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People living with HIV (PWH) are at higher risk for cardiovascular disease (CVD) and stroke in comparison to their non-infected counterparts. The ABCS (aspirin-blood pressure control-cholesterol control-smoking cessation) reduce atherosclerotic (ASCVD) risk in the general population, but little is known regarding strategies for promoting the ABCS among PWH. Guided by the Consolidated Framework for Implementation Research (CFIR), we designed multilevel implementation strategies that target PWH and their clinicians to promote appropriate use of the ABCS based on a 10-year estimated ASCVD risk. Implementation strategies include patient coaching, automated texting, peer phone support, academic detailing and audit and feedback for the patient's clinician. We are evaluating implementation through a stepped wedge cluster randomized trial based on the Reach-Effectiveness-Adoption-Maintenance/Qualitative-Evaluation-for-Systematic-Translation (RE-AIM/QuEST) mixed methods framework that integrates quantitative and qualitative assessments. The primary outcome is change in ASCVD risk. Findings will have important implications regarding strategies for reducing ASCVD risk among PWH. [ABSTRACT FROM AUTHOR]

It is very important to develop a rapid, simple, low cost point-of-care (POC) method for the early diagnosis of pathogens. In this work, a flexible paper-based electrode based on nickel metal-organic framework (Ni-MOF) composite/Au nanoparticles/carbon nanotubes/polyvinyl alcohol (Ni–Au composite/CNT/PVA) was constructed to detect target human immunodeficiency virus (HIV) DNA by DNA hybridization using methylene blue (MB) as a redox indicator. The CNT/PVA and Ni–Au composite were deposited on the cellulose membrane by vacuum filtration and drop-coating method in turn to obtain Ni–Au composite/CNT/PVA (CCP) film electrode. Compared to the CNT/PVA film electrode, CCP film electrode makes a higher loading of the probe DNA for its large specific surface area and conjugated π-electron system that can provide hydrogen bond sources to achieve interactions between MOF and single-stranded DNA, which improves the sensitivity for detecting target DNA. The variation of peak current for MB molecules adsorbed onto DNA before and after hybridization with HIV DNA was monitored. Electrochemical results proved that the CCP film maintained stable electrochemical property even after bending 200 times or stretching under different strains from 0% to 20%. The flexible paper electrode showed excellent sensing performance with a linear range of 10 nM–1 μM and a low detection limit of 0.13 nM. The target HIV DNA was successfully detected even in complex serum samples using the flexible CCP film electrode. Therefore, the simple and inexpensive flexible paper-based MOF composite film electrode can also be utilized for other pathogens POC diagnosis. • A flexible paper electrode based on Ni-MOF composite/AuNPs/CNTs. • The flexible paper-based electrode was used for HIV DNA POC detection. • CCP film maintained high electrochemical stability after bending and stretching states. • The flexible biosensor showed excellent sensing performance for HIV DNA detection. • The target HIV DNA can be successfully detected even in complex serum samples. [ABSTRACT FROM AUTHOR]

Accurate, rapid, and low-cost molecular diagnostics is essential in managing outbreaks of infectious diseases, such as the pandemic of coronavirus disease 2019 (COVID-19). Accordingly, microfluidic paper-based analytical devices (μPADs) have emerged as promising diagnostic tools. Among the extensive efforts to improve the performance and usability of diagnostic tools, biosensing mechanisms based on electrochemical impedance spectroscopy (EIS) have shown great promise because of their label-free operation and high sensitivity. However, the method to improve EIS biosensing on μPADs is less explored. Here, we present an experimental approach to enhancing the performance of paper-based EIS biosensors featuring zinc oxide nanowires (ZnO NWs) directly grown on working electrodes (WEs). Through a comparison of different EIS settings and an examination of ZnO-NW effects on EIS measurements, we show that ZnO-NW-enhanced WEs function reliably with Faradaic processes utilizing iron-based electron mediators. We calibrate paper-based EIS biosensors with different morphologies of ZnO NWs and achieve a low limit of detection (0.4 pg ml−1) in detecting p24 antigen as a marker for human immunodeficiency virus (HIV). Through microscopic imaging and electrochemical characterization, we reveal that the morphological and the electrochemical surface areas of ZnO-NW-enhanced WEs indicate the sensitivities and sensing ranges of the EIS nanobiosensors. Finally, we report that the EIS nanobiosensors are capable of differentiating the concentrations (blank, 10 ng ml−1, 100 ng ml−1, and 1 μg ml−1) of IgG antibody (CR3022) to SARS-CoV-2 in human serum samples, demonstrating the efficacy of these devices for COVID-19 diagnosis. This work provides a methodology for the rational design of high-performance EIS μPADs and has the potential to facilitate diagnosis in pandemics. • Paper-based electrochemical impedance biosensors for accurate, rapid, and low-cost diagnostics of infectious diseases. • Zinc oxide nanowires (ZnO NWs) were directly synthesized on paper electrodes through hydrothermal growth. • Morphological and electrochemical surface areas of ZnO NWs on a working electrode affect the sensitivity and detection range of the electrochemical impedance biosensors. • Serological testing of IgG antibody (CR3022) to COVID-19 was demonstrated. [ABSTRACT FROM AUTHOR]

Lateral flow assays (LFAs) hold great promise for point-of-care testing, especially in resource-poor settings. However, the poor sensitivity of LFAs limits their widespread applications. To address this, we developed a novel device by integrating dialysis-based concentration method into LFAs. The device successfully achieved 10-fold signal enhancement in Human Immunodeficiency Virus (HIV) nucleic acid detection with a detection limit of 0.1 nM and 4-fold signal enhancement in myoglobin (MYO) detection with a detection limit of 1.56 ng/mL in less than 25 min. This simple, low-cost and portable integrated device holds great potential for highly sensitive detection of various target analytes for medical diagnostics, food safety analysis and environmental monitoring. [ABSTRACT FROM AUTHOR]

Despite multiple efforts to reduce HIV rates among African American young adults, a significant racial disparity persists and continues to grow among this population. New approaches are needed to reach this at-risk group and engage them in prevention efforts. The Community Influences Transitions of Youth Health (CITY Health II) study aims to increase HIV preventive behaviors to decrease HIV rates among 18–25 year old African American emerging adults living in resource-poor southern urban communities. CITY Health II is a 5-year HIV prevention study that evaluates the efficacy of a peer-driven entertainment education intervention compared to an attention-control intervention using a cluster randomized trial design. Participants were recruited through respondent-driven sampling (RDS) to participate in a social media intervention. We enlisted eight musicians and groups to help us create an entertaining and educational web-based video series, "The Beat HIVe", for study participants to view on smartphones and share with peers on social media. Data collection interviews at baseline, 3-month, and 6-month follow-up assessed socio-demographics, risk and protective behaviors, social networks, and peer norms. Analyses will determine if participation is associated with improved HIV-related outcomes; examine whether intervention changes are mediated by perceived social norms and outcome expectations; determine whether intervention benefits vary by sociodemographic characteristics related to mediators, intervention outcome, or level of engagement; and examine the relationship between participant dose of intervention and outcomes. Outcomes will inform ways to engage African American emerging adults through entertainment education and other strategies for increasing optimal sexual health behaviors. Trial Registration: NCT04320186 [ABSTRACT FROM AUTHOR]

Abstract: This article presents the WHO recommendations on the use of polio vaccines excerpted from the recently published Polio vaccines and polio immunization in the pre-eradication era: WHO position paper. This document replaces the WHO position paper entitled Introduction of inactivated poliovirus vaccine into oral poliovirus vaccine-using countries published in the Weekly Epidemiological Record in July 2003. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization, or SAGE. [Copyright &y& Elsevier]

