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Sample records for hidden hiv epidemic

  1. A hidden HIV epidemic among women in Vietnam

    Directory of Open Access Journals (Sweden)

    Tran Hien

    2008-01-01

    Full Text Available Abstract Background The HIV epidemic in Vietnam is still concentrated among high risk populations, including IDU and FSW. The response of the government has focused on the recognized high risk populations, mainly young male drug users. This concentration on one high risk population may leave other populations under-protected or unprepared for the risk and the consequences of HIV infection. In particular, attention to women's risks of exposure and needs for care may not receive sufficient attention as long as the perception persists that the epidemic is predominantly among young males. Without more knowledge of the epidemic among women, policy makers and planners cannot ensure that programs will also serve women's needs. Methods More than 300 documents appearing in the period 1990 to 2005 were gathered and reviewed to build an understanding of HIV infection and related risk behaviors among women and of the changes over time that may suggest needed policy changes. Results It appears that the risk of HIV transmission among women in Vietnam has been underestimated; the reported data may represent as little as 16% of the real number. Although modeling predicted that there would be 98,500 cases of HIV-infected women in 2005, only 15,633 were accounted for in reports from the health system. That could mean that in 2005, up to 83,000 women infected with HIV have not been detected by the health care system, for a number of possible reasons. For both detection and prevention, these women can be divided into sub-groups with different risk characteristics. They can be infected by sharing needles and syringes with IDU partners, or by having unsafe sex with clients, husbands or lovers. However, most new infections among women can be traced to sexual relations with young male injecting drug users engaged in extramarital sex. Each of these groups may need different interventions to increase the detection rate and thus ensure that the women receive the care they

  2. Global HIV/AIDS Epidemic

    Science.gov (United States)

    ... Policy The Global HIV/AIDS Epidemic The Global HIV/AIDS Epidemic Published: Nov 29, 2017 Facebook Twitter ... 2001-FY 2018 Request The Global Response to HIV/AIDS International efforts to combat HIV began in ...

  3. HIV epidemic in South Africa: A comparison of HIV epidemic ...

    African Journals Online (AJOL)

    2014-08-26

    Aug 26, 2014 ... 2Department of Statistics,. University of South Africa,. Pretoria, South ... antenatal care surveillance (ANC) surveys, we explored trends and patterns in HIV prevalence in KwaZulu-Natal and Western ... HIV infection in this age group is associated with recent infection, thus indicating an increasing epidemic in ...

  4. HIV epidemic in South Africa: A comparison of HIV epidemic ...

    African Journals Online (AJOL)

    2014-08-26

    Aug 26, 2014 ... and population-based surveys conducted in different years show a decline in HIV prevalence amongst youth in KwaZulu-Natal compared with an increase in the same age group in the Western Cape. HIV infection in this age group is associated with recent infection, thus indicating an increasing epidemic in ...

  5. Phylodynamic analysis of HIV sub-epidemics in Mochudi, Botswana

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    Vlad Novitsky

    2015-12-01

    Real-time HIV genotyping and breaking down local HIV epidemics into phylogenetically distinct sub-epidemics may help to reveal the structure and dynamics of HIV transmission networks in communities, and aid in the design of targeted interventions for members of the acute sub-epidemics that likely fuel local HIV/AIDS epidemics.

  6. Phylogenetics of the Danish HIV epidemic

    DEFF Research Database (Denmark)

    Audelin, Anne Margrethe; Cowan, Susan A; Obel, Niels

    2013-01-01

    BACKGROUND:: In Denmark 300 new individuals are diagnosed with HIV every year, despite decades of public health campaigns aimed to raise awareness of potential risk behaviour for HIV transmission. It is important to identify the driving forces of the epidemic, to enable more targeted campaigns...

  7. The origin and emergence of an HIV-1 epidemic:

    DEFF Research Database (Denmark)

    Bruhn, Christian Anders Wathne; Audelin, Anne M.; Helleberg, Marie

    2014-01-01

    To describe, at patient-level detail, the determining events and factors involved in the development of a country's HIV-1 epidemic.......To describe, at patient-level detail, the determining events and factors involved in the development of a country's HIV-1 epidemic....

  8. Obesity and kidney disease: hidden consequences of the epidemic ...

    African Journals Online (AJOL)

    Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for Chronic Kidney Disease. A high body mass index is one of the strongest risk factors for new-onset ...

  9. Obesity and kidney disease: hidden consequences of the epidemic ...

    African Journals Online (AJOL)

    Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for chronic kidney disease. A high body mass index is one of the strongest risk factors for new-onset ...

  10. Obesity and kidney disease: hidden consequences of the epidemic

    African Journals Online (AJOL)

    Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for chronic kidney disease. A high body mass index is one of the strongest risk factors for new-onset ...

  11. Paediatric HIV treatment failure: a silent epidemic

    Directory of Open Access Journals (Sweden)

    Jonathan M Bernheimer

    2015-07-01

    Full Text Available Paediatric antiretroviral treatment (ART failure is an under-recognized issue that receives inadequate attention in the field of paediatrics and within HIV treatment programmes. With paediatric ART failure rates ranging from 19.3% to over 32% in resource limited settings, a comprehensive evaluation of the causes of failure along with approaches to address barriers to treatment adherence are urgently needed.In partnership with the local Department of Health, a pilot programme has been established by Medecins Sans Frontieres (MSF in Khayelitsha, South Africa, to identify and support paediatric HIV patients with high viral loads and potential treatment failure. Through detailed clinical and psychosocial evaluations and adherence support with an innovative counselling model, treatment barriers are identified and addressed.Demographic and clinical characteristics from the cohort show a delayed median start date for ART, prolonged viraemia including a large number of patients who have never achieved viral load (VL suppression, a low rate of regimen changes despite failure, and a high percentage of pre-adolescent and adolescent patients who have not gone through the disclosure process.Stemming this epidemic of paediatric treatment failure requires programmatic responses to high viral loads in children, starting with improved “case finding” of previously undiagnosed HIV-infected children and adolescents. Viral load testing needs to be prioritized over CD4 count monitoring, and flagging systems to identify high VL results should be developed in clinics. Clinicians must understand that successful treatment begins with good adherence, and that simple adherence support strategies can often dramatically improve adherence. Moreover, appropriate adherence counselling should begin not when the child fails to respond to treatment. Establishing good adherence from the beginning of treatment, and supporting ongoing adherence during the milestones in these

  12. Understanding the epidemic of HIV in South Africa | Williams | South ...

    African Journals Online (AJOL)

    Objectives. To investigate the magnitude and the time course of the HIV epidemic in the provinces of South Africa from the antenatal clinic HIV surveys. Design. We analysed the data on the provincial prevalences of HIV infection from 1990 to 1996 using maximum likelihood methods to determine the intrinsic growth rate and ...

  13. The South African HIV epidemic, reflected by nine provincial ...

    African Journals Online (AJOL)

    A major deflection from the exponential growth patterns seen hitherto can be anticipated only once all or most of the highly populated provinces have traversed their respective points of inflection. The exponential model significantly explains the HIV epidemics in the provinces. The combination of these provincial epidemics ...

  14. Obesity and Kidney Disease: Hidden Consequences of the Epidemic.

    Science.gov (United States)

    Kovesdy, Csaba P; Furth, Susan; Zoccali, Carmine

    2017-03-01

    Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes mellitus, cardiovascular disease, and also for chronic kidney disease. A high body mass index is one of the strongest risk factors for new-onset chronic kidney disease. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing chronic kidney disease in the long-term. The incidence of obesity-related glomerulopathy has increased 10-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year, the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviors an affordable option.

  15. Complex networks and agent-based models of HIV epidemic

    NARCIS (Netherlands)

    Zarrabi, N.

    2013-01-01

    In this thesis, we explore the limits of multi-scale models by looking into the HIV data present at different scales (from molecular and cellular to epidemiological scales). We build data-driven models and perform network analysis in order to understand the dynamics of HIV epidemic at different

  16. HIV/AIDS in the Southern USA: a disproportionate epidemic.

    Science.gov (United States)

    Reif, Susan S; Whetten, Kathryn; Wilson, Elena R; McAllaster, Carolyn; Pence, Brian W; Legrand, Sara; Gong, Wenfeng

    2014-01-01

    This research synthesis examined HIV/AIDS surveillance and health care financing data and reviewed relevant research literature to describe HIV epidemiology, outcomes, funding, and contributing factors to the HIV epidemic in the Southern USA with particular focus on a group of Southern states with similar demographic and disease characteristics and comparable HIV epidemics (Alabama, Georgia, Florida, Los Angeles, Mississippi, North Carolina, South Carolina, Tennessee, and Texas). These states are hereafter referred to as "targeted Southern states." Eight of the 10 states with the highest HIV diagnosis rates in 2011 were in the Southern USA; six were targeted states. Forty-nine percent of HIV diagnoses were in the South in 2011, which contains only 37% of the US population. The targeted states region had the highest HIV diagnosis rate than any other US region in 2011. The South was also found to have the highest HIV-related mortality and morbidity rates in the USA. The high levels of poverty, HIV-related stigma, and STDs found in the South, particularly in the targeted Southern states, likely contribute to greater HIV incidence and mortality. The disproportionate impact of HIV in the South, particularly among targeted states, demonstrates a critical need to improve HIV prevention and care and address factors that contribute to HIV disease in this region.

  17. A qualitative view of the HIV epidemic in coastal Ecuador

    Directory of Open Access Journals (Sweden)

    Adam L. Beckman

    2016-11-01

    Full Text Available In 2013 approximately 37,000 people were living with HIV in Ecuador (prevalence 0.4%, representing a generalized epidemic where most new infections arise from sexual interactions in the general population. Studies that examine attitudes towards people living with HIV (PLWH, individual risk perception of acquiring HIV amongst Ecuadorians, and the ways in which levels of risk perception may affect risk behaviors are lacking. This qualitative study aimed to fill this gap in the literature by investigating these issues in the rural, coastal community of Manglaralto, Ecuador, which has among the highest incidence of HIV in Ecuador. We conducted interviews with 15 patients at Manglaralto Hospital. Analysis of interview transcripts revealed widespread negative attitudes towards PLWH, prevalent risk behaviors such as multiple sex partners and lack of condom use, and low individual risk-perception of contracting HIV. These findings underscore the need for increased efforts to prevent further growth of the HIV epidemic in Ecuador.

