morbidity among those living with HIV.^36-44

Moreover, displaced populations or individuals forced to evacuate their homes due to disasters often encounter challenges in accessing healthcare services, including HIV testing, counseling, and follow-up care. This displacement can sever the established patient-provider relationships crucial for effective disease management, leaving individuals without critical medical guidance and support.^45-52Furthermore, the overwhelming demands on healthcare systems in the aftermath of a natural disaster often divert resources away from HIV/AIDS care programs. The allocation of resources towards immediate emergency response efforts may result in a temporary or prolonged neglect of ongoing HIV treatment and care services, exacerbating the vulnerabilities of HIV-positive individuals.^53-60Addressing the disruption of healthcare services during and after natural disasters necessitates proactive planning, resource allocation, and resilient healthcare systems. Ensuring the continuity of HIV/AIDS care amidst such crises requires pre-disaster planning, establishing contingency measures, and strengthening healthcare infrastructures to withstand the impact of disasters.^61-68Efforts to enhance disaster preparedness within healthcare systems should prioritize strategies for maintaining the supply chain of medications, securing alternative care sites, training healthcare personnel in disaster response protocols, and fostering collaborations between disaster response agencies and HIV care providers. By mitigating the disruptions to healthcare services, it becomes possible to safeguard the well-being and health outcomes of individuals living with HIV/AIDS in the face of natural disasters.

The experience of natural disasters significantly impacts the mental health and psychological well-being of individuals living with HIV/AIDS. The combination of managing a chronic illness and enduring the traumatic aftermath of a disaster creates a complex and heightened psychological burden on this vulnerable population.^69-74Natural disasters generate an array of stressors that exacerbate the existing challenges faced by HIV-positive individuals. The uncertainty surrounding access to essential medications, disrupted healthcare services, and the loss of stable living conditions can trigger acute stress, anxiety, and fear. The fear of treatment interruption, disease progression, or complications due to the unavailability of necessary medical care intensifies psychological distress among those managing HIV.^75-79Moreover, the trauma experienced during disasters, including the loss of loved ones, displacement, property damage, or witnessing distressing events, compounds the psychological impact. Individuals living with HIV may be particularly susceptible to the mental health consequences of such traumas, leading to heightened levels of post-traumatic stress disorder (PTSD), depression, and anxiety disorders.The psychological toll extends beyond the immediate aftermath, often resulting in prolonged mental health challenges. Chronic stressors stemming from the disruption of daily routines, loss of social support networks, and ongoing uncertainty regarding healthcare access contribute to sustained psychological distress among HIV-positive individuals affected by natural disasters.Addressing the stress and psychological impact necessitates comprehensive mental health support and interventions tailored to the unique needs of this population. Integrating mental health services into disaster response efforts and HIV care programs is crucial. Providing accessible and culturally sensitive mental health support, counseling services, and psychosocial interventions can aid in coping with trauma, reducing stress, and fostering resilience among individuals living with HIV in the wake of a natural disaster.Additionally, community-based support networks and peer-led interventions play a pivotal role in offering emotional support, sharing coping strategies, and reducing the isolation experienced by those affected. Empowering individuals with information, promoting self-care practices, and building adaptive coping mechanisms are essential components of mitigating the psychological impact of disasters on HIV-positive individuals, promoting mental well-being, and facilitating their recovery process.

Social support networks serve as a crucial lifeline for individuals living with HIV/AIDS, offering emotional, practical, and informational support.⁸⁰ However, the disruption caused by natural disasters profoundly impacts these support systems, leaving those affected by HIV more vulnerable and isolated. The aftermath of a natural disaster often leads to the disintegration or severe strain on established social support networks. Loss of family members, friends, or community ties, displacement, and relocation to unfamiliar environments can sever the vital connections that individuals living with HIV rely on for emotional support and solidarity. The breakdown of these networks intensifies feelings of loneliness, isolation, and helplessness among this already marginalized population.⁸⁰Moreover, disruptions in communication infrastructure and community services hinder the ability to access support groups, counseling services, and peer networks that are instrumental in coping with the challenges of HIV/AIDS. Lack of access to these resources further compounds the sense of social isolation and exacerbates the psychological distress experienced by HIV-positive individuals.⁸⁰Rebuilding and strengthening social support networks are pivotal in mitigating the psychosocial impact of natural disasters on individuals living with HIV/AIDS. Efforts aimed at community resilience and recovery should focus on reestablishing these networks, fostering community engagement, and providing platforms for mutual aid and peer support.Community-based organizations, NGOs, and healthcare providers play a critical role in facilitating the reconnection of affected individuals to support groups and community services. Creating safe spaces for dialogue, peer support initiatives, and support groups—whether in-person or through virtual platforms—can help individuals rebuild their social networks, share experiences, and access essential emotional support.Additionally, interventions that empower community members to become peer supporters or advocates within their communities can enhance social cohesion and resilience. Training programs aimed at equipping individuals with the skills to provide emotional support, disseminate accurate health information, and promote self-care practices foster a sense of empowerment and belonging among those affected by both HIV and natural disasters.By prioritizing the restoration and strengthening of social support networks, it becomes possible to alleviate the isolation and psychological distress experienced by individuals living with HIV in the aftermath of natural disasters, fostering resilience and promoting their overall well-being.