• HIV+ individuals are an important subpopulation in areas at risk of an Ebola outbreak. • The Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen induced antibodies that persisted 4·5 years. • Ad26.ZEBOV booster dose is safe and highly immunogenic in previously immunized HIV+ adults. • Ad26.ZEBOV boosters can be deployed safely to HIV+ adults with well-controlled infection. People living with HIV constitute an important part of the population in regions at risk of Ebola virus disease outbreaks. The two-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen induces strong immune responses in HIV-positive (HIV+) adults but the durability of this response is unknown. It is also unclear whether this regimen can establish immune memory to enable an anamnestic response upon re-exposure to antigen. This paper describes an open-label, phase 2 trial, conducted in Kenya and Uganda, of Ad26.ZEBOV booster vaccination in HIV+ participants who had previously received the Ad26.ZEBOV, MVA-BN-Filo primary regimen. HIV+ adults with well-controlled infection and on highly active antiretroviral therapy were enrolled, vaccinated with booster, and followed for 28 days. The primary objectives were to assess Ad26.ZEBOV booster safety and antibody responses against the Ebola virus glycoprotein using the Filovirus Animal Non-Clinical Group ELISA. The Ad26.ZEBOV booster was well-tolerated in HIV+ adults with mostly mild to moderate symptoms. No major safety concerns or serious adverse events were reported. Four and a half years after the primary regimen, 24/26 (92 %) participants were still classified as responders, with a pre-booster antibody geometric mean concentration (GMC) of 726 ELISA units (EU)/mL (95 %CI 447–1179). Seven days after the booster, the GMC increased 54-fold to 38,965 EU/mL (95 %CI 23532–64522). Twenty-one days after the booster, the GMC increased 176-fold to 127,959 EU/mL (95 %CI 93872–174422). The responder rate at both post-booster time points was 100 %. The Ad26.ZEBOV booster is safe and highly immunogenic in HIV+ adults with well-controlled infection. The Ad26.ZEBOV, MVA-BN-Filo regimen can generate long-term immune memory persisting for at least 4·5 years, resulting in a robust anamnestic response. Trial Registration: Pan African Clinical Trial Registry (PACTR202102747294430). Clinicaltrials.gov (NCT05064956). [ABSTRACT FROM AUTHOR]

Historically, human mpox was predominantly a zoonotic disease occurring more frequently in rural children in Africa and characterized by a largely self-limiting febrile centrifugal monomorphic rash illness. However, the 2022 mpox global outbreak has shown that the disease is changing in many ways, including sustained human-to-human transmission via sexual contact, novel clinical presentations, and adverse associations between mpox and advanced HIV. The aim of this paper is to review the traditional and emerging clinical aspects of human mpox and provide updated information on the clinical course and outcome of the disease. We searched electronic databases including PubMed and Google Scholar and identified relevant published literature on mpox. The clinical presentation of human mpox is influenced by the route of infectious exposure, the strain and dose of the infecting virus, and the host immune system. Exposure to the virus can result in sub-clinical or clinical diseases of variable severity. Infections caused by clade I viral strains are more severe than class IIa and IIb strains, which are associated with a milder febrile rash illness, and with anogenital skin lesions in clade IIb infections. Most cases of mpox recover entirely within 2–4 weeks after onset of illness and a few develop skin-related sequelae. Overall, people with advanced HIV infection, children <5 years of age, and pregnant women may present with more severe disease and higher case fatalities. The continued endemicity of the classical mpox in Africa, the emergence of a new clinical form of the disease during the 2022 global outbreak, and the adverse associations between advanced HIV and mpox have implications for the surveillance, clinical diagnosis, and management of human mpox. [ABSTRACT FROM AUTHOR]

Since 2007, the number of HIV diagnoses in Turkey has increased more than 600% and the AIDS-related deaths have more than doubled. Despite trans community being severely impacted by the growing epidemic, there exists a conspicuous absence of epidemiological data regarding the HIV burden of trans people. This paper examines the medical experiences of HIV-positive trans women who engage in sex work and the harmful violence they encounter at the hands of health providers. The paper emphasizes the urgent need for comprehensive interventions to address the intersecting issues of HIV risk, structural violence, and discrimination faced by HIV-positive trans sex workers, one of the most marginalized communities worldwide. To interpret better how transphobia and HIVphobia become deeply entangled in Turkish medical settings, the paper draws from the concepts of iatrogenesis , necropolitics, and immunity. By bringing together these conceptual tools with long-term ethnographic data and in-depth interviews, this paper demonstrates that trans women are treated by healthcare providers as though they are always-already infectious. The paper contends that aggressive immunitarian boundaries, erected between healthcare personnel and individuals deemed "contagious others," are central to doctors' denial of medical care and reluctance to touch, examine, or even admit trans patients, particularly when they are HIV-positive. • Social immunization lies at the core of doctors' refusal of care for trans patients. • Social immunization is central to the operation of necropolitics and iatrogenesis. • Doctors establish violent boundaries in an attempt to "protect" themselves. • Trans women are assumed to be inherently contagious by healthcare providers. • Trans communities are slowly debilitated through denial of healthcare services. [ABSTRACT FROM AUTHOR]

The Treat pillar of the Ending the HIV Epidemic in the U.S. plan calls for comprehensive strategies to enhance linkage to, and engagement in, HIV medical care to improve viral suppression among people with HIV and achieve the goal of 95% viral suppression by 2025. The U.S. has seen large increases in the proportion of people with HIV who have a suppressed viral load. Viral suppression has increased 41%, from 46% in 2010 to 65% in 2018. An additional increase of 46% is needed to meet the Ending the HIV Epidemic in the U.S. goal. The rate of viral suppression among those in care increased to 85% in 2018, highlighting the need to ensure sustained care for people with HIV. Greater increases in all steps along the HIV care continuum are needed for those disproportionately impacted by HIV, especially the young, sexual and racial/ethnic minorities, people experiencing homelessness, and people who inject drugs. Informed by systematic reviews and current research findings, this paper describes more recent promising practices that suggest an impact on HIV care outcomes. It highlights rapid linkage and treatment interventions; interventions that identify and re-engage people in HIV care through new collaborations among health departments, providers, and hospital systems; coordinated care and low-barrier clinic models; and telemedicine-delivered HIV care approaches. The interventions presented in this paper provide additional approaches that state and local jurisdictions can use to reach their local HIV elimination plans' goals and the ambitious Ending the HIV Epidemic in the U.S. Treat pillar targets by 2030. [ABSTRACT FROM AUTHOR]

Despite the progress in pharmaceutical and epidemiological tools for combating HIV spread, HIV stigma remains a significant social barrier impeding treatment and prevention efforts, potentially reducing the effectiveness of interventions to reduce HIV transmission. In this paper, we propose a novel approach to defining and estimating HIV stigmatization through the structure of sexual relations, as opposed to attitudes. We conceptualize structural stigma as arising from two mechanisms: (1) a reduced propensity towards HIV serodiscordant partnerships (exclusion); and (2) a reduced propensity towards partnerships with seroconcordant individuals who themselves have serodiscordant partnerships (ostracism). Both mechanisms can be assessed from observed partnership network data using exponential family random graph models (ERGMs). We demonstrate our approach on a sexual contact network of black men who have sex with men in the South Side of Chicago. We find a tendency for serodiscordant sexual relationships to be suppressed in the network (θ = −0.69, p <.05), as well as a suppressive tendency for HIV negative YBMSM to have sex with other HIV negative people in serodiscordant relationships (θ = −0.96, p <.05) suggesting that structural HIV stigma is present in this network. Potential relationships with attitudinal stigma and implications for epidemiological strategies for reducing HIV stigma are discussed. • HIV stigma is present structurally in a network of men who have sex with men. • One's network position co-varies with one's beliefs about HIV transmission. • The success of HIV destigmatization campaigns can be tracked through network structure. [ABSTRACT FROM AUTHOR]

Malgré l'essor des antirétroviraux (ARV), l'infection par le virus de l'immunodéficience humaine (VIH) reste un enjeu majeur de santé publique. Grâce à un meilleur accès à la prévention, un diagnostic plus précoce, un traitement et des soins plus efficaces, l'infection par le VIH est devenue une pathologie chronique avec des patients vieillissants, polypathologiques et polymédicamentés. Les personnes vivant avec le VIH (PV-VIH) voient leur espérance de vie augmenter tout comme leur risque cardiovasculaire. En plus du surrisque cardiovasculaire, l'incidence de la maladie veineuse thromboembolique (MVTE) est augmentée chez les PV-VIH avec une fréquence 2 à 10 fois plus importante que celle de la population générale. Les anticoagulants oraux directs (AOD) sont maintenant largement utilisés dans le traitement et la prévention de la MVTE et la prévention des complications thrombotiques chez les patients avec fibrillation atriale. Les AOD sont caractérisés par un délai d'action rapide, prévisible et un intervalle thérapeutique large. Néanmoins, des interactions médicamenteuses théoriques existent entre antirétroviraux (ARV) et AOD, exposant les PV-VIH à un risque hémorragique ou thrombotique théorique, puisque les AOD sont des substrats de la protéine de transport P-glycoprotéine et/ou des isoformes de la voie des cytochromes P450. Les recommandations disponibles sont limitées pour aider les médecins à faire face à la complexité des interactions médicamenteuses. Ainsi, l'objectif de ce travail est de synthétiser les données disponibles à ce jour quant au risque thrombotique veineux des PV-VIH et l'utilisation des AOD dans cette population. Nowadays, thanks to highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV) infection is transforming into a chronic disease. The life expectancy of people living with HIV (PWH) has increased, as well as their risk of developing several co-morbidities, in particular cardiovascular diseases. In addition, the incidence of venous thromboembolism (VTE) is increased in PWH with a 2 to 10 times higher incidence when compared to the general population. Over the last decade, direct oral anticoagulants (DOACs) have been widely used in the treatment and prevention of VTE and non-valvular atrial fibrillation. DOACs are characterized by a rapid onset of activity, a predictable response and a relatively wide therapeutic window. Nevertheless, drug interactions exist between HAART and DOACs, exposing PWH to a theoretically increased bleeding or thrombotic risk. DOACs are substrates of the transport protein P-glycoprotein and/or of isoforms of cytochromes P450 pathway, which can be affected by some antiretroviral drugs. Limited guidelines are available to assist physicians with the complexity of those drug-drug interactions. The aim of this paper is to provide an updated review on the evidence of the high risk of VTE in PWH and the place of DOAC therapy in this population. [ABSTRACT FROM AUTHOR]

