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This discussion explores the themes of the paper “When a therapist is diagnosed with a terminal illness.” Issues discussed include the meaning of a long term survivor of HIV/AIDS being diagnosed with a terminal cancer, abruptly closing a therapy practice and terminating with patients, and the personal process of coping with death and dying. [ABSTRACT FROM AUTHOR]

After more than twenty years of programming and activism aimed at stemming the sexual transmission of HIV (and addressing the needs of those most vulnerable to infection) the HIV/AIDS epidemic continues to grow worldwide. Taking up this concern, this paper argues that one of the reasons why HIV prevention has had limited success is because of inadequate conceptualization of human sexuality in such work. Giving sexuality a more prominent position in responses to the epidemic raises a range of issues, including theorization of gender, understanding of sexual subjectivity, the significance of pleasure (or lack of pleasure) in sexual decision-making, and conceptualization of sexual behaviour and culture. Taking these themes forward entails asking significant questions about the underlying paradigmatic and methodological commitments of mainstream HIV/AIDS research, especially the tendency to reproduce accounts of human sexuality as if it were a measurable form of conduct only. Advocating new approaches that take the meaning and symbolic value of sexualities into account complicates established orthodoxies in the field whilst offering potential for more effective HIV prevention strategies. [ABSTRACT FROM AUTHOR]

Enhancing the quality of life (QOL) of people living with HIV and AIDS (PLWHA) has become a significant global health goal, as combination antiretroviral therapy has helped to transform HIV/AIDS from a fatal illness to chronic disease. In this study, we aim to comprehensively describe the growth of research publications and the development of research landscapes regarding interventions to improve QOL among PLWH, as well as to characterize interdisciplinary topics and emerging interests of the research community. English articles and reviews published from 1991 to 2018 concerning interventions to improve QOL among PLWHA were retrieved from the Web of Science. Collaboration among organizations sharing coauthorships and co-occurrence network of authors' keywords was illustrated through network graphs. Latent Dirichlet Allocation was used for classifying papers into corresponding topics. A total of 2304 publications were included in the study. The USA continues to lead in research productivity, followed by South Africa, China, and India. Emerging research themes were found to be the application of multilevel interventions and long-term care, rehabilitation, along with topics relating to mental health issues, behavioral therapy and social supports for patients receiving treatments, and application of e-health approaches in designing and implementing interventions. There has been, however, a modest appearance of topics covering local, cultural, and environmental contexts of interventions. The findings of the study suggest expanding the coverage of psychosocial, behavioral, and contextualized interventions, increasing the involvement of family and community, improving the effectiveness of technology-based and e-health interventions, and developing strategies for lifelong treatment of HIV/AIDS. [ABSTRACT FROM AUTHOR]

The article elaborates on the study conducted by Charles Cobb, a neurosurgeon at the California Pacific Medical Center, in San Francisco, California. Aside from practicing his profession, he is also a virus hunter, Since 1998, he studied on whether viruses have an association with brain tumours. He and his co-authors discovered that the human cytomegalovirus (HCMV) needs a particular cellular receptor, normally involved in growth-factor signaling, to infect a type of cancer cell in the brain. He found out that this type of virus causes defects at birth and fatal diseases in immunocompromised people, especially patients with AIDS. People who are infected with the virus is associated with the occurrence of glioma, an extremely aggressive form of brain cancer that is difficult to treat.

Introduction: In this paper, we analyzed the study of a mathematical model of non-linear differential equation on the effect of HIV/AIDS disease among unaware HIV/AIDS-infected population. Material and methods: Population was divided into four categories, including HIV-negative individuals, unaware HIV-positive cases, aware HIV-positive, and AIDS patients. The model was investigated numerically and analytically using fourth-order Runge-Kutta approach and homotopy perturbation method (HPM). Results: We have discussed the parameter variation graphically. Conclusions: Determining the dynamics of HIV prevalence and investigating the effect of each parameter on the governing equation can be simple with analytical solution. [ABSTRACT FROM AUTHOR]

Aspergillus spp. are ubiquitous and cause severe infections in immunocompromised patients. Less is known about its incidence and prognosis in patients with HIV/AIDS. We reviewed the mortality of invasive aspergillosis in HIV/AIDS patients. Pubmed, Embase and Medline databases were used to search for articles. Studies were excluded if they contained other aspergillosis risk factors, no original or patient survival data or were not in English. From 747 articles published, 54 studies and case reports were identified following reading, published between 1985 and 2021, with 54% papers prior to 2000 reporting 853 patients from 16 countries, none from Africa. 707 (83%) patients died with an average time from diagnosis to death of 77.5 days. Postmortem diagnosis was seen in 21% of deaths recorded. A national series from France of 242 cases of invasive aspergillosis diagnosed in life recorded a 3 month mortality of 68% pre-ART, falling to 31% after introduction of ART and voriconazole. CD4 count was recorded in 39 studies and ranged from 2 to >1000 cells/mm3; only 8 patients (1.8%) had a CD4 > 100 cells/mm3. Aspergillosis occurs in patients with HIV/AIDS and associated with high mortality but its slow progression should allow diagnosis and treatment with improved outcome. [ABSTRACT FROM AUTHOR]

