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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]

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]

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]

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]

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]

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]

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]

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]

In this paper, we present experimental results from the application of model predictive control (MPC) to inventory management in a real hospital. In particular, the stock levels of ten different drugs that belong to the same laboratory have been controlled by using an MPC policy. The results obtained after four months show that the adopted approach outperforms the method employed by the hospital and reduces both the average stock levels and the work burden of the pharmacy department. This paper also paper presents some practical insights regarding the application of advanced control methods in this context. [ABSTRACT FROM AUTHOR]

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We assessed predictive models (PMs) for diagnosing Pneumocystis jirovecii pneumonia (PCP) in AIDS patients seen in the emergency room (ER), aiming to guide empirical treatment decisions. Data from suspected PCP cases among AIDS patients were gathered prospectively at a reference hospital's ER, with diagnoses later confirmed through sputum PCR analysis. We compared clinical, laboratory, and radiological data between PCP and non-PCP groups, using the Boruta algorithm to confirm significant differences. We evaluated ten PMs tailored for various ERs resource levels to diagnose PCP. Four scenarios were created, two based on X-ray findings (diffuse interstitial infiltrate) and two on CT scans ("ground-glass"), incorporating mandatory variables: lactate dehydrogenase, O2sat, C-reactive protein, respiratory rate (> 24 bpm), and dry cough. We also assessed HIV viral load and CD4 cell count. Among the 86 patients in the study, each model considered either 6 or 8 parameters, depending on the scenario. Many models performed well, with accuracy, precision, recall, and AUC scores > 0.8. Notably, nearest neighbor and naïve Bayes excelled (scores > 0.9) in specific scenarios. Surprisingly, HIV viral load and CD4 cell count did not improve model performance. In conclusion, ER-based PMs using readily available data can significantly aid PCP treatment decisions in AIDS patients. [ABSTRACT FROM AUTHOR]

Purpose: The assessment of tear film and ocular surface conditions in patients with acquired immunodeficiency syndrome (AIDS) has been poorly studied thus far. We aim to assess tear film parameters, ocular surface characteristics, and dry eye disease (DED) symptoms of patients with AIDS who did not undergo highly active antiretroviral treatment (HAART). Methods: This case-control study included 154 age-, sex-, and ethnicity-matched healthy controls and patients with AIDS. All participants underwent comprehensive ocular surface assessment and subjective DED symptomology evaluation. Data were collected between March 2022 and July 2022. Results: HAART-naïve patients with AIDS had a shorter noninvasive tear film breakup time (median 3.76 vs. 8.54 s), thinner tear film lipid layer thickness (median 73.00 vs. 91.00 nm), and lower Schirmer I test values (median 5.00 mm/5 min vs. 12.00 mm/5 min) (all P < 0.001). Moreover, higher corneal fluorescein staining scores (median 1.00 vs. 0.00) and higher upper, lower, and total meibomian gland grades were observed in AIDS patients (all P < 0.05). Negative correlations between the blood viral load and the Ocular Surface Disease Index score (r = -3.50, P = 0.027) and the Schirmer I test score (r = -0.374, P = 0.017) were detected in patients with AIDS. Conclusion: Altered tear film status was observed in individuals with HAART-naïve AIDS, even when there were no other ocular symptoms present. Therefore, patients with AIDS should be encouraged to undergo comprehensive ocular surface examinations to detect any subclinical tear film alterations occurring. [ABSTRACT FROM AUTHOR]