Fractional calculus plays an important role in the development of control strategies, the study of the dynamical transmission of diseases, and some other real-life problems nowadays. The time-fractional HIV/AIDS model is examined using a novel method in this paper. Based on the Atangana-concept Baleanu's of a derivative in the Caputo sense, the current modified fractional derivative operator uses singular and non-local kernels. This new modified fractional operator is given a numerical approximation and applied to the HIV/AIDS model. In the presence of this novel operator, we present some significant analysis for the HIV/AIDS epidemic model. The uniqueness and stability criteria of the model have been demonstrated using the Picard successive approximation approach and Banach's fixed point theory. The Laplace Adomian decomposition method (LADM) was used to obtain the numerical solution for the modified Atangana-Baleanu Caputo derivative model. The convergence analysis is verified for the proposed scheme. Finally, numerical results and simulations are derived with the proposed scheme for HIV/AIDS model. On the dynamics of HIV/AIDS transmission, the effects of many biological parameters are examined. [ABSTRACT FROM AUTHOR]

This paper constructs approximate solutions of the epidemic system of HIV/AIDS transmission model with the help of the conformable fractional differential transform method. The fractional derivatives considered in this paper are described in the sense of the conformable operator. This method provides the approximate solutions speedily in the form of a convergent series. The results show the efficiency of the proposed method. [ABSTRACT FROM AUTHOR]

In this paper, HIV/AIDS fractional-order model is studied. This epidemic phenomenon is analyzed using Caputo-Fabrizio and Fractal fractional derivative operator that includes an antiretroviral treatment compartment. The advanced approach is used for HIV/AIDS fractional-order model to get reliable outcomes with the help of sumudu transform. The fractional-order HIV/AIDS model is analyzed qualitatively as well as verify unique solutions. Numerical simulations are performed to explain the effects of changing the fractional-order and to support the theoretical results using proposed methods for a range of fractional orders. Also, the comparison has been made with classical order derivative to check the effectiveness of the proposed method for HIV/AIDS. [ABSTRACT FROM AUTHOR]

In this paper, a new mathematical model for dual variants of COVID-19 and HIV co-infection is presented and analyzed. The existence and uniqueness of the solution of the proposed model have been established using the well known Banach fixed point theorem. The model is solved semi-analytically using the Laplace Adomian decomposition Method. The impact of the Atangana-Baleanu fractional derivative on the dynamics of the proposed model is studied. The work also highlights the impact of COVID-19 vaccination on the dynamics of the co-infection of both diseases. The model is fitted to real COVID-19 data from Botswana. The impact of COVID-19 variants on HIV prevalence using simulations is also assessed. Simulation for the class of individuals co-infected with HIV and the wild or Delta COVID-19 variant reveals a significant decrease, as vaccination rate is increased. The impact of fractional order on different epidemiological classes is also studied. Drawing the plot of total infected population with the wild and Delta COVID-19 variants, at different vaccination rates, it is concluded that, as vaccination rate is increased, there is a significant reduction in population infected with the wild and delta COVID-19 variants. The plot of class of individuals co-infected with HIV and the wild or Delta COVID-19 variant is more interesting; as vaccination rate is increased, the co-infected populations experience a significant decrease. Thus, stepping up vaccination against the different variants of COVID-19 could reduce co-infection cases largely, among people already infected with HIV. [ABSTRACT FROM AUTHOR]

Participation of citizens and service users is increasingly commonplace in research, policy and technology development. Alongside this development, social scientists have become increasingly incorporated into large-scale research and innovation projects to facilitate participatory spaces. This requires reflection on the mechanisms, outcomes and, ultimately, the accountabilities of participation. In this paper, we propose the lens of care framework for approaching such reflections. We illustrate its value by using it to account for our role in establishing participatory spaces as part of a European Horizon 2020-funded research and innovation project, entitled EmERGE. We describe the codesign processes we developed and implemented with the aim of enabling heterogeneous voices, distinct experiences and multiple ideas to be articulated to inform the development and implementation of a digital platform for HIV care. We show how the lens of care framework enables us to trouble participation along prior theoretical distinctions between patients/citizens roles, invited/uninvited spaces and inclusive/scientistic voices and provides novel lines of inquiry to capture the relational and emergent processes of participation in digital health innovation. In the EmERGE project, spaces of participation were co-created within and by the community, whose members skilfully arranged the material, social and temporal set-up. Within these spaces we were able to articulate voices, deliberate knowledge and study the potentialities of technology so that initial technological inscriptions of empowerment through information-push were challenged and were, eventually, replaced by more interactive forms of clinician-patient engagement in digital HIV care. Through the lens of care , this paper aims to provide a reflective tool for researchers and practitioners who are involved in the design, implementation, and evaluation of participatory projects. • Demonstrates how participation has been troubled along three key dimensions. • Develops the lens of care framework to reflect and evaluate participatory processes. • Elaborates the codesign process to develop a digital health platform for HIV care. • Analyses the selection of actors and knowledges within participatory spaces. • Guides researchers to take responsibility for the worlds they co-construct. [ABSTRACT FROM AUTHOR]

The role of pharmacists is crucial in the care of individuals with HIV/AIDS. However, stigma in health care settings can be a deterrent to providing appropriate care. This paper assessed psychometric properties and convergent validity of the Health Care Provider HIV/AIDS Stigma Scale (HPASS) among pharmacy students in the United States (US) using Rasch analysis. Students enrolled in four US universities were administered the survey (N = 203). Rasch analysis was conducted for each HPASS subscale (Stereotyping, Discrimination, and Prejudice) to assess dimensionality, model data fit, item difficulty, individual stigma, distribution of items and persons across item-person map, and rating scale function. Convergent validity evidence was established by comparing Pearson's correlation coefficients between HPASS subscales and the AIDS Attitude Scale (AAS) Avoidance subscale. Two items in the Prejudice subscale were misfit and therefore removed. The 6-point rating scale did not perform satisfactorily for HPASS subscales. Item difficulty ranges were wide [Stereotyping (−5 to 0.8 logits), Discrimination (−6 to 1 logits), Prejudice (−5 to 0.4 logits)]. Items were biased towards measuring higher levels of stigma. Person separation index was satisfactory (Stereotyping = 2.2; Discrimination = 2.06; Prejudice = 2.17) as was person separation reliability (Stereotyping = 0.83; Discrimination = 0.81; Prejudice = 0.83). Convergent validity was established by showing significant correlations between HPASS subscales and AAS Avoidance (P <.001). Modifying or removing misfit items of HPASS and exploring alternate rating scales for HPASS subscales will help better assess HIV/AIDS related stigma among pharmacy students. [ABSTRACT FROM AUTHOR]