Natural disasters pose significant challenges to medication adherence and disease management among individuals living with HIV/AIDS. The disruptions caused by these catastrophic events often lead to barriers that compromise the continuity of care, medication adherence, and disease management for this vulnerable population.⁸¹The aftermath of a natural disaster can result in the displacement of individuals, damage to healthcare facilities, and disruptions in supply chains, leading to difficulties in accessing essential medications, including antiretroviral therapy (ART). Displaced individuals may face challenges in locating healthcare providers or pharmacies that supply their prescribed medications, resulting in treatment interruptions or delays in accessing necessary drugs.⁸¹

Moreover, the chaos and upheaval following a disaster can create logistical obstacles that hinder adherence to strict medication schedules. Individuals may lose their medication supply, have medications damaged, or face difficulties in storing medications properly in emergency situations, impacting their ability to adhere to the prescribed treatment regimens. Disruptions in healthcare services, including the unavailability of healthcare providers, the loss of medical records, and the absence of regular follow-up appointments, further complicate disease management for those living with HIV. The lack of continuity in care can lead to challenges in monitoring the progression of the disease, addressing potential complications, and providing necessary medical guidance to patients.⁸¹ Addressing medication adherence and disease management during and after natural disasters requires a multi-faceted approach that encompasses both short-term and long-term strategies. Pre-disaster planning and preparedness efforts are crucial in ensuring the availability and accessibility of medications, establishing contingency plans for medication distribution, and securing alternative healthcare facilities in the event of healthcare infrastructure damage. Furthermore, educating and empowering individuals living with HIV/AIDS about emergency preparedness, including strategies for medication storage, retrieval, and adherence during disasters, can enhance their resilience. Providing emergency medication kits, promoting adherence reminder systems, and utilizing telemedicine or remote consultations where feasible can also support continued disease management amidst disruptions. Collaboration between healthcare providers, public health agencies, community organizations, and disaster response teams is essential in developing comprehensive strategies that prioritize the continuity of HIV/AIDS care during and after natural disasters.⁸⁰ By addressing the challenges related to medication adherence and disease management, it becomes possible to minimize the adverse effects on the health outcomes of individuals living with HIV in the face of such crises.

The long-term mental health effects resulting from natural disasters among individuals living with HIV/AIDS can persist well beyond the immediate aftermath, posing substantial challenges to their overall well-being and quality of life.⁸²The traumatic experiences associated with natural disasters can leave enduring psychological impacts on HIV-positive individuals. Prolonged exposure to stress, loss of social support networks, displacement, and uncertainty about healthcare access contribute to the development of persistent mental health conditions among this vulnerable population.⁸²