Background: WHO statistics show that someone attempts suicide every three seconds and commits suicide every 40 seconds somewhere in the world. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of suicidal ideation, attempts, and associated factors among adult HIV/AIDS patients in Ethiopia to fill this gap. Methods: We extensively searched the bibliographic databases of PubMed, MEDLINE, Scopus, Google Scholar, and the Web of Science to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. To check heterogeneity, the Higgs I2 and Cochran's Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger's test and funnel plots were used. Results: The pooled prevalence of suicidal ideation and attempts among adult HIV/AIDS patients in Ethiopia was 20.3 with a 95% CI (14, 26.5) and 11.1 with a 95% CI (6.6, 15.5), respectively. Living alone (AOR 4.98; 95% CI: 2.96–8.37), having comorbidity or other opportunistic infection (AOR 4.67; 95% CI: 2.57–8.48), female sex (AOR 2.86; 95% CI: 1.76, 4.62), having WHO clinical stage III of HIV (AOR 3.69; 95% CI: 2.15, 6.32), having WHO clinical stage IV of HIV (AOR 5.43; 95% CI: 2.81, 10.53), having co-morbid depression (AOR 5.25; 95% CI: 4.05, 6.80), having perceived HIV stigma (AOR 2.53; 95% CI: 1.67, 3.84), and having family history of suicidal attempt (AOR 2.79; 95% CI: 1.38, 5.66) were significantly associated with suicidal ideation. Being female (AOR 4.33; 95% CI: 2.36, 7.96), having opportunistic infections (AOR 2.73; 95% CI: 1.69, 4.41), having WHO clinical stage III of HIV (AOR 3.78; 95% CI: 2.04, 7.03), having co-morbid depression (AOR 3.47; 95% CI: 2.38, 5.05), having poor social support (AOR 3.02; 95% CI: 1.78, 5.13), and having WHO clinical stage IV (AOR 7.39; 95% CI: 3.54, 15.41) were significantly associated with suicidal attempts. Conclusion: The pooled magnitude of suicidal ideation and attempt was high, and factors like opportunistic infection, WHO clinical stage III of HIV, WHO clinical stage III of HIV, and co-morbid depression were related to both suicidal ideation and attempt. Clinicians should be geared towards this mental health problem in HIV patients during management. [ABSTRACT FROM AUTHOR]

The AIDS pandemic represents one of the worst public health crises ever. Developing countries in particular have been ravaged by the pandemic. The development of antiretrovirals (ARVs) in the late 1980s forever altered the course of the pandemic, transforming AIDS from a death sentence into a chronic, but treatable disease. However, the introduction of ARVs sparked tension between the pharmaceutical industry and society at large, especially within developing countries. Although available, ARVs were incredibly expensive and out of the financial grasp of most sufferers in developing countries. Despite pressure from AIDS activists to reduce the prices of their ARVs for sufferers in developing countries, pharmaceutical companies argued that they required large profits to fund future research and development. This paper uses the principles of stakeholder analysis to evaluate whether the pharmaceutical industry has fulfilled its ethical responsibility to provide affordable ARVs to AIDS sufferers in developing countries. In order to act in an ethical manner, pharmaceutical companies must ensure that the burdens and benefits associated with their actions are fairly distributed amongst their various stakeholders. Thus, pharmaceutical companies must balance their financial responsibility to their stockholders with their commitments to their other stakeholders, specifically HIV/AIDs sufferers in developing countries who require but cannot afford antiretroviral drugs to survive. This paper also evaluates the impact that intellectual property rights, most notably patents, have on antiretroviral affordability in developing countries. [ABSTRACT FROM AUTHOR]

Background: Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA). In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods: Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results: The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion: Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting government injecting drug policy to harm reduction are discussed as some of the ways for stigma intervention to move forward. [ABSTRACT FROM AUTHOR]

There is a widespread belief that poverty leads to the spread of HIV/AIDS. However, intra-country comparisons of the phenomenon have been limited. This study seeks to fill this gap by examining the relationship between poverty and HIV prevalence amongst the 10 administrative regions of Ghana. Based on the available data for poverty and HIV, certain distinct patterns emerge. For example, poverty levels are the highest in the three northern regions (Upper East, Upper West and Northern region) even though their HIV prevalence is one of the lowest. It clearly follows that there are more complex forces at work than just the effects of poverty alone. To unravel some of these puzzles, the paper proposes a key role for culture, globalization and geographical accessibility. In addition, it is suggested that local level studies in a multivariate framework have much to contribute to the identification and quantification of relevant relationships. [ABSTRACT FROM AUTHOR]