In the United States, over 1.2 million people are living with HIV. This disease disproportionately affects men who have sex with men (MSM), people of color, youth and young adults, and transgender individuals. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method. Barriers exist for both primary care providers (PCPs) to prescribe PrEP and prevent patients from initiating PrEP. This study, MOST: PrEP, follows the multiphase optimization strategy (MOST) framework. The purpose is to identify a multi-level intervention among patients and PCPs to increase PrEP prescriptions in primary care. First, feedback will be obtained from providers and patients via focus groups, then, suggestions related to the context-specific (provider and individual level) factors of intervention component delivery will be incorporated. Subsequently, a rigorous experiment will be conducted using a 24 factorial design focusing on priority populations for PrEP initiation. Provider components include computer-based simulation training and a best practice alert. Patient components include a tailored PrEP educational video and HIV risk assessment. Finally, the facilitators and barriers to implementing the intervention components will be qualitatively examined. In this protocol paper, we describe the one of the first known multilevel MOST optimization trial in healthcare. Intervention components are to be delivered to patients and providers in a large healthcare system, based in an HIV Ending the Epidemic priority jurisdiction. If effective, this multi-level approach could be disseminated to providers and patients in other large healthcare systems to make a significant impact on HIV prevention. [ABSTRACT FROM AUTHOR]

Total hip arthroplasty (THA) has become a common intervention for human immunodeficiency virus (HIV)–positive patients who have osteonecrosis of the femoral head. This paper provides a systematic review to assess survivorships, patient-reported outcomes (PROMs), infection rates, other complications, and immune competence for patients who had THAs who did and did not have HIV. A comprehensive and systematic review of published studies investigating the outcomes of THA in HIV-positive patients (osteonecrosis and non-osteonecrosis patients) was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 10 studies with 9,534 HIV-positive patients fulfilled the inclusion and exclusion criteria. Manuscript quality was assessed on 2 scales: the Coleman Methodology Score and the level of evidence derived from Center for Evidence-Based Medicine criteria. Data were extracted from studies in the 5 key areas of interest: survivorships, PROMs, infection rates, complications, and clusters of differentiation-4 (CD4+) counts and viral loads. Implant survivorship was between 95% and 100%. Postoperative Harris Hip Scores were significantly improved from preoperative values in HIV-positive patients. Postoperative PROMs and infections did not appear to be different between HIV-positive and HIV-negative patients. Many of the cohort studies demonstrate comparable complication rates to matched controls. Where described (7 reports), mean CD4+ counts ranged from 425 to 646 cells/mm3, with low viral loads (3 reports) and variations not found to influence outcomes. THA is an effective treatment for HIV-positive patients, many of whom suffer from osteonecrosis of the femoral head. The results demonstrate excellent implant survivorship, improved quality of life, and a low risk of infections and complications. [ABSTRACT FROM AUTHOR]

• The use of telemedicine has increased in all areas of health care. • Training providers to successfully care for patients in remote settings is essential. • Trainings standardize visit protocols, control provider and patient expectations, identify how to incorporate remote visits into routine clinic flows, provide tools for increasing provider competency to interact with patients, utilize technology features, and increase understanding of types of ongoing support providers require. Engaging in HIV care is key to maintaining successful health outcomes for persons with HIV (PWH). Barriers to care affect engagement and can include access to transportation. Telemedicine has been used to overcome geographical barriers in rural settings, and PWH in urban areas without public transportation can also benefit from this strategy. The aim of this research is to explore the attitudes of providers in one health system about telemedicine after receiving training. From 2018–2020, a convenience sample of 112 providers at University of Florida Health in Jacksonville, FL were offered telemedicine training consisting of didactic, hands-on, and in-person support. Provider attitudes were assessed in pre- and post-training surveys, focus groups, and after telemedicine visits. Descriptive statistics and paired t -tests were used to analyze pre- and post-training surveys. Readiness and willingness to conduct telemedicine with PWH after training significantly increased among providers (n = 73). Providers reported increased readiness to conduct telemedicine visits (p < 0.0001), increased ability to communicate during telemedicine visits (p < 0.001), and increased confidence in troubleshooting technology issues (p < 0.0001). Of the 29 providers completing surveys after conducting telemedicine visits with PWH, 93 % reported that it was easy to access and use. Providers did report a sense of decreased patient-provider interaction via telemedicine. Future research should further explore provider experiences with telemedicine training and delivery to improve telemedicine training and to identify best practices and strategies/activities that promote remote efficient patient-provider interaction. The use of telemedicine has increased in all areas of health care, especially since the COVID-19 pandemic. Training providers to successfully care for patients in remote settings is essential, especially as technology platforms and capabilities evolve or become more complex. Telemedicine trainings help providers increase capacity to conduct telemedicine visits. Trainings standardize visit protocols, control provider and patient expectations, identify how to incorporate remote visits into routine clinic flows, provide tools for increasing provider competency to interact with patients and use technology features, and increase understanding of types of ongoing support providers require, such as administrative. This paper describes the attitudes of providers from University of Florida Health in Jacksonville, FL receiving training to deliver telemedicine to persons with HIV residing in an urban setting. [ABSTRACT FROM AUTHOR]

• The HIV epidemic in an heterosexual population is a multidimensional SIR model. • The dynamic of HIV is formulated by a stochastic diffusion process. • The posterior distributions for the parameters are generalized inverse Gaussian. • Methods and results are Illustrated by simulations and real application. A model of the HIV dynamic in a heterosexual population of fixed size is considered in this paper. We represent the dynamic by a multidimensional SIR model. We formulate the stochastic diffusion approximation process to describe the dynamic of HIV by using strong approximation theorems for density-dependent Markov chains. Our aim is to estimate the parameters of this model; to reach this goal, we use Bayesian inference with Markov chain Monte Carlo (MCMC) simulations. We prove that the posterior distributions of the parameters are shifted Generalized Inverse Gaussian (GIG). The obtained results are well illustrated by simulations and real application of Morocco's case. [ABSTRACT FROM AUTHOR]

Background: High levels of stigma towards people who inject drugs (PWID) and people living with HIV (PLWH) exist in Kazakhstan, yet little is known about the role of stigma in harm reduction service settings. In this paper, we use a mixed method design to explore and describe the actionable drivers and facilitators of stigma among harm reduction service providers. Additionally, we describe the manifestations of stigma among PWID who are living with HIV (PWID/LWH), and the impact that stigma has on harm reduction and healthcare service utilization.Methods: Eight focus groups with 57 PWID/LWH were convened between March 2016 and July 2016 to describe manifestations of stigma from the perspective of syringe exchange program (SEP) clients. Additionally, we surveyed 80 nurses, social workers, outreach workers, and providers of HIV care at SEPs between January 2017 and July 2017 to assess stigmatizing attitudes among staff within the SEP environment. Joint displays were used to integrate quantitative and qualitative data.Results: The actionable drivers of stigma identified in this study include negative opinions and moral judgements towards PWID/LWH. Facilitators identified included stigmatization as a social norm within the service provision environment, a lack of awareness of anti-discrimination policies, and lack of enforcement of anti-discrimination policies. Qualitative findings highlight manifestations of stigma in which PWID/LWH experienced denial of services, perceived negative attitudes, and avoidance from service provision staff. PWID/LWH also described segregation in healthcare settings, the use of unnecessary precautions by providers, and unauthorized disclosure of HIV status.Conclusions: This paper highlights the urgent need to address stigma in the harm reduction and HIV service settings in Kazakhstan. These findings have implications for informing an actionable model for stigma reduction for providers who deliver services to PWID/LWH in Kazakhstan. Drivers, facilitators, and manifestations of stigma are multifaceted and addressing them will require a multilevel approach. [ABSTRACT FROM AUTHOR]

Background: HIV-infected people who inject drugs (PWID) are particularly vulnerable to suboptimal ART adherence. The fastest-growing HIV epidemics globally are driven by injection drug use, but only a small percentage of HIV-positive PWID have achieved viral suppression. Virally suppressed individuals have better HIV-related health outcomes and effectively no risk of transmitting HIV to others. Hence, ART adherence is important for both HIV treatment and HIV prevention. There is a paucity of data on barriers and facilitators of ART adherence among PWID in low and middle income countries, which is problematic given the growing HIV epidemics among PWID in these countries.Methods: Using the Theory of Triadic Influence, this paper examines individual, interpersonal, and structural barriers and facilitators of ART adherence among HIV-positive PWID in four cities in Kazakhstan. Eight focus groups were conducted (two in each city) with a total of 57 participants. Data were coded and analyzed by three researchers.Results: We found a number of barriers and facilitators to ART adherence among PWID at the individual, interpersonal, and structural levels. Individual barriers to ART adherence include misperceptions about ART, forgetfulness due to the effects of illicit drug use, and medication side effects. Interpersonal facilitators of ART adherence include social support and good relationships with healthcare providers. Structural barriers include poverty, legal challenges, disruptions in the ART supply, and stigma and discrimination.Conclusion: The paper highlights important factors related to ART adherence for HIV-positive PWID and identifies potential strategies for intervention efforts, including couple-based interventions, electronic reminders, linkage to drug treatment services, and patient navigation. Effectively enhancing adherence to ART among PWID will likely require multi-level approaches and strategies. Further research should be conducted on potential methods and interventions for improving ART adherence among this vulnerable population. [ABSTRACT FROM AUTHOR]