  18. Monitoring linked epidemics: the case of tuberculosis and HIV.

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    María S Sánchez

    Full Text Available BACKGROUND: The tight epidemiological coupling between HIV and its associated opportunistic infections leads to challenges and opportunities for disease surveillance. METHODOLOGY/PRINCIPAL FINDINGS: We review efforts of WHO and collaborating agencies to track and fight the TB/HIV co-epidemic, and discuss modeling--via mathematical, statistical, and computational approaches--as a means to identify disease indicators designed to integrate data from linked diseases in order to characterize how co-epidemics change in time and space. We present R(TB/HIV, an index comparing changes in TB incidence relative to HIV prevalence, and use it to identify those sub-Saharan African countries with outlier TB/HIV dynamics. R(TB/HIV can also be used to predict epidemiological trends, investigate the coherency of reported trends, and cross-check the anticipated impact of public health interventions. Identifying the cause(s responsible for anomalous R(TB/HIV values can reveal information crucial to the management of public health. CONCLUSIONS/SIGNIFICANCE: We frame our suggestions for integrating and analyzing co-epidemic data within the context of global disease monitoring. Used routinely, joint disease indicators such as R(TB/HIV could greatly enhance the monitoring and evaluation of public health programs.

  19. An HIV epidemic is ready to emerge in the Philippines

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    Farr Anna C

    2010-04-01

    Full Text Available Abstract Background The state of the HIV epidemic in the Philippines has been described as "low and slow", which is in stark contrast to many other countries in the region. A review of the conditions for HIV spread in the Philippines is necessary. Methods We evaluated the current epidemiology, trends in behaviour and public health response in the Philippines to identify factors that could account for the current HIV epidemic, as well as to review conditions that may be of concern for facilitating an emerging epidemic. Results The past control of HIV in the Philippines cannot be attributed to any single factor, nor is it necessarily a result of the actions of the Filipino government or other stakeholders. Likely reasons for the epidemic's slow development include: the country's geography is complicated; injecting drug use is relatively uncommon; a culture of sexual conservatism exists; sex workers tend to have few clients; anal sex is relatively uncommon; and circumcision rates are relatively high. In contrast, there are numerous factors suggesting that HIV is increasing and ready to emerge at high rates, including: the lowest documented rates of condom use in Asia; increasing casual sexual activity; returning overseas Filipino workers from high-prevalence settings; widespread misconceptions about HIV/AIDS; and high needle-sharing rates among injecting drug users. There was a three-fold increase in the rate of HIV diagnoses in the Philippines between 2003 and 2008, and this has continued over the past year. HIV diagnoses rates have noticeably increased among men, particularly among bisexual and homosexual men (114% and 214% respective increases over 2003-2008. The average age of diagnosis has also significantly decreased, from approximately 36 to 29 years. Conclusions Young adults, men who have sex with men, commercial sex workers, injecting drug users, overseas Filipino workers, and the sexual partners of people in these groups are particularly

  20. The global HIV epidemic: current status and challenges.

    Science.gov (United States)

    Abdool Karim, Quarraisha

    2013-06-01

    Three decades after the first reported cases of AIDS we have within our reach sufficient evidence to substantially alter the HIV epidemic at a country level regardless of mode of transmission of HIV. There are a growing number of countries demonstrating control of the epidemic. Human rights violations and/or legislation relating to sexual orientation, status of minors, injecting drug use and sex work together with stigma and discrimination remain key barriers to knowledge of HIV status and access to appropriate services. The use of anti-retrovirals prophylactically to reduce sexual and vertical transmission and systemically to treat infected infants and adults is central to the optimism in responses to the epidemic. In the current fiscal climate careful thought needs to be given to how to efficiently optimise combinations of what is available to have the biggest impact in the context of limited human and infrastructure resources.

  1. [HIV epidemic: a study among physicians in Vaud].

    Science.gov (United States)

    Meystre-Agustoni, G; Van Melle, G; Chave, J P; Martin, J; Billo, N; Glauser, M P; Francioli, P

    1990-09-22

    A two-phase survey was conducted in the Canton of Vaud among the 1006 registered private practitioners (response rate 98%). The first phase aimed at determining the proportion of these physicians involved in the care of HIV+ persons. The results showed that 43% of the practitioners had been consulted by HIV+ patients. In the second phase, all institutions (hospitals, prisons and IV-drug user rehabilitation and testing centers) and a representative sample of the physicians with HIV+ patients were asked about the transmission category of their HIV+ patients. A mathematical method was used to estimate the true number of known HIV+ individuals by December 1988. Approximately 60% of the HIV+ persons had been seen exclusively by the private practitioners. IV-drug users represented 57% of all HIV+ persons compared to only 27% of the AIDS cases registered in 1988, suggesting that an important change in the transmission categories of AIDS cases is to be expected in the near future. These observations underscore the evolving nature of the HIV epidemic on the one hand, and the crucial role of the private practitioners in the prevention of the HIV infection on the other. This also points to the need for methods specifically designed to monitor HIV and AIDS epidemics respectively.

  2. The HIV/AIDS epidemic in Cuba: description and tentative explanation of its low HIV prevalence

    Directory of Open Access Journals (Sweden)

    Clémençon Stéphan

    2007-11-01

    Full Text Available Abstract Background The Cuban HIV/AIDS epidemic has the lowest prevalence rate of the Caribbean region. The objective of this paper is to give an overview of the HIV/AIDS epidemic in Cuba and to explore the reasons for this low prevalence. Methods Data were obtained from the Cuban HIV/AIDS programme established in 1983. This programme has an extensive adult HIV testing policy, including testing of all pregnant women. HIV and AIDS cases have been recorded since 1986. Persons found to be HIV-positive are interviewed on their sexual behaviour and partners. Tracing and voluntary testing of these partners are organised. Epidemiological description of this epidemic was obtained from analysis of this data set. Using elementary mathematical analyses, we estimated the coverage of the detection system (percentage of HIV-positive adults detected and the average period between HIV infection and detection. Estimated HIV prevalence rates were corrected to account for the coverage. Results HIV prevalence has increased since 1996. In 2005, the prevalence among pregnant women was 1.2 per 10,000 (16/137000. Estimated HIV prevalence among 15- to 49-year-olds was 8.1 per 10,000 (4913/6065000; 95%CI: 7.9 per 10,000 – 8.3 per 10,000. Most (77% of the HIV-positive adults were men, most (85.1% of the detected HIV-positive men were reported as having sex with men (MSM, and most of the HIV-positive women reported having had sex with MSM. The average period between HIV infection and detection was estimated to be 2.1 years (IQR = 1.7 – 2.2 years. We estimated that, for the year 2005, 79.6% (IQR: 77.3 – 81.4% of the HIV-positive persons were detected. Conclusion MSM drive the HIV epidemic in Cuba. The extensive HIV testing policy may be an important factor in explaining the low HIV prevalence. To reduce the HIV epidemic in Cuba, the epidemic among MSM should be addressed. To understand this epidemic further, data on sexual behaviour should be collected. Now that

  3. AIDS update: the HIV epidemic: what lies ahead?

    Science.gov (United States)

    Esterhuyse, T; Doyle, P

    1993-10-01

    Results of the antenatal seroprevalence survey recently released by the South African Department of National Health and Population Development show the HIV/AIDS epidemic reaching critical levels, especially in the Natal/KwaZulu region of the country. 400,000 people are estimated to be currently infected with HIV in South Africa. It is highly probable that all of these individuals will ultimately develop AIDS. It is predicted that there will be 800,000 AIDS cases by the year 2010 if the epidemic continues to spread as it currently does. A lack of emerging AIDS cases, most probably due to widespread and significant underreporting, has, however, impeded the accurate assessment of the number of AIDS cases which will ultimately develop over time. An epidemic pattern like that observed in other African countries is nonetheless emerging in South Africa without an expected levelling-off at 8-10% HIV infection prevalence as observed elsewhere. This latter phenomenon is due to the population's high degree of social mobility and migration facilitated by a good transportation network. Economically and socially disenfranchised black antenatal women were found to be the most extensively infected with HIV and syphilis compared to antenatal women in other ethnic groups. HIV prevalence among black antenatal women is estimated to be 2.8%, 0.33% among colored and Asian women, and 0.09% among white women. 7.1% and 0.7% black and white antenatal women, respectively, were infected with syphilis. The luxury of modelling the course of the HIV/AIDS epidemic no longer exists. Urgent action must instead be taken to change the projected course of this epidemic. Black women and families need to be uplifted socially, provided with better housing and living conditions, and effectively treated and counseled for sexually transmitted diseases (STD). Further, young people need to be targeted in HIV and STD prevention campaigns.

  4. The HIV/AIDS epidemic in South Africa

    African Journals Online (AJOL)

    S Afr Med J 2014;104(8):583. DOI:10.7196/SAMJ.8645. ARTICLE. The HIV/AIDS epidemic in South Africa: Convergence with tuberculosis, socioecological vulnerability, and climate change patterns. A Abayomi,1 MB BS (London), MRCP (UK), FCPath Haem (SA), MPhil (Pretoria), FRCP (Edin), FRCPath (UK); M N Cowan2.