Drawing from ethnographic, archival and secondary research, this article examines multiple-sexual partners in historical perspective in KwaZulu-Natal, a South Africa province where one in three people are thought to be HIV positive. Research on masculinities, multiple-partners, and AIDS has been predominantly directed towards the present day. This paper stresses the importance of unraveling the antecedents of contemporary masculinities particularly the gendered cultural politics through which they have been produced. Arguing against dominant conceptions of African masculinity as being innate or static, it charts the rise and fall of the isoka , the Zulu man with multiple-sexual partners, over the last century. Showing how the isoka developed through changing conditions occasioned by capitalism, migrant labour and Christianity, it contends that an important turning point took place from the 1970s when high unemployment threatened previous expressions of manliness, notably marriage, setting up an independent household and becoming umnumzana (a household head). The high value placed on men seeking multiple-partners increasingly filled the void left by men's inability to become men through previous means. Turning to the contemporary period, the article argues that, shaken by the huge AIDS deaths, men are betraying increasing doubts about the isoka masculinity. [ABSTRACT FROM AUTHOR]

This paper critiques a recent article in this journal in terms of its use of persuasive techniques. The central issue of the original article by Miles, Munilla and Covin and this paper is whether there should be a change in intellectual property rights to address the needs of impoverished people who are HIV positive or have full blown AIDS and the countries that do not have the means to buy AIDS medication in the absence of subsidies. This paper argues that patents are state sanctioned monopolies that worked effectively for nearly a century. However, new circumstances and a globally interdependent world represent a new environment calling for an adjustment in the conventional public policy premises underlying patents. Most of the meaning and complexity of this issue is lost to the persuasive techniques of the original article. [ABSTRACT FROM AUTHOR]

Drawing from theory on institutionalized organizational environments, this paper analyzes the actions of community-based service programs providing care for people with AIDS. The focus is on the interorganizational relations developed by the lead agencies in demonstration projects attempting to coordinate services in three communities. The paper identifies differential styles of organizational response to developmental and operational issues. These differences are related to the conceptual distinction between organizational responses to technical environments and those to normative, or "institutional," environmental features. Various factors are identified that appear to promote a higher degree of institutionalization in interorganizational relations. Coordination as a reform strategy is seen to have become, in itself, an institutionalized myth to which organizations must subscribe in order to gain legitimacy. [ABSTRACT FROM AUTHOR]

Background: An estimated 301 million people worldwide suffer from anxiety disorders. People living with HIV/AIDS (PLWHA) are particularly prone to anxiety disorders that could interfere with the important developmental process in an individual's development and ultimately result in a wide range of negative mental, physical, and psychosocial consequences, as well as poor quality of life in those population groups. Early intervention for anxiety disorders can reverse some of the physical damage caused by anxiety. However, based on systematic reviews and meta-analyses, the specific prevalence of anxiety disorders in PLWHA remains unknown. Method: We conducted a literature search on PubMed, Embase, and Web of Science up to 22 October 2022. A random-effects meta-analysis was used to pool prevalence rates from the included studies. Sensitivity and subgroup analyses were performed to identify the possible sources of heterogeneity and to compare the prevalence estimates across groups. The Joanna Briggs Institute's Quality Assessment Checklist was used to assess the quality of the included studies. Cochran's Q and I² tests were used to assess the betweenstudy heterogeneity. Results: Ten studies with a total of 238,570 cases were included for the final analysis. Results showed that 15.5% of HIV/AIDS patients had anxiety disorders. The prevalence was higher in females (20.8%) than males (20.7%). The mean age of PLWHA with anxiety disorders was 46.58 ± 11.15 years in these included studies. The subgroup analyses showed significant higher prevalence in non-heterosexual (32.1%). Conclusion: We attempted to quantify literature that could allow for stronger inferences to be made regarding the significantly higher prevalence of anxiety disorders in PLWHA, a finding that suggests the imperativeness of intervention strategies to alleviate suffering and reduce the probable negative ramifications. [ABSTRACT FROM AUTHOR]