Abstract Aim This paper examines HIV-infected Asian Americans' experiences with religion throughout the course of their illness and their family relationships. Background As the number of Asians in the United States continues to grow, health professionals are beginning notice obvious gaps of knowledge in caring for this population, including HIV-infected individuals. Little is known about the impact of religion and faith on Asian Americans with HIV and their families. The study focuses on the participants' reported experiences to understand the variety of roles religion can play in the progression of a highly stigmatized chronic disease. Methods An in-depth interview was conducted in San Francisco and New York City with 30 HIV-infected Asians. Narrative samples and summarized responses was used to highlight themes that emerged from the participants' anecdotes. Interpretive content analysis was employed. Results These groups were categorized as (a) those who did not adhere to any religion, (b) those of tenuous religious faith with conflicted feelings, and (c) those of strong religious faith with congruent beliefs. Within these three groups, various themes were synthesized from the members' perceptions and past experiences with religion. Within each group, participants displayed various stages of reconciliation with their current faith-related beliefs and escape the family stress from their religion practices. Each participant's story shown the vast range of human understanding and faith experiences including self-actualization, acculturation, and depression. Conclusions This research provides new insight on the challenge of managing HIV-infected patients in a culturally and religiously appropriate manner. Highlights • Providers should understand spirituality to provide a better care for PLWHA. • For HIV-infected individuals, addressing the mental health becomes a top priority. • This paper shares on how PLWLHA reconcile themselves to a lifelong disease. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to describe an Emergency Department (ED)-based, HIV prevention and navigation program and the individuals linked to an in-house clinic for HIV pre-exposure prophylaxis (PrEP) in the first eleven months of program implementation.Methods: This is a retrospective, observational study of an ED-based HIV prevention and navigation program between January 1, 2019, and November 30, 2019. A status neutral navigation program is housed in the ED with 2-3 navigators staffing approximately 80 h per week. Navigators provide HIV screening with point-of-care testing, sexual health education and counseling, including PEP and PrEP information, and HIV risk assessments. They also make follow-up appointments, appointment reminder calls, and offer to accompany individuals to an in-house HIV clinic for clients who either test positive in the ED for HIV, are known to be living with HIV but are out-of-care, are HIV negative but require post-exposure prophylaxis (PEP) and/or meet criteria for and are interested in starting PrEP. Clients are approached if they request HIV or other sexually transmitted infection testing, present to the ED with genitourinary complaints, or are referred to the program by ED medical providers. Funding for the program is from a New York City Department of Health (NYCDOH) service grant. Data were manually abstracted from program records and from a NYCDOH database. The primary study outcomes are how many clients accepted clinic referral for PrEP, attended their appointments, and received a prescription for PrEP.Results: In the time-period reviewed, complete demographic data and CDC risk factors for HIV were available for 1174 patients. Our program provided appointments for 22 patients who met CDC criteria for PrEP and expressed interest in initiating PrEP. Thirteen patients who attended their scheduled appointment had same day appointments at the on-site clinic, and 11 (85%) were prescribed PrEP. From 1024 paper records with complete data, 914 clients reported that they do not consider themselves at risk for HIV infection.Conclusions: Most clients that were both eligible and interested in PrEP were prescribed PrEP if given a same day follow-up appointment. Of the clients engaged in this navigation program, almost 80% did not perceive that they were at-risk for HIV infection. [ABSTRACT FROM AUTHOR]

A mathematical model describing the HIV/AIDS transmission dynamics in the existence of an aware community using fractional differential operator having Mittag–Leffler kernel is presented and investigated in this paper. By using the fixed point theorem, the existence and uniqueness conditions of the model are obtained. We have used a novel technique known as the iterative Laplace transform approach to obtain the approximate solution of the mathematical model of HIV/AIDS based on the Atagana-Baleanu operator.We investigate the necessary conditions for the disease control in order to determine the role of unaware infective in the spread of HIV/AIDS. The numerical simulations and plots are demonstrated for different values of fractional order. Moreover, we have compared the obtained numerical results based on the Atagana-Baleanu operator with the values obtained using the Caputo operator for the suggested model. We believe that Atangana-Baleanue fractional derivative and the suggested algorithm are expected to be used in future to formulate and analyse many generalised fractional models. [ABSTRACT FROM AUTHOR]

The usage of antigen-functionalized nanoparticles has become a major focus in the field of experimental HIV-1 vaccine research during the last decade. Various molecular mechanisms to couple native-like trimers of the HIV-1 envelope protein (Env) onto nanoparticle surfaces have been reported, but many come with disadvantages regarding the coupling efficiency and stability. In this study, a short amino acid sequence ("aldehyde-tag") was introduced at the C-terminus of a conformationally stabilized native-like Env. The post-translational conversion of a tag-associated cysteine to formylglycine creates a site-specific aldehyde group without alteration of the Env antigenicity. This aldehyde group was further utilized for bioconjugation of Env trimers. We demonstrated that the low acidic environment necessary for this bioconjugation is not affecting the trimer conformation. Furthermore, we developed a two-step coupling method for pH-sensitive nanoparticles. To this end, we conjugated aldehyde-tagged Env with Propargyl-PEG 3 -aminooxy linker (oxime ligation; Step-one) and coupled these conjugates by copper-catalyzed azide-alkyne cycloaddition (Click reaction; Step-two) to calcium phosphate nanoparticles (CaPs) functionalized with terminal azide groups. CaPs displaying orthogonally arranged Env trimers on their surface (o-CaPs) were superior in activation of Env-specific B-cells (in vitro) and induction of Env-specific antibody responses (in vivo) compared to CaPs with Env trimers coupled in a randomly oriented manner. Taken together, we present a reliable method for the site-specific, covalent coupling of HIV-1 Env native-like trimers to the surface of nanoparticle delivery systems. This method can be broadly applied for functionalization of nanoparticle platforms with conformationally stabilized candidate antigens for both vaccination and diagnostic approaches. During the last decade antigen-functionalized nanoparticles have become a major focus in the field of experimental HIV-1 vaccines. Rational design led to the production of conformationally stabilized HIV-1 envelope protein (Env) trimers - the only target for the humoral immune system. Various molecular mechanisms to couple Env trimers onto nanoparticle surfaces have been reported, but many come with disadvantages regarding the coupling efficiency and stability. In this paper, we describe a highly selective bio-conjugation of Env trimers to the surface of medically relevant calcium phosphate nanoparticles. This method maintains the native-like protein conformation and has a broad potential application in functionalization of nanoparticle platforms with stabilized candidate antigens (including stabilized spike proteins of coronaviruses) for both vaccination and diagnostic approaches. [Display omitted] [ABSTRACT FROM AUTHOR]

HIV infection is still a serious worldwide public health problem. During the early stage of HIV infection, the number of infected cells and viruses are extremely low and the process of infection is stochastic. In this paper, we use a stochastic model consisting of continuous-time Markov chain to investigate CTL immune response and two modes of infection (viral transmission and cellular transmission). A multitype branching process is used to approximate the probability of clearance and outbreak of HIV infection near the infection-free equilibrium. In addition, we compare the dynamics of the deterministic model with the results of the stochastic model, and the differences are as follows: (1) when R 0 > 1 , the deterministic model shows HIV infection outbreak, while the stochastic model indicates a positive probability of HIV infection elimination; (2) the initial number of infected cells and viruses have no effect on the dynamics of the deterministic model, whereas the dynamics of the stochastic model are highly dependent on the initial sizes and cannot be ignored. [ABSTRACT FROM AUTHOR]

With the Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS) pandemic, the study of HIV/AIDS on bones has become of pivotal interest for research in bone pathologies, forensic applications (especially in the matter of identification when confronted to antemortem data) and medical purposes. In this paper, we document and discuss the macroscopic lesions found on the skeletons of nine individuals with known HIV, including four with known AIDS, coming from the identified CAL Milano Cemetery Skeletal Collection. As a result, several types of lesions were observed on bones: periosteal new bone formation, dental lesions, thickening of the frontal diploë, destructive localized porosity and evidence of trauma. None of the lesions reported can be directly linked to HIV because the virus does not directly affect bones in a macroscopic way. However, HIV/AIDS-induced infections and inflammations and HIV-related risk factors may leave bone markers. The differential diagnosis of each of the lesions noted in this research and its potential link to HIV or AIDS was discussed. Although it is not possible to diagnose HIV on bare bones, this was not the focus of this study. To our knowledge, no anthropological study has ever been performed on known HIV individuals. With this paper, we present for the first time skeletons with known HIV. [ABSTRACT FROM AUTHOR]

