MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of the International AIDS Society' source. Wed, 08 Feb 2012 18:15:46 +0100 http://www.medworm.com/index.php?rid=5649464&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F15%2F1%2F3 This study evaluated performance of the point-of-care Pima CD4 device using capillary blood sampling in representative primary health care clinics doing HIV testing. Methods: Prior to testing, prescribed capillary-sampling and instrument training was undertaken by suppliers across all sites. Matching venous EDTA samples were drawn throughout for comparison to laboratory predicate methodology (PLG/CD4). In Phase I, Pima cartridges were pipette-filled with EDTA venous blood in the laboratory (N=100). In Phase II (N=77), Pima CD4 with capillary sampling was performed by a single operator in a hospital-based antenatal clinic. During subsequent field testing, Pima CD4 with capillary sampling was performed in primary health care clinics on HIV-positive patients by multiple attending nursing pers... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5649464 Mon, 30 Jan 2012 05:00:00 +0100 5649464 http://www.medworm.com/index.php?rid=5649463&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F15%2F1%2F4 Conclusions: HIV-free survival among HIV-exposed children aged nine to 24 months is estimated at 91.9% in Rwanda. The national PMTCT programme could achieve greater impact on child survival by ensuring access to HAART for all HIV-positive pregnant women in need, improving the quality of the programme in rural areas, and strengthening linkages with community-based support systems, including associations of people living with HIV. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5649463 Mon, 30 Jan 2012 05:00:00 +0100 5649463 http://www.medworm.com/index.php?rid=5649462&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F15%2F1%2F5 Conclusions: In data from 34 cohorts of HIV-infected patients from sub-Saharan Africa, Central and South America, and Asia, the risk of anaemia within 12 months of initiating cART was moderate. Routine haemoglobin monitoring was recommended in patients at risk of developing anaemia following cART initiation. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5649462 Mon, 30 Jan 2012 05:00:00 +0100 5649462 http://www.medworm.com/index.php?rid=5630036&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F15%2F1%2F1 This study examines the proportion of patients in the TREAT Asia HIV Observational Database (TAHOD) receiving PCP prophylaxis, and its effect on PCP and mortality. Methods: TAHOD patients with prospective follow up had data extracted for prophylaxis using co-trimoxazole, dapsone or pentamidine. The proportion of patients on prophylaxis was calculated for each calendar year since 2003 among patients with CD4 counts of less than 200 cells/mm3. The effect of prophylaxis on PCP and survival were assessed using random-effect Poisson regression models. Results: There were a total of 4050 patients on prospective follow up, and 90% of them were receiving combination antiretroviral therapy. Of those with CD4 counts of less than 200 cells/mm3, 58% to 72% in any given year received PCP prophylaxis, p... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5630036 Thu, 26 Jan 2012 05:00:00 +0100 5630036 http://www.medworm.com/index.php?rid=5630035&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F15%2F1%2F2 Conclusions: R5 HIV-1 was predominant in TN individuals with HIV-1 subtypes C, A, and D and TE individuals with subtypes C and A. Higher CD4+ count correlated with R5 prevalence, while treatment experience was associated with increased non-R5 infection in all subtypes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5630035 Thu, 26 Jan 2012 05:00:00 +0100 5630035 http://www.medworm.com/index.php?rid=5545263&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F61 Background: We set out to determine the relative roles of stigma versus health systems in non-uptake of prevention of mother to child transmission of HIV-1 interventions: we conducted a cross-sectional assessment of all consenting mothers accompanying infants for six-week immunizations. Methods: Between September 2008 and March 2009, mothers at six maternal and child health clinics in Kenya's Nairobi and Nyanza provinces were interviewed regarding PMTCT intervention uptake during recent pregnancy. Stigma was ascertained using a previously published standardized questionnaire and infant HIV-1 status determined by HIV-1 polymerase chain reaction. Results: Among 2663 mothers, 2453 (92.1%) reported antenatal HIV-1 testing. Untested mothers were more likely to have less than secondary education... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5545263 Wed, 28 Dec 2011 05:00:00 +0100 5545263 http://www.medworm.com/index.php?rid=5538864&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F60 Conclusions: While care is available and relatively accessible, Swaziland health workers still face unique usage barriers that relate to a self-stigmatizing process of boundary maintenance - described here as a form of "othering" from the HIV-vulnerable general population - and a lack of trust in privacy and confidentiality. Interventions that target health workers should address these issues. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5538864 Thu, 22 Dec 2011 05:00:00 +0100 5538864 http://www.medworm.com/index.php?rid=5526389&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F58 Conclusions: Since no socio-demographic or sexual behavior variable was associated with inconsistent condom use, we recommend intensive and regular condom counselling for every heterosexual HIV-positive outpatient who attends the clinic. Further studies should be done to determine condom use negotiation between partners; and to determine social, interpersonal and psychological factors that might affect the decision to use a condom or not. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5526389 Mon, 19 Dec 2011 05:00:00 +0100 5526389 http://www.medworm.com/index.php?rid=5526388&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F59 Conclusions: This paper shows through a concrete example how NGOs implementing OVC programmes (and other public health programmes) can organize themselves for data collection and documentation prospectively during the implementation of their OVC programmes so that costing analyses become routine practice to inform programme implementation rather than a painful and flawed retrospective activity. Such information is required if the costs and outcomes achieved by OVC programmes will ever be clearly documented and compared across OVC programmes and other types of programmes (prevention, treatment, etc.). (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5526388 Mon, 19 Dec 2011 05:00:00 +0100 5526388 http://www.medworm.com/index.php?rid=5516109&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F57 Conclusions: Environmentally triggered immune activation may contribute to the increased expression of the activation markers CD95 and CD38 on peripheral blood T cells from healthy adults living in rural versus urban settings in Burkina Faso. T cell activation is further increased in HIV-1-infected individuals due to T cell loss and high plasma viral load levels. The observed variations in T cell activation levels or the proportion of naive T cells in our study patients, however, are not explained by differences in CD4+ T cell counts or HIV-1 plasma viral load levels alone. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5516109 Sat, 17 Dec 2011 05:00:00 +0100 5516109 http://www.medworm.com/index.php?rid=5423306&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F56 This article reviews the evidence of what works to meet the sexual and reproductive health needs of women living with HIV in developing countries and includes 35 studies and evaluations of eight general interventions using various methods of implementation science from 15 countries. Data are primarily from 2000-2009. Searches to identify effective evaluations used SCOPUS, Popline, Medline, websites and consultations with experts. Evidence was ranked using the Gray Scale.A range of successful and promising interventions to improve the sexual and reproductive health and rights of women living with HIV include: providing contraceptives and family planning counselling as part of HIV services; ensuring early postpartum visits providing family planning and HIV information and services; providing... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5423306 Fri, 18 Nov 2011 05:00:00 +0100 5423306 http://www.medworm.com/index.php?rid=5409779&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F55 Conclusions: In children with pre-existing PI resistance, although initially effective, the long-term durability of a lopinavir/ritonavir-based treatment regimen can be compromised by the accumulation of resistance mutations. Furthermore, a second-line NNRTI regimen is often not durable in these patients. As genotypic resistance testing and third-line treatment regimens are costly and limited in availability, we propose eligibility criteria to identify patients with high risk for resistance and guidance on drug selection for children who would benefit from third-line therapy. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5409779 Tue, 15 Nov 2011 05:00:00 +0100 5409779 http://www.medworm.com/index.php?rid=5409780&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F54 In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. Of the estimated 21.6 million unsafe abortions occurring worldwide in 2008 (around one in 10 pregnancies), approximately 21.2 million occurred in developing countries, often due to restrictive abortion laws and leading to an estimated 47,000 maternal deaths and untold numbers of women who will suffer long-term health consequences. Despite this context, little research has focused on decisions about and experiences of women living with HIV with regard to terminating a pregnancy, although this should form part of comprehen... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5409780 Mon, 14 Nov 2011 05:00:00 +0100 5409780 http://www.medworm.com/index.php?rid=5401444&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F53 Background: Micronutrient deficiencies occur commonly in people infected with the human immunodeficiency virus (HIV). Since aflatoxin exposure also results in reduced levels of several micronutrients, HIV and aflatoxin may work synergistically to increase micronutrient deficiencies. However, there has been no report on the association between aflatoxin exposure and micronutrient deficiencies in HIV infected people. We measured aflatoxin B1 albumin adduct levels (AF-ALB) and vitamins A and E concentrations in the plasma of HIV positive and negative Ghanaians and examined the association of vitamins A and E with HIV status, aflatoxin levels and hepatitis B virus (HBV) infection. Methods: A cross-sectional study was conducted in which participants completed a demographic survey and gave a 20 ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5401444 Fri, 11 Nov 2011 05:00:00 +0100 5401444 http://www.medworm.com/index.php?rid=5389062&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F52 Background: Because men in Africa are less likely to access HIV/AIDS care than women, we aimed to determine if men have differing outcomes from women across a nationally representative sample of adult patients receiving combination antiretroviral therapy in Uganda. Methods: We estimated survival distributions for adult male and female patients using Kaplan-Meier, and constructed multivariable regressions to model associations of baseline variables with mortality. We assessed person-years of life lost up to age 55 by sex. To minimize the impact of patient attrition, we assumed a weighted 30% mortality rate among those lost to follow up. Results: We included data from 22,315 adults receiving antiretroviral therapy. At baseline, men tended to be older, had lower CD4 baseline values, more adva... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5389062 Thu, 03 Nov 2011 04:00:00 +0100 5389062 http://www.medworm.com/index.php?rid=5495612&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F51 Conclusions: There has been a sustained scale up of the Global Fund's HIV support. Funding has targeted the countries and populations with higher HIV burden and lower income. Prevention in most-at-risk populations is not adequately prioritized in most of the recipient countries. The Global Fund Board has recently modified eligibility and prioritization criteria to better target most-at-risk populations in Round 10 and beyond. More guidance is being provided for Round 11 to strategically focus demand for Global Fund financing in the present resource-constrained environment. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5495612 Wed, 26 Oct 2011 04:00:00 +0100 5495612 http://www.medworm.com/index.php?rid=5349202&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F51 Conclusions: There has been a sustained scale up of the Global Fund's support to HIV programmes. Funding has targeted the countries and populations with higher HIV burden and lower income. Prevention in most-at-risk populations is not adequately prioritized in most of the recipient countries. In response, the Global Fund Board has recently modified eligibility and prioritization criteria to better target most-at-risk populations in Round 10 and beyond. More guidance is being provided for Round 11 to strategically focus demand for the Global Fund financing in the present resource-constrained environment. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5349202 Wed, 26 Oct 2011 04:00:00 +0100 5349202 http://www.medworm.com/index.php?rid=5337434&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F50 Conclusions: We found a progressive decline in medication adherence across the perinatal period. There is a big gap between mediation initiated during pregnancy and actually ingested by the mother-infant pairs at birth. Follow up for HIV-exposed infants seem not to be organized and is inconsistent. In order to maximize effectiveness of the PMTCT programme, the rate of institutional delivery should be increased, the quality of obstetric services should be improved and missed opportunities to exposed infant follow up should be minimized. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5337434 Fri, 21 Oct 2011 04:00:00 +0100 5337434 http://www.medworm.com/index.php?rid=5337435&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F49 Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5337435 Thu, 20 Oct 2011 04:00:00 +0100 5337435 http://www.medworm.com/index.php?rid=5305333&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F48 Conclusions: Despite screening of all HIV-positive adult inpatients with the serum CRAG at the time of admission and prompt treatment with high-dose intravenous fluconazole in those with confirmed cryptococcal meningitis, the in-hospital mortality rate remained unacceptably high. Improved strategies for earlier diagnosis and treatment of HIV, implementation of fluconazole pre-emptive treatment for high-risk patients and acquisition of better resources for treatment of cryptococcal meningitis are needed. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5305333 Tue, 11 Oct 2011 04:00:00 +0100 5305333 http://www.medworm.com/index.php?rid=5286853&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F47 Conclusions: The opinions of this group of secondary and tertiary graduate Malawians do not always coincide with the current literature and policies. They give deeper insight into what is perceived and what may be taking place, and hint at what the future holds for their people. The widespread and divergent perspectives must be seriously considered because these experiences describe the potential positive and negative consequences that occur on the ground throughout Malawi as a result of HIV/AIDS policies. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5286853 Tue, 04 Oct 2011 04:00:00 +0100 5286853 http://www.medworm.com/index.php?rid=5262012&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F46 Background: East Africa has experienced a rapid expansion in access to antiretroviral therapy (ART) for HIV-infected patients. Regionally representative socio-demographic, laboratory and clinical characteristics of patients accessing ART over time and across sites have not been well described. Methods: We conducted a cross-sectional analysis of characteristics of HIV-infected adults initiating ART between 2002 and 2009 in Kenya, Uganda and Tanzania and in the International Epidemiologic Databases to Evaluate AIDS Consortium. Characteristics associated with advanced disease (defined as either a CD4 cell count level of less than 50 cells/mm3 or a WHO Stage 4 condition) at the time of ART initiation and use of stavudine (D4T) or nevirapine (NVP) were identified using a log-link Poisson model ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5262012 Wed, 28 Sep 2011 04:00:00 +0100 5262012 http://www.medworm.com/index.php?rid=5239212&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F45 The Brazilian network for genotyping is composed of 21 laboratories that perform and analyze genotyping tests for all HIV-infected patients within the public system, performing approximately 25,000 tests per year. We assessed the interlaboratory and intralaboratory reproducibility of genotyping systems by creating and implementing a local external quality control evaluation. Plasma samples from HIV-1-infected individuals (with low and intermediate viral loads) or RNA viral constructs with specific mutations were used. This evaluation included analyses of sensitivity and specificity of the tests based on qualitative and quantitative criteria, which scored laboratory performance on a 100-point system. Five evaluations were performed from 2003 to 2008, with 64% of laboratories scoring over 80... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5239212 Wed, 21 Sep 2011 04:00:00 +0100 5239212 http://www.medworm.com/index.php?rid=5227421&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F43 Conclusions: The effect of the intervention and the control on couple antenatal attendance was similar. In addition, the trial demonstrated that a simple intervention, such as a letter to the spouse, could increase couple antenatal clinic attendance by 10%. Significantly, the majority of male partners who attended the antenatal clinic accepted HIV testing. Therefore, to further evaluate this simple and cost-effective intervention method, adequately powered studies are required to assess its effectiveness in increasing partner participation in antenatal clinics and the programme for prevention of mother to child transmission of HIV.ClinicalTrials.gov Identifier: NCT01144234. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5227421 Tue, 13 Sep 2011 04:00:00 +0100 5227421 http://www.medworm.com/index.php?rid=5227420&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F44 Models of sexual behavior in sub-Saharan Africa show that concurrent sexual partnerships may not be the main cause of high levels of HIV infection in the region, casting doubt over the commonly held belief that it is. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5227420 Tue, 13 Sep 2011 04:00:00 +0100 5227420 http://www.medworm.com/index.php?rid=5133053&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F41 ${item.shortDescription} (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5133053 Sun, 14 Aug 2011 23:00:00 +0100 5133053 http://www.medworm.com/index.php?rid=5133052&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F42 ${item.shortDescription} (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5133052 Sun, 14 Aug 2011 23:00:00 +0100 5133052 http://www.medworm.com/index.php?rid=5110699&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F40 ${item.shortDescription} (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5110699 Tue, 09 Aug 2011 23:00:00 +0100 5110699 http://www.medworm.com/index.php?rid=5110700&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F39 ${item.shortDescription} (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5110700 Mon, 08 Aug 2011 23:00:00 +0100 5110700 http://www.medworm.com/index.php?rid=5081022&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F38 ${item.shortDescription} (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5081022 Fri, 29 Jul 2011 23:00:00 +0100 5081022 http://www.medworm.com/index.php?rid=5081023&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F37 ${item.shortDescription} (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5081023 Thu, 28 Jul 2011 23:00:00 +0100 5081023 http://www.medworm.com/index.php?rid=5000126&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F36 Background: Evidence is increasing of high HIV risks among southern African men who have sex with men (MSM). This represents the first study of HIV risks and human rights contexts among MSM in Lesotho. Methods: Two hundred and fifty-two men who reported ever having anal sex with another man were accrued with snowball sampling and were administered a structured quantitative instrument in October and November 2009. Results: Of the participants, 96.4% (240/249) were ethnic Basotho with a mean age of 26.3 years (range 18-56), 49.6% (124/250) were currently employed, and 95.2% (238/250) had at least a secondary-level education. Self-reported HIV prevalence was 11.6% (22/190); 54.5% (128/235) reported being tested for HIV in the last year. HIV knowledge was low; only 3.7% (8/212) of MSM knew tha... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=5000126 Sun, 03 Jul 2011 23:00:00 +0100 5000126 http://www.medworm.com/index.php?rid=4987079&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F34 Conclusions: HIV-infected, HAART-naive Ugandan children had a lower prevalence of H. pylori colonization compared with apparently healthy Ugandan children (44.3%). Children with a low CD4 cell percentage and an advanced clinical stage of HIV had an even lower risk of H. pylori colonization. Treatment with antibiotics due to co-morbidity with infectious diseases is a possible explanation for the relatively low prevalence. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4987079 Wed, 29 Jun 2011 23:00:00 +0100 4987079 http://www.medworm.com/index.php?rid=4987078&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F35 Conclusions: The uptake of family planning among HIV-infected individuals is fairly high. However, there are a large number of unplanned pregnancies. These findings highlight the need for strengthening of family planning services for HIV-infected people. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4987078 Wed, 29 Jun 2011 23:00:00 +0100 4987078 http://www.medworm.com/index.php?rid=4947110&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F33 Multiple sexual partnerships must necessarily lie at the root of a sexually transmitted epidemic. However, that overlapping or concurrent partnerships have played a pivotal role in the generalized epidemics of sub-Saharan Africa has been challenged. Much of the original proposition that concurrent partnerships play such a role focused on modelling, self-reported sexual behaviour data and ethnographic data. While each of these has definite merit, each also has had methodological limitations. Actually, more recent cross-national sexual behaviour data and improved modelling have strengthened these lines of evidence. However, heretofore the epidemiologic evidence has not been systematically brought to bear. Though assessing the epidemiologic evidence regarding concurrency has its challenges, a... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4947110 Sun, 19 Jun 2011 23:00:00 +0100 4947110 http://www.medworm.com/index.php?rid=4939016&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F32 Background: In 2002, Cameroon initiated scale up of antiretroviral therapy (ART); on 1 October 2004, a substantial reduction in ART cost occurred. We assessed the impact of this event and other factors on enrolment and retention in care among HIV-infected patients initiating ART from February 2002 to December 2005 at the single ART clinic serving the Southwest Region in Limbe, Cameroon. Methods: We retrospectively analyzed clinical and pharmacy payment records of HIV-infected patients initiating ART according to national guidelines. We compared two cohorts of patients, enrolled before and after 1 October 2004, to determine if price reduction was associated with enhanced enrolment. We assessed factors associated with retention and survival by Cox proportional hazards models. Retention in ca... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4939016 Wed, 15 Jun 2011 23:00:00 +0100 4939016 http://www.medworm.com/index.php?rid=4923974&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F31 Background: The World Health Organization (WHO) has recently recommended that antiretrovirals be initiated in all individuals with CD4 counts of less than 350 cells/mm3. For countries with resources too limited to expand care to all such patients, it would be of value to able to identify and target populations at highest risk of HIV progression. Renal disease has been identified as a risk factor for disease progression or death in some populations. Methods: Times to meeting combination antiretroviral therapy (cART) initiation criteria (developing either a CD4 count (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4923974 Fri, 10 Jun 2011 23:00:00 +0100 4923974 http://www.medworm.com/index.php?rid=4914914&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F30 Conclusions: In Togo, efforts to provide access to ARV therapy for infected persons have increased since 2003, and scaling up of ART started in 2007. The high number of resistant strains observed in Togo shows clearly that the emergence of HIV drug resistance is of increasing concern in countries where ART is now widely used, and can compromise the long-term success of first- and second-line ART. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4914914 Thu, 09 Jun 2011 23:00:00 +0100 4914914 http://www.medworm.com/index.php?rid=4914915&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F29 Conclusions: Hegemonic notions of masculinity can interfere with women's adherence to ART. It is important that those concerned with promoting effective treatment services recognise the gender and household dynamics that may prevent some women from successfully adhering to ART, and explore ways to work with both women and men to identify couples-based strategies to increase adherence to ART (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4914915 Wed, 08 Jun 2011 23:00:00 +0100 4914915 http://www.medworm.com/index.php?rid=4865242&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F28 "No virus, no transmission." Studies have repeatedly shown that viral load (the quantity of virus present in blood and sexual secretions) is the strongest predictor of HIV transmission during unprotected sex or transmission from infected mother to child.Effective treatment lowers viral load to undetectable levels. If one could identify and treat all HIV-infected people immediately after infection, the HIV/AIDS epidemic would eventually disappear.Such a radical solution is currently unrealistic. In reality, not all people get tested, especially when they fear stigma and discrimination. Thus, not all HIV-infected individuals are known. Of those HIV-positive individuals for whom the diagnosis is known, not all of them have access to therapy, agree to be treated, or are taking therapy effectiv... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4865242 Tue, 24 May 2011 23:00:00 +0100 4865242 http://www.medworm.com/index.php?rid=4855074&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F27 Conclusions: In Manicaland, Zimbabwe, the 2005 UNGASS target to reduce HIV prevalence by 25% was achieved. However, most prevention gains occurred before 2003. ANC surveillance trends overall were an adequate indicator of trends in the population, although lags were observed. Behaviour data and socio-demographic characteristics of participants are needed to interpret ANC trends. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4855074 Mon, 23 May 2011 23:00:00 +0100 4855074 http://www.medworm.com/index.php?rid=4843597&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F26 The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release.We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons.A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4843597 Wed, 18 May 2011 23:00:00 +0100 4843597 http://www.medworm.com/index.php?rid=4832807&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F25 Conclusions: Studies on HIV risk in orphaned populations, which mostly include samples from sub-Saharan Africa, show nearly two-fold greater odds of HIV infection among orphaned youth and higher levels of sexual risk behaviour than among their non-orphaned peers. Interventions to reduce risk for HIV transmission in orphaned youth are needed to address the sequelae of parental illness and death that might contribute to sexual risk and HIV infection. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4832807 Tue, 17 May 2011 23:00:00 +0100 4832807 http://www.medworm.com/index.php?rid=4832808&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F24 Conclusions: Incorporating resistance testing into treatment guidelines in South Africa is potentially cost-neutral and can identify other reasons for failure, conserve treatment options, and generate information about emerging resistance patterns. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4832808 Sat, 14 May 2011 23:00:00 +0100 4832808 http://www.medworm.com/index.php?rid=4814772&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F23 Conclusions: Viral load testing performed without rigorous quality control carries the risk of erroneous and potentially damaging results. Viral load testing should be utilized only if robust quality assurance has been implemented. Our experience in this and other settings led to the development of a guide for assessing the suitability of a laboratory for viral load testing that can be used to help achieve reliable results. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4814772 Wed, 11 May 2011 23:00:00 +0100 4814772 http://www.medworm.com/index.php?rid=4798251&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F22 For persons living with HIV, hepatitis C is a major public health problem that must be controlled and could be eliminated. The challenge arises because the hepatitis C virus (HCV) is prevalent among HIV-infected persons in most parts of the world, because HIV worsens all HCV outcomes, and because HCV may add additional individual economic and psychosocial complications to HIV disease. Despite the major benefits of antiretroviral therapy on HIV outcomes, antiretroviral therapy is not sufficient to halt the complications of HCV. Nonetheless, HCV can be controlled at all stages, including prevention of infection and cure. Thus, HCV is an eradicable disease. There are significant inequalities worldwide in HCV control that could markedly constrain the impact of these measures. (Source: Journal ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4798251 Sat, 07 May 2011 23:00:00 +0100 4798251 http://www.medworm.com/index.php?rid=4749413&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F21 Conclusions: Deep-seated ideas about gender roles and hierarchy are major obstacles to male participation in the PMTCT programme. Empowering women remains a huge challenge. Empowering men to participate by creating a space within the PMTCT programme that is male friendly should be feasible and should be highly prioritized for the PMTCT programme to achieve its potential. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4749413 Mon, 25 Apr 2011 23:00:00 +0100 4749413 http://www.medworm.com/index.php?rid=4726698&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F20 Conclusions: Inconsistent condom use was especially common among women and patients who had recently started ART, i.e., when the risk of HIV transmission is higher. Having multiple partners was quite common, especially among married men, with the potential of creating sexual networks and an increased risk of HIV transmission. ART needs to be accompanied by other preventive interventions to reduce the risk of new HIV infections among sero-discordant couples and to increase overall community effectiveness. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4726698 Sun, 17 Apr 2011 23:00:00 +0100 4726698 http://www.medworm.com/index.php?rid=4699189&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F19 Background: A low body mass index (BMI) at antiretroviral therapy (ART) initiation is a strong predictor of mortality among HIV-infected adults in resource-constrained settings. The relationship between nutrition and inflammation-related serum biomarkers and early treatment outcomes (e.g., less than 90 days) in this population is not well described. Methods: An observational cohort of 142 HIV-infected adults in Lusaka, Zambia, with BMI under 16kg/m2 or CD4+ lymphocyte counts of less than 50 cells/mm3, or both, was followed prospectively during the first 12 weeks of ART. Baseline and serial post-treatment phosphate, albumin, ferritin and highly sensitive C-reactive protein (hsCRP) serum levels were measured. The primary outcome was mortality. Results: Lower baseline phosphate and albumin se... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4699189 Sat, 09 Apr 2011 23:00:00 +0100 4699189 http://www.medworm.com/index.php?rid=4694081&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F18 Conclusions: In more than 45,000 individuals counselled and tested as couples, only 5% of individuals with indeterminate or discrepant rapid HIV test results were HIV infected. This represented only 0.1% of all individuals tested. Thus, algorithms using screening, confirmatory and tie-breaker rapid tests are reliable with two of three tests negative, but not when two of three tests are positive. False positive antibody tests may persist. HIV-positive partner serostatus should prompt repeat testing. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4694081 Thu, 07 Apr 2011 23:00:00 +0100 4694081 http://www.medworm.com/index.php?rid=4687393&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F17 The article published in J Int AIDS Soc. 2011 Feb 9;14(1):7, contains incorrect data in Table 1 regarding the nationally recommended paediatric second-line ART regimen after NNRTI failure in India. This has been corrected. The editors and authors regret the inconvenience caused to readers by the error in the original paper. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4687393 Thu, 07 Apr 2011 23:00:00 +0100 4687393 http://www.medworm.com/index.php?rid=4645716&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F16 Background: Non-AIDS-defining malignancies (NADM) are becoming a major cause of mortality in the era of highly active antiretroviral therapy. We wished to investigate the incidence, risks factors and outcome of NADM in an urban cohort. Methods: We carried out an observational cohort of HIV patients with 12,746 patient-years of follow up between January 2002 and March 2009. Socio-demographics and clinical characteristics of patients diagnosed with NADM were retrospectively compared with the rest of the cohort. Causes of death and risk factors associated with NADM were assessed using logistic regression. Survival analyses were performed with Kaplan-Meier estimates. Cancer incidences were compared with those of the general population of the Brussels-Capital Region using the standardized incid... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4645716 Sun, 27 Mar 2011 23:00:00 +0100 4645716 http://www.medworm.com/index.php?rid=4645717&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F15 Since 2000, access to antiretroviral drugs to treat HIV infection has dramatically increased to reach more than five million people in developing countries. Essential to this achievement was the dramatic reduction in antiretroviral prices, a result of global political mobilization that cleared the way for competitive production of generic versions of widely patented medicines.Global trade rules agreed upon in 1994 required many developing countries to begin offering patents on medicines for the first time. Government and civil society reaction to expected increases in drug prices precipitated a series of events challenging these rules, culminating in the 2001 World Trade Organization's Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights and Public Hea... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4645717 Sun, 27 Mar 2011 00:00:00 +0100 4645717 http://www.medworm.com/index.php?rid=4637243&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F14 Conclusions: These data suggest that a LPV/r-based second-line regimen is associated with a high rate of virological suppression and immune reconstitution after 24 months of follow up in Cambodia. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4637243 Sat, 26 Mar 2011 00:00:00 +0100 4637243 http://www.medworm.com/index.php?rid=4596695&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F12 In their recent article, Sawers and Stillwaggon critique the "concurrency hypothesis" on a number of grounds. In this commentary, I focus on one thread of their argument, pertaining to the evidence derived from modelling work. Their analysis focused on the foundational papers of Morris and Kretzschmar; here, I explore the research that has been conducted since then, which Sawers and Stillwaggon leave out of their review. I explain the methodological limitations that kept progress on the topic slow at first, and the various forms of methodological development that were pursued to overcome these. I then highlight recent modelling work that addresses the various limitations Sawers and Stillwaggon outline in their article. Collectively, this line of research provides considerable support for t... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4596695 Tue, 15 Mar 2011 00:00:00 +0100 4596695 http://www.medworm.com/index.php?rid=4596694&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F13 The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4596694 Tue, 15 Mar 2011 00:00:00 +0100 4596694 http://www.medworm.com/index.php?rid=4562256&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F11 The HIV epidemic has been continuously growing among women, and in some parts of the world, HIV-infected women outnumber men. Women's greater vulnerability to HIV, both biologically and socially, influences their health risk and health outcome. This disparity between sexes has been established for other diseases, for example, autoimmune diseases, malignancies and cardiovascular diseases. Differences in drug effects and treatment outcomes have also been demonstrated.Despite proven sex and gender differences, women continue to be underrepresented in clinical trials, and the absence of gender analyses in published literature is striking. There is a growing advocacy for consideration of women in research, in particular in the HIV field, and gender mainstreaming of policies is increasingly call... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4562256 Tue, 08 Mar 2011 00:00:00 +0100 4562256 http://www.medworm.com/index.php?rid=4513820&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F10 Conclusions: Predicted detectable viral load in Australian HIV Observational Database patients receiving cART declined over calendar time, albeit at higher levels than observed. However, over this period, HIV diagnoses and estimated HIV incidence increased in Australia. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4513820 Wed, 23 Feb 2011 00:00:00 +0100 4513820 http://www.medworm.com/index.php?rid=4478794&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F9 Background: Injection drug use remains a major risk factor for HIV transmission in Georgia. The study aims to characterize the prevalence of HIV among injection drug users in Georgia. Methods: A cross-sectional, anonymous bio-behavioural survey to assess knowledge and behaviour in injection drug users in combination with laboratory testing on HIV status was conducted in five Georgian cities (Tbilisi, Gori, Telavi, Zugdidi and Batumi) in 2009. A snowball sample of 1127 eligible injection drug user participants was investigated. Results: Odds of HIV exposure were increased for injection drug users of greater age, with greater duration of drug use and with a history of imprisonment or detainment (p (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4478794 Tue, 15 Feb 2011 00:00:00 +0100 4478794 http://www.medworm.com/index.php?rid=4461283&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F8 Conclusions: Current conditions and the lack of available medical care in Zambia's prisons violate human rights protections and threaten prisoners' health. In order to protect the health of prisoners, prison-based health services, linkages to community-based health care, general prison conditions and failures of the criminal justice system that exacerbate overcrowding must be immediately improved. International donors should work with the Zambian government to support prison and justice system reform and ensure that their provision of funding in such areas as health services respect human rights standards, including non-discrimination. Human rights protections against torture and cruel, inhuman or degrading treatment, and criminal justice system rights, are essential to curbing the spread ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4461283 Fri, 11 Feb 2011 00:00:00 +0100 4461283 http://www.medworm.com/index.php?rid=4451798&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F7 Conclusions: In order to provide life-long ART for children, better use of current first-line regimens and broader access to heat-stable, paediatric second-line and salvage formulations are needed. There will be limited benefit to earlier diagnosis of treatment failure unless providers and patients have access to appropriate drugs for children to switch to. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4451798 Wed, 09 Feb 2011 00:00:00 +0100 4451798 http://www.medworm.com/index.php?rid=4439897&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F6 Conclusions: Few countries, including G-countries, had developed comprehensive guidelines on protecting the confidentiality and security of HIV information. Countries must develop their own guidelines, using established frameworks to guide their efforts, and may require assistance in adapting, adopting and implementing them. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4439897 Sun, 06 Feb 2011 00:00:00 +0100 4439897 http://www.medworm.com/index.php?rid=4390513&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F4 Combination antiretroviral therapy (cART) has led to a major reduction in HIV-related mortality and morbidity. However, HIV can still not be cured. With the absence of an effective prophylactic or therapeutic vaccine, increasing numbers of infected people, emerging new toxicities secondary to cART and the need for life-long treatment, there is now a real urgency to find a cure for HIV.There are currently multiple barriers to curing HIV. The most significant barrier is the establishment of a latent or "silent" infection in resting CD4+ T cells. In latent HIV infection, the virus is able to integrate into the host cell genome, but does not proceed to active replication. As a consequence, antiviral agents, as well as the immune system, are unable to eliminate these long-lived, latently infect... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4390513 Mon, 24 Jan 2011 00:00:00 +0100 4390513 http://www.medworm.com/index.php?rid=4390512&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F5 Since the first reports of AIDS, skin involvement has become a burdensome stigma for seropositive patients and a challenging task for dermatologist and infectious disease specialists due to the severe and recalcitrant nature of the conditions. Dermatologic manifestations in AIDS patients act as markers of disease progression, a fact that enhances the importance of understanding their pathogenesis.Broadly, cutaneous disorders associated with HIV type-1 infection can be classified as primary and secondary. While the pathogenesis of secondary complications, such as opportunistic infections and skin tumours, is directly correlated with a decline in the CD4+ T cell count, the origin of the certain manifestations primarily associated with the retroviral infection itself still remains under inves... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4390512 Mon, 24 Jan 2011 00:00:00 +0100 4390512 http://www.medworm.com/index.php?rid=4373834&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F3 Conclusions: There is a high rate of underreporting of OIs in a routine HIV clinic database. This has important implications for the use and interpretation of routine observational databases for research and audit, and highlights the need for regular data validation of these databases. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4373834 Thu, 20 Jan 2011 00:00:00 +0100 4373834 http://www.medworm.com/index.php?rid=4327792&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F2 Conclusions: Concomitant administration of ART and ready-to-use therapeutic food increases the chances of nutritional recovery in these high-risk patients. While adequate nutrition is necessary to treat malnourished HIV patients, development of improved strategies for the management of severely malnourished patients with HIV/AIDS are urgently needed. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4327792 Mon, 10 Jan 2011 00:00:00 +0100 4327792 http://www.medworm.com/index.php?rid=4310750&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F14%2F1%2F1 Conclusions: Staff clinic and support group services successfully provided care and support to HIV-positive health workers. Similar initiatives should be considered in other settings with a high HIV prevalence. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4310750 Wed, 05 Jan 2011 00:00:00 +0100 4310750 http://www.medworm.com/index.php?rid=4254711&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F52 Conclusions: Routine offer of antenatal HIV counselling and testing is largely acceptable to the pregnant women in eastern Uganda and has enabled most of them to know their HIV status as part of the prevention of mother to child transmission of HIV package of services. Our findings call for further strengthening and scaling up of this HIV testing approach in many more antenatal clinics countrywide in order to maximize its potential benefits to the population. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4254711 Mon, 13 Dec 2010 00:00:00 +0100 4254711 http://www.medworm.com/index.php?rid=4246865&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F51 Background: This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer. Methods: TREAT Asia HIV Observational Database (TAHOD) sites retrospectively reviewed clinic medical records to determine cancer diagnoses since 2000. For each diagnosis, the following data were recorded: date, type, stage, method of diagnosis, demographic data, medical history, and HIV-related information. For risk factor analyses, two HIV-infected control subjects without cancer diagnoses were also selected. Cancers were grouped as AIDS-defining cancers (ADCs), and non-ADCs. Non-ADCs were further categorized as being infection related (NADC-IR) and unrelated (N... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4246865 Fri, 10 Dec 2010 00:00:00 +0100 4246865 http://www.medworm.com/index.php?rid=4246866&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F50 Conclusions: The present study offers one of the first perspectives on the experiences of mothers who have lost a young child to AIDS. Interventions that are tailored to the local context and address bereavement issues, as well as other issues that affect the daily lives of these mothers, are urgently needed. Further studies are needed to identify factors that promote resilience among these women. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4246866 Thu, 09 Dec 2010 00:00:00 +0100 4246866 http://www.medworm.com/index.php?rid=4234692&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F49 Conclusions: Thirty-five percent of patients missed one or more visits in the first six months on treatment, increasing their risk of poorer outcomes. These patients could be targeted for additional adherence counselling to help improve ART outcomes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4234692 Tue, 07 Dec 2010 00:00:00 +0100 4234692 http://www.medworm.com/index.php?rid=4234693&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F48 Conclusions: Promoting good adherence practices among caregivers of children on antiretrovirals is challenging but essential in the treatment of paediatric HIV. Participants in this exercise achieved poor adherence rates, but identified with many of the barriers commonly reported by caregivers. Simulations such as this have the potential to promote awareness of paediatric ARV adherence issues among healthcare staff and ultimately improve adherence support and patient outcomes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4234693 Mon, 06 Dec 2010 00:00:00 +0100 4234693 http://www.medworm.com/index.php?rid=4226889&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F47 In the history of public health, HIV/AIDS is unique; it has widespread and long-lasting demographic, social, economic and political impacts. The global response has been unprecedented. AIDS exceptionalism - the idea that the disease requires a response above and beyond "normal" health interventions - began as a Western response to the originally terrifying and lethal nature of the virus. More recently, AIDS exceptionalism came to refer to the disease-specific global response and the resources dedicated to addressing the epidemic. There has been a backlash against this exceptionalism, with critics claiming that HIV/AIDS receives a disproportionate amount of international aid and health funding.This paper situations this debate in historical perspective. By reviewing histories of the disease... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4226889 Fri, 03 Dec 2010 00:00:00 +0100 4226889 http://www.medworm.com/index.php?rid=4201323&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F46 Conclusions: Rural HIV-positive children are a vulnerable group, exhibiting delayed access to ART and an increased risk of poor outcomes while on ART. Expansion of rural paediatric ART programmes, with future research exploring improvements to rural health system effectiveness, is required. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4201323 Thu, 25 Nov 2010 00:00:00 +0100 4201323 http://www.medworm.com/index.php?rid=4173080&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F45 Conclusions: The higher HIV-1 prevalence among pregnant women in Zimbabwe compared with Tanzania cannot be explained by differences in risky sexual behaviour: all risk factors tested for in our study were higher for Tanzania than Zimbabwe. Non-sexual transmission of HIV might have played an important role in variation of HIV prevalence. Male circumcision rates and mobility could contribute to the rate and extent of spread of HIV in the two countries. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4173080 Tue, 16 Nov 2010 00:00:00 +0100 4173080 http://www.medworm.com/index.php?rid=4169209&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F44 Conclusions: Symptoms of depression should be considered as potential markers of increased HIV risk and this association may be causal. HIV prevention needs to encompass promotion of adolescent mental health. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4169209 Mon, 15 Nov 2010 00:00:00 +0100 4169209 http://www.medworm.com/index.php?rid=4136131&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F43 Conclusions: The quantitative viral load test remains the single most expensive component of the process. For the patient, the distance of his or her residence from the specimen collection site is a large determinant of cost. Importantly, the efficiency of results reporting has a large impact on the cost per result delivered to the clinician and utility of the result for patient monitoring. Detailed cost analysis can identify opportunities for removing barriers to effective antiretroviral therapy monitoring programmes in limited-resource countries with low HIV prevalence. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4136131 Fri, 05 Nov 2010 00:00:00 +0100 4136131 http://www.medworm.com/index.php?rid=4128083&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F42 Background: Stavudine is no longer recommended as part of first-line therapy for patients initiating antiretroviral therapy (ART) in Uganda. Most patients are currently initiated on zidovudine-containing regimens, which can induce anaemia. We investigated the risk factors for early severe anaemia in the first six months of ART initiation. Methods: We defined baseline (ART initiation) anaemia as haemoglobin (Hb) (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4128083 Wed, 03 Nov 2010 00:00:00 +0100 4128083 http://www.medworm.com/index.php?rid=4111192&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F41 This study identified three hotspots with excessively high HIV prevalence rates of 56%, 51% and 39%. A total of 458 sexually active women (19% of all cases) were included in these hotspots, and had been exclusively recruited by the Botha's Hill (west of Durban) and Umkomaas (south of Durban) clinic sites. Most of these women were Christian and Zulu-speaking. They were also less likely to be married than women outside these areas (12% vs. 16%, p=0.001) and more likely to have sex more than three times a week (27% vs. 20%, p (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4111192 Tue, 26 Oct 2010 23:00:00 +0100 4111192 http://www.medworm.com/index.php?rid=4102051&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F40 This article discusses recent efforts to identify the minimal test specifications for a new TB point-of-care diagnostic test through an approach based on medical and patient needs. As a first step, survey interviews with field practitioners were designed in order to identify the top-priority medical needs in resource-limited settings concerning new TB diagnostics. Subsequently, an expert meeting convening field practitioners, laboratory experts, diagnostic test developers and researchers was held with the objective of defining the minimal test specifications for a new TB point-of-care test that would meet the identified medical needs. Finally, gaps in, as well as potential solutions for, enabling the development of adequate, patient needs-driven, low-cost new TB diagnostic tests specifical... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4102051 Sun, 24 Oct 2010 23:00:00 +0100 4102051 http://www.medworm.com/index.php?rid=4079100&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F39 Conclusions: High condom use levels achieved during the trial were not sustained post trial in the condom group. Post-trial diaphragm use remained relatively high in the diaphragm group (given its unknown effectiveness), but was very low in the condom group. Introducing "new" methods for HIV prevention may require time and user skills before they get adopted. Our findings underscore the potential benefit of providing a mix of methods to women as it may encourage more protected acts. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4079100 Mon, 18 Oct 2010 23:00:00 +0100 4079100 http://www.medworm.com/index.php?rid=4037943&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F38 Conclusions: Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral to care and treatment programmes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=4037943 Tue, 05 Oct 2010 23:00:00 +0100 4037943 http://www.medworm.com/index.php?rid=3995868&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F37 Conclusions: These barriers to antiretroviral treatment of pregnant and post-natal women need to be addressed in order to improve HAART uptake and adherence for this group of the population. This would improve their survival and, at the same time, drastically reduce HIV transmission from mother to child. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3995868 Wed, 22 Sep 2010 23:00:00 +0100 3995868 http://www.medworm.com/index.php?rid=3966914&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F36 Conclusions: Routine counselling and testing for HIV at the antenatal clinics was greatly accepted and included practically every mother in this time period. However, the counselling was suboptimal due to time and resource constraints. We interpret the higher level of PMTCT knowledge among the urban as opposed to the rural attendees as a result of differences in the start up of the PMTCT programme and, thus, programme maturation. After comparison with earlier studies conducted in this setting, we conclude that when the programme has had time to get established, both its acceptance and the understanding of the topics dealt with during the counselling increases. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3966914 Mon, 13 Sep 2010 23:00:00 +0100 3966914 http://www.medworm.com/index.php?rid=3963315&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F35 Conclusions: Indian generic producers supply the majority of ARVs in developing countries. Future scale up using newly recommended ARVs will likely be hampered until Indian generic producers can provide the dramatic price reductions and improved formulations observed in the past. Rather than agreeing to inappropriate intellectual property obligations through free trade agreements, India and its trade partners - plus international organizations, donors, civil society and pharmaceutical manufacturers - should ensure that there is sufficient policy space for Indian pharmaceutical manufacturers to continue their central role in supplying developing countries with low-priced, quality-assured generic medicines. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3963315 Mon, 13 Sep 2010 23:00:00 +0100 3963315 http://www.medworm.com/index.php?rid=3963316&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F34 The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region's high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual contact, gender symmetry, levels of concurrency, and per-act transmission rates. Moreover, qua... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3963316 Sun, 12 Sep 2010 23:00:00 +0100 3963316 http://www.medworm.com/index.php?rid=3939941&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F33 Conclusions: Our results demonstrate that serum leptin levels are inversely associated with viral replication, independent of disease progression: we postulate that leptin may affect viral replication. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3939941 Mon, 06 Sep 2010 23:00:00 +0100 3939941 http://www.medworm.com/index.php?rid=3893387&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F32 Conclusions: YFS interventions can remain well delivered even after expansion through existing systems. The scaling up process did affect some aspects of intervention quality and our research supports others in emphasizing the need to train more staff (both clinical and non clinical) per facility in order to ensure YFS delivery. Further research is needed to identify effective strategies to address structural constraints and broader social norms that hampered the scale-up. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3893387 Sun, 22 Aug 2010 23:00:00 +0100 3893387 http://www.medworm.com/index.php?rid=3829310&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F31 The standard first-line antiretroviral (ART) regimen in Malawi for both adults and children is a fixed-dose combination tablet containing stavudine (d4T), lamivudine (3TC) and nevirapine (NVP). This regimen has been shown to yield satisfactory virologic and immunologic outcomes in children. Published studies have described insights into discontinuation of first-line regimen and toxicities of ART in adults, but similar studies in paediatric populations are lacking.A retrospective cohort study was undertaken to assess reasons for discontinuation of the standard first-line ART regimen (d4T/3TC/NVP) in a paediatric population. In total, 1434 patients met eligibility criteria and were included. The cohort had mean and median age at ART initiation of 4.7 years and 2.9 years, respectively (range:... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3829310 Thu, 05 Aug 2010 23:00:00 +0100 3829310 http://www.medworm.com/index.php?rid=3825198&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F30 Conclusions: In this study the Duet was found to be acceptable and safe when inserted precoitally or used continuously for 14 days. Assignment to use of the Duet continuously did not increase adherence to the Duet during sex. Future HIV prevention trials should evaluate use of the Duet (precoitally and continuously) with promising microbicide candidates. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3825198 Wed, 04 Aug 2010 23:00:00 +0100 3825198 http://www.medworm.com/index.php?rid=3818726&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F29 Background: Long-term regular clinic follow up is an important component of HIV care. We determined the frequency and characteristics of HIV-infected patients lost to follow up from a London HIV clinic, and factors associated with loss to all HIV follow up in the UK. Methods: We identified 1859 HIV-infected adults who had registered and attended a London clinic on one or more occasions between January 1997 and December 2005. Loss to follow up was defined as clinic non-attendance for one or more years. Through anonymized linkage with the Survey of Prevalent HIV Infections Diagnosed and Health Protection Scotland, national databases of all HIV patients in care covering the UK up to December 2006, loss-to-follow-up patients were categorized as "transfers" (subsequently received care at anothe... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3818726 Tue, 03 Aug 2010 23:00:00 +0100 3818726 http://www.medworm.com/index.php?rid=3810307&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F28 Conclusions: A non-nucleoside reverse transcriptase inhibitor-based antiretroviral regimen, initiated a year or more after PMTCT exposure and that includes nevirapine, remains a good option for at least the first 36 months of treatment. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3810307 Sun, 01 Aug 2010 23:00:00 +0100 3810307 http://www.medworm.com/index.php?rid=3778452&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F27 Conclusions: While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational int... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3778452 Wed, 21 Jul 2010 23:00:00 +0100 3778452 http://www.medworm.com/index.php?rid=3765697&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F26 Conclusions: Existing evidence provides support for linkages, although significant gaps in the literature remain. Policy makers, programme managers and researchers should continue to advocate for, support, implement and rigorously evaluate SRH and HIV linkages at the policy, systems and service levels. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3765697 Sun, 18 Jul 2010 23:00:00 +0100 3765697 http://www.medworm.com/index.php?rid=3748153&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F25 Background: In-vitro studies suggest that reducing cholesterol inhibits HIV replication. However, this effect may not hold in-vivo, where other factors such as cholesterol's immuno-modulatory properties may interact. Methods: Fasting blood samples were obtained on 165 people living with HIV (PLWH) at baseline and after 24 weeks on HAART. Participants were classified as hypocholesterolemic (HypoCHL400 copies (95% CI 1-2.6, p=0.05) and, to exhibit (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3748153 Mon, 12 Jul 2010 23:00:00 +0100 3748153 http://www.medworm.com/index.php?rid=3744893&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F24 There are currently several ongoing or planned trials evaluating the efficacy of pre-exposure prophylaxis (PrEP) as a preventative approach to reducing the transmission of HIV. PrEP may prove ineffective, demonstrate partial efficacy, or show high efficacy and have the potential to reduce HIV infection in a significant way. In addition to the trial results, it is important that issues related to delivery, implementation, and further research are also discussed. As a part of the ongoing discussion, in June 2009, the Bill & Melinda Gates Foundation sponsored a Planning for PrEP conference with stakeholders to review expected trial results, outline responsible educational approaches, and develop potential delivery and implementation strategies. The conference reinforced the need for continued... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3744893 Sun, 11 Jul 2010 23:00:00 +0100 3744893 http://www.medworm.com/index.php?rid=3735190&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F23 In this study, we describe disease characteristics and risk factors for mortality in a public sector HIV programme in South Africa. Methods: We analysed data from an observational cohort study of HIV-infected adults with AIDS-associated Kaposi's sarcoma, enrolled between May 2001 and January 2007 in three primary care clinics. Paper records from primary care and tertiary hospital oncology clinics were reviewed to determine the site of Kaposi's sarcoma lesions, immune reconstitution inflammatory syndrome stage, and treatment. Baseline characteristics, cART use and survival outcomes were extracted from an electronic database maintained for routine monitoring and evaluation. Cox regression was used to model associations with mortality. Results: Of 6292 patients, 215 (3.4%) had AIDS-associated... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3735190 Wed, 07 Jul 2010 23:00:00 +0100 3735190 http://www.medworm.com/index.php?rid=3660685&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F22 Conclusions: Insights into volunteer caregiver rewards provide opportunities for policy makers and programme managers to develop a model of home-based care that facilitates the accrual of rewards to volunteers in addition to providing an enabling environment for volunteers' traditional duties of patient care. Programme managers could employ these insights in recruiting and assisting volunteers to identify and reflect on rewards in the caregiving situation as a means of reducing the burden of care, improving volunteer satisfaction and sustaining volunteer interest in caregiving. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3660685 Sun, 13 Jun 2010 23:00:00 +0100 3660685 http://www.medworm.com/index.php?rid=3656499&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F21 Conclusion: This study suggests that vertical programs, even one the scale of PEPFAR, may have little or no impact on health outcomes not explicitly targeted. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3656499 Fri, 11 Jun 2010 23:00:00 +0100 3656499 http://www.medworm.com/index.php?rid=3650371&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F20 Conclusions: In developing home-based care programmes, it is vital to consider the perceived needs of persons living with HIV/AIDS and their direct informal caregivers. The results from this study serve as a basis for the development of a home-based care programme in one resource-poor setting of South Africa and could provide a model for such programmes in similar areas. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3650371 Thu, 10 Jun 2010 23:00:00 +0100 3650371 http://www.medworm.com/index.php?rid=3634444&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F19 Conclusions: Achieving operational sustainability in a resource-limited setting is feasible. Developing and institutionalizing a quality assurance/quality improvement system is the basis on which facilities and districts can move beyond project support and, therefore, sustain services. Quality assurance/quality improvement tools should be based on national standards, and project implementation should use and improve existing health system structures. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3634444 Sun, 06 Jun 2010 23:00:00 +0100 3634444 http://www.medworm.com/index.php?rid=3623227&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F18 Conclusions: Twice the recommended dietary allowance of 14 micronutrients compared with a standard recommended dietary allowance of six multivitamins for six months was well tolerated, but it did not significantly alter mortality, growth or CD4 counts. Future intervention studies should carefully consider: (1) the composition and dosing of the supplements; and (2) the power needed to detect a difference between arms.ClinicalTrials.gov Identifier: NCT00122941 (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3623227 Wed, 02 Jun 2010 23:00:00 +0100 3623227 http://www.medworm.com/index.php?rid=3575133&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F17 Background: Limited data is available on kidney function in HIV-infected children in sub-Saharan Africa. In addition, malnutrition in these children further reduces the utility of diagnostic methods such as creatinine-based estimates of glomerular filtration rate. We determined the serum cystatin C level and estimated glomerular filtration rate of 60 antiretroviral-naive, HIV-infected children and 60 apparently healthy age and sex matched children. Methods: Serum cystatin C level was measured using enzyme-linked immunosorbent assay technique, while glomerular filtration rate was estimated using Filler's serum cystatin C formula. Student t test, Mann Whitney U test, Pearson chi square and Fisher's exact test were used, where appropriate, to test difference between groups. Results: Compared ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3575133 Mon, 17 May 2010 23:00:00 +0100 3575133 http://www.medworm.com/index.php?rid=3492135&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F16 Conclusions: Young adults, men who have sex with men, commercial sex workers, injecting drug users, overseas Filipino workers, and the sexual partners of people in these groups are particularly vulnerable to HIV infection. There is no guarantee that a large HIV epidemic will be avoided in the near future. Indeed, an expanding HIV epidemic is likely to be only a matter of time as the components for such an epidemic are already present in the Philippines. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3492135 Wed, 21 Apr 2010 23:00:00 +0100 3492135 http://www.medworm.com/index.php?rid=3484598&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F14 Conclusions: The study, therefore, concludes that as the cost of providing care services to PLHIV is very high, the Government of Botswana should substantially increase the allowances paid to caregivers and the support it provides for the families of the clients. The overall costs for such a programme would be quite low compared with the huge sum of money budgeted each year for health care and for HIV and AIDS. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3484598 Mon, 19 Apr 2010 23:00:00 +0100 3484598 http://www.medworm.com/index.php?rid=3484597&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F15 Conclusion: The prevalence of neurocognitive impairment in HIV+ individuals in Botswana is higher than expected, especially since almost all of the subjects in this study were prescribed HAART. This suggests the need to reconsider the timing of introduction of antiretroviral therapy in developing countries where HAART is generally not administered until the CD4 cell count has dropped to 200/uL or below. The contribution of other factors should also be considered, such as poor CNS penetration of some ARVs, drug resistance, potential neurotoxicity, and co-morbidities. Memory impairment and poor judgment may be underlying causes for behaviors that contribute to the spread HIV, and to poor adherence. It is important to identify these neurobehavioral complications of HIV, so that effective tre... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3484597 Mon, 19 Apr 2010 23:00:00 +0100 3484597 http://www.medworm.com/index.php?rid=3392307&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F12 Conclusions: There is a high prevalence of PAD in young HIV-infected patients. A number of traditional cardiovascular risk factors and increased osteoprotegerin concentrations are associated with abnormal ABIs. Thus, early screening and aggressive medical management for PAD may be warranted in HIV-infected patients. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3392307 Mon, 22 Mar 2010 00:00:00 +0100 3392307 http://www.medworm.com/index.php?rid=3386420&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F11 Conclusions: Good survival, immunological restoration and viral suppression can be sustained after two to three years of ART among children in resource-constrained settings. Increased access to routine virological measurements is needed for timely diagnosis of treatment failure. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3386420 Sun, 21 Mar 2010 00:00:00 +0100 3386420 http://www.medworm.com/index.php?rid=3367840&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F10 Conclusions: Weekend CVCT, though new, was feasible in both capital cities. The beneficial impact of CVCT on loss to follow up was significant, while nevirapine compliance was similar in women tested alone or with their partners. Pre-measured nevirapine syrup syringes provided flexibility to HIV-positive mothers in Lusaka, but may have contributed to study loss to follow up. These two prevention interventions remain a challenge, with CVCT still operating without supportive government policy in Zambia. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3367840 Mon, 15 Mar 2010 00:00:00 +0100 3367840 http://www.medworm.com/index.php?rid=3339226&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F9 Conclusions: The major challenges in the delivery of paediatric HIV services were related to the knowledge gap in paediatric HIV and the lack of counselling skills, as well as health system-related constraints. There is a need to train health workers in child-counselling skills, especially in the issues of disclosure, sexuality and sexual abuse, as well as in addressing fears related to death and an uncertain future, in order to improve paediatric HIV care. Provision of child-friendly services, guidelines and antiretroviral formulations for children may provide a window of hope to improve HIV counselling and testing services for children. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3339226 Sun, 07 Mar 2010 00:00:00 +0100 3339226 http://www.medworm.com/index.php?rid=3339227&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F8 Conclusions: Patients in home based care for HIV/AIDS who never initiated ART experienced greater financial and logistical barriers to seeking HIV care and had more negative perceptions about the benefits of the treatment. Future efforts to expand access to ARV care should consider ways to reduce these barriers in order to encourage more of those medically eligible for ARVs to initiate care. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3339227 Sat, 06 Mar 2010 00:00:00 +0100 3339227 http://www.medworm.com/index.php?rid=3324595&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F7 Conclusions: The rate of condom use at first sexual intercourse is low among the students. It indicates students are exposed to health hazards through their sexual behaviour. If low use of condom at first sex continues, vulnerable sexual networks will grow among them that allow quicker spreading of sexually transmitted diseases and HIV. Findings from this study point to areas that policy and programmes can address to provide youth with access to the kinds of information and services they need to achieve healthy sexual and reproductive lives. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3324595 Tue, 02 Mar 2010 00:00:00 +0100 3324595 http://www.medworm.com/index.php?rid=3252300&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F6 Research shows that gender power inequity in relationships and intimate partner violence places women at enhanced risk of HIV infection. Men who have been violent towards their partners are more likely to have HIV. Men's behaviours show a clustering of violent and risky sexual practices, suggesting important connections. This paper draws on Connell's notion of hegemonic masculinity and reflections on emphasised femininities to argue that these sexual, and male violent, practices are rooted in and flow from cultural ideals of gender identities. The latter enable us to understand why men and women behave as they do, and the emotional and material context within which sexual behaviours are enacted.In South Africa, whilst gender identities show diversity, the dominant ideal of Black African ma... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3252300 Tue, 09 Feb 2010 00:00:00 +0100 3252300 http://www.medworm.com/index.php?rid=3241425&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F5 Conclusions: Such results suggest that there is a need for in-depth behavioural research and serological studies in this domain to better understand the determinants of risky sexual behaviour among the hearing impaired, and to propose operational prevention approaches for this group. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3241425 Thu, 04 Feb 2010 00:00:00 +0100 3241425 http://www.medworm.com/index.php?rid=3233286&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F4 Conclusions: This is the first study from an industrialized country to show a faster CD4 cell decline and higher rate of subsequent virological failure with subtype D infection. Further studies are needed to identify the molecular mechanisms responsible for the greater virulence of subtype D. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3233286 Wed, 03 Feb 2010 00:00:00 +0100 3233286 http://www.medworm.com/index.php?rid=3187103&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F3 Conclusion: The integration approach enables the public sector PHC system to test more patients for HIV, place more patients on ART more quickly and efficiently, reduce loss-to-follow-up, and achieve greater geographic HIV care coverage compared to the vertical model. Through the integration process, HIV resources have been used to rehabilitate PHC infrastructure (including laboratories and pharmacies), strengthen supervision, fill workforce gaps, and improve patient flow between services and facilities in ways that can benefit all programs. Using aid resources to integrate and better link HIV care with existing services can strengthen wider PHC systems. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3187103 Wed, 20 Jan 2010 00:00:00 +0100 3187103 http://www.medworm.com/index.php?rid=3177399&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F2 Conclusions: In 32% of the countries in the European Region, there are either some kind of HIV-related travel restrictions, or we were unable to determine if such restrictions are in force. Most of these countries defend restrictions as being justified by public health concerns. However, there is no evidence that denying HIV-positive foreigners access to a country is effective in protecting public health. Governments should revise legislation on HIV-related travel restrictions and in the meantime a joint effort is needed to draw attention to the continuing discrimination and stigmatization of PLHIV that takes place in the European Region where such laws and policies are still in force. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3177399 Fri, 15 Jan 2010 00:00:00 +0100 3177399 http://www.medworm.com/index.php?rid=3161256&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F13%2F1%2F1 In 2007 an estimated 33 million people were living with HIV; 67% resided in sub-Saharan Africa, with 35% in eight countries alone. In 2007, there were about 1.4 million HIV-positive tuberculosis cases. Globally, approximately 4 million people had been given highly active antiretroviral therapy (HAART) by the end of 2008, but in 2007, an estimated 6.7 million were still in need of HAART and 2.7 million more became infected with HIV.Although there has been unprecedented investment in confronting HIV/AIDS - the Joint United Nations Programme on HIV/AIDS estimates $13.8 billion was spent in 2008 - a key challenge is how to address the HIV/AIDS epidemic given limited and potentially shrinking resources. Economic disparities may further exacerbate human rights issues and widen the increasingly d... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3161256 Tue, 12 Jan 2010 00:00:00 +0100 3161256 http://www.medworm.com/index.php?rid=3094219&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F38 Conclusion: Despite advanced disease presentation and a very large-scale programme, high-quality care was achieved as indicated by good long-term clinical, immunologic and virologic outcomes and a low rate of second-line HAART initiation. High rates of single drug substitution suggest that the public health approach to HAART could be further improved by the use of a more durable first-line regimen. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3094219 Thu, 17 Dec 2009 00:00:00 +0100 3094219 http://www.medworm.com/index.php?rid=3083618&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F37 Conclusions: The total lost benefits of ART not reaching the people who need it are estimated at 3.8 million life years for the period, 2000 to 2005. The economic cost of those lost life years over this period has been estimated at more than US$15 billion. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3083618 Mon, 14 Dec 2009 00:00:00 +0100 3083618 http://www.medworm.com/index.php?rid=3080780&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F36 Clinical and epidemiologic research has identified increasingly effective interventions to reduce mother-to-child HIV transmission in resource-limited settings These scientific breakthroughs have been implemented in some programs, although much remains to be done to improve coverage and quality of these programs. But prevention of HIV transmission is not enough. It is necessary also to consider ways to improve maternal health and protect child survival. A win-win approach is to ensure that all pregnant and lactating women with CD4 counts (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3080780 Fri, 11 Dec 2009 00:00:00 +0100 3080780 http://www.medworm.com/index.php?rid=3046232&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F35 Conclusion: Despite suggestions that family-based approaches to preventing adolescent HIV infection may be culturally inappropriate, our results suggest that a family-based intervention to prevent adolescent HIV infection is feasible if it: (1) provides families with comprehensive HIV prevention strategies and knowledge; (2) addresses barriers to participation; (3) is adolescent friendly, flexible and convenient; and (4) is developmentally and culturally appropriate for rural Indian families. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046232 Thu, 19 Nov 2009 00:00:00 +0100 3046232 http://www.medworm.com/index.php?rid=3035147&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F35 Conclusions: Despite suggestions that family-based approaches to preventing adolescent HIV infection may be culturally inappropriate, our results suggest that a family-based intervention to prevent adolescent HIV infection is feasible for rural Indian families if it (1) provides families with relevant family-based prevention strategies and knowledge about HIV/AIDS, (2) addresses barriers to participation, (3) is adolescent-friendly, flexible, and convenient, and (4) is developmentally and culturally appropriate. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3035147 Thu, 19 Nov 2009 00:00:00 +0100 3035147 http://www.medworm.com/index.php?rid=3046233&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F34 This systematic review focuses on empirical work on disability and HIV/AIDS in Africa in the past decade and considers all the literature currently accessible. The review presents data from different surveys and summarizes the findings. In this way, it convincingly reveals that people with disabilities are very vulnerable to contracting HIV, and lack access to information, testing and treatment. The review further reveals gaps in the research and areas of concern. While vulnerability and accessibility have been investigated, there are few prevalence studies or evaluations available. A certain amount of work has focused on the deaf population, but little has been done for other disability groups. A growing area of concern is sexual abuse and exploitation of people with disabilities. Only a ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046233 Fri, 13 Nov 2009 00:00:00 +0100 3046233 http://www.medworm.com/index.php?rid=3046235&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F32 Conclusion: The proportion of HIV-positive formal sector employees in Namibia is in line with national prevalence estimates and varies widely by employment sector. Following the surveys, there was a considerable increase in private health insurance uptake. This suggests that anonymous HIV workplace surveys can serve as a tool to motivate private companies to provide health insurance to their workforce. Health insurance taken up by those who are able to pay the fees will alleviate the burden on the public sector. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046235 Wed, 11 Nov 2009 00:00:00 +0100 3046235 http://www.medworm.com/index.php?rid=3046234&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F33 Conclusion: Our study suggests that CSF leukocyte count influences CSF HIV-1 viral load in patients with meningitis caused by Cryptococcus neoformans. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046234 Wed, 11 Nov 2009 00:00:00 +0100 3046234 http://www.medworm.com/index.php?rid=3035148&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F31 Conclusions: The referral system reduced delays in seeking care, and enabled the monitoring of access to HIV treatment among diagnosed persons. Similar systems to monitor referral uptake and linkages between HIV services could be readily implemented in other settings. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3035148 Wed, 11 Nov 2009 00:00:00 +0100 3035148 http://www.medworm.com/index.php?rid=2982872&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F7 Conclusions: The proportion of HIV-positive formal sector employees in Namibia is in line with national prevalence estimates and varies widely by employment sector. Following the surveys, there was a considerable increase in private health insurance uptake. This suggests that anonymous HIV workplace surveys can serve as a tool to motivate private companies to provide health insurance to their workforce. Health insurance taken up by those who are able to pay the fees will alleviate the burden on the public sector. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2982872 Wed, 11 Nov 2009 00:00:00 +0100 2982872 http://www.medworm.com/index.php?rid=2982871&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F8 Conclusions: Our study suggests that CSF leukocyte count influences CSF HIV-1 viral load in patients with meningitis caused by Cryptococcus neoformans. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2982871 Wed, 11 Nov 2009 00:00:00 +0100 2982871 http://www.medworm.com/index.php?rid=2979123&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F6 Conclusions: The referral system reduced delays in seeking care, and enabled the monitoring of access to HIV treatment among diagnosed persons. Similar systems to monitor referral uptake and linkages between HIV services could be readily implemented in other settings. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2979123 Wed, 11 Nov 2009 00:00:00 +0100 2979123 http://www.medworm.com/index.php?rid=3046239&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F26 With the success of antiretrovirals and increased access to this lifesaving treatment, the life expectancy of people living with HIV has been substantially increased and, in many instances, is comparable to that of the general population. However, HIV infection, as well as its treatment, can cause physical, psychological or social disabilities that prevent people living with HIV from full and equal participation in society. At the same time, there is evidence that people with disabilities are at greater risk of contracting HIV. Although more attention is being paid to these overlapping fields, the field of HIV and disability remains largely overlooked.The Journal of the International AIDS Society is publishing, for the first time, a thematic section consisting of a number of papers on HIV ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046239 Mon, 09 Nov 2009 00:00:00 +0100 3046239 http://www.medworm.com/index.php?rid=3046238&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F27 As part of a partnership arrangement with the Joint United Nations Programme on HIV/AIDS and the Public Health Agency of Canada, Health Canada hosted an International Policy Dialogue on HIV/AIDS and Disability from 11 to 13 March 2009 in Ottawa, Canada. The dialogue provided a forum for stakeholders from governments, academia, and non-governmental and multilateral organizations to explore the issues and evidence related to HIV/AIDS and disability, and to chart a way forward in terms of policy and programme development. This meeting report outlines the participants, objectives and high-level outcomes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046238 Mon, 09 Nov 2009 00:00:00 +0100 3046238 http://www.medworm.com/index.php?rid=3046237&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F28 This article provides an historic overview of the fields of disability and HIV. We describe this area of concern in terms of "fields" versus "a single field" because of the two related but distinct trends that have evolved over time. The first field involves people living with HIV and their experiences of disability, disablement and rehabilitation brought on by the disease and its treatments. The second involves people with disabilities and their experiences of vulnerability to and life with HIV. These two fields have evolved relatively independently over time. However, in the final section of this article, we argue that the divide between these fields is collapsing, and that this collapse is beginning to produce a new understanding about shared concerns, cross-field learning and the mutua... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046237 Mon, 09 Nov 2009 00:00:00 +0100 3046237 http://www.medworm.com/index.php?rid=3046236&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F30 Conclusion: This framework is the first to consider the contextual factors that influence experiences of disability from the perspective of adults living with HIV. Extrinsic factors (level of social support and stigma) and intrinsic factors (living strategies and personal attributes) may exacerbate or alleviate episodes of HIV-related disability. These factors offer a broader understanding of the disability experience and may suggest ways to prevent or reduce disability for adults living with HIV. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3046236 Mon, 09 Nov 2009 00:00:00 +0100 3046236 http://www.medworm.com/index.php?rid=3035149&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F29 Stigma and discrimination constitute one of the greatest barriers to dealing effectively with the HIV epidemic, underlying a range of human rights violations and hindering access to prevention, care, treatment and support. There is some existing protection against HIV-based discrimination under international law, but the extent of states' obligations to address such discrimination has not been comprehensively addressed in an international instrument.The United Nations Convention on the Rights of Persons with Disabilities entered into force in May 2008. As countries ratify the convention, they are required to amend national laws and policies to give greater protection to the human rights of people with disabilities, including abolishing disability-based discrimination by the state and prote... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3035149 Mon, 09 Nov 2009 00:00:00 +0100 3035149 http://www.medworm.com/index.php?rid=3028066&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F2 As part of a partnership arrangement with the Joint United Nations Programme on HIV/AIDS and the Public Health Agency of Canada, Health Canada hosted an International Policy Dialogue on HIV/AIDS and Disability from 11 to 13 March 2009 in Ottawa, Canada. The dialogue provided a forum for stakeholders from governments, academia, and non-governmental and multilateral organizations to explore the issues and evidence related to HIV/AIDS and disability, and to chart a way forward in terms of policy and programme development. This meeting report outlines the participants, objectives and high-level outcomes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=3028066 Mon, 09 Nov 2009 00:00:00 +0100 3028066 http://www.medworm.com/index.php?rid=2975210&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F1 With the success of antiretrovirals and increased access to this lifesaving treatment, the life expectancy of people living with HIV has been substantially increased and, in many instances, is comparable to that of the general population. However, HIV infection, as well as its treatment, can cause physical, psychological or social disabilities that prevent people living with HIV from full and equal participation in society. At the same time, there is evidence that people with disabilities are at greater risk of contracting HIV. Although more attention is being paid to these overlapping fields, the field of HIV and disability remains largely overlooked.The Journal of the International AIDS Society is publishing, for the first time, a thematic section consisting of a number of papers on HIV ... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2975210 Mon, 09 Nov 2009 00:00:00 +0100 2975210 http://www.medworm.com/index.php?rid=2975209&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F2 As part of a partnership arrangement with the Joint United Nations Programme on HIV/AIDS and the Public Health Agency of Canada, Health Canada hosted an International Policy Dialogue on HIV/AIDS and Disability from 11 to 13 March 2009 in Ottawa, Canada. The dialogue provided a forum for stakeholders from governments, academia, and non-governmental and multilateral organizations to explore the issues and evidence related to HIV/AIDS and disability, and to chart a way forward in terms of policy and programme development. This meeting report outlines the participants, objectives and high-level outcomes. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2975209 Mon, 09 Nov 2009 00:00:00 +0100 2975209 http://www.medworm.com/index.php?rid=2975208&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F3 This article provides an historic overview of the fields of disability and HIV. We describe this area of concern in terms of "fields" versus "a single field" because of the two related but distinct trends that have evolved over time. The first field involves people living with HIV and their experiences of disability, disablement and rehabilitation brought on by the disease and its treatments. The second involves people with disabilities and their experiences of vulnerability to and life with HIV. These two fields have evolved relatively independently over time. However, in the final section of this article, we argue that the divide between these fields is collapsing, and that this collapse is beginning to produce a new understanding about shared concerns, cross-field learning and the mutua... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2975208 Mon, 09 Nov 2009 00:00:00 +0100 2975208 http://www.medworm.com/index.php?rid=2975207&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F4 Stigma and discrimination constitute one of the greatest barriers to dealing effectively with the HIV epidemic, underlying a range of human rights violations and hindering access to prevention, care, treatment and support. There is some existing protection against HIV-based discrimination under international law, but the extent of states' obligations to address such discrimination has not been comprehensively addressed in an international instrument.The United Nations Convention on the Rights of Persons with Disabilities entered into force in May 2008. As countries ratify the convention, they are required to amend national laws and policies to give greater protection to the human rights of people with disabilities, including abolishing disability-based discrimination by the state and prote... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2975207 Mon, 09 Nov 2009 00:00:00 +0100 2975207 http://www.medworm.com/index.php?rid=2975206&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F2%2F1%2F5 Conclusions: This framework is the first to consider the contextual factors that influence experiences of disability from the perspective of adults living with HIV. Extrinsic factors (level of social support and stigma) and intrinsic factors (living strategies and personal attributes) may exacerbate or alleviate episodes of HIV-related disability. These factors offer a broader understanding of the disability experience and may suggest ways to prevent or reduce disability for adults living with HIV. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2975206 Mon, 09 Nov 2009 00:00:00 +0100 2975206 http://www.medworm.com/index.php?rid=2924255&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F25 Conclusions: Despite a low rate of therapeutic failure (4%) among these patients, those who failed possessed high numbers of resistance mutations as well as novel resistance mutations and/or polymorphisms at sites within reverse transcriptase and protease. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2924255 Sun, 25 Oct 2009 00:00:00 +0100 2924255 http://www.medworm.com/index.php?rid=2924256&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F24 Conclusion: Improvements in hospitals and within government offices are necessary to strengthen the vital registration system. These should include such strategies as training physicians and coders in accurate reporting and recording of death statistics, implementing continuous quality assurance methods, and working with the government to underscore the importance of using mortality statistics in future evidence-based planning. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2924256 Sat, 24 Oct 2009 00:00:00 +0100 2924256 http://www.medworm.com/index.php?rid=2873731&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F23 IntroductionLesotho has the third highest HIV prevalence in the world (an adult prevalence of 23.2%). Despite a lack of resources for health, the country has implemented state-of-the-art antiretroviral treatment guidelines, including early initiation of treatment ( (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2873731 Wed, 07 Oct 2009 23:00:00 +0100 2873731 http://www.medworm.com/index.php?rid=2844504&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F22 Conclusions: We found that an ART delivery model that shifted patient monitoring and antiretroviral dispensing tasks into the community by HIV-infected patients was both acceptable and feasible.Trial registration: ClinicalTrials.gov ID NCT00371540 (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2844504 Mon, 28 Sep 2009 23:00:00 +0100 2844504 http://www.medworm.com/index.php?rid=2808790&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F21 Conclusions: In an African HIV-infected ambulatory population presenting with new onset headache, aetiology was found in at least 70%. Cryptococcal meningitis and sinusitis accounted for more than half of the cases. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2808790 Fri, 18 Sep 2009 23:00:00 +0100 2808790 http://www.medworm.com/index.php?rid=2805855&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F19 Conclusions: The distribution of HIV incidence for birth cohorts by infection year suggests that the HIV epidemic continues to affect older homosexual men as much as, if not more than, younger men. The results are useful for evaluating the impact of the epidemic across successive birth cohorts and study trends among the age groups most at risk. (Source: Journal of the International AIDS Society) Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2805855 Thu, 17 Sep 2009 23:00:00 +0100 2805855 http://www.medworm.com/index.php?rid=2805854&cid=s_38189_20_f&fid=38189&url=http%3A%2F%2Fwww.jiasociety.org%2Fcontent%2F12%2F1%2F20 Use of antiretrovirals is widespread in Brazil, where more than 200,000 individuals are under treatment. Although general prevalence of primary antiretroviral resistance in Brazil is low, systematic sampling in large metropolitan areas has not being performed.The HIV Threshold Survey methodology (HIV-THS, WHO) was utilized, targeting Brazil's four major regions and selecting the six most populated state capitals: Sao Paulo, Rio de Janeiro, Salvador, Porto Alegre, Brasilia and Belem. We were able to sequence samples from 210 individuals with recent HIV diagnosis, 17 of them (8.1%) carrying HIV isolates with primary antiretroviral resistance mutations. Five, nine and four isolates showed mutations related to resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside re... Journal of the International AIDS Society journals http://www.medworm.com/rss/comments.php?id=2805854 Thu, 17 Sep 2009 23:00:00 +0100 2805854