  5. COURSE FEATURES EPIDEMIC PROCESS HIV INFECTION IN KHARKIV REGION

    Directory of Open Access Journals (Sweden)

    Nikolaeva LG

    2016-03-01

    Full Text Available Introduction. In the context of the transformation of the spheres of human living epidemic HIV-infection continues. According to the intensity of the epidemic process of HIV-infection, Ukraine takes one of the first places among the European countries. The epidemic process of the infection is concentrated mainly on the high-risk groups, and there is uneven prevalence. Besides in most cases this distribution can not be explained by the social and economic characteristics of certain territories. Kharkiv region belongs to the territory of Ukraine with the lowest prevalence level of HIV-infection. Though in terms of the social and economic crisis due to hostilities in the east of the country, which the region borders, the epidemic situation may significantly become worse. Work objective: to study the peculiarities of the course of the epidemic process of HIV-infection for the period from 1987 till 2015 in Kharkiv region that will improve the epidemiological surveillance of the infection and develop appropriate preventive measures in modern conditions. Material & methods. The studies were conducted in Kharkiv region, which is a big industrial and administrative center. The city of Kharkiv is located at the crossroads of drug trafficking from Asia and Russia. The reportings and analytics of the Kharkiv regional center for prevention and control of AIDS and the Ministry of Health of Ukraine for the period of 1987 – 2015 were used in the research. The analysis of incidence of HIV prevalence, structure of transmission routes and sex-age groups were carried out using descriptive and evaluative and analytical ways of epidemiological research method. Results & discussion. During 1987 – 2015 in Kharkiv region there were officially registered 7868 cases of HIV-infection what was equal to 4.0 % of the registered cases in Ukraine. Since 1996 a marked upward tendency of the incidence of HIV infection in Kharkiv region (growth rate – +7.0 %, and on the

  6. The global spread of HIV-1 subtype B epidemic.

    Science.gov (United States)

    Magiorkinis, Gkikas; Angelis, Konstantinos; Mamais, Ioannis; Katzourakis, Aris; Hatzakis, Angelos; Albert, Jan; Lawyer, Glenn; Hamouda, Osamah; Struck, Daniel; Vercauteren, Jurgen; Wensing, Annemarie; Alexiev, Ivailo; Åsjö, Birgitta; Balotta, Claudia; Gomes, Perpétua; Camacho, Ricardo J; Coughlan, Suzie; Griskevicius, Algirdas; Grossman, Zehava; Horban, Anders; Kostrikis, Leondios G; Lepej, Snjezana J; Liitsola, Kirsi; Linka, Marek; Nielsen, Claus; Otelea, Dan; Paredes, Roger; Poljak, Mario; Puchhammer-Stöckl, Elizabeth; Schmit, Jean Claude; Sönnerborg, Anders; Staneková, Danica; Stanojevic, Maja; Stylianou, Dora C; Boucher, Charles A B; Nikolopoulos, Georgios; Vasylyeva, Tetyana; Friedman, Samuel R; van de Vijver, David; Angarano, Gioacchino; Chaix, Marie-Laure; de Luca, Andrea; Korn, Klaus; Loveday, Clive; Soriano, Vincent; Yerly, Sabine; Zazzi, Mauricio; Vandamme, Anne-Mieke; Paraskevis, Dimitrios

    2016-12-01

    Human immunodeficiency virus type 1 (HIV-1) was discovered in the early 1980s when the virus had already established a pandemic. For at least three decades the epidemic in the Western World has been dominated by subtype B infections, as part of a sub-epidemic that traveled from Africa through Haiti to United States. However, the pattern of the subsequent spread still remains poorly understood. Here we analyze a large dataset of globally representative HIV-1 subtype B strains to map their spread around the world over the last 50years and describe significant spread patterns. We show that subtype B travelled from North America to Western Europe in different occasions, while Central/Eastern Europe remained isolated for the most part of the early epidemic. Looking with more detail in European countries we see that the United Kingdom, France and Switzerland exchanged viral isolates with non-European countries than with European ones. The observed pattern is likely to mirror geopolitical landmarks in the post-World War II era, namely the rise and the fall of the Iron Curtain and the European colonialism. In conclusion, HIV-1 spread through specific migration routes which are consistent with geopolitical factors that affected human activities during the last 50years, such as migration, tourism and trade. Our findings support the argument that epidemic control policies should be global and incorporate political and socioeconomic factors. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  7. The History of the HIV/AIDS Epidemic in Africa.

    Science.gov (United States)

    Kagaayi, Joseph; Serwadda, David

    2016-08-01

    HIV testing of African immigrants in Belgium showed that HIV existed among Africans by 1983. However, the epidemic was recognized much later in most parts of sub-Saharan Africa (SSA) due to stigma and perceived fear of possible negative consequences to the countries' economies. This delay had devastating mortality, morbidity, and social consequences. In countries where earlier recognition occurred, political leadership was vital in mounting a response. The response involved establishment of AIDS control programs and research on the HIV epidemiology and candidate preventive interventions. Over time, the number of effective interventions has grown; the game changer being triple antiretroviral therapy (ART). ART has led to a rapid decline in HIV-related morbidity and mortality in addition to prevention of onward HIV transmission. Other effective interventions include safe male circumcision, pre-exposure prophylaxis, and post-exposure prophylaxis. However, since none of these is sufficient by itself, delivering a combination package of these interventions is important for ending the HIV epidemic as a public health threat.

  8. Together we can end the HIV epidemic.

    Science.gov (United States)

    Warriner, Jason

    2017-05-24

    Over the past 30 years, HIV care and treatment has changed beyond recognition in the UK. In the 1980s and 1990s services focused on providing support for people with a virus for which there was no treatment, and on end of life care.

  9. The hidden epidemic of schistosomiasis in recent African immigrants and asylum seekers to Italy.

    Science.gov (United States)

    Beltrame, Anna; Buonfrate, Dora; Gobbi, Federico; Angheben, Andrea; Marchese, Valentina; Monteiro, Geraldo Badona; Bisoffi, Zeno

    2017-08-01

    The prevalence of schistosomiasis among recent refugees from sub-Saharan Africa in Italy is unknown. This is a retrospective review of African immigrants screened at Centre for Tropical Diseases of Negrar from March 2014 to February 2016. Of the 373 immigrants tested, 34% were positive at least at one schistosomiasis test. The proportion of positive ELISA serology was 103/373 (27.6%). At microscopy, infected subjects were 65/373 (17.4%), (51% Schistosoma haematobium, 38% Schistosoma mansoni, 11% both). CCA antigen for S. mansoni was positive in 47/373 individuals (12.6%). We found a particularly high positivity rate in subjects from Mali (72.1%) and Ivory Coast (48%). This "hidden epidemic" of schistosomiasis cannot be longer neglected, considering the risk of severe complications, and the effective and inexpensive treatment available.

  10. Patterns and trends in Pakistan's heterogeneous HIV epidemic.

    Science.gov (United States)

    Reza, Tahira; Melesse, Dessalegn Y; Shafer, Leigh Anne; Salim, Momina; Altaf, Arshad; Sonia, Altaf; Jayaraman, Gayatri C; Emmanuel, Faran; Thompson, Laura H; Blanchard, James F

    2013-09-01

    Considerable HIV transmission occurs among injection drug users (IDUs) in Pakistan and recently the HIV prevalence has been increasing among male (MSW), hijra (transgender; HSW) and female (FSW) sex workers. We describe past and estimate future patterns of HIV emergence among these populations in several cities in Pakistan. The density of these key populations per 1000 adult men was calculated using 2011 mapping data from Karachi, Lahore, Faisalabad, Larkana, Peshawar and Quetta, and surveillance data were used to assess bridging between these key populations. We used the UNAIDS Estimation and Projection Package model to estimate and project HIV epidemics among these key populations in Karachi, Lahore, Faisalabad and Larkana. The density and bridging of key populations varied across cities. Lahore had the largest FSW population (11.5/1000 adult men) and the smallest IDU population (1.7/1000 adult men). Quetta had the most sexual and drug injection bridging between sex workers and IDUs (6.7%, 7.0% and 3.8% of FSW, MSW and HSW, respectively, reported injecting drugs). Model evidence suggests that by 2015 HIV prevalence is likely to reach 17-22% among MSWs/HSWs in Karachi, 44-49% among IDUs in Lahore and 46-66% among IDUs in Karachi. Projection suggests the prevalence may reach as high as 65-75% among IDUs in Faisalabad by 2025. HIV prevalence is also estimated to increase among FSWs, particularly in Karachi and Larkana. There is a need to closely monitor regional and subpopulation epidemic patterns and implement prevention programmes customised to local epidemics.

  11. HIV/AIDS in Vancouver, British Columbia: a growing epidemic

    Science.gov (United States)

    McInnes, Colin W; Druyts, Eric; Harvard, Stephanie S; Gilbert, Mark; Tyndall, Mark W; Lima, Viviane D; Wood, Evan; Montaner, Julio SG; Hogg, Robert S

    2009-01-01

    The prevalence of HIV in Vancouver, British Columbia was subject to two distinct periods of rapid increase. The first occurred in the 1980s due to high incidence among men who have sex with men (MSM), and the second occurred in the 1990s due to high incidence among injection drug users (IDU). The purpose of this study was to estimate and model the trends in HIV prevalence in Vancouver from 1980 to 2006. HIV prevalence data were entered into the UNAIDS/WHO Estimation and Projection Package (EPP) where prevalence trends were estimated by fitting an epidemiological model to the data. Epidemic curves were fit for IDU, MSM, street-based female sex trade workers (FSW), and the general population. Using EPP, these curves were then aggregated to produce a model of Vancouver's overall HIV prevalence. Of the 505 000 people over the age of 15 that reside in Vancouver, 6108 (ranging from 4979 to 7237) were living with HIV in the year 2006, giving an overall prevalence of 1.21 percent (ranging from 0.99 to 1.43 percent). The subgroups of IDU and MSM account for the greatest proportion of HIV infections. Our model estimates that the prevalence of HIV in Vancouver is greater than one percent, roughly 6 times higher than Canada's national prevalence. These results suggest that HIV infection is having a relatively large impact in Vancouver and that evidence-based prevention and harm reduction strategies should be expanded. PMID:19265531

  12. Phylodynamics of the HIV-1 epidemic in Cuba.

    Science.gov (United States)

    Delatorre, Edson; Bello, Gonzalo

    2013-01-01

    Previous studies have shown that the HIV-1 epidemic in Cuba displayed a complex molecular epidemiologic profile with circulation of several subtypes and circulating recombinant forms (CRF); but the evolutionary and population history of those viral variants remains unknown. HIV-1 pol sequences of the most prevalent Cuban lineages (subtypes B, C and G, CRF18_cpx, CRF19_cpx, and CRFs20/23/24_BG) isolated between 1999 and 2011 were analyzed. Maximum-likelihood analyses revealed multiple introductions of subtype B (n≥66), subtype C (n≥10), subtype G (n≥8) and CRF18_cpx (n≥2) viruses in Cuba. The bulk of HIV-1 infections in this country, however, was caused by dissemination of a few founder strains probably introduced from North America/Europe (clades B(CU-I) and B(CU-II)), east Africa (clade C(CU-I)) and central Africa (clades G(CU), CRF18(CU) and CRF19(CU)), or locally generated (clades CRFs20/23/24_BG). Bayesian-coalescent analyses show that the major HIV-1 founder strains were introduced into Cuba during 1985-1995; whereas the CRFs_BG strains emerged in the second half of the 1990s. Most HIV-1 Cuban clades appear to have experienced an initial period of fast exponential spread during the 1990s and early 2000s, followed by a more recent decline in growth rate. The median initial growth rate of HIV-1 Cuban clades ranged from 0.4 year⁻¹ to 1.6 year⁻¹. Thus, the HIV-1 epidemic in Cuba has been a result of the successful introduction of a few viral strains that began to circulate at a rather late time of the AIDS pandemic, but then were rapidly disseminated through local transmission networks.