Objectives Analyze and synthesize the research evidence to understand the reproductive decisions made by women living with HIV from the beginning of the epidemic to the present. Evaluate the barriers and the facilitators for reproductive decision-making. Identify areas of strength, improvement, and those requiring further research. Design and data sources Systematic review following the PRISMA guideline. PubMed, CINAHL, PsycINFO, Cochrane Library, SocINDEX, Embase, and Scopus databases were searched from 1985 to 2016 using the following Keywords: HIV, AIDS, pregnancy, reproduction, and decision-making. Study selection A total of 42 research papers were included in this review. Initially, 1563 papers were identified for the review by database (n = 1544) and hand (n = 19) searches. With three review levels, 1521 papers were excluded (title review, n = 1272; abstract review, n = 136; and full paper review, n = 113). Studies published in English in peer-reviewed journals using both quantitative and qualitative methods and addressing reproductive decisions in women living with HIV were included. Thirdly, inclusion eligibility was assessed by title, abstract, and full text. Review methods Random allocation conducted by the primary researcher assigned an equal number of papers to each researcher for review, including detailed instructions with an abstraction form. Discrepancies were resolved by two researchers. Research quality was assessed using the NCHBL Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, the Critical Appraisal Skills Programme for the qualitative studies and its version for systematic reviews Results The review included 42 papers, both quantitative (n = 24) and qualitative methods (n = 14). Most studies were completed by physicians (n = 16) or nurses (n = 15). More than two-thirds of the studies were performed in urban settings with predominantly African-American women (n = 27). Eight factors were identified as influencing the reproductive decision-making process in women living with HIV: ‘Socio-demographic, Health status and Pregnancy’, ‘Religion and spirituality’, ‘Beliefs and Attitudes about Antiretroviral Therapy’, ‘Healthcare providers’, ‘Significant others’, ‘Motherhood and fulfillment’, ‘Fear of perinatal infection and infection of partner(s)’, ‘Birth control and pregnancy management’. Conclusions Health care providers are not providing patient-centered care by applying scientific evidence to their practice when advising women with HIV in making reproductive decisions. Despite the strong evidence indicating pregnancy for women with HIV results in a safe birthing trajectory, one not likely to jeopardize the health of the either the mother or fetus, providers continue to recommend the women with HIV avoid pregnancy and neglect to invite partners to participate in the discussion. [ABSTRACT FROM AUTHOR]

Transmasculine people (TM) constitute an invisibilized group within the transgender population. Little is known about their relationship to sexuality in transgender medicine. Their presence and needs are still unacknowledged within HIV prevention research and services. Pre-exposure prophylaxis (or PrEP) is an oral medication that prevents HIV in HIV-negative individuals at risk of infection with the virus. This paper proposes to bring TM back into the focus of PrEP research by questioning how they navigate and situate themselves in relation to existing PrEP categorization and services, and how they think about and (re)shape the meanings of PrEP. It is based on the "interpretative descriptive" method and a transfeminist theoretical framework applied to the analysis of ten semi-structured interviews with TM conducted in France between 2019 and 2023. Findings show that PrEP is gendered. We identify specific barriers to getting PrEP as well as to access healthcare and we show that a cisnormative and homonormative approach to prevention generates them. PrEP use and PrEP disclosure are embedded in structural and symbolic power relations between cisgender and transgender MSM that are reflected in the intimate sphere. TM use PrEP to prevent sexual assault and to alleviate the difficulty of condom negotiation. PrEP comes into play following major changes in TM's sexualities and is integrated post-exposure. • Transgender men are excluded from the MSM populations targeted by PrEP. • The uses and non-uses of PrEP by transgender men reveal that PrEP is gendered. • PrEP for HIV reveals unequal power relations between trans and cisgender MSM. • PrEP is embedded in unique temporalities inherent in transgender men's transitions. [ABSTRACT FROM AUTHOR]

Biomedical big data has revolutionized biomarker identification and has become a key driver for the development of precision medicine applications. However, existing computational methods have been able to rapidly identify biomarkers (variable selection), but true validation of biomarkers is still hampered by low statistical power and poor reproducibility of results. To address the above issues, in this paper, we propose two knockoff-based nonconvex regularization methods for identifying biomarkers. These two methods can perform variable selection while rigorously guaranteeing the false discovery rate (FDR) at a given desired level with high statistical power. We combine two nonconvex regularization methods, Smoothly Clipped Absolute Deviation (SCAD) and Minimax Concave Penalty (MCP), with the knockoff framework, respectively. Knockoff variables are first constructed to mimic the correlation structure of the original variables while maintaining independence from the response, and then the original and knockoff variables are used as augmentation matrices for variable selection. Since the nonconvex regularization method has good statistical theoretical properties such as unbiasedness, sparsity and Oracle, the proposed methods are better able to deal with heavy-tailed distributions, high noise and high correlation data. We verify the effectiveness of the proposed methods through numerical simulation experiments, and the results show that the proposed methods have strong statistical power while controlling the FDR compared to the comparison baseline method. We also apply the proposed methods to identify Human Immunodeficiency Virus (HIV) drug resistance-related gene mutations, Alzheimer's disease brain lesion regions, and purity-related genes in tumor samples, which can provide references and help for clinical diagnosis and treatment. • We propose two controlled variable selection methods for identifying biomarkers. • The proposed methods perform variable selection while controlling FDR. • The proposed methods obtain high statistical power under exactly controlling FDR. • The results provide reference and help for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Transactional sex in sub–Saharan Africa's fishing communities, driven by the highly gendered organisation of production, is widely recognised as a key driver of HIV transmission in lakeshore areas. This longitudinal study investigates the economic drivers of the trade and its impact on sexual health outcomes. Specifically, the impact of regional and district fish market shocks and comparable maize shocks on facility-level sexual health outcomes are examined in Tanzania's shoreline communities. Following unfavourable shocks to the fish market, such as high prices or low amounts of fish captured, this paper finds that new HIV cases, newly pregnant women attending antenatal clinic, and the number of people treated for syphilis increases with proximity to the shoreline, supporting the hypothesis that the fish-for-sex trade intensifies when fish supply is relatively scarce. Further, the observed increase in new HIV cases is driven by new cases in women. Contrasting effects are observed following maize price shocks, where facilities see an increase in both male and female new HIV cases following a favourable price shock. These findings highlight the role that gender-based organisation of production plays in shaping sexual health inequalities following shocks to a good. • Transactional sex increases in shoreline areas following months of fish scarcity. • Increases in HIV cases following fish market shocks are driven by new infections in women. • Increases in HIV cases following maize shocks are shared across the sexes. • A gender-based economic inequality is translating into a sexual health inequality. [ABSTRACT FROM AUTHOR]

Cardiovascular disease, particularly coronary heart disease, is becoming more common among those living with HIV. Individuals with HIV face an increased susceptibility to myocardial infarction, also known as a heart attack, as compared to the general population in developed countries. This heightened risk can be attributed mainly to the presence of effective antiretroviral drugs and the resulting longer lifespan. Some cardiac issues linked to non-antiretroviral medications, including myocarditis, endocarditis, cardiomyopathy with dilation, pulmonary hypertension, and oedema of the heart, may affect those not undergoing highly active antiretroviral therapy (ART). Impaired immune function and systemic inflammation are significant contributors to this phenomenon after initiating highly aggressive antiretroviral treatment ART. It is becoming more challenging to determine the best course of treatment for HIV-associated cardiomyopathy due to new research suggesting that protease inhibitors might have a negative impact on the development of HF. Currently, the primary focus of research on ART medications is centered on the cardiovascular adverse effects of nucleoside reverse transcriptase inhibitors and protease inhibitors. This review paper thoroughly evaluates the advancements achieved in cardiovascular disease research and explores the potential implications for prospects. Additionally, it considers the field's future prospects while examining how ART might be altered and its clinical applications. [ABSTRACT FROM AUTHOR]