Post-traumatic stress disorder (PTSD) is one of the long-term mental health effects commonly observed in individuals affected by both natural disasters and HIV/AIDS. Symptoms of PTSD, such as intrusive thoughts, hyperarousal, and avoidance behaviors, may persist long after the disaster has occurred, significantly impairing daily functioning and exacerbating the existing challenges of managing a chronic illness like HIV.⁸³Additionally, depression and anxiety disorders tend to linger as enduring mental health concerns among HIV-positive individuals affected by natural disasters. The ongoing stressors stemming from the disruption of routine, loss of stability, and difficulties in rebuilding life post-disaster contribute to a higher prevalence of depressive symptoms and anxiety disorders within this demographic.⁸³These long-term mental health effects often lead to a complex interplay of physical and psychological health issues. Chronic stress and mental health disorders can impact immune function, potentially affecting HIV disease progression and treatment outcomes. Moreover, untreated mental health conditions can hinder medication adherence, further complicating disease management and increasing the risk of adverse health outcomes.⁸²Addressing the long-term mental health effects necessitates sustained and tailored interventions that prioritize mental health support as an integral component of ongoing care for individuals living with HIV/AIDS post-disaster. Long-term mental health programs, counseling services, and access to psychiatric care should be integrated into HIV care settings to ensure continued support for those grappling with persistent psychological challenges.Psychoeducation, coping skills training, and trauma-focused interventions are essential in helping individuals build resilience, manage stress, and address lingering mental health issues. Moreover, fostering peer support networks and community-based initiatives that promote social connectedness and emotional support can aid in mitigating the long-term mental health effects, promoting recovery, and enhancing overall well-being among individuals living with HIV affected by natural disasters.

Addressing the mental health and psychosocial effects of natural disasters on individuals living with HIV/AIDS requires a multi-dimensional approach that integrates various strategies and interventions. Develop comprehensive disaster preparedness plans within healthcare systems that specifically address the needs of individuals living with HIV/AIDS. Integrate strategies to ensure continuity of care, medication access, and psychosocial support during and after disasters. Establish contingency plans for the distribution of essential medications, including antiretroviral therapy (ART), during disasters. Ensure stockpiling, alternative distribution methods, and collaborations with local pharmacies or healthcare facilities to provide uninterrupted access to medications.

Integrate mental health services into routine HIV care settings. Provide access to counseling, psychotherapy, and support groups tailored to address trauma, stress, depression, and anxiety among HIV-positive individuals affected by disasters. Foster community resilience by empowering and engaging local communities in disaster response efforts. Develop peer support networks, community-based organizations, and initiatives that provide emotional support, information dissemination, and assistance in rebuilding social support structures. Conduct education and training programs aimed at raising awareness about disaster preparedness, stress management, and coping strategies among individuals living with HIV/AIDS. Empower them with knowledge and skills to navigate emergencies and mitigate mental health challenges. Forge partnerships between healthcare providers, disaster response agencies, governmental organizations, NGOs, and community groups. Collaborate to create a coordinated response system that addresses both immediate and long-term needs of HIV-positive individuals affected by disasters.

Utilize telemedicine and technology to facilitate remote healthcare consultations, medication monitoring, and psychosocial support services, especially in situations where physical access to healthcare facilities is disrupted. Encourage research initiatives to understand the specific mental health and psychosocial needs of individuals living with HIV/AIDS after disasters. Collect data to inform evidence-based interventions and policies aimed at better supporting this population.

Advocate for policies that prioritize the mental health needs of individuals living with HIV/AIDS in disaster response and recovery efforts. Support policy changes that ensure equitable access to healthcare and mental health services in post-disaster scenarios.

The intersection of natural disasters and the lives of individuals living with HIV/AIDS presents complex challenges, significantly impacting their mental health and psychosocial well-being. The aftermath of disasters disrupts healthcare services, medication adherence, social support networks, and exacerbates stress, trauma, and long-term mental health conditions among this vulnerable population. Addressing the mental health and psychosocial effects of natural disasters on individuals living with HIV/AIDS requires concerted efforts at various levels. Integrating disaster preparedness plans within healthcare systems, ensuring uninterrupted access to medications, and strengthening mental health support services are crucial steps in mitigating the impact.

Community-based initiatives that rebuild social support networks, educate and empower individuals, and foster resilience within affected communities play a pivotal role. Collaboration between healthcare providers, disaster response agencies, policymakers, and community organizations are essential in creating a holistic response that meets the specific needs of this population. Sustained interventions focused on mental health, psychosocial support, and rebuilding resilience can contribute significantly to the recovery and well-being of individuals living with HIV/AIDS affected by natural disasters. By prioritizing these efforts, we can strive towards ensuring equitable access to healthcare, promoting mental well-being, and enhancing the overall quality of life for this vulnerable demographic in the wake of calamities. Ultimately, these actions are fundamental in creating a more supportive and resilient environment for individuals managing HIV/AIDS amidst the challenges posed by natural disasters.