  13. The epidemiology of HIV among men who have sex with men in countries with generalized HIV epidemics.

    Science.gov (United States)

    Baral, Stefan D; Grosso, Ashley; Holland, Claire; Papworth, Erin

    2014-03-01

    Key populations at high risk for HIV acquisition and transmission, such as MSM, have long been identified as essential subpopulations for epidemiological surveillance of the HIV epidemic. However, surveillance systems in the context of generalized and widespread HIV epidemics have traditionally excluded these men. Emerging and consistent data highlight the disproportionate burden of HIV among MSM that exists when compared with other men of reproductive age across countries with generalized epidemics. Correlates of prevalent HIV infection include individual-level determinants of HIV acquisition and transmission similar to that found in concentrated HIV epidemics and community-level structural factors, such as stigma, being blackmailed, and history of homophobic abuse. HIV incidence was only available from two countries (Kenya, Thailand) with generalized HIV epidemics, but in both settings was an order of magnitude higher than that of other populations. The data presented here suggest that the dynamics of HIV infection among men are more similar across the world than they are different. Many HIV epidemics among average-risk reproductive age adults are slowing across both generalized and concentrated settings. It is in this context that high HIV incidence is observed among MSM, especially young MSM. This trend suggests a change in the trajectory of these HIV epidemics, a change that we may miss if we continue to understudy these populations based on unproved and dated assumptions.

  14. HIV Epidemic in Asia: Implications for HIV Vaccine and Other Prevention Trials

    Science.gov (United States)

    Phanuphak, Nittaya; Lo, Ying-Ru; Shao, Yiming; Solomon, Sunil Suhas; O'Connell, Robert J.; Tovanabutra, Sodsai; Chang, David; Kim, Jerome H.

    2015-01-01

    Abstract An overall decrease of HIV prevalence is now observed in several key Asian countries due to effective prevention programs. The decrease in HIV prevalence and incidence may further improve with the scale-up of combination prevention interventions. The implementation of future prevention trials then faces important challenges. The opportunity to identify heterosexual populations at high risk such as female sex workers may rapidly wane. With unabating HIV epidemics among men who have sex with men (MSM) and transgender (TG) populations, an effective vaccine would likely be the only option to turn the epidemic. It is more likely that efficacy trials will occur among MSM and TG because their higher HIV incidence permits smaller and less costly trials. The constantly evolving patterns of HIV-1 diversity in the region suggest close monitoring of the molecular HIV epidemic in potential target populations for HIV vaccine efficacy trials. CRF01_AE remains predominant in southeast Asian countries and MSM populations in China. This relatively steady pattern is conducive to regional efficacy trials, and as efficacy warrants, to regional licensure. While vaccines inducing nonneutralizing antibodies have promise against HIV acquisition, vaccines designed to induce broadly neutralizing antibodies and cell-mediated immune responses of greater breadth and depth in the mucosal compartments should be considered for testing in MSM and TG. The rationale and design of efficacy trials of combination prevention modalities such as HIV vaccine and preexposure prophylaxis (PrEP) remain hypothetical, require high adherence to PrEP, are more costly, and present new regulatory challenges. The prioritization of prevention interventions should be driven by the HIV epidemic and decided by the country-specific health and regulatory authorities. Modeling the impact and cost–benefit may help this decision process. PMID:26107771

  15. Education: the key to curb HIV and AIDS epidemic.

    Science.gov (United States)

    Bhatta, D N; Aryal, U R; Khanal, K

    2013-01-01

    Overwhelming impact has been established among different aspects and burden of incurable HIV and AIDS is increasing day-by-day globally. The aim of this article is to discuss the potential benefits and strengths of an education system in the absence of remedy and help to develop future strategies. Education has great impact on HIV and AIDS and vice-versa. An education plays a vital role to curb the transmission of HIV and AIDS thorough capacity building, provides information, reduces vulnerability, empowerment, improve life skill, maintain equity, reduce dependence, stigma, and discrimination, where are abundance foundations for HIV infection. HIV and AIDS has role for devastation of education system and level which has great impact on productivity, economic growth, demand, supply and daily life of human being. Low and middle income countries needs to be improve recording and reporting systems related to impact of HIV and AIDS on education. By analyzing preceding evidences, policy makers or governance feels to reformulate policies relating to education and health. Evidence based policy and program will be more useful to address distressing squall of epidemic.

  16. HIV Epidemic situation among Small Indigenous Populations of Northeast Russia

    Directory of Open Access Journals (Sweden)

    L. Yu. Volova

    2014-01-01

    Full Text Available The aim of the study was to analyze and assess the real situation of HIV infection among indigenous peoples established , to investigate the prevalence of risky behavior in relation to HIV also determine the level of awareness of the indigenous population about HIV / AIDS.Materials and Methods 1. Analysis of the data cards of the epidemical investigation hearth HIV data form number 283 «About measures on prevention of HIV , hepatitis B and C , detection and treatment of HIV» , form number 61 «Information on the groups of HIV», outpatients patient. 2. The analysis of the statistical prevalence of HIV infection among men and women , including among indigenous representatives , the structure of HIV transmission , coverage of clinical examination. 3. Data analysis of the sociological study among indigenous representatives. The proposed questionnaire contained both closed and open-ended questions to assess the risk factors of respondents’ behavior and their level of awareness of HIV infection. Evaluation of the reliability of the data performed using Student t-test. Results. In 2000, HIV infection in region penetrated into the population of indigenous peoples and continues to spread. Particular way of life and living conditions, such as seasonal migration within the county, early sexual activity, lack of skills in safe sexual behavior , bad habits contributed to the spread of HIV among this ethnic group. Link transition of HIV infection in a group of indigenous peoples is a high incidence of working shifts and workers, among them 30% are already infected with HIV. In connection with this, the spread of HIV infection among women occurs rapidly. Special role in the spread of HIV infection among women of indigenous peoples plays lifestyle and delated psychosocial problems.Conclusion 1. The most vulnerable to HIV infection and sexually transmitted infections by representatives of indigenous peoples living in the

  17. The evolutionary rate dynamically tracks changes in HIV-1 epidemics

    Energy Technology Data Exchange (ETDEWEB)

    Maljkovic-berry, Irina [Los Alamos National Laboratory; Athreya, Gayathri [Los Alamos National Laboratory; Daniels, Marcus [Los Alamos National Laboratory; Bruno, William [Los Alamos National Laboratory; Korber, Bette [Los Alamos National Laboratory; Kuiken, Carla [Los Alamos National Laboratory; Ribeiro, Ruy M [Los Alamos National Laboratory

    2009-01-01

    Large-sequence datasets provide an opportunity to investigate the dynamics of pathogen epidemics. Thus, a fast method to estimate the evolutionary rate from large and numerous phylogenetic trees becomes necessary. Based on minimizing tip height variances, we optimize the root in a given phylogenetic tree to estimate the most homogenous evolutionary rate between samples from at least two different time points. Simulations showed that the method had no bias in the estimation of evolutionary rates and that it was robust to tree rooting and topological errors. We show that the evolutionary rates of HIV-1 subtype B and C epidemics have changed over time, with the rate of evolution inversely correlated to the rate of virus spread. For subtype B, the evolutionary rate slowed down and tracked the start of the HAART era in 1996. Subtype C in Ethiopia showed an increase in the evolutionary rate when the prevalence increase markedly slowed down in 1995. Thus, we show that the evolutionary rate of HIV-1 on the population level dynamically tracks epidemic events.

  18. Patterns of infection: using age prevalence data to understand epidemic of HIV in South Africa

    CSIR Research Space (South Africa)

    Williams, BG

    2000-06-01

    Full Text Available South Africa is experiencing an explosive epidemic of HIV/AIDS, with about one in four women attending ante-natal clinics nation-wide being HIV-positive. In order to understand the natural history of the epidemic, to design and target intervention...

  19. The HIV epidemic in Greenland - a slow spreading infection among adult heterosexual Greenlanders

    DEFF Research Database (Denmark)

    Bjørn-Mortensen, Karen; Ladefoged, Karin; Obel, Niels

    2013-01-01

    We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths.......We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths....

  20. Addressing the challenge of the emerging NCD epidemic: lessons learned from Botswana's response to the HIV epidemic.

    Science.gov (United States)

    Reid, M J A; Mosepele, M; Tsima, B M; Gross, R

    2012-09-21

    Botswana has the second highest prevalence of human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) in the world, and yet it has built one of Africa's most progressive and comprehensive HIV programs. While public health infrastructure has responded remarkably to the HIV epidemic, the prevalence of non-communicable diseases (NCDs), particularly diabetes mellitus and cardiovascular disease, in both HIV-infected and non-infected individuals, is increasing rapidly. Applying lessons learned from the scale-up of HIV/AIDS services may help with the implementation of an effective response to the challenges of the emerging NCD epidemic. We suggest that a successful response should include integrated service delivery, capacity building to provide disease-specific care, and strong partnerships to mobilize communities.

