...COH/200301; Total nos of Pages: 7; COH 200301 Potential impact of early antiretroviral therapy on transmission David Paoa, Deenan Pillayb,c and Martin Fishera HIV/GUM Research Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, Department of Infection, University College London Medical School and cCentre for Infections, Health Protection Agency, London, UK b a Correspondence to Deenan Pillay, Centre for Virology (Bloomsbury), Windeyer Building, 46 Cleveland Street, London W1T 4JF, UK Tel: +44 20 7679 9482; fax: +44 20 7580 5896; e-mail: d.pillay@ucl.ac.uk Current Opinion in HIV and AIDS 2009, 4:000–000 Purpose of review In this review, we will discuss the potential of early highly active antiretroviral therapy (HAART) to reduce the sexual transmission of HIV on an individual and population level. We will focus on the biological plausibility and behavioural factors associated with HAART use and interventions that might influence such a strategy. Recent findings Empiric and phylogenetic studies support the view that recent HIV infection is a highly infectious disease stage. Evidence increasingly demonstrates that individuals on fully suppressive HAART are significantly less likely to transmit HIV to sexual partners and some even suggest that such individuals cannot transmit HIV. Changes in risk behaviour are associated with the availability of HAART but behavioural studies offer contradictory observations regarding the direction and magnitude of these...
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...HIV/AIDS & HOMELESSNESS Recommendations for Clinical Practice and Public Policy Developed for The Bureau of Primary Health Care and The HIV/AIDS Bureau Health Resources and Services Administration by John Song, M.D., M.P.H., M.A.T. November 1999 Financial and other support for the development and distribution of this paper were provided by the Bureau of Primary Health Care and the HIV/AIDS Bureau, Health Resources Services Administration, United States Department of Health and Human Services, to the National Health Care for the Homeless Council, Inc., and its subsidiary, the Health Care for the Homeless Clinicians’ Network. The views presented in this paper are those of the author and do not necessarily represent those of the United States government or of the National Health Care for the Homeless Council. Nothing in this paper should be construed as providing authoritative guidelines for the practice of medicine or for treatment of medical conditions. This paper may be reproduced in whole or in part with appropriate recognition to the author, John Y. Song, MD, and the publisher, the Health Care for the Homeless Clinicians’ Network, National Health Care for the Homeless Council, Inc. Second Printing February, 2000 National Health Care for the Homeless Council Health Care for the Homeless Clinicians’ Network Post Office Box 60427 Nashville TN 37206-0427 Phone 615/226-2292 Fax 615/226-1656 council@nhchc.org or network@nhchc.org http://www.nhchc.org i PREFACE HIV/AIDS...
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...Mitigation and adaptation measures to HIV/AIDS in the Philippines Mitigation and adaptation measures to HIV/AIDS in the Philippines STS 1 - X GROUP 16 STS 1 - X GROUP 16 Mitigation and adaptation measures to HIV/AIDS in the Philippines ------------------------------------------------- Factolerin, M., Mantala, C.J., Bernardo, M.C., Villa, A., Navarro, A.J., Ausa, E., Obiña, M.L., Velarde, E., Bernabe, M., Lusanta, A., & Bolanos, J. I. Introduction Acquired immunodeficiency syndrome (AIDS) is a pattern of devastating infections caused by the human immunodeficiency virus (HIV) transmitted through the exchange of a variety of body fluids from infected individuals. It occurs in three ways: sexual transmission, exposure to infected blood or blood products, or perinatal transmission, which includes breastfeeding. The likelihood for transmission is affected by social, cultural, and environmental factors that differ between and within the various regions, countries, and continents. This virus attacks and destroys certain white blood cells that are essential to the body’s immune system (UNAIDS, 2000). When HIV infects a cell, it combines with that cell's genetic material and may lie inactive for years. Most people infected with HIV are still healthy and can live for years with no symptoms or only minor illnesses. They might be infected with HIV, but this does not necessarily mean that they have AIDS. HIV targets CD4+ lymphocytes that help recognize and destroy bacteria, viruses...