All the authors were involved in conceptualization, methodology, visualization, validation, drafting and editing of the article

1. Saxena D, Gupta A, Gaur P, Gehlot T. Disaster management-A comprehensive Approach. Academic Guru Publishing House. 2023.

2. Obeagu EI, Okwuanaso CB, Edoho SH, Obeagu GU. Under-nutrition among HIV-exposed Uninfected Children: A Review of African Perspective. Madonna University journal of Medicine and Health Sciences. 2022;2(3):120-7.

5. Obeagu EI, Obeagu GU. An update on premalignant cervical lesions and cervical cancer screening services among HIV positive women. J Pub Health Nutri. 2023; 6 (2). 2023; 141:1-2. links/63e538ed64252375639dd0df/An-update-on-premalignant-cervical-lesions-and-cervical-cancer-screening-services-among-HIV-positive-women.pdf .

6. Ezeoru VC, Enweani IB, Ochiabuto O, Nwachukwu AC, Ogbonna US, Obeagu EI. Prevalence of Malaria with Anaemia and HIV status in women of reproductive age in Onitsha, Nigeria. Journal of Pharmaceutical Research International. 2021;33(4):10-9. https://doi.org/10.9734/jpri/2021/v33i431166

7. Omo-Emmanuel UK, Chinedum OK, Obeagu EI. Evaluation of laboratory logistics management information system in HIV/AIDS comprehensive health facilities in Bayelsa State, Nigeria. Int J Curr Res Med Sci. 2017;3(1): 21-38.DOI: https://doi.org/10.22192/ijcrms.2017.03.01.004

8. Obeagu EI, Obeagu GU, Musiimenta E, Bot YS, Hassan AO. Factors contributing to low utilization of HIV counseling and testing services. Int. J. Curr. Res. Med. Sci. 2023;9(2): 1-5.DOI: https://doi.org/10.22192/ijcrms.2023.09.02.001

9. Obeagu EI, Obeagu GU. An update on survival of people living with HIV in Nigeria. J Pub Health Nutri. 2022

10. Offie DC, Obeagu EI, Akueshi C, Njab JE, Ekanem EE, Dike PN, Oguh DN. Facilitators and barriers to retention in HIV care among HIV infected MSM attending Community Health Center Yaba, Lagos Nigeria. Journal of Pharmaceutical Research International. 2021;33(52B):10-9. https://doi.org/10.9734/jpri/2021/v33i52B33593

11. Obeagu EI, Ogbonna US, Nwachukwu AC, Ochiabuto O, Enweani IB, Ezeoru VC. Prevalence of Malaria with Anaemia and HIV status in women of reproductive age in Onitsha, Nigeria. Journal of Pharmaceutical Research International. 2021;33(4):10-19. https://doi.org/10.9734/jpri/2021/v33i431166

12. Tran DN, Ching J, Kafu C, Wachira J, Koros H, Venkataramani M, Said J, Pastakia SD, Galárraga O, Genberg BL. Interruptions to HIV care delivery during pandemics and natural disasters: a qualitative study of challenges and opportunities from frontline healthcare providers in Western Kenya. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2023:23259582231152041. https://doi.org/10.1177/23259582231152041 PMid:36718505 PMCid:PMC9893388

13. Odo M, Ochei KC, Obeagu EI, Barinaadaa A, Eteng UE, Ikpeme M, Bassey JO, Paul AO. TB Infection Control in TB/HIV Settings in Cross River State, Nigeria: Policy Vs Practice. Journal of Pharmaceutical Research International. 2020;32(22):101-9. https://doi.org/10.9734/jpri/2020/v32i2230777

16. Izuchukwu IF, Ozims SJ, Agu GC, Obeagu EI, Onu I, Amah H, Nwosu DC, Nwanjo HU, Edward A, Arunsi MO. Knowledge of preventive measures and management of HIV/AIDS victims among parents in Umuna Orlu community of Imo state Nigeria. Int. J. Adv. Res. Biol. Sci. 2016;3(10): 55-65. https://doi.org/10.22192/ijarbs.2016.03.10.009

18. Oloro OH, Oke TO, Obeagu EI. Evaluation of Coagulation Profile Patients with Pulmonary Tuberculosis and Human Immunodeficiency Virus in Owo, Ondo State, Nigeria. Madonna University journal of Medicine and Health Sciences. 2022;2(3):110-119.