  1. HIV Prevalence Trends, Risky Behaviours, and Governmental and Community Responses to the Epidemic among Men Who Have Sex with Men in China

    Science.gov (United States)

    Chow, Eric P. F.; Lau, Joseph T. F.; Zhang, Xiaohu; Wang, Yanjie

    2014-01-01

    Purpose of Review. Numerous studies reported the rapid spread of HIV/AIDS epidemic among men who have sex with men (MSM) in China. This paper aims to investigate the overall epidemic trend and associated high-risk behaviours among Chinese MSM and to explore the governmental and community responses to the epidemic. Recent Findings. HIV prevalence among Chinese MSM increased rapidly in all Chinese regions in the past decade and disproportionally affected the Southwest China. In addition to the high-risk homosexual behaviours, overlapping bisexual, commercial, and drug use behaviours are commonly observed among Chinese MSM. The Chinese government has significantly expanded the surveillance efforts among MSM over the past decade. Community responses against HIV have been substantially strengthened with the support of international aid. However, lack of enabling legal and financial environment undermines the role of community-based organisations (CBOs) in HIV surveillance and prevention. Conclusion. HIV continues to spread rapidly among MSM in China. The hidden nature of MSM and the overlapping homosexual, bisexual, and commercial behaviours remain a challenge for HIV prevention among MSM. Strong collaboration between the government and CBOs and innovative intervention approaches are essential for effective HIV surveillance and prevention among MSM in China. PMID:24822214

  2. HIV epidemiology. The early spread and epidemic ignition of HIV-1 in human populations.

    Science.gov (United States)

    Faria, Nuno R; Rambaut, Andrew; Suchard, Marc A; Baele, Guy; Bedford, Trevor; Ward, Melissa J; Tatem, Andrew J; Sousa, João D; Arinaminpathy, Nimalan; Pépin, Jacques; Posada, David; Peeters, Martine; Pybus, Oliver G; Lemey, Philippe

    2014-10-03

    Thirty years after the discovery of HIV-1, the early transmission, dissemination, and establishment of the virus in human populations remain unclear. Using statistical approaches applied to HIV-1 sequence data from central Africa, we show that from the 1920s Kinshasa (in what is now the Democratic Republic of Congo) was the focus of early transmission and the source of pre-1960 pandemic viruses elsewhere. Location and dating estimates were validated using the earliest HIV-1 archival sample, also from Kinshasa. The epidemic histories of HIV-1 group M and nonpandemic group O were similar until ~1960, after which group M underwent an epidemiological transition and outpaced regional population growth. Our results reconstruct the early dynamics of HIV-1 and emphasize the role of social changes and transport networks in the establishment of this virus in human populations. Copyright © 2014, American Association for the Advancement of Science.

  3. HIV status awareness, partnership dissolution and HIV transmission in generalized epidemics.

    Directory of Open Access Journals (Sweden)

    Georges Reniers

    Full Text Available HIV status aware couples with at least one HIV positive partner are characterized by high separation and divorce rates. This phenomenon is often described as a corollary of couples HIV Testing and Counseling (HTC that ought to be minimized. In this contribution, we demonstrate the implications of partnership dissolution in serodiscordant couples for the propagation of HIV.We develop a compartmental model to study epidemic outcomes of elevated partnership dissolution rates in serodiscordant couples and parameterize it with estimates from population-based data (Rakai, Uganda.Via its effect on partnership dissolution, every percentage point increase in HIV status awareness reduces HIV incidence in monogamous populations by 0.27 percent for women and 0.63 percent for men. These effects are even larger when the assumption of monogamy can be relaxed, but are moderated by other behavior changes (e.g., increased condom use in HIV status aware serodiscordant partnerships. When these behavior changes are taken into account, each percentage point increase in HIV status awareness reduces HIV incidence by 0.13 and 0.32 percent for women and men, respectively (assuming monogamy. The partnership dissolution effect exists because it decreases the fraction of serodiscordant couples in the population and prolongs the time that individuals spend outside partnerships.Our model predicts that elevated partnership dissolution rates in HIV status aware serodiscordant couples reduce the spread of HIV. As a consequence, the full impact of couples HTC for HIV prevention is probably larger than recognized to date. Particularly high partnership dissolution rates in female positive serodiscordant couples contribute to the gender imbalance in HIV infections.

  4. HIV status awareness, partnership dissolution and HIV transmission in generalized epidemics.

    Science.gov (United States)

    Reniers, Georges; Armbruster, Benjamin

    2012-01-01

    HIV status aware couples with at least one HIV positive partner are characterized by high separation and divorce rates. This phenomenon is often described as a corollary of couples HIV Testing and Counseling (HTC) that ought to be minimized. In this contribution, we demonstrate the implications of partnership dissolution in serodiscordant couples for the propagation of HIV. We develop a compartmental model to study epidemic outcomes of elevated partnership dissolution rates in serodiscordant couples and parameterize it with estimates from population-based data (Rakai, Uganda). Via its effect on partnership dissolution, every percentage point increase in HIV status awareness reduces HIV incidence in monogamous populations by 0.27 percent for women and 0.63 percent for men. These effects are even larger when the assumption of monogamy can be relaxed, but are moderated by other behavior changes (e.g., increased condom use) in HIV status aware serodiscordant partnerships. When these behavior changes are taken into account, each percentage point increase in HIV status awareness reduces HIV incidence by 0.13 and 0.32 percent for women and men, respectively (assuming monogamy). The partnership dissolution effect exists because it decreases the fraction of serodiscordant couples in the population and prolongs the time that individuals spend outside partnerships. Our model predicts that elevated partnership dissolution rates in HIV status aware serodiscordant couples reduce the spread of HIV. As a consequence, the full impact of couples HTC for HIV prevention is probably larger than recognized to date. Particularly high partnership dissolution rates in female positive serodiscordant couples contribute to the gender imbalance in HIV infections.

  5. What impact might the economic crisis have on HIV epidemics in Southeast Asia?

    Science.gov (United States)

    Gray, Richard T; Heymer, Kelly-Jean; Hoare, Alexander; Kwon, Jisoo A; Thein, Hla-Hla; Lote, Namarola; Siba, Peter; Saramony, Sarun; Saphonn, Vonthanak; Worth, Heather; Kaldor, John M; Wilson, David P

    2009-11-01

    To evaluate the potential impact of the current global economic crisis (GEC) on the spread of HIV. To evaluate the impact of the economic downturn we studied two distinct HIV epidemics in Southeast Asia: the generalized epidemic in Cambodia where incidence is declining and the epidemic in Papua New Guinea (PNG) which is in an expansion phase. Major HIV-related risk factors that may change due to the GEC were identified and a dynamic mathematical transmission model was developed and used to forecast HIV prevalence, diagnoses, and incidence in Cambodia and PNG over the next 3 years. In Cambodia, the total numbers of HIV diagnoses are not expected to be largely affected. However, an estimated increase of up to 10% in incident cases of HIV, due to potential changes in behavior, may not be observed by the surveillance system. In PNG, HIV incidence and diagnoses could be more affected by the GEC, resulting in respective increases of up to 17% and 11% over the next 3 years. Decreases in VCT and education programs are the factors that may be of greatest concern in both settings. A reduction in the rollout of antiretroviral therapy could increase the number of AIDS-related deaths (by up to 7.5% after 3 years). The GEC is likely to have a modest impact on HIV epidemics. However, there are plausible conditions under which the economic downturns can noticeably influence epidemic trends. This study highlights the high importance of maintaining funding for HIV programs.

  6. The Characteristics of TB Epidemic and TB/HIV Co-Infection Epidemic: A 2007-2013 Retrospective Study in Urumqi, Xinjiang Province, China.

    Science.gov (United States)

    Wei, Wang; Wei-Sheng, Zhang; Ahan, Alayi; Ci, Yan; Wei-Wen, Zhang; Ming-Qin, Cao

    2016-01-01

    This study was aimed to find out epidemiologic characteristic of tuberculosis (TB) cases, and Human Immunodeficiency Virus (HIV) positive cases among TB patients (TB/HIV co-infection) through demographic, temporal, and spatial study in Urumqi. Descriptive statistics and multivariate logistic regression were applied to identify the epidemiologic characteristics and risk factors of TB epidemic and TB/HIV co-infection epidemic. All addresses of each TB case, TB/HIV co-infection case, and administrative street were transformed into geographical coordinate. Subsequently, the geocoded address for 82 streets was transformed into a dot map used as the basis of spatial datasets. In addition, the paper also used quantile map and the spatial scan statistic in order to identify the spatial distribution and spatial clusters of TB epidemic and TB/HIV co-infection epidemic. There was a declining trend of the notification rates of TB epidemic from 2007 to 2009, as well as a rising trend from 2010 to 2013. However, the notification rates of TB/HIV co-infection epidemic showed a rising trend from 2007 to 2010, and a declining trend from 2011 to 2013. Moreover, a significant share of TB epidemic and TB/HIV co-infection epidemic happened between the age of 15 to 45 years old, indicating an increase in risk of TB and TB/HIV infection. It is worth noting that the risk of HIV infection for male TB patients was 2.947 times (95% CI [2.178, 3.988]) than that of female patients. Han ethnicity and Uygur ethnicity in urban region accounted for a large proportion of total TB and TB/HIV co-infection cases. Most of the TB cases of minorities in Urumqi showed a statistically significant increase in risk of HIV infection than Han ethnicity in Urumqi. In addition, the spatial distribution of TB epidemic and TB/HIV co-infection epidemic was highly skewed. Most of the local clusters were located in urban area and rural-urban continuum where showed an increase in risk of TB and TB/HIV infection. The

  7. The Characteristics of TB Epidemic and TB/HIV Co-Infection Epidemic: A 2007-2013 Retrospective Study in Urumqi, Xinjiang Province, China.

    Directory of Open Access Journals (Sweden)

    Wang Wei

    Full Text Available This study was aimed to find out epidemiologic characteristic of tuberculosis (TB cases, and Human Immunodeficiency Virus (HIV positive cases among TB patients (TB/HIV co-infection through demographic, temporal, and spatial study in Urumqi.Descriptive statistics and multivariate logistic regression were applied to identify the epidemiologic characteristics and risk factors of TB epidemic and TB/HIV co-infection epidemic. All addresses of each TB case, TB/HIV co-infection case, and administrative street were transformed into geographical coordinate. Subsequently, the geocoded address for 82 streets was transformed into a dot map used as the basis of spatial datasets. In addition, the paper also used quantile map and the spatial scan statistic in order to identify the spatial distribution and spatial clusters of TB epidemic and TB/HIV co-infection epidemic.There was a declining trend of the notification rates of TB epidemic from 2007 to 2009, as well as a rising trend from 2010 to 2013. However, the notification rates of TB/HIV co-infection epidemic showed a rising trend from 2007 to 2010, and a declining trend from 2011 to 2013. Moreover, a significant share of TB epidemic and TB/HIV co-infection epidemic happened between the age of 15 to 45 years old, indicating an increase in risk of TB and TB/HIV infection. It is worth noting that the risk of HIV infection for male TB patients was 2.947 times (95% CI [2.178, 3.988] than that of female patients. Han ethnicity and Uygur ethnicity in urban region accounted for a large proportion of total TB and TB/HIV co-infection cases. Most of the TB cases of minorities in Urumqi showed a statistically significant increase in risk of HIV infection than Han ethnicity in Urumqi. In addition, the spatial distribution of TB epidemic and TB/HIV co-infection epidemic was highly skewed. Most of the local clusters were located in urban area and rural-urban continuum where showed an increase in risk of TB and TB/HIV

  8. Optima: A Model for HIV Epidemic Analysis, Program Prioritization, and Resource Optimization

    National Research Council Canada - National Science Library

    Kerr, Cliff C; Stuart, Robyn M; Gray, Richard T; Shattock, Andrew J; Fraser-Hurt, Nicole; Benedikt, Clemens; Haacker, Markus; Berdnikov, Maxim; Mahmood, Ahmed Mohamed; Jaber, Seham Abdalla; Gorgens, Marelize; Wilson, David P

    2015-01-01

    Optima is a software package for modeling HIV epidemics and interventions that we developed to address practical policy and program problems encountered by funders, governments, health planners, and program implementers...