Objectives: Cytomegalovirus (CMV) is frequently detected in lung and/or blood samples of patients with Pneumocystis jirovecii pneumonia (PJP), although this co-detection is not precisely understood. We aimed to determine whether PJP was more severe in case of CMV detection. Methods: We retrospectively included all patients with a diagnosis of PJP between 2009 and 2020 in our centre and with a measure of CMV viral load in blood and/or bronchoalveolar lavage (BAL). PJP severity was assessed by the requirement for intensive care unit (ICU) admission. Results: The median age of the 249 patients was 63 [IQR: 53–73] years. The main conditions were haematological malignancies (44.2%), solid organ transplantations (16.5%), and solid organ cancers (8.8%). Overall, 36.5% patients were admitted to ICU. CMV was detected in BAL in 57/227 patients; the 37 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (78.4% vs 28.4%, p<0.001). CMV was also detected in blood in 57/194 patients; the 48 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (68.7% vs 29.4%, p<0.001). ICU admission rate was found to increase with each log of BAL CMV viral load and each log of blood CMV viral load. Conclusions: PJP is more severe in the case of concomitant CMV detection. This may reflect either the deleterious role of CMV itself, which may require antiviral therapy, or the fact that patients with CMV reactivation are even more immunocompromised. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral skills of people living with HIV/AIDS (PLWHA) in consuming antiretrovirals (ARV) can reduce their morbidity and mortality; however, behavioral skills in ARV therapy are still low. Motivational factor is considered to have an effect on behavior skills. The purpose of this study was to explain the influence of motivational factors on behavioral skills of PLWHA. Material and methods: Descriptive correlational cross-sectional approach was applied as study design. One hundred respondents, who met inclusion criteria were selected through simple random sampling method, and were requested to fill out a questionnaire. Results were analyzed using descriptive analysis and logistic regression test, with a significance value of p = 0.05. Results: In general, there is a significant effect of personal motivation (p = 0.000) and social motivation (p = 0.016) on behavioral skills. Personal motivation is based on attitudes towards preventive behavior, perceptions of disease susceptibility, benefits, and barriers to preventive behavior, while social motivation is a support provided by family and/ or friends as an assistance during treatment. Conclusions: Behavioral skills of PLWHA consisting of taking medication skills and managing information, are influenced by personal and social motivation. Support from family and friends is an important value that can play a role in achieving optimal motivation for treatment. [ABSTRACT FROM AUTHOR]

AIDS is a highly harmful malignant infectious disease caused by human immunodeficiency virus infection. The majority of HIV-infected people in the world are caused by HIV-1 infection. The HIV-1 virus mainly invades the most important CD4+ T cells in the human immune system, destroying the cells in large quantities, and ultimately depriving the body of its immune function. At present, there is no vaccine to prevent, and there is no effective drug or method to cure this disease. With the increase of age, the generation of various free radicals in the middle and old people increases, the activity of antioxidant enzymes gradually decreases, and the risk of insufficient intake of various vitamins increases. Due to the importance of micronutrients for human physiological function and the effectiveness of HAART for AIDS treatment, this article attempts to explore the effect of micronutrient supplementation combined with HAART treatment on the nutritional status and immune function of AIDS patients. In this paper, through an experimental simulation of HIV-1 infected patients in a hospital infection department or a specialty clinic, the experimental results show that the virus suppression rate of the micronutrient supplement group and the HAART treatment group is about 35%, and the micronutrient supplement combined with HAART the cure rate of the treatment group was close to 100%. After using mineral interventions, the nutritional status of HIV-infected and AIDS patients has been improved to varying degrees. [ABSTRACT FROM AUTHOR]

Introduction: Prevention of acquired immune deficiency syndrome (AIDS) requires proper awareness and attitude towards the disease, and ways of transmission and prevention. This study aimed to investigate the awareness and attitude of students at Kurdistan University of Medical Sciences and University of Kurdistan towards AIDS in 2020. Material and methods: This was cross-sectional, descriptive-analytical study. The study population was students at Kurdistan University of Medical Sciences (MUK) and University of Kurdistan (UOK) in 2020. 369 students were selected based on relative sampling. Data collection tool was international AIDS questionnaire (IAQ). Independent t-test and analysis of variance were applied for analysis. Results: The total IAQ score among students of MUK (75.38 ± 7.66) was higher than that of UOK students (71.17 ± 8.52) (p = 0.023). Although the total score in men (74.04 ± 8.14) was slightly higher than women (72.71 ± 8.50), there was no significant difference (p = 0.13). The difference in the scores of students living in single house with students living with their parents (p = 0.002) and students living in dormitories (p = 0.006) was statistically significant. The average score of undergraduates was the lowest, and doctorates the highest (p = 0.035). Conclusions: In light of the need to increase the awareness of ways of AIDS transmission, and appropriate attitudes towards people living with HIV/AIDS, with a focus on non-medical students, schemes should be designed and implemented to raise awareness and attitudes among people. [ABSTRACT FROM AUTHOR]