20. Au A. Mental Health in East Asia: Cultural Beliefs, Social Networks, and Mental Health Experiences. Taylor & Francis; 2023. https://doi.org/10.4324/9781003308720

21. Igwe CM, Obeagu IE, Ogbuabor OA. Clinical characteristics of people living with HIV/AIDS on ART in 2014 at tertiary health institutions in Enugu, Nigeria. J Pub Health Nutri. 2022 https://doi.org/10.9734/ajrid/2022/v10i430294

24. Omo-Emmanuel UK, Ochei KC, Osuala EO, Obeagu EI, Onwuasoanya UF. Impact of prevention of mother to child transmission (PMTCT) of HIV on positivity rate in Kafanchan, Nigeria. Int. J. Curr. Res. Med. Sci. 2017;3(2): 28-34.DOI: https://10.22192/ijcrms.2017.03.02.005

25. Aizaz M, Abbas FA, Abbas A, Tabassum S, Obeagu EI. Alarming rise in HIV cases in Pakistan: Challenges and future recommendations at hand. Health Science Reports. 2023 Aug;6(8):e1450. https://doi.org/10.1002/hsr2.1450 PMid:37520460 PMCid:PMC10375546

26. Obeagu EI, Amekpor F, Scott GY. An update of human immunodeficiency virus infection: Bleeding disorders. J Pub Health Nutri. 2023

6 (1). 2023;139. links/645b4a6c2edb8e5f094d9bd9/An-update-of-human-immunodeficiency-virus-infection-Bleeding.pdf.

27. Obeagu EI, Scott GY, Amekpor F, Ofodile AC, Edoho SH, Ahamefula C. Prevention of New Cases of Human Immunodeficiency Virus: Pragmatic Approaches of Saving Life in Developing Countries. Madonna University journal of Medicine and Health Sciences. 2022;2(3):128-34. https://madonnauniversity.edu.ng/journals/index.php/medicine/article/view/86 .

28. Walter O, Anaebo QB, Obeagu EI, Okoroiwu IL. Evaluation of Activated Partial Thromboplastin Time and Prothrombin Time in HIV and TB Patients in Owerri Metropolis. Journal of Pharmaceutical Research International. 2022:29-34. https://doi.org/10.9734/jpri/2022/v34i3A35560

29. Obeagu EI, Ubosi NI, Uzoma G. Storms and Struggles: Managing HIV Amid Natural Disasters. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(11):14-25.

30. Odo M, Ochei KC, Obeagu EI, Barinaadaa A, Eteng EU, Ikpeme M, Bassey JO, Paul AO. Cascade variabilities in TB case finding among people living with HIV and the use of IPT: assessment in three levels of care in cross River State, Nigeria. Journal of Pharmaceutical Research International. 2020;32(24):9-18. https://doi.org/10.9734/jpri/2020/v32i2430789

31. Jakheng SP, Obeagu EI. Seroprevalence of human immunodeficiency virus based on demographic and risk factors among pregnant women attending clinics in Zaria Metropolis, Nigeria. J Pub Health Nutri. 2022 https://doi.org/10.9734/sajrm/2022/v13i230295

5 (8). 2022;137. links/6317a6b1acd814437f0ad268/Seroprevalence-of-human-immunodeficiency-virus-based-on-demographic-and-risk-factors-among-pregnant-women-attending-clinics-in-Zaria-Metropolis-Nigeria.pdf.

35. Dixit A, Dutta P. Thematic review of healthcare supply chain in disasters with challenges and future research directions. International Journal of Disaster Risk Reduction. 2023 :104161. https://doi.org/10.1016/j.ijdrr.2023.104161

36. Jakheng SP, Obeagu EI, Abdullahi IO, Jakheng EW, Chukwueze CM, Eze GC, Essien UC, Madekwe CC, Madekwe CC, Vidya S, Kumar S. Distribution Rate of Chlamydial Infection According to Demographic Factors among Pregnant Women Attending Clinics in Zaria Metropolis, Kaduna State, Nigeria. South Asian Journal of Research in Microbiology. 2022;13(2):26-31. https://doi.org/10.9734/sajrm/2022/v13i230295