  9. Bayesian projection of life expectancy accounting for the HIV/AIDS epidemic

    Directory of Open Access Journals (Sweden)

    Jessica Godwin

    2017-11-01

    Full Text Available Background: While probabilistic projection methods for projecting life expectancy exist, few account for covariates related to life expectancy. Generalized HIV/AIDS epidemics have a large, immediate negative impact on the life expectancy in a country, but this impact can be mitigated by widespread use of antiretroviral therapy (ART. Thus, projection methods for countries with generalized HIV/AIDS epidemics could be improved by accounting for HIV prevalence, the future course of the epidemic, and ART coverage. Methods: We extend the current Bayesian probabilistic life expectancy projection methods of Raftery et al. (2013 to account for HIV prevalence and adult ART coverage in countries with generalized HIV/AIDS epidemics. Results: We evaluate our method using out-of-sample validation. We find that the proposed method performs better than the method that does not account for HIV prevalence or ART coverage for projections of life expectancy in countries with a generalized epidemic, while projections for countries without an epidemic remain essentially unchanged. Conclusions: In general, our projections show rapid recovery to pre-epidemic life expectancy levels in the presence of widespread ART coverage. After the initial life expectancy recovery, we project a steady rise in life expectancy until the end of the century. Contribution: We develop a simple Bayesian hierarchical model for long-term projections of life expectancy while accounting for HIV/AIDS prevalence and coverage of ART. The method produces well-calibrated projections for countries with generalized HIV/AIDS epidemics up to 2100 while having limited data demands.

  10. Culture, myths and panic: Three decades and beyond with an HIV/AIDS epidemic in Zimbabwe.

    Science.gov (United States)

    Chingwaru, Walter; Vidmar, Jerneja

    2018-02-01

    Zimbabwe is going through a generalised acquired immunodeficiency syndrome (AIDS) epidemic. The first five years of the epidemic (1985-1990) were characterised by lack of medicines against human immunodeficiency virus (HIV), and an exponential increase in prevalence (65-fold) and incidence (13-fold), which were fuelled by high-risk sexual behaviour. The high HIV prevalence, mortality and stigma yielded great fear and panic in the population, which are thought to have led to confusion and hopelessness, and, in turn, increased risky sexual behaviour. The country's government and civil society embarked on HIV awareness campaigns that are claimed to have played a central role in slowing down the epidemic since the mid-2000s. HIV-related mortality then fell by 70% between 2003 and 2013, which is attributed to high uptake of antiretroviral therapy (ART) and prevention of mother-to-child transmission (95%) prophylaxis. However, the epidemic has been characterised by a low paediatric ART coverage (35% in 2011 to 46.12% in 2013). Year 2014 saw an increase in adolescent and young adult HIV prevalence, which may be signalling a rebound of the epidemic. A more holistic approach which deals with the epidemic in its socio-political context is required to effectively lower the country's HIV burden.

  11. The spread of HIV in Pakistan: bridging of the epidemic between populations.

    Science.gov (United States)

    Khanani, Muhammad R; Somani, Mehreen; Rehmani, Sadiq S; Veras, Nazle M C; Salemi, Marco; Ali, Syed H

    2011-01-01

    In the last two decades, 'concentrated epidemics' of human immunodeficiency virus (HIV) have established in several high risk groups in Pakistan, including Injecting Drug Users (IDUs) and among men who have sex with men (MSM). To explore the transmission patterns of HIV infection in these major high-risk groups of Pakistan, 76 HIV samples were analyzed from MSM, their female spouses and children, along with 26 samples from a previously studied cohort of IDUs. Phylogenetic analysis of HIV gag gene sequences obtained from these samples indicated a substantial degree of intermixing between the IDU and MSM populations, suggesting a bridging of HIV infection from IDUs, via MSM, to the MSM spouses and children. HIV epidemic in Pakistan is now spreading to the female spouses and offspring of bisexual MSM. HIV control and awareness programs must be refocused to include IDUs, MSM, as well as bisexual MSM, and their spouses and children.

  12. Fitting the HIV epidemic in Zambia: a two-sex micro-simulation model.

    Directory of Open Access Journals (Sweden)

    Pauline M Leclerc

    Full Text Available BACKGROUND: In describing and understanding how the HIV epidemic spreads in African countries, previous studies have not taken into account the detailed periods at risk. This study is based on a micro-simulation model (individual-based of the spread of the HIV epidemic in the population of Zambia, where women tend to marry early and where divorces are not frequent. The main target of the model was to fit the HIV seroprevalence profiles by age and sex observed at the Demographic and Health Survey conducted in 2001. METHODS AND FINDINGS: A two-sex micro-simulation model of HIV transmission was developed. Particular attention was paid to precise age-specific estimates of exposure to risk through the modelling of the formation and dissolution of relationships: marriage (stable union, casual partnership, and commercial sex. HIV transmission was exclusively heterosexual for adults or vertical (mother-to-child for children. Three stages of HIV infection were taken into account. All parameters were derived from empirical population-based data. Results show that basic parameters could not explain the dynamics of the HIV epidemic in Zambia. In order to fit the age and sex patterns, several assumptions were made: differential susceptibility of young women to HIV infection, differential susceptibility or larger number of encounters for male clients of commercial sex workers, and higher transmission rate. The model allowed to quantify the role of each type of relationship in HIV transmission, the proportion of infections occurring at each stage of disease progression, and the net reproduction rate of the epidemic (R(0 = 1.95. CONCLUSIONS: The simulation model reproduced the dynamics of the HIV epidemic in Zambia, and fitted the age and sex pattern of HIV seroprevalence in 2001. The same model could be used to measure the effect of changing behaviour in the future.

  13. A Candle Lit from Both Sides : The Epidemic of HIV Infection In Central and Eastern Europe

    NARCIS (Netherlands)

    J-P.C. Grund (Jean-Paul)

    2002-01-01

    textabstractUntil 1995 central and eastern Europe as well as the Asian republics of the former Soviet Union have been more-or-less devoid of epidemic outbreaks of HIV infection. In this region with more than 450 million inhabitants (United Nations 1997), the total number of HIV infections was

  14. Cultural Practices and the HIV Epidemic in Swaziland: Student\\'s ...

    African Journals Online (AJOL)

    HIV/AIDS is the most devastating experience that Swaziland has had to face in her history. Since the first HIV/AIDS cases were reported in the early 80s, this epidemic has been expanding relentlessly, destroying peoples lives and seriously impacting negatively on the very fabric of society. Time and resources have been ...

  15. HIV epidemics and prevention responses in Asia and Eastern Europe: lessons to be learned?

    DEFF Research Database (Denmark)

    Bridge, Jamie; Lazarus, Jeff; Atun, Rifat

    2010-01-01

    This paper describes characteristics of the HIV epidemics in Eastern Europe and Central Asia (EECA) and Asia and Central Asia, and draws comparisons between these regions. It focuses on the role that key populations continue to play in HIV transmission in both regions, the challenges...

  16. The role of recombination in the emergence of a complex and dynamic HIV epidemic

    Directory of Open Access Journals (Sweden)

    Morgenstern Burkhard

    2010-03-01

    Full Text Available Abstract Background Inter-subtype recombinants dominate the HIV epidemics in three geographical regions. To better understand the role of HIV recombinants in shaping the current HIV epidemic, we here present the results of a large-scale subtyping analysis of 9435 HIV-1 sequences that involve subtypes A, B, C, G, F and the epidemiologically important recombinants derived from three continents. Results The circulating recombinant form CRF02_AG, common in West Central Africa, appears to result from recombination events that occurred early in the divergence between subtypes A and G, followed by additional recent recombination events that contribute to the breakpoint pattern defining the current recombinant lineage. This finding also corrects a recent claim that G is a recombinant and a descendant of CRF02, which was suggested to be a pure subtype. The BC and BF recombinants in China and South America, respectively, are derived from recent recombination between contemporary parental lineages. Shared breakpoints in South America BF recombinants indicate that the HIV-1 epidemics in Argentina and Brazil are not independent. Therefore, the contemporary HIV-1 epidemic has recombinant lineages of both ancient and more recent origins. Conclusions Taken together, we show that these recombinant lineages, which are highly prevalent in the current HIV epidemic, are a mixture of ancient and recent recombination. The HIV pandemic is moving towards having increasing complexity and higher prevalence of recombinant forms, sometimes existing as "families" of related forms. We find that the classification of some CRF designations need to be revised as a consequence of (1 an estimated > 5% error in the original subtype assignments deposited in the Los Alamos sequence database; (2 an increasing number of CRFs are defined while they do not readily fit into groupings for molecular epidemiology and vaccine design; and (3 a dynamic HIV epidemic context.