Background: People living with HIV (PLWH) are susceptible to social isolation as a result of stigma and discrimination, which not only diminishes adherence to antiretroviral therapy but also heightens the risks of hospital readmission, depression, and mortality. However, there is currently no systematic review addressing the occurrence and impact of social isolation in individuals with HIV. Therefore, this study undertook a comprehensive systematic review and meta-analysis of existing literature to examine the prevalence and influencing factors associated with social isolation among PLWH. Methods and analysis: PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Google Scholar, China Science and Technology Journal Database, The China National Knowledge Infrastructure, WanFang Data and Chinese Biomedicine Literature Database will be searched from the establishment of the database to the latest search date. Literature screening, data extraction and literature quality assessment will be done independently by two researchers and results will be cross-referenced. Data analysis will be performed using stata15.1 software. Risk of publication bias will be assessed using Begg's and Egger's methods. Heterogeneity between studies will then be assessed using the I2 index and its 95% CI and Q statistics. Sources of heterogeneity will be accounted for by subgroup and sensitivity analyses. Results: The results may reveal the prevalence of social isolation among PLWH and provide data support for understanding its etiology and prevention. Conclusion: By systematically reviewing the existing literature on social isolation among PLWH, this study aims to provide a comprehensive understanding of the prevalence of social isolation within this population, elucidate the detrimental effects it poses for people affected by HIV, and effectively inform targeted interventions for high-risk groups. Furthermore, these findings offer valuable insights to support evidence-based decision-making in public health policy. Systematic review registration: PROSPERO registration number: CRD42024499044 [ABSTRACT FROM AUTHOR]

In this paper, I aim to show how Swahili literature takes on the responsibility and challenge of creating an environment of co-existence and inclusion between human beings as well as between humans and nature, building upon the concept of “Afro-communitarianism”. This piece of research focuses on the contemporary challenges of African philosophy as a discipline and aims at connecting African philosophical inquiries with the textual medium of Swahili literature. By analysing selected Swahili novels, I will illustrate how literature is not only an instrument of inclusion, but also a device to exemplify the application of contemporary intercultural philosophies. The Swahili novels that will be analysed have been selected thematically, namely: inclusion of people with diseases such as HIV/AIDS; inclusion of people with genetic disorders such as albinism; and co-existence with the ecosystem. [ABSTRACT FROM AUTHOR]

Background: Clarity on what constitutes a palliative care need is essential to ensure that health systems and clinical services deliver an appropriate response within Universal Health Coverage. Aim: To synthesise primary evidence from Africa for palliative care needs among patients and families with serious illness. Design: We conducted a mixed methods systematic review with sequential synthesis design. The protocol was registered with PROSPERO (CRD42019136606) and included studies were quality assessed using Mixed Method Appraisal Tool. Data sources: Six global literature databases and Three Africa-specific databases were searched up to October 2020 for terms related to palliative care, serious illnesses and Africa. Palliative care need was defined as multidimensional problems, symptoms, distress and concerns which can benefit from palliative care. Results: Of 7810 papers screened, 159 papers met eligibility criteria. Palliative care needs were mostly described amongst patients with HIV/AIDS (n = 99 studies) or cancer (n = 59), from East (n = 72) and Southern (n = 89) Africa. Context-specific palliative care needs included managing pregnancy and breastfeeding, preventing infection transmission (physical); health literacy needs, worry about medical bills (psychological); isolation and stigma, overwhelmed families needing a break, struggling to pay children's school fees and selling assets (social and practical needs); and rites associated with cultural and religious beliefs (spiritual). Conclusions: Palliative care assessment and care must reflect the context-driven specific needs of patients and families in Africa, in line with the novel framework. Health literacy is a crucial need in this context that must be met to ensure that the benefits of palliative care can be achieved at the patient-level. [ABSTRACT FROM AUTHOR]

Outliers are common in longitudinal data analysis, and the multivariate contaminated normal (MCN) distribution in model‐based clustering is often used to detect outliers and provide robust parameter estimates in each subgroup. In this paper, we propose a method, the mixture of MCN (MCNM), based on the joint mean‐covariance model, specifically designed to analyze longitudinal data characterized by mild outliers. Our model can automatically detect outliers in longitudinal data and provide robust parameter estimates in each subgroup. We use iteratively expectation‐conditional maximization (ECM) algorithm and Aitken acceleration to estimate the model parameters, achieving both algorithm acceleration and stable convergence. Our proposed method simultaneously clusters the population, identifies progression patterns of the mean and covariance structures for different subgroups over time, and detects outliers. To demonstrate the effectiveness of our method, we conduct simulation studies under various cases involving different proportions and degrees of contamination. Additionally, we apply our method to real data on the number of people infected with AIDS in 49 countries or regions from 2001 to 2021. Results show that our proposed method effectively clusters the data based on various mean progression trajectories. In summary, our proposed MCNM based on the joint mean‐covariance model and MCD of covariance matrices provides a robust method for clustering longitudinal data with mild outliers. It effectively detects outliers and identifies progression patterns in different groups over time, making it valuable for various applications in longitudinal data analysis. [ABSTRACT FROM AUTHOR]

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted. [ABSTRACT FROM AUTHOR]

Pneumocystis pneumonia (PCP) is an opportunity acquired infection, which is usually easy to occur in patients with AIDS, organ transplantation, and immunosuppressive drugs. The prevention and treatment must be necessary for PCP patients with immunocompromise. And the oxidants are currently a typical regimen, including sulfanilamide, dapsone, primaquine, etc. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked gene-disease that affects about 400 million people worldwide. The lack of G6PD in this population results in a decrease in intracellular glutathione synthesis and a weakening of the detoxification ability of the oxidants. As a result, oxidants can directly damage haemoglobin in red blood cells, inducing methemoglobin and hemolysis. When patients with G6PD deficiency have low immunity, they are prone to PCP infection, so choosing drugs that do not induce hemolysis is essential. There are no clear guidelines to recommend the drug choice of this kind of population at home and abroad. This paper aims to demonstrate the drug choice for PCP patients with G6PD deficiency through theoretical research combined with clinical cases. [ABSTRACT FROM AUTHOR]