37. Viola N, Kimono E, Nuruh N, Obeagu EI. Factors Hindering Elimination of Mother to Child Transmission of HIV Service Uptake among HIV Positive Women at Comboni Hospital Kyamuhunga Bushenyi District. Asian Journal of Dental and Health Sciences. 2023;3(2):7-14. Http://ajdhs.com/index.php/journal/article/view/39 . https://doi.org/10.22270/ajdhs.v3i2.39

39. Ezugwu UM, Onyenekwe CC, Ukibe NR, Ahaneku JE, Onah CE, Obeagu EI, Emeje PI, Awalu JC, Igbokwe GE. Use of ATP, GTP, ADP and AMP as an Index of Energy Utilization and Storage in HIV Infected Individuals at NAUTH, Nigeria: A Longitudinal, Prospective, Case-Controlled Study. Journal of Pharmaceutical Research International. 2021;33(47A):78-84. https://doi.org/10.9734/jpri/2021/v33i47A32992

40. Emannuel G, Martin O, Peter OS, Obeagu EI, Daniel K. Factors Influencing Early Neonatal Adverse Outcomes among Women with HIV with Post Dated Pregnancies Delivering at Kampala International University Teaching Hospital, Uganda. Asian Journal of Pregnancy and Childbirth. 2023 Jul 29;6(1):203-211. http://research.sdpublishers.net/id/eprint/2819/ .

41. Igwe MC, Obeagu EI, Ogbuabor AO, Eze GC, Ikpenwa JN, Eze-Steven PE. Socio-Demographic Variables of People Living with HIV/AIDS Initiated on ART in 2014 at Tertiary Health Institution in Enugu State. Asian Journal of Research in Infectious Diseases. 2022;10(4):1-7. https://doi.org/10.9734/ajrid/2022/v10i430294

42. Vincent CC, Obeagu EI, Agu IS, Ukeagu NC, Onyekachi-Chigbu AC. Adherence to Antiretroviral Therapy among HIV/AIDS in Federal Medical Centre, Owerri. Journal of Pharmaceutical Research International. 2021;33(57A):360-368. https://doi.org/10.9734/jpri/2021/v33i57A34007

43. Igwe MC, Obeagu EI, Ogbuabor AO. ANALYSIS OF THE FACTORS AND PREDICTORS OF ADHERENCE TO HEALTHCARE OF PEOPLE LIVING WITH HIV/AIDS IN TERTIARY HEALTH INSTITUTIONS IN ENUGU STATE. Madonna University journal of Medicine and Health Sciences. 2022;2(3):42-57. https://madonnauniversity.edu.ng/journals/index.php/medicine/article/view/75 .

45. Echendu GE, Vincent CC, Ibebuike J, Asodike M, Naze N, Chinedu EP, Ohale B, Obeagu EI. WEIGHTS OF INFANTS BORN TO HIV INFECTED MOTHERS: A PROSPECTIVE COHORT STUDY IN FEDERAL MEDICAL CENTRE, OWERRI, IMO STATE. European Journal of Pharmaceutical and Medical Research, 2023; 10(8): 564-568

47. Obeagu EI, Obeagu GU. Effect of CD4 Counts on Coagulation Parameters among HIV Positive Patients in Federal Medical Centre, Owerri, Nigeria. Int. J. Curr. Res. Biosci. Plant Biol. 2015;2(4):45-49.

52. Obeagu EI, Okeke EI, Anonde Andrew C. Evaluation of haemoglobin and iron profile study among persons living with HIV in Umuahia, Abia state, Nigeria. Int. J. Curr. Res. Biol. Med. 2016;1(2):1-5.

53. Alum EU, Ugwu OP, Obeagu EI, Okon MB. Curtailing HIV/AIDS Spread: Impact of Religious Leaders. Newport International Journal of Research in Medical Sciences (NIJRMS). 2023;3(2):28-31.

54. Obeagu EI, Obeagu GU, Paul-Chima UO. Stigma Associated With HIV. AIDS: A Review. Newport International Journal of Public Health and Pharmacy (NIJPP). 2023;3(2):64-67.

55. Alum EU, Obeagu EI, Ugwu OP, Aja PM, Okon MB. HIV Infection and Cardiovascular diseases: The obnoxious Duos. Newport International Journal of Research in Medical Sciences (NIJRMS). 2023;3(2):95-99.