  17. The role of recombination in the emergence of a complex and dynamic HIV epidemic.

    Science.gov (United States)

    Zhang, Ming; Foley, Brian; Schultz, Anne-Kathrin; Macke, Jennifer P; Bulla, Ingo; Stanke, Mario; Morgenstern, Burkhard; Korber, Bette; Leitner, Thomas

    2010-03-23

    Inter-subtype recombinants dominate the HIV epidemics in three geographical regions. To better understand the role of HIV recombinants in shaping the current HIV epidemic, we here present the results of a large-scale subtyping analysis of 9435 HIV-1 sequences that involve subtypes A, B, C, G, F and the epidemiologically important recombinants derived from three continents. The circulating recombinant form CRF02_AG, common in West Central Africa, appears to result from recombination events that occurred early in the divergence between subtypes A and G, followed by additional recent recombination events that contribute to the breakpoint pattern defining the current recombinant lineage. This finding also corrects a recent claim that G is a recombinant and a descendant of CRF02, which was suggested to be a pure subtype. The BC and BF recombinants in China and South America, respectively, are derived from recent recombination between contemporary parental lineages. Shared breakpoints in South America BF recombinants indicate that the HIV-1 epidemics in Argentina and Brazil are not independent. Therefore, the contemporary HIV-1 epidemic has recombinant lineages of both ancient and more recent origins. Taken together, we show that these recombinant lineages, which are highly prevalent in the current HIV epidemic, are a mixture of ancient and recent recombination. The HIV pandemic is moving towards having increasing complexity and higher prevalence of recombinant forms, sometimes existing as "families" of related forms. We find that the classification of some CRF designations need to be revised as a consequence of (1) an estimated > 5% error in the original subtype assignments deposited in the Los Alamos sequence database; (2) an increasing number of CRFs are defined while they do not readily fit into groupings for molecular epidemiology and vaccine design; and (3) a dynamic HIV epidemic context.

  18. Addressing men and gender diversity in education: a promising solution to the HIV/AIDS epidemic.

    Science.gov (United States)

    Ghajarieh, Amir Biglar Beigi; Kow, Karen Yip Cheng

    2011-04-01

    To date, researchers investigating gender in relation to social issues underscore women and appear to sideline men. Focusing on women in studies concerning sociogender issues may exclude not only men from mainstream research, but also those who do not fit into the binary gender system, including gay, lesbian, bisexual, and transgender (GLBT) people. One area closely related to gender issues is the HIV epidemic. Mainstream discussions of men and other versions of masculinity and femininity including GLBT people in the gender-related studies of the HIV epidemic can decrease the vulnerability of individuals against HIV infections regardless of their biological sex.

  19. Epidemic Impacts of a Community Empowerment Intervention for HIV Prevention among Female Sex Workers in Generalized and Concentrated Epidemics

    Science.gov (United States)

    Wirtz, Andrea L.; Pretorius, Carel; Beyrer, Chris; Baral, Stefan; Decker, Michele R.; Sherman, Susan G.; Sweat, Michael; Poteat, Tonia; Butler, Jennifer; Oelrichs, Robert; Semini, Iris; Kerrigan, Deanna

    2014-01-01

    Introduction Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. Methods We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5–65% in Kenya and Ukraine; 10–70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012–2016 and, compared to status quo when all interventions are held constant. Results Optimistic but feasible coverage (65%–70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. Discussion A community empowerment approach to HIV prevention and

  20. Impact of age at marriage and migration on HIV and AIDS epidemics in Japan

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    Ohkusa Yasushi

    2009-06-01

    Full Text Available Abstract The causes of wide variation in the rates of HIV and AIDS epidemics among Japanese and non-Japanese nationals are not well understood. So, this paper examines the associations and assesses the potential roles of mean age at marriage, and migration in the HIV and AIDS epidemics in Japan. For the purpose, bivariate and multivariate regression analysis have been performed using epidemiological panel data to build up the relationships among overall HIV and AIDS prevalence, mean age at marriage, and migration. The same analyses have done for non-Japanese nationals living with HIV and AIDS separately. These indicators were significantly correlated with mean age at marriage, and migration. Multivariate linear regression analysis identified non-Japanese nationals' HIV and AIDS prevalence and mean age at marriage as the two most prominent factors linked with the national HIV and AIDS epidemics. The findings of this study supported the hypotheses that a high average age at marriage in the population leads to long period of premarital sex and the non-Japanese nationals' high prevalence facilitating the spread of the HIV and AIDS epidemics in Japan.

  1. Heterogeneity of the HIV epidemic in the general population of Karnataka state, south India

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    Banandur Pradeep

    2011-12-01

    Full Text Available Abstract Background In the context of AVAHAN, the India AIDS Initiative of the Bill & Melinda Gates Foundation, general population surveys (GPS were carried out between 2006 and 2008 in Belgaum (northern, Bellary (mid-state and Mysore (southern districts of Karnataka state, south India. Data from these three surveys were analysed to understand heterogeneity in HIV risk. Methods Outcome variables were the prevalence of HIV and sexually transmitted infections (STIs. Independent variables included age, district, place of residence, along with socio-demographic, medical and behavioural characteristics. Multivariate logistic regression was undertaken to identify characteristics associated with HIV and differences between districts, incorporating survey statistics to consider weights and cluster effects. Results The participation rate was 79.0% for the interview and 72.5% for providing a blood or urine sample that was tested for HIV. Belgaum had the highest overall HIV (1.43% and Herpes simplex type-2 (HSV-2 (16.93% prevalence, and the lowest prevalence of curable STIs. In Belgaum, the HIV epidemic is predominantly rural, and among women. In Bellary, the epidemic is predominantly in urban areas and among men, and HIV prevalence was 1.18%. Mysore had the lowest prevalence of HIV (0.80% and HSV-2 (10.89% and the highest prevalence of curable STIs. Higher HIV prevalence among men was associated with increasing age (p25-29years=11.22,95%CI:1.42-88.74, AOR30-34years=13.13,95%CI:1.67-103.19 and AOR35-39years=11.33,95%CI:1.32-96.83, having more than one lifetime sexual partner (AOR=4.61,95%CI:1.26-16.91 and having ever used a condom (AOR=3.32,95%CI:1.38-7.99. Having a dissolved marriage (being widowed/divorced/separated was the strongest predictor (AOR=10.98,95%CI: 5.35-22.57 of HIV among women. Being a muslim woman was associated with lower HIV prevalence (AOR=0.27,95%CI:0.08-0.87. Conclusion The HIV epidemic in Karnataka shows considerable heterogeneity

  2. Genetic and phylogenetic evolution of HIV-1 in a low subtype heterogeneity epidemic: the Italian example

    Directory of Open Access Journals (Sweden)

    Tornesello Maria

    2007-05-01

    Full Text Available Abstract The Human Immunodeficiency Virus type 1 (HIV-1 is classified into genetic groups, subtypes and sub-subtypes which show a specific geographic distribution pattern. The HIV-1 epidemic in Italy, as in most of the Western Countries, has traditionally affected the Intra-venous drug user (IDU and Homosexual (Homo risk groups and has been sustained by the genetic B subtype. In the last years, however, the HIV-1 transmission rate among heterosexuals has dramatically increased, becoming the prevalent transmission route. In fact, while the traditional risk groups have high levels of knowledge and avoid high-risk practices, the heterosexuals do not sufficiently perceive the risk of HIV-1 infection. This misperception, linked to the growing number of immigrants from non-Western Countries, where non-B clades and circulating recombinant forms (CRFs are prevalent, is progressively introducing HIV-1 variants of non-B subtype in the Italian epidemic. This is in agreement with reports from other Western European Countries. In this context, the Italian HIV-1 epidemic is still characterized by low subtype heterogeneity and represents a paradigmatic example of the European situation. The continuous molecular evolution of the B subtype HIV-1 isolates, characteristic of a long-lasting epidemic, together with the introduction of new subtypes as well as recombinant forms may have significant implications for diagnostic, treatment, and vaccine development. The study and monitoring of the genetic evolution of the HIV-1 represent, therefore, an essential strategy for controlling the local as well as global HIV-1 epidemic and for developing efficient preventive and therapeutic strategies.

  3. Effects of density of infected population to the spreading of HIV epidemic in communities

    Science.gov (United States)

    Mukwembi, Simon

    2011-10-01

    We present a dynamical model for the spread of HIV in a finite discrete population of size n represented by the set V. The model takes into account the structure of the sexual network, the density of infected population in each individual’s sexual partners, and a reasonable amount of the influence of noninfectious HIV positive individuals on HIV infectious partners which may occur in communities. In our analytic results, we give a precise epidemic threshold which, together with certain network properties, is then used to analyse and investigate the existence of epidemic and stability in the HIV spreading dynamics. Our results reproduce common observed patterns in the dynamics of HIV spreading in communities.

  4. HIV Among Indigenous peoples: A Review of the Literature on HIV-Related Behaviour Since the Beginning of the Epidemic.

    Science.gov (United States)

    Negin, Joel; Aspin, Clive; Gadsden, Thomas; Reading, Charlotte

    2015-09-01

    From the early days of the HIV epidemic, Indigenous peoples were identified as a population group that experiences social and economic determinants-including colonialism and racism-that increase exposure to HIV. There are now substantial disparities in HIV rates between Indigenous and non-Indigenous peoples in some countries. We conducted a comprehensive literature review to assess the evidence on HIV-related behaviors and determinants in four countries-Australia, Canada, New Zealand and the United States-in which Indigenous peoples share important features of colonization and marginalization. We identified 107 articles over more than 20 years. The review highlights the determinants of HIV-related behaviors including domestic violence, stigma and discrimination, and injecting drug use. Many of the factors associated with HIV risk also contribute to mistrust of health services, which in turn contributes to poor HIV and health outcomes among Indigenous peoples.

  5. The hepatitis C epidemic among HIV-positive MSM

    DEFF Research Database (Denmark)

    van der Helm, Jannie J; Prins, Maria; del Amo, Julia

    2011-01-01

    Outbreaks of acute hepatitis C virus (HCV) infection among HIV-infected MSM have been described since 2000. However, phylogenetic analysis suggests that the spread of HCV started around 1996. We estimated the incidence of HCV in HIV-infected MSM with well estimated dates of HIV seroconversion from...

  6. Promoting identification of HIV-infected youths: borrowing concepts from the media to reduce the HIV epidemic?

    Science.gov (United States)

    Peralta, Ligia; Deeds, Bethany Griffin; Young, Kalima

    2002-04-01

    The HIV/AIDS epidemic is dramatically affecting adolescents. Although it is estimated that 50% of new HIV infections in the United States is among people under 25 years of age, adolescents seek HIV counseling and testing services at a much lower rate than adults. Furthermore, many HIV-infected adolescents remain unaware of their status and do not seek health care. As HIV identification remains the most important gap in the efforts to control the spread of the HIV epidemic among youths, there is an increasing need to implement creative strategies to attract youths to HIV screening services. This article describes the implementation of an innovative HIV/AIDS social marketing campaign designed to attract at-risk urban adolescents to youth-friendly HIV counseling and testing services and link them to comprehensive health care. In addition, the article describes the key elements of the social marketing initiative: 1) designing a meaningful message, 2) attaining audience credibility, and 3) mobilizing the community.