HIV-related spatial analysis studies in China are relatively few, and Jiangsu Province has not reported the relevant data in recent years. To describe the spatial distribution and molecular linkage characteristics of HIV-infected patients, this article combined descriptive epidemiology, spatial analysis, and molecular epidemiology methods to analyze patient reporting, patient mobility information, and HIV sequence information simultaneously. The results showed that HIV reporting profiles differed among Jiangsu cities, with the reporting rate in southern Jiangsu being above average. There was a spatial autocorrelation (Global Moran I = 0.5426, p < 0.05), with Chang Zhou showing a High–High aggregation pattern. Chang Zhou and Wu Xi were identified as hotspots for HIV reporting and access to molecular transmission networks. Some infected individuals still showed cross-city or even cross-province mobility after diagnosis, and three were linked with individuals in the destination cities within the largest molecular transmission cluster, involving 196 patients. The cross-city or cross-province mobility of patients may result in a potential HIV transmission risk, suggesting that combining timely social network surveys, building an extensive transmission network across cities and provinces, and taking critical regions and key populations as entry points could contribute to improved prevention and control efficiency and promote achievement of the 95-95-95 target and cascade. [ABSTRACT FROM AUTHOR]

Concurrent infections caused by multiple fungal pathogens in immunocompromised patients can pose diagnostic and treatment challenges. Here, we presented the first reported case in Taiwan of an AIDS patient who had concurrent infection with Cryptococcus neoformans meningitis and Talaromyces amestolkiae lymphadenopathy. The patient presented with an enlarged inguinal lymph node and was diagnosed with T. amestolkiae lymphadenitis. The species T. amestolkiae was identified using DNA sequencing, which had the capability of differentiating it from other Talaromyces species. The patient was discharged from the hospital following treatment with amphotericin B and subsequent administration of voriconazole. This case highlights the importance of maintaining a suspicion of co-infections and utilizing appropriate diagnostic tools, such as DNA sequencing, to identify possible pathogens. Further studies are needed to determine the optimal treatment for T. amestolkiae and other co-infecting fungal pathogens. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) has the ability to affect any organ in the body. In 70% of HIV -infected patients ocular manifestations were observed, these, in the vast majority reflect the systemic disease and may be the first signs of disseminated infections. Aim: The purpose of this paper is to determine the prevalence of posterior segment ocular manifestations in HIV / AIDS (Acquired Immunodeficiency Syndrome) patients. Method: The study is retrospective, conducted in the Cabinet of Ophthalmology of "Matei Bals" Infectious Diseases Hospital in Bucharest, during the period 1 August 2007 - 1 August 2013. Each patient was examined thoroughly at the biomicroscope ocular slit by using 90D microscope lens and 20D indirect lens after the administration of topical mydriatics. Results: 348 patients with HIV/AIDS and ocular disorders were followed. There was a high number of children and young people with HIV who had eye disorders (194 patients aged between 14 and 25 years). 44.25% of patients had posterior segment ocular damage, 17.55% of them had the anterior segment affected. 22.90% of the 131 patients with compromised posterior segment microangiopathy have been diagnosed with HIV / AIDS. Conclusions: Doctors should be aware of the existence of ocular damage in HIV / AIDS and to emphasize the importance of regular ophthalmologic examination of patients with HIV / AIDS. [ABSTRACT FROM AUTHOR]