In light of the dilemma of global climate change that we have presented ourselves with in the twenty-first century and beyond, many researchers express despair at the ability of humans and societies to change behavior. The paper identifies how global humanity at individual, institutional, and governmental levels have addressed life-threatening dangers in the recent past and begun processes of long-term corrective action. The paper thus discusses global social transformations from the recent past in regards to tobacco use and HIV/AIDS, to think about how Hannah Arendt's concept of the Polis detailed in The Human Condition (1958) may be engaged to address the human dimensions of climate change. As an output of the Andrew W. Mellon European Observatory of the New Human Condition, this paper's focus is commensurate with the thrust of this special issue of Global and Planetary Change which considers climate change to be more of a crisis in the human condition than an environmental problem. Arendt's concept of the Polis provides a framework for a better understanding of change in behavior, preference and motivation. We argue that her perspectives are central to developing multi and inter-disciplinary humanities, social science, science and business perspectives to mobilize collective human action towards adapting to and mitigating the social and environmental threats of global climate change. [ABSTRACT FROM AUTHOR]

In this paper, a stochastic HIV/AIDS epidemic model has been studied numerically. A discussion among the solutions related to deterministic HIV/AIDS model and stochastic HIV/ AIDS epidemic model has shown that the stochastic solution is more realistic than the deterministic solution. To control the diseases, the threshold parameter R 0 plays a key role in the stochastic HIV/AIDS epidemic model. If R 0 < 1 then disease is under control while the disease is out of control if R 0 > 1. The explicit approaches such as the Milstein scheme, stochastic Euler scheme, and stochastic Runge-Kutta 4 are dependent on temporal step size, whereas non-standard finite difference approaches are independent of step size. The results for numerical approaches like the Milstein scheme, stochastic Euler scheme, and stochastic Runge-Kutta 4 scheme fail for outsized step size. The stochastic non-standard finite difference scheme conserves dynamic features like confinedness, consistency and positivity. [ABSTRACT FROM AUTHOR]

To investigate whether current contraceptive uptake, unmet need for contraception, and unintended pregnancy among female adolescents living with HIV (ALHIV) vary with the model of access sites for HIV-related services, that is, stand-alone youth clinics (YCs) versus general primary health clinics (PHC). Exit interviews. Multi-center, primary healthcare facilities. Female adolescents living with HIV (ALHIV) aged 14-19 years and interviewed between March 1, 2017 and July 31, 2017. Structured exit paper-based survey. Participants were divided into stand-alone YC and general PHC groups. Uptake of contraceptive counseling and products were compared between the 2 clinic groups. A total of 303 female ALHIV completed the exit interviews. For female ALHIV, contraceptive prevalence was high among both general PHCs (84.2%) and stand-alone YCs (82.9%). Contraceptive method mix was similar between both groups of female ALHIV. Compared to stand-alone YCs, the general PHCs had similar likelihood of contraceptive counseling provision (aOR 0.84 95% CI [0.55, 1.26]) and provision of contraceptive products, including condoms (aOR 0.54 95% CI [0.26, 1.16]) and dual-method (aOR 1.80 95% CI [0.81, 3.99]) for female ALHIV. Also, there were no significant differences in the likelihood of contraceptive prevalence (aOR 0.99 95% CI [0.59, 1.67], unmet need for contraception (aOR 1.64 95% CI [0.90, 2.98]), and unintended pregnancy (aOR 1.06 95% CI [0.57, 1.98]) between clinic groups. Mainstreaming youth-friendly services into existing health facilities could achieve similar contraceptive service provision, uptake and outcomes for ALHIV as stand-alone youth clinics. [ABSTRACT FROM AUTHOR]

Introduction: The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system.Objective: This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS.Methods: This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis.Results: Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use.Conclusions: This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource-constrained environments seeking to improve PMS implementation. [ABSTRACT FROM AUTHOR]

The approval of the novel long-acting HIV injection; Cabenuva®- Cabotegravir and Rilpivirine injectable formulation) and the recent call by the World Health Organization for promoting community-based ART management, underscore the remarkable progress towards meeting the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95–95–95 targets by 2030. As the availability of antiretroviral therapy (ART) for the treatment of HIV/AIDS has increased in resource-limited settings, there has been a move to develop and implement alternative treatment delivery models such as Differentiated Service Delivery (DSD) in high prevalence countries to meet the global targets for HIV treatment while maintaining the quality of care. However, there is limited data on the involvement of community pharmacies in the delivery of ART within the community. Although, in western countries, several studies have documented the different roles community pharmacists can play in the management of HIV/AIDS. Community pharmacists are the most accessible and first points of health care for most clients. They are trusted, highly trained health care professionals. They should be incorporated and allowed to administer the Cabenuva® injection if the battle against the HIV pandemic is to be totally won. In this paper, we, therefore, aim to explore how the community pharmacist can be positioned in HIV service delivery regarding the administration of the Novel long-acting Cabenuva® injection formulation. It is therefore recommended that the Nigerian government embrace community pharmacy-led drug administration initiatives and embark on accredited training programmes for the profession in line with drug administration services. The government should also put in place necessary funding mechanisms for community pharmacists for the extra workload placed on them in administering injection drug formulation in their respective pharmacies. [ABSTRACT FROM AUTHOR]

Background: People living with HIV/AIDS (PLWHA) are at increased risk of stigma and mental illness, and this appears to be a particular issue in South Africa, which is home to 19% of the world's HIV-positive population. This paper aims to systematically review the literature investigating the relationship between HIV-stigma and depressive symptoms among PLWHA in South Africa.Methods: A keyword search of four bibliographic databases (CINAHL, Ovid MEDLINE, PsycINFO, and Web of Science) and two grey literature websites was conducted. The quality of eligible studies was assessed using established criteria.Results: Fourteen quantitative studies were included in the review. PLWHA in South Africa experience high levels of HIV-stigma and depressive symptoms. All forms of stigma were found to be associated with depressive symptoms amongst PLWHA. Prospective findings were mixed, with one study finding that stigma did not predict depressive symptoms over 36 months, and another that depressive symptoms predicted stigma 12 months later, suggesting a potentially bidirectional relationship. Females and young adults may be particularly vulnerable to HIV-stigma and its negative psychological effects. Some support was found for the moderating role of social support in the relationship between stigma and depressive symptoms across different sub-populations.Limitations: Few studies conducted prospective analyses or tested mediation/moderation.Conclusions: Despite limitations, this study highlights the importance of understanding the mechanisms underlying HIV-stigma across different sub-populations in South Africa. This may lead to more effective and context-specific interventions to combat adverse mental health outcomes. [ABSTRACT FROM AUTHOR]

This paper describes two phases of formative research that had the goal of developing a treatment designed to improve adherence with the nicotine patch in HIV-positive Latino smokers. Each research phase (Phase I and II) was conducted independent of the other and used different qualitative methods to inform the development of the intervention. Phase I interviewed n=14 smokers who had previous experience using the nicotine patch to gain detailed understanding of how, when, and why they used it; their perceived barriers to using it; and their perspective on ways to improve adherence to it. Phase II provided n=35 smokers with brief smoking cessation treatment and nicotine patches, then interviewed them in "near real time" over a two month period about their use of the patch during a quit attempt (e.g., perceived barriers and facilitators). Authors of the paper extracted relevant themes emerging from the interview transcripts across the two phases. Results indicated that consistent use of the nicotine patch was associated with maintaining high motivation for use (i.e., not necessarily motivation to quit, but motivation to continue patch use); linking its use with established daily routines (e.g., with taking other medications, with brushing teeth); and maintaining realistic expectations for patch efficacy (e.g., that users may still experience some level of craving and/or withdrawal). This information will used to develop and pilot test a brief treatment module that focuses on improving nicotine patch adherence. [ABSTRACT FROM AUTHOR]

The ‘new variant famine’ hypothesis suggests AIDS is contributing to food insecurity in southern Africa. Proposed causal mechanisms include a loss of livelihood assets and skills, brought about through AIDS′ impacts on children’s access to inherited property and intergenerationally-transferred knowledge. This paper employs a sustainable livelihoods framework to examine how AIDS is impacting on young people’s access to assets and skills in two southern African countries: Malawi and Lesotho. Drawing on qualitative research with rural youth, the paper shows that AIDS affects some young people’s access to some livelihood assets, but does not do so in a systematic or predictable way, nor are its impacts invariably negative. The broader cultural and institutional context is of key importance. The paper also demonstrates the need for the sustainable livelihoods framework to take greater account of the temporalities of livelihoods, and in particular the significance of lifecourse and generation. [ABSTRACT FROM AUTHOR]