The aim of this meta-analysis is to summarize the available evidence on the social and demographic determinants of health-related quality of life (QoL) for HIV-infected populations in order to provide a direction to policy makers, planners, and program developers on how best to use their resources to improve the QoL of HIV-infected people. PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched (up to February 2017) to identify the relevant studies. A meta-analysis was conducted with procreate polled odds ratios (ORs and β) and the confidence intervals of 95% on determining factors of QoL in social and demographic terms. Random effect model was applied to calculate pooled estimation, due to varied sampling methods of researches. In total, 5607 papers were identified from 4 databases and additional search in reference lists. Of these, 2107 articles were selected for full-text review. We included 19 studies that met the eligibility criteria. The pooled effect size shows a relative positive impact of social support for QoL among HIV/AIDS patients and its lower boundary is about 0.61 and the higher about 1.49. The pooled effect size has a considerable negative impact stigma on people who live with HIV/AIDS (PWLHs') QoL ranges from −0.34 to −0.32. Low socioeconomic status (poverty situation) was found to have a degenerative impact with PWLHs' QoL. Our finding indicates an association between younger 35 and QoL is negative with a relatively wide range, the minimum level of education has a weak association with PWLHs' QoL (ES: 0.14–0.2). There are several sociodemographic determinants of QoL among PWLHs and in this study, we found that stigma, low level of socioeconomic status, and being younger than 35 years old have a negative association with QoL, while the social support showed a positive association and a minimum level of education did not show a rigorous negative or positive association. [ABSTRACT FROM AUTHOR]

Background: Mobile health is gradually revolutionizing the way medical care is delivered worldwide. In Mozambique, a country with a high human immunodeficiency virus prevalence, where antiretroviral treatment coverage is 77% accompanied by a 67% of retention rate, the use of mobile health technology may boost the antiretroviral treatment, by delivering care beyond health facilities and reaching underrepresented groups. Leveraging new technologies is crucial to reach the 95–95-95 United Nations target by 2030. The design, development, implementation, and evaluation of a mobile health platform called Infomóvel were covered in this article. Its intended use involves collaboration with community health workers and aims to increase human immunodeficiency virus patient access, adherence, and retention to care. Methods: Using the Design Science Research Methodology, Infomóvel was created, as well as this publication. The explanation of various actions includes everything from problem description to observational study and goal-following for a solution, which results in the design and development of a platform proposal. Before the utility assessment of Infomóvel was conducted to make adjustments, a demonstration phase was conducted in one region of Mozambique. Results: The initial subjects of the Infomóvel flowchart and physical process design were patients receiving antiretroviral medication who were enrolled in the patients tracking system and who had consented to home visits. The case manager examines the file before importing it into the Infomóvel database stored on a cloud server using the website www.commcarehq.org. The case manager application synchronises with the Infomóvel server database, enabling the import of latest data and access to the lists of new patients and community health workers. The community health worker uses his phone to access his application, which allows him to record the geographic coordinates and sort the list of patients by priority and type of visit. Conclusion: Results from Infomóvel add to the growing body of data showing that mobile health techniques are beneficial for managing stable individuals with chronic conditions in Mozambique. These approaches can be scaled up and better utilised. However, additional studies should be conducted to quantify the resources needed to implement on a larger scale. [ABSTRACT FROM AUTHOR]

Crimp may not have been convinced by Edelman's disclaimer, given the overall dense academic tenor of "The Plague of Discourse", and my point is not to suggest that Crimp's uses of Edelman or Watney are erroneous, or necessarily extra-ordinary in scholarly writing practice. In the opening paragraph of the chapter on disco in Before Pictures, Douglas Crimp writes of a folder of miscellaneous project papers he has kept from the 1970s, which includes an old, unpursued book proposal on the topic of contemporary art since Minimalism. In the culminating scene of the series, an emotional Jill confronts Valerie on the seafront of the Isle of Wight, where Ritchie has been taken by his parents to live out his final days; Jill and Roscoe were in hot pursuit, but denied a visit to Ritchie by Valerie before his death. Douglas Crimp, "Mourning and Militancy" (1989), in Melancholia and Moralism: Essays on AIDS and Queer Politics (Cambridge, Mass.: MIT Press, 2002), 128-49 (pp. 136-7) 9. [Extracted from the article]

In HIV-infected adults, psychiatric disorders result in poor quality of life, HIV disease progression, poor compliance and increased mortality. The same may be true for children and adolescents challenged with HIV/AIDS. The literature regarding the prevalence of Diagnostic and Statistical Manual of the American Psychiatric Association (DSM) psychiatric disorders in pediatric patients with HIV/AIDS was reviewed. Of over 500 papers reviewed only eight attempted to quantify prevalence in some way. Average prevalences of 28.6% for attention deficit hyperactivity disorder, 24.3% for anxiety disorders and 25% for depression were found with respective risk ratios of 6.0, 3.8 and 7.1. However, sample sizes were small and only two of the eight studies were controlled. Surprisingly little has been done to describe and quantify what mental-health problems these HIV-positive children and adolescents face. [ABSTRACT FROM AUTHOR]

This paper is the third and final of a series that has previously presented the rationale (Rier and Indyk, this volume) and major program elements (Indyk and Rier, this volume) of an approach to link community and tertiary sociomedical providers, clients/patients, sites, and systems into an integrated response to HIV/AIDS. The primary goal has been to improve sociomedical HIV/AIDS services for a hard-to-reach inner city population. The current paper first summarizes the main advantages (e.g., greater efficiency; more realistic, effective programs with greater credibility among the community; stimulation of knowledge production and dissemination amongst players rarely formally engaged in such activities; creation of a platform useful for other applications) of this work. It then examines some of the main organizational challenges in conducting the work (involving issues such as personnel, coordination, funding, turf conflicts, sustainability). From this discussion emerge organizational requisites to conducting this work (e.g., development of key boundary-spanning figures; attention to the specific interests of potential linkage partners; translation efforts to demonstrate the value of participation; a continuous quality improvement approach featuring wide distribution of feedback in user-friendly form; flexibility, tact and patience), so that others can adapt and apply the linkage approach to manage HIV/AIDS or other problems. Finally, we explain how theory and practice have driven one another in this work. [ABSTRACT FROM AUTHOR]