The Stitches Doll Project is a community-based initiative that enables women and girls to express their feelings about living with HIV/AIDS through creating a doll that speaks for them. In a very personal and powerful way, women and girls are able to tell their stories both visually, through their dolls, and verbally/non-verbally, through their dolls' monographs. The completed dolls become part of an online and traveling oral history exhibit. Based on an analysis of the dolls and their monographs, interviews with doll contributors and project coordinators, and archived Stitches materials, this paper explores the meaning making and identity work/repair articulated through textile creation and the cultural transmission of oral histories. Our analysis reveals four recurrent message themes: making sense of infection, the impact of HIV, the role of social support and connection, and educating others. These themes speak to the nature of the oral history the artists transmit via their dolls. As they design their contribution to the project at Stitches workshops, the healing benefits of creative engagement through textile artwork is made available to them. It is these two components of the project in combination that afford doll makers a unique opportunity to engage in a process of meaning making and identity work/repair. In the process they help advance public education efforts by challenging cultural beliefs regarding "the face of AIDS," the experience of living with HIV/AIDS, and ultimately who is at risk for acquiring the virus and by poignantly calling attention to the variety of social factors (e.g., poverty, domestic violence, and sexual abuse and assault) that put women at risk for contracting HIV. [ABSTRACT FROM AUTHOR]

The study explores how HIV-positive couples negotiate and make reproductive and sexually related decisions. The broader aim of the paper is to understand how men and women with HIV make decisions about contraception and reproduction and what those decisions indicate about the realities of HIV-positive relationships. In line with the study's aim to explore meanings related to the decision making process, a qualitative research approach was adopted. In-depth interviews were conducted with 15 couples in which at least one of them was HIV-positive. A critical interpretive analysis of the data was adopted in order to gain insight into decision making among the HIV-positive couples. The results indicate that decisions made were usually a result of negotiation and compromise between partners. However, women's fertility and sexual preferences were found to be a major factor in determining the outcome of the decision making process. Couples who intended to have a child were found to be active decision makers while those who only desired or did not desire to have a child were mainly passive decision makers. The study concludes that women exercise significant power over contraceptive and reproductive decisions among both active and passive decision makers. [ABSTRACT FROM AUTHOR]

Introduction Despite the relatively effective roll-out of free life-prolonging antiretroviral therapy (ART) in public sector clinics in Zambia since 2005, and the proven efficacy of ART, some people living with HIV (PLHIV) are abandoning the treatment. Drawing on a wider ethnographic study in a predominantly low-income, high-density residential area of Lusaka, this paper reports the reasons why PLHIV opted to discontinue their HIV treatment. Methods Opened-ended, in-depth interviews were held with PLHIV who had stopped ART (n = 25), ART clinic staff (n = 5), religious leaders (n = 5), herbal medicine providers (n = 5) and lay home-based caregivers (n = 5). In addition, participant observations were conducted in the study setting for 18 months. Interview data were analysed using open coding first, and then interpreted using latent content analysis. The presentation of the results is guided by a social-ecological framework. Findings Patient attrition from ART care is influenced by an interplay of personal, social, health system and structural-level factors. While improved corporeal health, side effects and need for normalcy diminished motivation to continue with treatment, individuals also weighed the social and economic costs of continued uptake of treatment. Long waiting times for medical care and placing 'defaulters' on intensive adherence counselling in the context of insecure labour conditions and livelihood constraints not only imposed opportunity costs which patients were not willing to forego, but also forced individuals to balance physical health with social integrity, which sometimes forced them to opt for faith healing and traditional medicine. Conclusions Complex and dynamic interplay of personal, social, health system and structural-level factors coalesces to influence patient attrition from ART care. Consequently, while patient-centred interventions are required, efforts should be made to improve ART care by extending and establishing flexible ART clinic hours, improving patient-provider dialogue about treatment experiences and being mindful of the way intensive adherence counselling is being enforced. In the context of insecure labour conditions and fragile livelihoods, this would enable individuals to more easily balance time for treatment and their livelihoods. As a corollary, the perceived efficacy of alternative treatment and faith healing needs to be challenged through sensitizations targeting patients, religious leaders/faith healers and herbal medicine providers. [ABSTRACT FROM AUTHOR]

Background: In order to ensure their population's regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. Methods: This paper considers the 'make-or-buy' dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania's imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. Results: Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. Conclusions: Within the "make-or-buy" context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives. [ABSTRACT FROM AUTHOR]