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...Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis May 2007 NACO Ministry of Health & Family Welfare Government of India Assessment and Management of HIV-Infected Person No Is HIV infection confirmed? Send to ICTC for confirmation of HIV status Yes Perform history taking and physical examination (see p 9 ) Evaluate for signs and symptoms of HIV infection or OIs and WHO clinical staging (see p 10) Provide appropriate investigations/treatment of OIs (see p 13 ) If pregnant, refer to PPTCT Screen for TB Screen for STI Identify need for: CTX prophylaxis (see p 16 ) ART (see p 18 ) No Pre ART care (see p 15 ) Yes Give patient education on treatment and adherence (see p 54 ) Arrange psychosocial, nutrition and community support (see p 56) Start ART, (see p 19 ) Arrange follow-up + monitoring (see p 25 ) Assess adherence every visit Provide positive prevention advice and condoms Provide patient information sheet on the ART regimen prescribed (see annex 7, 8) Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis May 2007 NACO National AIDS Control organisation Ministry of Health and Family Welfare Government of India with support from CDC . Clinton Foundation . WHO TAble of T A b l e o f Acronyms and Abbreviations Introduction....... ..........................................................................................
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...family-based interventions. To maintain high levels of adherence in some patients, it is critically important to provide substance abuse therapy and to strengthen social support. Directly observed therapy (DOT) has been effective in providing ART to active drug users but not to patients in a general clinic...
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...The Impact of Globalization on the Health Sector in South Africa After the Apartheid era, massive inequalities in income, health status, access to health care and other social services continued to dominate in South Africa. The Apartheid era was a system of racial segregation that was implemented in South Africa from 1948 to 1994. Due to colonization, whites had ruled South Africa for several centuries, which resulted in the creation of a system that was constructed to serve as a legal framework for continued economic and political dominance by people of European descent (WHO 2003: Antiretroviral Therapy). The apartheid era came to an end as a consequence of both inner and global pressure and South Africa’s new democratic government. The new government claims that improving the access to health care is a main priority noting, “emphasis should be placed on reaching … the most vulnerable” (Department of Health 1997:13). Giving access to health care is becoming an even greater challenge. South Africa was, and is still facing an exploding HIV/AIDS epidemic that, if anything, is highly associated with health care demands. Today, there are more than 5.3 million people living with HIV/AIDS in South Africa, this accounts for more than 21.5% of the entire population (CIA World Fact book: 2006). This paper aims to understand how the health care sector has dealt with the challenges faced in dealing with immense inequalities and a growing epidemic in the context of globalization...
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...for posttrial access to antiretroviral treatment for research participants in developing countries. Am J Public Health. 2009; 99(9):1556–1562. 2. National Institutes of Health. Guidance for addressing the provision of antiretroviral treatment for trial participants following their completion of NIH funded antiretroviral treatment trials in developing countries. 2005. Available at: http://grants.nih.gov/ grants/policy/antiretroviral/index.htm. Accessed October 20, 2009. 3. Shaffer DN, Yebei VN, Ballidawa JB, et al. Equitable treatment for HIV/AIDS clinical trial participants: a focus group study of patients, clinician researchers, and administrators in western Kenya. J Med Ethics. 2006;32:55–60. 4. Posse M, Meheus F, Van Asten H, van der Ven A, Baltussen R. Barriers to access to antiretroviral treatment in developing countries: a review. Trop Med Int Health. 2008;13(7):904–913. 5. MacQueen KM, Namey E, Chilongozi DA, et al. Community perspectives on care options for HIV prevention trial participants. AIDS Care. 2007;19(4): 554–560. SHAH AND GRADY RESPOND Onyeabor’s letter highlighted some of the ethical complexities inherent in posttrial access. Although we agree that ethically, individuals benefiting from antiretroviral therapy should continue to receive it, the challenge for all of us involved in the ethical conduct of research is to be clear about how this should occur. Many study participants in developing countries, including those in the studies cited, understandably feel...