The significance of opportunistic infections in immunocompromised patients and the enigmatic pathogenicity of Blastocystis directed us to conduct the first global systematic review and meta-analysis on Blastocystis prevalence, odds ratios (ORs), and subtypes distribution in various immunocompromised patients (HIV/AIDS, cancer and hemodialysis patients, as well as transplant recipients). The systematic searching procedure was done in Web of Science, PubMed, Scopus, and Google Scholar databases for relevant published literature until November 11, 2020. Random-effects model was utilized to calculate the weighted estimates and 95% confidence intervals (95% CIs). The computed pooled prevalence of Blastocystis inferred from 118 papers (128 datasets) on immunocompromised patients was 10.3% (95% CI: 8.7–12.2%), with 16.1% (95% CI: 11.3–22.2%), 12.5% (95% CI: 8.5–18%), 8.4% (95 % CI: 6.6–10.6%), and 6% (95% CI: 2.6–13.3%) for hemodialysis patients, cancer patients, HIV/AIDS patients, and transplant recipients, respectively. Based on 50 case-control studies (54 datasets), the highest ORs were associated with cancer [2.81 (95% CI: 1.24–6.38, P = 0.013)] and hemodialysis patients [2.78 (95% CI: 1.19–6.48, P = 0.018)]. The most frequent subtype being found in immunocompromised patients was ST3 [41.7% (95% CI: 31.4–52.7%)], followed by ST1 [31.7% (95% CI: 23.2–41.8%)] and ST2 [23.1% (95% CI: 14.8–34.1%)]. Also, the weighted frequency of Blastocystis in various subgroups (publication year, WHO regions, geographical distribution, continents, and country income) was analyzed separately. In total, the results of the present meta-analysis highlighted that one's immunodeficiency status is probably associated with an increased Blastocystis infection, underpinning strict preventive measures to be taken. [ABSTRACT FROM AUTHOR]

Announces the availability of the summary proceedings from the International Council of Nurses' AIDS Nursing Forum conferences entitled "AIDS Patients-Clinical Issues". Summaries of the papers presented in several conferences; Issues on AIDS patient counseling and disease management; Contact information.

This paper focuses on the aesthetics of the fine art, photographic representation of the dead body in Pieter Hugo’s photographic series,The Bereaved, produced in 2005. The series consists of four close-up colour photographs of the faces of men who died of AIDS-related illnesses and were photographed in their caskets, in an informal morgue in Khayelitsha, Cape Town, South Africa. Katarzyna Majak’s theory of socialisation as an attempt to lessen the scandal of the corpse through representation is central as an analytical tool throughout this paper. Majak argues that for the viewer the corpse is a scandal, because it discomfortingly presents the transformation of a body from subject to object. For Majak, socialisation is essentially the taming of the dead body, achieved by re-presenting the corpse as an individual. This paper expands on Majak’s valuable theory by arguing that socialisation is a continuum between emphasising the subject-ness of the deceased individual, rather than the object-ness of the corpse as matter. Importantly, this continuum reveals varying degrees of socialisation within Hugo’s series, and other fine art examples discussed. Socialisation offers an alternative reading of the series concerned with the absence of the subject created by death and representation. [ABSTRACT FROM AUTHOR]

African-American and Latino/Hispanic persons living with HIV/AIDS are underrepresented in AIDS clinical trials (ACTs). The aim of this paper was to uncover factors, either unmodifiable or not directly targeted for change, that predicted screening for ACTs during an efficacious peer-driven intervention ( N = 540 total; N = 351 in an intervention arm, N = 189 control). This paper focused on participants assigned to an intervention arm, 56 % of whom were screened for ACTs. We found a decreased odds of screening was associated with closer proximity to the screening site, gay/lesbian orientation, lower mental health symptoms, current injection drug use, more recent HIV diagnosis, lack of prior screening experience, and failure to attend all intervention sessions, but there were no gender or racial/ethnic differences. Efforts to reduce racial/ethnic disparities in ACTs can be enhanced by attending to these specific factors, which may interfere with programmatic efforts to increase African-American and Latino/Hispanic representation in ACTs. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

Usually, decision-making processes regarding the activities of economic entities require core activity metrics analysis. Identification of trends in changes in numerical indicators over time allows us to assume their future values. Such tasks can be reduced to forecasting of numerical sequences, which based on investigation of rules of changing values of sequence and discovering forecasting values by defined precision criteria. Analytical overview of recent scientific papers shows that forecasting numerical sequences is topical. There are lots of research of development an effective hybrid forecasting methods based on several of other methods. Research is about development of forecasting model which use best properties of base forecasting models, allows us to improve forecasting precision and its volatility. During the research an evolutionary method of forecasting based on base forecasting models was developed. To compute forecasting values we build optimisation model which includes forecasting values taken from base models. Parameters of model can be defined by genetic algorithm. The quality criteria of forecasting system was relative error of forecasting and volatility of forecast. Such approach allows us to reduce a deviation of forecasting values against exact values. Experimental verification of the proposed forecasting method was done. A comparative analysis of the results of the developed method and other forecasting methods for the time series "Number of AIDS patients" was performed. It is shown that the use of the forecast scheme allows both to increase the accuracy of the forecast and to improve its volatility. [ABSTRACT FROM AUTHOR]