57. Obeagu EI, Obarezi TN, Omeh YN, Okoro NK, Eze OB. Assessment of some haematological and biochemical parametrs in HIV patients before receiving treatment in Aba, Abia State, Nigeria. Res J Pharma Biol Chem Sci. 2014; 5:825-830.

58. Obeagu EI, Obarezi TN, Ogbuabor BN, Anaebo QB, Eze GC. Pattern of total white blood cell and differential count values in HIV positive patients receiving treatment in Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria. International Journal of Life Science, Biotechnology and Pharama Research. 2014; 391:186-9.

59. Obeagu EI. A Review of Challenges and Coping Strategies Faced by HIV/AIDS Discordant Couples. Madonna University journal of Medicine and Health Sciences. 2023; 3 (1): 7-12.

60. Oloro OH, Obeagu EI. A Systematic Review on Some Coagulation Profile in HIV Infection. International Journal of Innovative and Applied Research. 2022;10(5):1-1.

61. Nwosu DC, Obeagu EI, Nkwuocha BC, Nwanna CA, Nwanjo HU, Amadike JN, Ezemma MC, Okpomeshine EA, Ozims SJ, Agu GC. Alterations in superoxide dismutiase, vitamins C and E in HIV infected children in Umuahia, Abia state. International Journal of Advanced Research in Biological Sciences. 2015;2(11):268-271.

62. Obeagu EI, Malot S, Obeagu GU, Ugwu OP. HIV resistance in patients with Sickle Cell Anaemia. Newport International Journal of Scientific and Experimental Sciences (NIJSES). 2023;3(2):56-59.

63. Ifeanyi OE, Uzoma OG, Stella EI, Chinedum OK, Abum SC. Vitamin D and insulin resistance in HIV sero positive individuals in Umudike. Int. J. Curr. Res. Med. Sci. 2018;4(2):104-108.

64. Ifeanyi OE, Leticia OI, Nwosu D, Chinedum OK. A Review on blood borne viral infections: universal precautions. Int. J. Adv. Res. Biol. Sci. 2018;5(6):60-66.

65. Nwovu AI, Ifeanyi OE, Uzoma OG, Nwebonyi NS. Occurrence of Some Blood Borne Viral Infection and Adherence to Universal Precautions among Laboratory Staff in Federal Teaching Hospital Abakaliki Ebonyi State. Arch Blood Transfus Disord. 2018;1(2).

66. Chinedu K, Takim AE, Obeagu EI, Chinazor UD, Eloghosa O, Ojong OE, Odunze U. HIV and TB co-infection among patients who used Directly Observed Treatment Short-course centres in Yenagoa, Nigeria. IOSR J Pharm Biol Sci. 2017;12(4):70-75.

67. Offie DC, Obeagu EI, Akueshi C, Njab JE, Ekanem EE, Dike PN, Oguh DN. Facilitators and barriers to retention in HIV care among HIV infected MSM attending Community Health Center Yaba, Lagos Nigeria. Journal of Pharmaceutical Research International. 2021;33(52B):10-19. https://doi.org/10.9734/jpri/2021/v33i52B33593

68. Obeagu EI, Obeagu GU, Ede MO, Odo EO, Buhari HA. Translation of HIV/AIDS knowledge into behavior change among secondary school adolescents in Uganda: A review. Medicine (Baltimore). 2023;102(49): e36599. doi: https://doi.org/10.1097/MD.0000000000036599 . PMID: 38065920; PMCID: PMC10713174.

69. Mbithi G, Abubakar A. Assessing and Supporting Mental Health Outcomes Among Adolescents in Urban Informal Settlements in Kenya and Uganda. European Psychiatry. 2023;66(S1): S988-989. https://doi.org/10.1192/j.eurpsy.2023.2101 PMCid:PMC10478869

70. Anyiam AF, Arinze-Anyiam OC, Irondi EA, Obeagu EI. Distribution of ABO and rhesus blood grouping with HIV infection among blood donors in Ekiti State Nigeria. Medicine (Baltimore). 2023;102(47): e36342. https://doi.org/10.1097/MD.0000000000036342 PMid:38013335 PMCid:PMC10681551

71. Echefu SN, Udosen JE, Akwiwu EC, Akpotuzor JO, Obeagu EI. Effect of Dolutegravir regimen against other regimens on some hematological parameters, CD4 count and viral load of people living with HIV infection in South Eastern Nigeria. Medicine (Baltimore). 2023;102(47): e35910. https://doi.org/10.1097/MD.0000000000035910 PMid:38013350 PMCid:PMC10681510