The Streamlining Tasks & Roles to Expand Treatment and Care for HIV (STRETCH) program was developed to increase the reach of antiretroviral therapy (ART) for HIV/AIDS patients in Sub-Saharan Africa by training nurses to prescribe, initiate, and maintain ART. Fairall and colleagues conducted a cluster-randomized trial to determine the effects/impact of STRETCH on patient health outcomes in South Africa between 2008 and 2010. The purpose of our replication study is to evaluate Fairall and colleagues’ findings. We conducted push button and pure replication studies and measurement and estimation analyses (MEA). Our MEA validates the original findings: (1) overall, time to death did not differ between intervention (STRETCH) and control (ART) patients; (2) in a subgroup analysis of patients with CD4 counts of 201–350 cells per μL, the intervention group patients had a 30% lower risk of death than those in the control group, when controlling for baseline characteristics; (3) in a subgroup analysis of patients with CD4 counts of ≤200 cells per μL, time to death did not differ between the two groups; and (4) rates of viral suppression one year after enrollment did not differ between the intervention and control groups. This set of results have more caveats in the MEA. Although the intervention did not lead to improvements in the main outcomes, the effectiveness of STRETCH was proven to be similar to standard care while increasing the pool of prescribers, expanding their geographical range, and improving the quality of care for patients. Therefore, our analyses support the implementation of task shifting of antiretroviral therapy from doctors to trained nurses, which enhances confidence in the implementation of the intervention program and policymaking not only in South Africa but also in other developing countries that have similar circumstances. [ABSTRACT FROM AUTHOR]

The actual number of HIV/AIDS cases in Turkey is higher than the number of cases reported, and People Living with HIV (PLWHIV) may refrain from acknowledging their sickness or seeking help because of the stigma associated with HIV and fear of discrimination from their close friends, workmates, and even their families. In this paper we aim to explore HIV-positive people's relationships with significant others such as family members, friends, sexual partners, employers and health professionals in order to present the patients' perceptions about stigma and attitudes that lead to pro-social or anti-social behavior towards them. We carried out a qualitative study based on in-depth interviews with 16 PLWHIV in order to understand the conditions of people living with HIV/AIDS in Turkey. Our results revealed that except for family relations, the fear of contagion is the main obstacle for HIV-positive people's relations with others. HIV-positive people are severely afflicted with discrimination due to the overlapping "instrumental" and "symbolic" stigmas that directly affect their relations. The attribute of responsibility is related to gender and socio-economic status of PLWHIV living in Turkey. [ABSTRACT FROM AUTHOR]

Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multistage random sampling procedure was employed in administration of 1358 questionnaires. For qualitative data, four focus group discussions (FGD) were conducted to collect information from stakeholders within the study population, while In-depth interview was employed to collect information from 188 people living with HIV/AIDS through support groups in the State. The data collected were subjected to basic demographic analytical techniques. Combination of univariate, bivariate, and multivariate analysis were employed. Information from focus group discussions and in-depth interviews were transcribed and organized under broad headings that depict different aspects of the discussions. Majority of the respondents interviewed did not inform their partners about their infection in the study area. It was also discovered that stigmatization did not allow some women to disclose their status to their sexual partners. Some of the HIV-positive patients interviewed agreed that they did not attend the health facilities to treat the STI’s before they were finally confirmed positive. The study hypothesis revealed that communication between partners about STI’s was associated with an increase in risk reduction behaviour. The paper concluded that there is need for more information and education on communication about STI’s between the sexual partners; to reduce the spread of sexually transmitted diseases within the nation. [ABSTRACT FROM AUTHOR]

This paper reviews the incidence, pathogenetic mechanisms and management strategies of diabetes mellitus in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). It classifies patients based on the aetiopathogenetic mechanisms, and proposes rational methods of management of the condition, based on aetiopathogenesis and concomitant pharmacotherapy. [ABSTRACT FROM AUTHOR]

Estimated worldwide deaths caused by HIV/AIDS total approximately 25 million. This epidemic has harmed the African continent in numerous ways and has profoundly changed its demographic profile. Globally, women who are most physiologically and socially vulnerable to infections are devastatingly affected by it. The President's Emergency Plan for AIDS Relief, launched by the administration of President George W. Bush, was the largest U.S. investment in any disease;however, its strategies were flawed by its failure to coordinate efforts with other global partners and to engage local indigenous organizations. This paper examines the impact of HIV/AIDS on women and children in sub-Saharan Africa and reviews the U.S. response to this epidemic. [ABSTRACT FROM AUTHOR]