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This paper reports on the use of video to enhance qualitative research. Advances in technology have improved our ability to capture lived experiences through visual means. I reflect on my previous work with individuals living with HIV/AIDS, the results of which are described in another paper, to evaluate the effectiveness of video as a medium that not only collects data, but also produces knowledge. I have provided strategies for confronting specific technological barriers and concerns in research. I made sure to consider my own role within this research, and have chosen to share the personal insights and revelations that occurred in light of using this visual method. [ABSTRACT FROM AUTHOR]

Global publications on the international AIDS epidemic report on the existence of an ever-increasing number of orphans and vulnerable children. It has been suggested that by the end of this decade there will be in excess of 25 million AIDS orphans globally, an issue which will require understanding and organisation of long-term medical, psychological and social support. This study provides a systematic review to examine the use, overuse and misuse of the term orphan and explores the benefits and limitations of this approach. It then summarises the knowledge on orphans to date. Using a search strategy of published studies and recent conference abstracts, 383 papers were identified where the concept of AIDS and Orphan was raised. The papers were systematically coded and reviewed to understand when and how a child is labelled an orphan, and to summarise the effect of orphanhood on outcome measures, most notably psychologically and physically. All controlled studies published prior to 2006 were reviewed. A consistent picture of negative effects of parental death (however defined) on a wide range of physical, socioeconomic and psychological outcomes were recorded. Seventeen studies met criteria for in-depth review (empirical, fully published, control group). The majority of studies are cross-sectional (two are longitudinal) and employ a very wide array of measures - both standardised and study specific. This detailed analysis shows a mixed picture on outcome. Although most studies report some negative effects, there are often no differences and some evidence of protective effects from quality of subsequent care and economic assistance. The lack of consistent measures and the blurring of definitions are stumbling blocks in this area. [ABSTRACT FROM AUTHOR]

The reality and effects of HIV and Aids are enormous and devastating, i.e. marriages are broken, the married are widowed and children become orphans. This has direct impact in the church's life in that some of the people infected and affected by the spread of HIV and Aids are members of the global church. In most cases these people are rejected and judged by the church without realising that the church is rejecting its own. Metaphorically speaking the church of God is HIV positive whenever one of its own is positive. The main question that this paper addresses is: what is it to become a church when and where the effects of HIV and Aids shake marriages and families? What should be the response of the church in the light of the scourge that she faces? This paper proposes a theology of hope and accompaniment that seeks to stand in solidarity with those infected and affected by HIV and Aids thereby providing them with hope that enables them deal with the present as they wait eagerly for the future. [ABSTRACT FROM AUTHOR]

The systematic measurement of HIV/AIDS-related discrimination is imperative within the current rhetoric that holds discrimination as one of the two ‘biggest’ barriers to HIV/AIDS pandemic intervention. This paper provides a methodological critique of the UNAIDS (2000b) Protocol for the Identification of Discrimination against People Living with HIV (the Protocol) . Specifically, the paper focuses on the Protocol's capacity to accurately identify and measure institutional levels of HIV-related discrimination that allows data that are reliable and comparable across time and contexts. Conceptual issues including the Protocol's objective as an indicator versus a direct measure of discrimination and the role of the Protocol as a tool of research versus a tool of advocacy are explored. Design issues such as the operationalization of discrimination, appropriateness of indicator content, sampling and data collection strategies and issues of scoring are also evaluated. It is hoped that the matters outlined will provide readers with ways of critically reflecting and evaluating the findings of the research papers presented in this Special Issue, as well as pointing to ways of improving research design. [ABSTRACT FROM AUTHOR]

This paper outlines a six-country study of institutionalised forms of HIV/AIDS-related discrimination in the Asia-Pacific region. Although recognised as a barrier to disease prevention and treatment, very limited data are available on the effects of institutionalised HIV-related stigma and discrimination. Understanding the forms of discrimination within the institutions where they occur is the first step to identifying effective ways of promoting compassionate, non-discriminatory treatment of PLWHA. Thus, the goal of this research project was to document institutional discrimination against PLWHA, as guided by the UNAIDS Protocol for the Identification of Discrimination Against People Living with HIV (2000), in six Asian countries: India, Thailand, Philippines, China, Vietnam and Indonesia. As a precursor to the six individual studies, this paper provides a brief overview of the literature on HIV discrimination, and then describes the UNAIDS Protocol and the shared methodological considerations relevant to all of the study sites. Commonalities in sampling, procedures and analysis are also discussed. [ABSTRACT FROM AUTHOR]

A drama-as-education practitioner and an anthropologist illustrate the potential of process drama to promote HIV/AIDS competence, the ability to live a healthy life in the time of HIV/AIDS, among young Zambians. [ABSTRACT FROM PUBLISHER]

People living with HIV/AIDS who have both a co-occurring mental health diagnosis and a substance use disorder (individuals with triple diagnoses) frequently do not receive adequate treatment for one or more of their illnesses. Poverty, risky behaviours, vacillating motivation, and cognitive impairments are additional problems facing many individuals with triple diagnoses. In many communities the service system is inadequately prepared to serve this population. Treatment barriers include stigma associated with the three illnesses, separate funding streams, and lack of co-ordination between medical, mental health, and substance abuse treatment facilities. This paper discusses strategies for recruiting, engaging, and retaining individuals with triple diagnoses in both treatment and research. Recruitment strategies should be directed at both professionals and individuals with triple diagnoses themselves. Recruiting and engaging these individuals in treatment requires that comprehensive services be provided on a 24-hour basis in a flexible and culturally competent manner. A team approach is often the most effective way of providing such services. Retaining individuals with triple diagnoses in a longitudinal research study requires multiple strategies including the collection of detailed tracking information, outreach workers, and financial incentives for completing the interviews. [ABSTRACT FROM AUTHOR]