Neonatal infections are the leading cause for neonatal deaths in developing countries, resulting in more than 1.5 million infant fatalities annually. The most effective prevention against neonatal infections is exclusive breastfeeding. However, reasons such as maternal death during birth, maternal illnesses such as HIV and TB-meningitis, and lack of rooming-in facilities prevent the infant to be breastfed by his/her mother. One way to mitigate these infections is by supplying pasteurized donor-expressed breastmilk. In this paper, we consider the network expansion of the donated breastmilk distribution supply chain in South Africa. As with the distribution of most public sector and humanitarian relief goods and services, the transportation of donated breastmilk is hampered by the inherent uncertainty in the environment, and by the fact that in addition to efficient usage of resources, distribution should be made in an equitable manner. We incorporate uncertainty into our models by means of multiple scenarios, which are determined based on different assumptions about population size, HIV prevalence, and status of public health in the country, income, and education. We consider various equity-based objectives and propose rounding-based heuristics to solve these. We focus on two delivery schemes; one which uses out-and-back transportation, and one that makes multiple stops on the delivery route. Using computational experiments, we analyze the trade-offs between the objectives as well as the effects of various public health policies, network expansion budget, and assumptions on supply and demand. We also describe the teaching materials resulting from this paper, which include a case study, a supply/demand estimation tool, and an interactive decision support tool. [ABSTRACT FROM AUTHOR]

• Uptake of services including HIV testing and ART are low in fishing communities. • Limited information is available on effect of interventions on virological suppression. • HIV services tailored to the needs of mobile fishing communities are required. • Combinations of multiple HIV interventions including education are most successful. • Innovations e.g. mhealth, point of care tools, medical drones, should be evaluated. This systematic review aims to qualitatively synthesize existing evidence on the efficacy of HIV interventions in African fishing communities. Five databases (NCBI PubMed, EMBASE, Web of Science Core Collection, The Cochrane Library, and CABI Global Health Database) were searched in March 2019 for eligible studies. All peer-reviewed papers with a defined HIV intervention explicitly mentioning African fishing communities were included. Outcomes included any measure of the efficacy of HIV interventions. Of 22,289 search results, data was extracted from 25 eligible studies that passed critical appraisal; seven involved HIV prevention, six HIV testing and counseling, three treatment, and nine combinations of more than one intervention. Findings include a high coverage of safe male circumcision (SMC) but low condom use among fisher folk, and a preference for PrEP over other HIV prevention services. Uptake of HIV testing and ART coverage are below levels required to reach UNAIDS 90-90-90 targets, and there is a high demand for ART and HIV self-testing kits. Greater provision of services to combat HIV, specifically amongst fishing communities, is required; there is limited information on retaining fisher folk in care and achieving an undetectable viral load. Interventions tailored to individual fishing populations, offered in parallel to education or counseling services are likely to be most effective. Use of innovations, including mobile health and medical drones, could assist these hard-to-reach populations. Our findings will inform future HIV service provision in fishing communities. [ABSTRACT FROM AUTHOR]

Because of the proximity of Persian Iran to Afghanistan, the main opium producer in the world, drug use especially opium use has a long history in Iran. Opium and its residues are the traditional drugs while heroin, heroin Kerack , norgesic, temgesic, and methamphetamine use and injection have emerged more recently. In recent decades, heroin smoking and injection have presented challenges to the Persian health policy makers to accept and develop the internationally-approved programs of drug use treatment and harm reduction. The current paper summarizes the overall picture of main drugs used and the history of establishing the nationwide movement of drug use treatment and harm reduction programs after the 1979 revolution until the end of 2014. The paper concludes that Persian Iran has a well-developed healthcare system in the provision of drug use treatment and harm reduction programs in the south-west of Asia especially the Persian Gulf region. These therapeutic and harm reduction-related programs are required to be strengthened by opium supply reduction and eradicating drug production in Afghanistan. The provision of prevention programs, drug education via mass-media, employment and inexpensive leisure activities are required in Iran. In addition, conducting household surveys of the prevalence of drug use and evaluating the clinical effectiveness and treatment outcomes of the provided drug treatment and harm reduction programs are required. National and regional collaborations are rigorously suggested to manage supply reduction along the borders and implement demand reduction inside the borders. [ABSTRACT FROM AUTHOR]

Summary Introduction The monitoring of pre-antiretroviral therapy (pre-ART) is a key indicator of HIV quality of care. This study investigated the association of an electronic medical record system (EMR) with adherence to pre-ART guidelines in rural HIV clinics in Kenya. Methods A retrospective study was carried out to assess the quality of pre-ART care using three indicators: (1) the performance of a baseline CD4 test, (2) time from enrollment in care to first CD4 test, and (3) time from baseline CD4 to second CD4 test. A comparison of these indicators was made pre and post the introduction of an EMR system in 17 rural HIV clinics. Results A total of 18 523 patients were receiving pre-ART care, of whom 38.8% in the paper group had had at least one CD4 test compared to 53.4% in the EMR group ( p < 0.001). The adjusted odds of performing a CD4 test in clinics using an EMR was 1.59 (95% confidence interval 1.49–1.69). The median time from enrolment into HIV care to first CD4 test was 1.40 months (interquartile range (IQR) 0.47–4.87) for paper vs. 0.93 months (IQR 0.43–3.37) for EMR. The median time from baseline to first CD4 follow-up was 7.5 months (IQR 5.97–10.73) for paper and 6.53 months (IQR 5.57–7.87) for EMR. Conclusion The use of the EMR system was associated with better compliance to HIV guidelines for pre-ART care. EMRs have a potential positive impact on quality of care for HIV patients in resource-constrained settings. [ABSTRACT FROM AUTHOR]

• Most clinical trials have excluded special populations. Dedicated studies are needed. • Elderly and some poor PS patients may be able to develop a response to ICIs. • Safety was good but activity was lower for the poor PS patients not selected. • In the HIV population, safety and efficacy was similar to the non-HIV population. • A selection should be performed before to candidate special population to ICIs. Immunotherapy with immune checkpoint inhibitors (ICIs) represents a breakthrough in lung cancer treatment. The efficacy of monoclonal antibodies targeting the programmed cell death protein 1 (PD-1), its ligand L1 (PD-L1), and cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) pathways has been demonstrated in several randomized trials, resulting in significantly improved survival rates in lung cancer patients, especially those with non-small-cell lung cancer (NSCLC), compared to standard chemotherapy. Hence, new therapeutic options have been opened up for advanced-stage lung cancer patients. However, most clinical trials on ICIs conducted so far have either excluded patients with poor performance status (PS) or chronic infections like human immunodeficiency virus (HIV), or accrued only a minor proportion of elderly patients despite the lack of an upper age limit. Our review paper provides a brief summary on the ICI data obtained so far in these special populations. Further dedicated studies are urgently needed to enable us to draw definitive conclusions on the usefulness of ICI in these special patient populations. The combination of ICI and chemotherapy must also be further assessed. It would, additionally, be useful to determine reliable biomarkers that should help us identify those patients who are more likely to benefit from ICI therapy. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) is the primary infectious agent of acquired immunodeficiency syndrome (AIDS), and non-nucleoside reverse transcriptase inhibitors (NNRTIs) are the cornerstone of HIV treatment. In the last 20 years, our medicinal chemistry group has made great strides in developing several distinct novel NNRTIs, including 1-[(2-hydroxyethoxy)methyl]-6-(phenylthio)thymine (HEPT), thio-dihydro-alkoxy-benzyl-oxopyrimidine (S -DABO), diaryltriazine (DATA), diarylpyrimidine (DAPY) analogues, and their hybrid derivatives. Application of integrated modern medicinal strategies, including structure-based drug design, fragment-based optimization, scaffold/fragment hopping, molecular/fragment hybridization, and bioisosterism, led to the development of several highly potent analogues for further evaluations. In this paper, we review the development of NNRTIs in the last two decades using the above optimization strategies, including their structure–activity relationships, molecular modeling, and their binding modes with HIV-1 reverse transcriptase (RT). Future directions and perspectives on the design and associated challenges are also discussed. Human immunodeficiency virus (HIV) is the primary infectious agent of acquired immunodeficiency syndrome (AIDS), and non-nucleoside reverse transcriptase inhibitors (NNRTIs) are the cornerstone of HIV treatment. In this review, we summarize the development of NNRTIs in our past two decades using the multiple optimization strategies. Image 1 [ABSTRACT FROM AUTHOR]