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...illness. This is typically followed by a prolonged period without symptoms. As the illness progresses, it interferes more and more with the immune system, making the person much more likely to get infections, including opportunistic infections and tumors that do not usually affect people who have working immune systems. HIV is transmitted primarily via unprotected sexual intercourse, contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding. Prevention of HIV infection, primarily through safe sex and needle-exchange programs, is a key strategy to control the spread of the disease. There is no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications from the disease, these medications are expensive and may be associated with side effects. Genetic research indicates that HIV originated in west-central Africa during the early twentieth century. AIDS was first recognized by the Centers for Disease Control and Prevention in 1981 and its cause—HIV infection—was identified in the early part of the decade. Since its discovery, AIDS has caused nearly 30 million deaths . As of 2010, approximately 34 million people are living with HIV globally. Signs and symptoms There are three main stages of HIV infection: acute infection, clinical latency and AIDS. Acute infection ...
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...Study of the rates of co-infection of HIV/AIDS and Tuberculosis in Urbanized regions within Sub-Saharan Africa Sistla Sumanth Introduction: Airborne communication of mycobacterium tuberculosis is responsible for the evolution of primary tuberculosis (TB) in immunostable and immunocomprimsed patients (Aaron, et al. 2004). In 1993, the center for disease control classification identified that TB was the defining illness in HIV infected patients, as it is typically the first symptom bearing illness to afflict the patient (Aaron, et al. 2004). TB cases have dramatically increased in the global setting in recent, particularly in Sub-Saharan Africa, illustrating the sensitivity of HIV infected patients to this co-infection. TB results from a pathogenic infection caused primarily by M. tuberculosis, and seldom Mycobacterium bovis; the infiltration of the bacterium into the respiratory tract leads to the infection of the macrophages and cytotoxic cells debilitating intracellular growth (Aaron, et al. 2004). The risk of HIV infected patients to succumb due to the co-infection of tuberculosis and HIV is twice that of patients only infected with HIV (Aaron, et al. 2004). A 1997 estimate suggests that atleast 10.7million people were co-infected with HIV and M. tuberculosis; more than 30% of TB cases in Africa are also infected with HIV (Aaron, et al. 2004) showing the susceptibility of co-infection in immunocompromised patients. Those living in Sub-Saharan Africa...
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...Case Study: Lesotho Appeal Industry Fight AIDS Anne Menlove, Hugo Vera, Hannah Nielsen, & Moriah Martin Grand Canyon University: HLT 411 May 29, 2016 Lesotho is a small country in the Southern tip of Africa that has been burden by an epidemic of HIV. It is estimated that 22 percent of the population is infected, being 270,000 people in the country but only one-quarter of those infected has received antiretroviral treatment (ART) (Gilden, 2009). There is an apparel company, Precious garments, that has taken on the fight against AIDS by starting the Apparel Lesotho Alliance to Fight AIDS (ALAFA). ALAFA goals as an organization are to determine social and economic factors of the population with HIV, develop a peer education model, and find the cost-effectiveness (Gilden, 2009). Roles and Importance The overall role that ALAFA has to help to fight against HIV/AIDS by giving help to HIV positive Basotho women that work in the apparel and textile industry. The organization provides information on prevention, testing and treatment (antiretroviral therapy) services in factory based clinics (Gilden, 2009). The issue of HIV/AIDS is important to ALAFA because not only do they want to create a healthier and more stable work environment, but they also want to change the lives of the apparel workers and provide the necessary care that they need (Gilden, 2009). Social and Economic Factors The Apparel Lesotho Alliance to Fight AIDS launch did encounter some social and economic...
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...staphylococcal skin infections and septicaemia. These are diseases that people with normal immune systems can also get, but with HIV they occur at a much higher rate. It also takes longer for a person with HIV to recover than it takes for someone with a healthy immune system. When the immune system is very weak due to advanced HIV disease or AIDS, opportunistic infections such as PCP, toxoplasmosis and cryptococcosis develop. Some infections can spread to a number of different organs, which is known as 'disseminated' or 'systemic' disease. Many of the opportunistic infections that occur at this late stage can be fatal. 1 back to top Why is there still a need to prevent and treat opportunistic infections? Highly Active Antiretroviral Therapy (HAART) can reduce the amount of HIV in someone's body and restore their immune system. The introduction of HAART has dramatically reduced the incidence of...