ABSTRACT: Today the medical literature is dominated by discussions on issues related to HIV/AIDS. This is not surprising considering the fact that in the history of humankind, the HIV/AIDS scenario has posed one of the greatest challenges. The reality of the physical, socioeconomic and psychological problems associated with the AIDS epidemic has become obvious to the general populace in Africa. Currently, both the AIDS victims and several others in the society continue to entertain the fear of dying from AIDS. The situation has become a source of concern to almost everyone, including primary health-care (PHC) workers. While several options are being examined to address the AIDS problem in Africa, one area that is often neglected is how to foster hope in people living with AIDS (PLWA) and their caregivers. In an attempt to examine this issue, this paper discusses the concept of hope, the cultural construct of HIV/AIDS in African countries and the role of PHC workers in fostering hope in PLWA. The paper concludes that by assisting the PLWA to develop a good sense of hope, PHC workers will be able to meet an important challenge: how to improve the quality of life for PLWA. [ABSTRACT FROM AUTHOR]

This article discusses a qualitative study conducted in China that explores the experiences of informal caregivers for people living with HIV or AIDS (PLWHA). The study involved 21 informants, including family members, partners, and close friends of PLWHA, and aimed to understand the psychological, physical, economic, and social burdens faced by these caregivers. The findings highlight the need for health services to address the challenges faced by informal caregivers in addition to focusing on the needs of PLWHA. However, the study has some limitations, including a lack of investigation into the duration of care and participants' educational backgrounds, as well as the potential influence of the caregiver's presence during the interview. The article suggests the need for further research to address these limitations and enhance the generalizability of the findings. [Extracted from the article]

Background: Virological failure, drug resistance, toxicities, and other issues make it difficult for ART to maintain long-term sustainability. These issues would force a modification in the patient's treatment plan. The aim of this research was to determine whether first-line antiretroviral therapy is durable and to identify the factors that lead to patients on HAART changing their first highly active antiretroviral therapy regimen. Methods: A retrospective cohort study was conducted from October, 2019—March, 2020 across all regional states including Addis Ababa and Dire Dawa administrative cities. The target population is from all health facilities that have been providing ART service for at least the past 6 months as of October 2019. Multi-stage clustered sampling method was used to select study facilities and participants. Simple random selected ART medical records of patients ever enrolled in ART treatment services. We adopted a multi-state survival modelling (msm) approach assuming each treatment regimen as state. We estimate the transition probability of patients to move from one regimen to another for time to treatment change/switch. We estimated the transition probability, prediction probabilities and length of stay and factor associated with treatment modification of patients to move from one regimen to another. Results: Any of the six therapy combinations (14.4%) altered their treatment at least once during the follow-up period for a variety of reasons. Of the patients, 4,834 (13.26%) changed their treatments just once, while 371 (1.1%) changed it more than once. For 38.6% of the time, a treatment change was undertaken due to toxicity, another infection or comorbidity, or another factor, followed by New drugs were then made accessible and other factors 18.3% of the time, a drug was out of supply; 2.6% of those instances involved pregnancy; and 43.1% involved something else. Highly active anti-retroviral therapy (HAART) combinations TDF + 3TC + NVP, d4T + 3TC + NVP, and TDF + 3TC + EFV were high to treatment alterations in all reasons of treatment modifications, with 29.74%, 26.52%, and 19.52% treatment changes, respectively. Early treatment modification or regime change is one of the treatment combinations that include the d4T medication that creates major concern. The likelihood of staying and moving at the the start of s = 0 and 30-month transitions increased, but the likelihood of staying were declined. For this cohort dataset, the presence of opportunistic disease, low body weight, baseline CD4 count, and baseline TB positive were risk factors for therapy adjustment. Conclusion: Given that the current study took into account a national dataset, it provides a solid basis for ART drug status and management. The patient had a higher likelihood of adjusting their treatment at some point during the follow-up period due to drug toxicity, comorbidity, drug not being available, and other factors, according to the prediction probability once more. Baseline TB positivity, low CD4 count, opportunistic disease, and low body weight were risk factors for therapy adjustment in this cohort dataset. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality impedes the progression of chronic illnesses, while chronic illnesses themselves are caused by poor sleep quality. Despite this fact, there is no research that has been conducted in Ethiopia that provides a thorough estimate of the self-reported sleep quality among patients with chronic illnesses. In order to present a complete picture of poor sleep quality among diabetes, hypertension, heart failure, cancer, HIV/AIDS and epilepsy patients, this systematic review and meta-analysis was carried out. Methods: Systematic review and meta-analysis was conducted to estimate the quality of sleep among patients with chronic illness in Ethiopia. The Preferred Reporting Items for Systematic Review and Meta Analysis standard was followed in the reporting of this systematic review and meta-analysis. An extensive exploration of digital repositories, including PubMed, EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and an advanced Google search, was conducted to obtain published studies until December 1st, 2023 detailing poor sleep quality of patients with chronic illness. STATA version 17 commands were used to create the pooled estimate. The I2 test and Egger's test, respectively, were used to identify the presence of heterogeneity and publication bias. To manage heterogeneity, a subgroup analysis and random effect model were used. Results: A total 21 articles with a total of 7393 participants were included in the final systematic review and meta-analysis. The pooled estimate of poor sleep quality among patients with chronic illness was 52% (95% of CI: 48%, 59%; I² = 97.26%). In subgroup analysis, the highest pooled estimate of poor sleep quality was observed in cancer patients 63% (95% CI: (95% CI: 45% - 80%). Regarding to data collection period, the highest pooled estimate of poor sleep quality was seen during spring 68% (95% CI: 42% - 94%). Conclusions: Patients with chronic illnesses in Ethiopia had a high pooled estimate of poor sleep quality. Patients with cancer had the highest pooled estimate of poor-quality sleep compared with other patients. Patients with chronic illnesses had trouble sleeping in the spring, according to this systematic review and meta-analysis. Therefore, attention and intervention should be given to enhance the quality of sleep for patients with chronic illnesses. [ABSTRACT FROM AUTHOR]

