Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 6 Articles
Ageing is the result of biological events that progressively and irreversibly compromise the function of vital organs\nand eventually result in death. There is a general perception that ageing is accelerated in people living with HIV, with\nan increasing body of evidence to support this view. With the introduction of effective antiretroviral therapy, the life\nexpectancy of people living with HIV has improved. Since people with HIV are living longer than previously, while also\nageing faster than the general population, there is an increase in HIV-positive patients living with age-related comorbidities.\nThis brief overview of ageing and HIV discusses aspects of the complications of HIV infection as they impact\nthe ageing process. How diseases of age affect patients with HIV provides clues to help unravel the interactions\nbetween HIV and ageing that ultimately should help clinicians understand the basis of â??normalâ?? ageing and manage\nageing HIV-positive patients more effectively....
This paper introduces the online Sociometrics Social, Behavioral, and Health\nSciences Library, an exciting new science-based resource for HIV/AIDS researchers,\nhealth educators, and clinicians. The over 400 products in the Sociometrics\nLibrary supplement the online publicationsâ??journal articles,\nbooks, reports, monographsâ??that have been the focus of scientific research\nlibraries and publishers to date, both printed and online. Examples of the innovative\nscience-based products that serve as the libraryâ??s content include:\nEvidence-based interventions and programs (EBIs/EBPs) that evaluation research\nhas shown to be effective in preventing HIV or its risky social and behavioral\nantecedents; primary research data and survey instruments; and interactive,\nmultimedia training tools and courses to build HIV professionalsâ??\ncapacity to implement EBPs with fidelity and to cooperate with evaluators in\nthe assessment of their effectiveness. A Scientist Expert Panel has guided and\nwill continue to guide product selection and acquisition, ensuring the collectionâ??s\ncontinuing technical merit, research utility, and relevance for practice\nand policy. The Sociometrics Library aims to become the dominant online\nsource of behavioral and social science-based HIV research by-products,\noperationally sustainable and able to stay up-to-date both from a technological\nand scientific perspective....
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Background: Prevention of Mother-to-Child HIV Transmission (PMTCT) coverage has been low in Ethiopia and the\nservice has been implemented in a fragmented manner. Solutions to this problem have mainly been sought on the\nsupply-side in the form of improved management and allocation of limited resources. However, this approach\nlargely ignores the demand-side factors associated with low PMTCT coverage in the country. The study assesses the\nfactors associated with the utilization of PMTCT services taking into consideration counts of visits to antenatal care\n(ANC) services in urban high-HIV prevalence and rural low-HIV prevalence settings in Ethiopia.\nMethods: A multivariate regression model was employed to identify significant factors associated with PMTCT\nservice utilization. Poisson and negative binomial regression models were applied, considering the number of ANC\nvisits as a dependent variable. The explanatory variables were age; educational status; type of occupation; decisionmaking\npower in the household; living in proximity to educated people; a neighborhood with good welfare\nservices; location (urban high-HIV prevalence and rural low-HIV prevalence); transportation accessibility; walking\ndistance (in minutes); and household income status. The alpha dispersion test (a) was performed to measure the\ngoodness-of-fit of the model. Significant results were reported at p-values of < 0.05 and < 0.001.\nResults: Household income, socio-economic setting (urban high-HIV prevalence and rural low-HIV prevalence) and\nwalking distance (in minutes) had a statistically significant relationship with the number of ANC visits by pregnant\nwomen (p < 0.05). A pregnant woman from an urban high-HIV prevalence setting would be expected to make 34%\nmore ANC visits (counts) than her rural low-HIV prevalence counterparts (p < 0.05). Holding other variables constant,\na unit increase in household income would increase the expected ANC visits by 0.004%. An increase in walking\ndistance by a unit (a minute) would decrease the number of ANC visits by 0.001(p < 0.001).\nConclusion: Long walking distance, low household income and living in a rural setting are the significant factors\nassociated with low PMTCT service utilization. The primary strategies for a holistic policy to improve ANC/PMTCT\nutilization should thus include improving the geographical accessibility of ANC/PMTCT services, expanding\nhousehold welfare and paying more attention to remote rural areas....
Background: Like other countries, Tanzania instituted mobile and outreach testing approaches to address low HIV\ntesting rates at health facilities and enhance linkage to care. Available evidence from hard-to-reach rural settings of\nMbeya region, Tanzania suggests that clients testing HIV+ at facility-based sites are more likely to link to care, and\nto link sooner, than those testing at mobile sites. This paper (1) describes the populations accessing HIV testing at\nmobile/outreach and facility-based testing sites, and (2) compares processes and dynamics from testing to linkage to\ncare between these two testing models from the same study context.\nMethods: An explanatory sequential mixed-method study (a) reviewed records of all clients (n = 11,773) testing at 8\nmobile and 8 facility-based testing sites over 6 months; (b), reviewed guidelines; (c) observed HIV testing sites (n = 10)\nand Care and Treatment Centers (CTCs) (n = 8); (d) applied questionnaires at 0, 3 and 6 months to a cohort of 1012 HIV\nnewly-diagnosed clients from the 16 sites; and (e) conducted focus group discussions (n = 8) and in-depth qualitative\ninterviews with cohort members (n = 10) and health care providers (n = 20).\nResults: More clients tested at mobile/outreach than facility-based sites (56% vs 44% of 11,733, p < 0.001). Mobile\nsite clients were more likely to be younger and male (p < 0.001). More clients testing at facility sites were HIV positive\n(21.5% vs. 7.9% of 11,733, p < 0.001). All sites in both testing models adhered to national HIV testing and care guidelines.\nStaff at mobile sites showed more proactive efforts to support linkage to care, and clients report favouring the\nconfidentiality of mobile sites to avoid stigma. Clients who tested at mobile/outreach sites faced longer delays and\nwaiting times at treatment sites (CTCs).\nConclusions: Rural mobile/outreach HIV testing sites reach more people than facility based sites but they reach a\ndifferent clientele which is less likely to be HIV +ve and appears to be less â??linkage-readyâ?. Despite more proactive\ncare and confidentiality at mobile sites, linkage to care is worse than for clients who tested at facility-based sites. Our\nfindings highlight a combination of (a) patient-level factors, including stigma; and (b) well-established procedures and\nroutines for each step between testing and initiation of treatment in facility-based sites. Long waiting times at treatment\nsites are a further barrier that must be addressed....
Abstract: The utility of the adenosine deaminase (ADA) assay in the diagnosis of patients with pleural\ntuberculosis (TB) and human immunodeficiency virus (HIV) infection is controversial. Forty-eight\nHIV positive patients with pleural effusion were evaluated; ADA assay was obtained in forty-three\nof them. Twenty-five patients presented diagnosis of TB. Patients with diagnosis of TB showed a\nmedian value of ADA of 70 IU/L (interquartile range (IQR) 41â??89) and the non-TB group a median\nof 27.5 IU/L (IQR 13.5â??52). Patients with diagnosis of TB had a median cluster of differentiation 4\n(CD4) count of 174 (IQR 86â??274) and the non-TB group had a median of 134 (IQR 71â??371). Receiver\noperating characteristic curve was performed with an area under the curve of 0.79. The best cut-off\nobtained was 35 IU/L with a sensibility of 80% and a specificity of 66%. There was no correlation\nbetween CD4 lymphocytes count and the value of ADA in the TB patient group....
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