72. Opeyemi AA, Obeagu EI. Regulations of malaria in children with human immunodeficiency virus infection: A review. Medicine (Baltimore). 2023;102(46): e36166. PMID: 37986340; PMCID: PMC10659731. https://doi.org/10.1097/MD.0000000000036166 PMid:37986340 PMCid:PMC10659731

73. Alum EU, Obeagu EI, Ugwu OPC, Samson AO, Adepoju AO, Amusa MO. Inclusion of nutritional counseling and mental health services in HIV/AIDS management: A paradigm shift. Medicine (Baltimore). 2023;102(41): e35673. https://doi.org/10.1097/MD.0000000000035673 PMid:37832059 PMCid:PMC10578718

74. Aizaz M, Abbas FA, Abbas A, Tabassum S, Obeagu EI. Alarming rise in HIV cases in Pakistan: Challenges and future recommendations at hand. Health Sci Rep. 2023;6(8): e1450. https://doi.org/10.1002/hsr2.1450 PMid:37520460 PMCid:PMC10375546

75. Moran L, Fuller SM, Joshi S, Outram S, Koester KA, Steward WT, Arnold EA. "Am I going to have to run to get out of this place?" A qualitative study exploring HIV clinical and service provider experiences from California regions heavily impacted by climate disaster. PLOS Climate. 2023;2(10): e0000269. https://doi.org/10.1371/journal.pclm.0000269

76. Obeagu EI, Obeagu GU, Obiezu J, Ezeonwumelu C, Ogunnaya FU, Ngwoke AO, Emeka-Obi OR, Ugwu OP. Hematologic Support in HIV Patients: Blood Transfusion Strategies and Immunological Considerations. APPLIED SCIENCES (NIJBAS). 2023;3(3). https://doi.org/10.59298/NIJBAS/2023/1.2.11000

77. Obeagu EI, Obeagu GU. Human Immunodeficiency Virus and tuberculosis infection: A review of prevalence of associated factors. Int. J. Adv. Multidiscip. Res. 2023;10(10):56-62.

78. Obeagu EI, Malot S, Obeagu GU, Ugwu OP. HIV resistance in patients with Sickle Cell Anaemia. Newport International Journal of Scientific and Experimental Sciences (NIJSES). 2023;3(2):56-59.

79. Alum EU, Ugwu OP, Obeagu EI, Aja PM, Okon MB, Uti DE. Reducing HIV Infection Rate in Women: A Catalyst to reducing HIV Infection pervasiveness in Africa. International Journal of Innovative and Applied Research. 2023;11(10):01-6. https://doi.org/10.34172/ajmb.2023.2421

80. Hess DB, Bitterman A. Community support organizations in gay neighborhoods: Assessing engagement during the Covid-19 pandemic. Urban Planning. 2023;8(2):235-48. https://doi.org/10.17645/up.v8i2.6404

81. Bouey JZ, Han J, Liu Y, Vuckovic M, Zhu K, Zhou K, Su Y. A case study of HIV/AIDS services from community-based organizations during COVID-19 lockdown in China. BMC Health Services Research. 2023;23(1):1-11. https://doi.org/10.1186/s12913-023-09271-4 PMid:36973805 PMCid:PMC10042409

82. Bouchard JP, Pretorius TB, Kramers-Olen AL, Padmanabhanunni A, Stiegler N. Global warming and psychotraumatology of natural disasters: The case of the deadly rains and floods of April 2022 in South Africa. InAnnales Médico-psychologiques, revue psychiatrique 2023; 181(3):234-239. Elsevier Masson. https://doi.org/10.1016/j.amp.2022.07.004

83. Parcesepe AM, Filiatreau LM, Ebasone PV, Dzudie A, Pence BW, Wainberg M, Yotebieng M, Anastos K, Pefura-Yone E, Nsame D, Ajeh R. Prevalence of potentially traumatic events and symptoms of depression, anxiety, hazardous alcohol use, and post-traumatic stress disorder among people with HIV initiating HIV care in Cameroon. BMC psychiatry. 2023;23(1):1-11. https://doi.org/10.1186/s12888-023-04630-1 PMid:36894918 PMCid:PMC9996899