Background and Aim(S): This study retrospectively assessed the prevalence of TB and human immunodeficiency virus (HIV)/AIDS coinfection among patients that attended the Directly Observed Treatment Short‐course (DOTS) centers in Anambra State, Southeast, Nigeria, between 2013 and 2017. Methods: The study adopted a descriptive and retrospective epidemiological survey design. A total of 1443 case files of patients aged 15−60 who were treated in DOTS centers selected from Anambra State's 21 Local Government Areas between 2013 and 2017 were investigated. The uniform data form, a standardized instrument used in Anambra State's health facilities for data collection, was used to collect data from case files of all those identified as coinfected with TB and HIV/AIDS. Results: The mean prevalence rate of TB and HIV/AIDS coinfection in the state during the 5‐year period (2013–2017) was 20.00%. The highest annual prevalence of TB and HIV/AIDS coinfection was recorded in 2014 (23.84%). The state's prevalence of TB and HIV/AIDS coinfection increased dramatically from 13.17% in 2013 to 23.84% in 2014, followed by a slight downward trend to 22.80% in 2015, 20.17% in 2016, and 20.03% in 2017. In terms of gender, age, marital status, and occupation, females (59.5%), those aged 15 to 25 years (30.7%), married people (43.90%), and traders/business owners (50.7%), respectively, had the highest rates of tuberculosis and HIV/AIDS coinfection during the study period. Conclusion: The findings of this study show that young people, females, married people, and traders/business owners appear to be the most vulnerable groups affected by TB and HIV/AIDS coinfection, accounting for the majority of the disease burden in the state. To address the high prevalence of TB and HIV/AIDS coinfection in the Anambra State, novel intervention and control programs should be developed and implemented, and existing intervention frameworks should be strengthened. [ABSTRACT FROM AUTHOR]

The costs of providing healthcare resources for patients with HIV disease have continued to rise during the last 2 decades since the first outbreak of AIDS. Although new and effective therapies have become available during this time, and are increasingly being used, outcome measures for, and the economic consequences of, differing models of care are poorly documented or understood. Most available economic and clinical data, especially data documenting post-therapy outcomes, are from small, short term studies. This has led to the use of modelling to estimate which determinants can improve the quality and cost effectiveness of HIV care in the future. Although the attempt to provide what is currently perceived to be the standard of care is stretching many healthcare budgets, it is an anachronism that there are few studies of health economics in HIV disease. Most published data relate only to North America, and there remains a paucity of European studies. This paper provides a review of the available data from Europe and attempts to highlight the trends that have taken place to date. [ABSTRACT FROM AUTHOR]

Masters, Johnson and Kolodny (MJK) have published a volume which claims that the heterosexual risk of AIDS has been greatly understated by public officials and AIDS researchers. This paper presents a brief analysis of the key data contained in MJK's book using simple mathematical models. The paper shows that the unconditional per partner risk of infection for the sexually active heterosexuals in the MJK study is exceeded by the similar risk for typical gay men in San Francisco by a factor of nearly fifty; that the conditional probability of infection given exposure via vaginal sex is about 2% for men and 3% for women per partner (both of these numbers are lower than the corresponding infectivities for unprotected anal sex among gay men); and the an AIDS epidemic among the general heterosexual population would occur only if the average number of sexual partners per year exceeds about 5.3, and unlikely number given the data in MJK's study. [ABSTRACT FROM AUTHOR]

AIDS is an increasingly urgent issue for clinical nurses, managers and for nurse educators. This paper describes the analysis of part of a set of interviews with a purposive sample of 21 AIDS counsellors, nurse educators and other health care workers. In particular, responses to the question: 'What are the psychosocial needs of the person diagnosed as HIV-positive or who has AIDS?' are discussed. The paper begins with a brief description of the study and then offers a more detailed description of the method of analysis used to obtain the findings. These are then reported within 16 categories. Psychosocial problems identified included issues of emotion, acceptance, a variety of fears, stigma, issues relating to insurance and travel, health care facilities and the attitudes of the Church. [ABSTRACT FROM AUTHOR]

A qualitative study was conducted in order to understand how nurses cope with the risk of contagion while providing care to persons with AIDS (PWAs). Data were collected through in-depth interviews with 13 nurses who had cared for PWAs in an acute-care hospital in a western Canadian city. The data were analysed using the constant comparative methodology of grounded theory. The analysis revealed that caring for PWAs involved achieving a sense of control over uncertainty. One aspect of this process, making risk meaningful, centred on efforts to justify caring for PWAs in the face of risk. The purpose of this paper to describe how nurses make risk meaningful. A sense of meaning was found to be related to three major factors: accepting the patient as a person who needs and deserves care, finding work enjoyable and worthwhile, and professional commitment to care for all patients. Attaining a sense of meaning led to a reappraisal of the risk situation as worthy of investment and provided the motivation to care for patients in spite of risk. The paper concludes with implications for practice and suggestions for further research. [ABSTRACT FROM AUTHOR]

This paper shows how the co-creation and telling of narratives helped members of an AIDS support group transform their unique and separate experiences of suffering into shared insights, intense connections and comfort. Examples of narratives are drawn from the author's experience as a co-leader of a support group for gay men living with AIDS. Current literature on group work with persons living with AIDS is embedded in a modernist orientation in which the therapist is the scientist/expert, the client has the problem and the therapist helps the client's through exploring and interpreting the client's story according to a superseding theory (Gergen and Kaye, 1992). This approach emphasizes the need for leaders to maintain objectivity and emotional distance to avoid burnout (Gabriel, 1991; Grossman and Silverstein, 1993; Tunnell, 1991). In contrast, in a pest-modern therapeutic approach, there is no privileging of the therapist's narrative and the traditional hierarchical relationship is replaced by a mutual effort as therapist and client together develop stories that translate and transcend experience. Using the AIDS work as illustration, this paper offers a post-modern, narrative approach to group work and shows how persons living with AIDS can use narrative to move beyond finite structures and the limits of life. [ABSTRACT FROM AUTHOR]