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...HIV and its causes to humans I. AIDS is a disease caused by a virus called HIV (Human Immunodeficiency Virus). The illness alters the immune system, making people much more vulnerable to infections and diseases. This susceptibility worsens as the disease progresses. HIV is found in the body fluids of an infected person (semen and vaginal fluids, blood and breast milk). The virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their babies during pregnancy, delivering the baby during childbirth, and through breast feeding. HIV can be transmitted in many ways, such as vaginal, oral sex, anal sex, blood transfusion, and contaminated hypodermic needles. Both the virus and the disease are often referred to together as HIV/AIDS. People with HIV have what is called HIV infection. As a result, some will then develop AIDS. The development of numerous opportunistic infections in an AIDS patient can ultimately lead to death. According to research, the origins of HIV date back to the late nineteenth or early twentieth century in west-central Africa. AIDS and its cause, HIV, were first identified and recognized in the early 1980s. There is currently no cure for HIV/AIDS. Treatments can slow the course of the disease - some infected people can live a long and relatively healthy life. II. What is the difference...
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...HIV/AIDS treatments: Sub-Saharan African nations still have a long way to go HIV-AIDS has infected over thirty million people in the world. Over 95% of all AIDS cases in the world are in Africa and in some of those countries over 40% of the people are infected (Frederickson and Kanabus HIV and AIDS in Africa 1). AIDS does not solely affect homosexuals, or any certain ethnicity of people, either; HIV-AIDS can affect any type of ethnicity including African Americans, Caucasians, Asians, Indians, and Hispanic people. AIDS cannot be reversed or cured, but with proper treatment this deadly virus can be controlled and people can live a nearly normal life. In Africa, though, proper treatment is not nearly as available as it is in some other countries. Approximately 2.3 million people died in 2003 in Sub-Saharan Africa alone and that is only the beginning (Frederickson and Kanabus HIV 1). Particularly in Sub-Saharan Africa, where hospital provide inferior treatment to infected patients because of their socioeconomic status, lack of training of their health providers, shortage of medical staffs, lack of appropriate equipment, insufficient funds allocated for medicine and doctors salary and the absence of counselor or prevention unit in these facilities. HIV/Aids has been named a global epidemic with its toll felt significantly especially in Africa. It has been a major cause of death in the world; it also continued to be a public health concern. It poses huge threat of wiping out...
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...Farber (1989) discusses how it is important to educate students in a variety of ways regarding neurobiology to enhance skills and application to occupational therapy. She discusses how the traditional learning style in memorization of concepts does not carry over into clinical practice (Farber, 1989). She also states that current practicing occupational therapists continue to explore the literature as it is constantly changing (Farber, 1989). Although this article was written almost 30 years ago, I find the statements regarding education and remaining current still applicable today. On the idea of the ever-changing neuroscience literature, I cannot help but think about the information that is presented in the article and the...
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...HIV Human Immunodeficiency Virus HIV Human Immunodeficiency Virus Suanchirae Williams Devry Unviersity BIO 260 Professor Daudi Langat Suanchirae Williams Devry Unviersity BIO 260 Professor Daudi Langat INTRODUCTION Growing up my little brother was the man of our house, a household of seven with my little brother being the only boy, such a heavy burden on such small shoulders. It seemed to be a role that he just woke up one day and assumed he needed to fill. My mother was a single mother of six children so she worked long hours every day which left me, being the oldest, as the secondary mother. It seemed to become my role as caregiver and my little brother, who is almost 5 yrs. younger than me, the protector. As we all grew up and started branching off into our own little worlds my little brother became a more private person. It was a surprise in late 2005 when he brought home a girl and announced her as his girlfriend and that he loved her. She was a great girl we all took a shine to her and welcomed her into our family. After a few months this new girlfriend decided it was time for us all to have a family meeting, there was something that she felt she needed to share with us all before anything more happened with her and my brother. She sat us all down and started to explain her family to us ending with her...
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