Candida albicans species can cause severe morbidity and mortality in Human Immunodeficiency Virus (HIV) patients when they become systemically involved, known as candidemia. Mangrove (Aegiceras corniculatum) is a plant that is commonly distributed and has been shown to have several advantages to be used as phytotherapy. Objective to investigate the anti-fungal ability of Mangrove Ethanol Extract (MEE) (A.corniculatum) to Candida albicans isolated from Oral Candidiasis HIV/AIDS patient in vitro. The fresh mangrove leaf (A. corniculatum) was extracted by means of maceration methods. There were 5 groups, each with 4 samples: (1) control negative group (2) control doxycycline group, (3) MEE (A. corniculatum) concentration 25%, (3) 50% concentration group, (4) 75% concentration group, and (5) 100% concentration group. C. albicans isolated from stadium HIV/AIDS patients who were assessed clinically but did not seek fungal infection therapy. Saboraoud dextrose agar (SDA) containing the tested C. albicans suspension was poured into a petri dish around the paper disk. Observation of the inhibition zone around the well and then measuring the diameter of the inhibition zone horizontally and vertically using a digital scale ruler. It was discovered that 100%, 75%, 50%, and 25% MEE (A corniculatum) had no antifungal efficacy against C. albicans isolated from HIV/AIDS with no significant difference in inhibitory zone (p>0.05). MEE (A. corniculatum) did not have an inhibitory zone against C. albicans isolated from HIV/AIDS patients in vitro. [ABSTRACT FROM AUTHOR]

The aim of this paper was to review cohort studies that analyze changes in the quality of life of people living with HIV/AIDS. We searched the PubMed and EmBase databases from inception to December 2012 for primary cohort studies of the quality of life of people living with HIV/AIDS after combination antiretroviral therapy (cART). Two independent reviewers screened and selected published studies of quality of life that had been followed up for more than 12 weeks after the beginning of cART. Data from the papers were analyzed to identify common characteristics of the effects of cART on the quality of life of HIV/AIDS patients. Eight cohort studies were found: only four were assessed as high quality and four were assessed as moderate quality. None of the studies described patient selection. Six studies followed the patients for one year or more, and the other studies for less than 6 months. Seven studies reported quality of life had been improved after initiation of cART, and one study reported no change. Previous research suggested that cART improved the quality of life of AIDS patients for a limited time, so further research for longer periods is needed to confirm this outcome. [ABSTRACT FROM AUTHOR]

The goal of a traditional Markov decision process (MDP) is to maximize the expectation of cumulative reward over a finite or infinite horizon. In many applications, however, a decision maker may be interested in optimizing a specific quantile of the cumulative reward. For example, a physician may want to determine the optimal drug regime for a risk-averse patient with the objective of maximizing the 0.10 quantile of the cumulative reward; this is the cumulative improvement in health that is expected to occur with at least 90% probability for the patient. In "Quantile Markov Decision Processes," X. Li, H. Zhong, and M. Brandeau provide analytic results to solve the quantile Markov decision process (QMDP) problem. They develop an efficient dynamic programming procedure that finds the optimal QMDP value function for all states and quantiles in one pass. The algorithm also extends to the MDP problem with a conditional value-at-risk objective. The goal of a traditional Markov decision process (MDP) is to maximize expected cumulative reward over a defined horizon (possibly infinite). In many applications, however, a decision maker may be interested in optimizing a specific quantile of the cumulative reward instead of its expectation. In this paper, we consider the problem of optimizing the quantiles of the cumulative rewards of an MDP, which we refer to as a quantile Markov decision process (QMDP). We provide analytical results characterizing the optimal QMDP value function and present a dynamic programming-based algorithm to solve for the optimal policy. The algorithm also extends to the MDP problem with a conditional value-at-risk objective. We illustrate the practical relevance of our model by evaluating it on an HIV treatment initiation problem, in which patients aim to balance the potential benefits and risks of the treatment. [ABSTRACT FROM AUTHOR]

Tuberculosis is a major health threat in many regions of the world. Opportunistic infections in immunocompromised HIV/AIDS patients and multi-drug-resistant bacterial strains have exacerbated the problem, while diagnosing tuberculosis still remains a challenge. When left undiagnosed and thus untreated, mortality rates of patients with tuberculosis are high. Standard diagnostics still rely on methods developed in the last century. They are slow and often unreliable. In an effort to reduce the burden of the disease, this paper presents our automated approach for detecting tuberculosis in conventional posteroanterior chest radiographs. We first extract the lung region using a graph cut segmentation method. For this lung region, we compute a set of texture and shape features, which enable the X-rays to be classified as normal or abnormal using a binary classifier. We measure the performance of our system on two datasets: a set collected by the tuberculosis control program of our local county's health department in the United States, and a set collected by Shenzhen Hospital, China. The proposed computer-aided diagnostic system for TB screening, which is ready for field deployment, achieves a performance that approaches the performance of human experts. We achieve an area under the ROC curve (AUC) of 87% (78.3% accuracy) for the first set, and an AUC of 90% (84% accuracy) for the second set. For the first set, we compare our system performance with the performance of radiologists. When trying not to miss any positive cases, radiologists achieve an accuracy of about 82% on this set, and their false positive rate is about half of our system's rate. [ABSTRACT FROM AUTHOR]