  7. The Genetic Diversity and Evolution of HIV-1 Subtype B Epidemic in Puerto Rico.

    Science.gov (United States)

    López, Pablo; Rivera-Amill, Vanessa; Rodríguez, Nayra; Vargas, Freddie; Yamamura, Yasuhiro

    2015-12-23

    HIV-1 epidemics in Caribbean countries, including Puerto Rico, have been reported to be almost exclusively associated with the subtype B virus (HIV-1B). However, while HIV infections associated with other clades have been only sporadically reported, no organized data exist to accurately assess the prevalence of non-subtype B HIV-1 infection. We analyzed the nucleotide sequence data of the HIV pol gene associated with HIV isolates from Puerto Rican patients. The sequences (n = 945) were obtained from our "HIV Genotyping" test file, which has been generated over a period of 14 years (2001-2014). REGA subtyping tool found the following subtypes: B (90%), B-like (3%), B/D recombinant (6%), and D/B recombinant (0.6%). Though there were fewer cases, the following subtypes were also found (in the given proportions): A1B (0.3%), BF1 (0.2%), subtype A (01-AE) (0.1%), subtype A (A2) (0.1%), subtype F (12BF) (0.1%), CRF-39 BF-like (0.1%), and others (0.1%). Some of the recombinants were identified as early as 2001. Although the HIV epidemic in Puerto Rico is primarily associated with HIV-1B virus, our analysis uncovered the presence of other subtypes. There was no indication of subtype C, which has been predominantly associated with heterosexual transmission in other parts of the world.

  8. The epidemic of HIV/AIDS in developing countries; the current scenario in Pakistan.

    Science.gov (United States)

    Yousaf, Muhammad Z; Zia, Sadia; Babar, Masroor E; Ashfaq, Usman A

    2011-08-12

    HIV (Human Immunodeficiency virus) causes (acquired immunodeficiency syndrome) AIDS, in which the immune system of body totally fails to develop any defense against the foreign invaders. Infection with HIV occurs by transfer of blood, semen, and breast milk. HIV/AIDS is a global problem and it results nearly 25 million deaths worldwide. Developing countries like Pakistan have issues regarding Public Health. Currently, epidemic of HIV/AIDS is established in Pakistan and there is a threat of an expanded HIV/AIDS outbreak in the country. The major reason is that population is engaging in high-risk practices, low awareness about HIV/AIDS, and treacherous blood transfusion practices. A supplementary threat to Pakistan is India because both sharing a border and India is facing a rapidly growing HIV/AIDS epidemic. Local NGOs, National and International organizations are warning that in near future Pakistan may experiences bad situation regarding HIV/AIDS.In the present article we focused current situation of surveillance of HIV/AIDS, its virology, genotype, diagnostics, high-risk groups, reasons of vulnerability in Pakistani population, and the role of different national and international organizations in this situation.

  9. The epidemic of HIV/AIDS in developing countries; the current scenario in Pakistan

    Directory of Open Access Journals (Sweden)

    Babar Masroor E

    2011-08-01

    Full Text Available Abstract HIV (Human Immunodeficiency virus causes (acquired immunodeficiency syndrome AIDS, in which the immune system of body totally fails to develop any defense against the foreign invaders. Infection with HIV occurs by transfer of blood, semen, and breast milk. HIV/AIDS is a global problem and it results nearly 25 million deaths worldwide. Developing countries like Pakistan have issues regarding Public Health. Currently, epidemic of HIV/AIDS is established in Pakistan and there is a threat of an expanded HIV/AIDS outbreak in the country. The major reason is that population is engaging in high-risk practices, low awareness about HIV/AIDS, and treacherous blood transfusion practices. A supplementary threat to Pakistan is India because both sharing a border and India is facing a rapidly growing HIV/AIDS epidemic. Local NGOs, National and International organizations are warning that in near future Pakistan may experiences bad situation regarding HIV/AIDS. In the present article we focused current situation of surveillance of HIV/AIDS, its virology, genotype, diagnostics, high-risk groups, reasons of vulnerability in Pakistani population, and the role of different national and international organizations in this situation.

  10. A Candle Lit from Both Sides: The Epidemic of HIV Infection In Central and Eastern Europe

    OpenAIRE

    Grund, Jean-Paul

    2002-01-01

    textabstractUntil 1995 central and eastern Europe as well as the Asian republics of the former Soviet Union have been more-or-less devoid of epidemic outbreaks of HIV infection. In this region with more than 450 million inhabitants (United Nations 1997), the total number of HIV infections was estimated lower than 30.000 (WHO 1995; UNAIDS 1996). Most of these infections resulted from sexual and nosocomial transmission. In 1995 this epidemiologically soporific picture started changing drastical...

  11. Emergence of recombinant forms in geographic regions with co-circulating HIV subtypes in the dynamic HIV-1 epidemic

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ming [Los Alamos National Laboratory; Letiner, Thomas K [Los Alamos National Laboratory; Korber, Bette T [Los Alamos National Laboratory; Foley, Brian [Los Alamos National Laboratory

    2009-01-01

    We have reexamined the subtype designations of {approx}10,000 subtype A, B, C, G, and AG, BC, BF recombinant sequences, and compared the results of the new analysis with their published designations. Intersubtype recombinants dominate HIV epidemics in three different geographical regions. The circulating recombinant from (CRF) CRF02-AG, common in West Central Africa, appears to result from a recombination event that occurred early in the divergence between subtypes A and G, although additional more recent recombination events may have contributed to the breakpoint pattern in this recombinant lineage as well. The Chinese recombinant epidemic strains CRF07 and CRF08, in contrast, result from recent recombinations between more contemporary strains. Nevertheless, CRF07 and CRF08 contributed to many subsequent recombination events. The BF recombinant epidemics in two HIV-1 epicenters in South America are not independent and BF epidemics in South America have an unusually high fraction of unique recombinant forms (URFs) that have each been found only once and carry distinctive breakpoints. Taken together, these analyses reveal a complex and dynamic picture of the current HIV-1 epidemic, and suggest a means of grouping and tracking relationships between viruses through preservation of shared breakpints.

  12. Patterns and trends in Pakistan's heterogeneous HIV epidemic

    OpenAIRE

    Reza, Tahira; Melesse,Dessalegn Y.; Shafer, Leigh Anne; Salim, Momina; Altaf, Arshad; Sonia, Altaf; Jayaraman, Gayatri C.; Emmanuel, Faran; Thompson, Laura H.; Blanchard, James F

    2013-01-01

    Background Considerable HIV transmission occurs among injection drug users (IDUs) in Pakistan and recently the HIV prevalence has been increasing among male (MSW), hijra (transgender; HSW) and female (FSW) sex workers. We describe past and estimate future patterns of HIV emergence among these populations in several cities in Pakistan. Methods The density of these key populations per 1000 adult men was calculated using 2011 mapping data from Karachi, Lahore, Faisalabad, Larkana, Peshawar and Q...

  13. HIV epidemic in Far-Western Nepal: effect of seasonal labor migration to India.

    Science.gov (United States)

    Vaidya, Naveen K; Wu, Jianhong

    2011-05-13

    Because of limited work opportunities in Nepal and the open-border provision between Nepal and India, a seasonal labor migration of males from Far-Western Nepal to India is common. Unsafe sexual activities of these migrants in India, such as frequent visits to brothels, lead to a high HIV prevalence among them and to a potential transmission upon their return home to Nepal. The present study aims to evaluate the role of such seasonal labor-migration to India on HIV transmission in Far-Western Nepal and to assess prevention programs. An HIV epidemic model was developed for a population in Far-Western Nepal. The model was fitted to the data to estimate the back and forth mobility rates of labor-migrants to India, the HIV prevalence among migrants and the HIV transmission rate in Far-Western Nepal. HIV prevalence, new infections, disease deaths and HIV infections recruited from India were calculated. Prevention programs targeting the general population and the migrants were evaluated. Without any intervention programs, Far-Western Nepal will have about 7,000 HIV infected individuals returning from India by 2015, and 12,000 labor-migrants living with HIV in India. An increase of condom use among the general population from 39% to 80% will reduce new HIV infections due to sexual activity in Far-Western Nepal from 239 to 77. However, such a program loses its effectiveness due to the recruitment of HIV infections via returning migrants from India. The reduction of prevalence among migrants from 2.2% to 1.1% can bring general prevalence down to 0.4% with only 3,500 recruitments of HIV infections from India. Recruitment of HIV infections from India via seasonal labor-migrants is the key factor contributing to the HIV epidemic in Far-Western Nepal. Prevention programs focused on the general population are ineffective. Our finding highlights the urgency of developing prevention programs which reduce the prevalence of HIV among migrants for a successful control of the HIV

  14. HIV epidemic in Far-Western Nepal: effect of seasonal labor migration to India

    Directory of Open Access Journals (Sweden)

    Vaidya Naveen K

    2011-05-01

    Full Text Available Abstract Background Because of limited work opportunities in Nepal and the open-border provision between Nepal and India, a seasonal labor migration of males from Far-Western Nepal to India is common. Unsafe sexual activities of these migrants in India, such as frequent visits to brothels, lead to a high HIV prevalence among them and to a potential transmission upon their return home to Nepal. The present study aims to evaluate the role of such seasonal labor-migration to India on HIV transmission in Far-Western Nepal and to assess prevention programs. Methods An HIV epidemic model was developed for a population in Far-Western Nepal. The model was fitted to the data to estimate the back and forth mobility rates of labor-migrants to India, the HIV prevalence among migrants and the HIV transmission rate in Far-Western Nepal. HIV prevalence, new infections, disease deaths and HIV infections recruited from India were calculated. Prevention programs targeting the general population and the migrants were evaluated. Results Without any intervention programs, Far-Western Nepal will have about 7,000 HIV infected individuals returning from India by 2015, and 12,000 labor-migrants living with HIV in India. An increase of condom use among the general population from 39% to 80% will reduce new HIV infections due to sexual activity in Far-Western Nepal from 239 to 77. However, such a program loses its effectiveness due to the recruitment of HIV infections via returning migrants from India. The reduction of prevalence among migrants from 2.2% to 1.1% can bring general prevalence down to 0.4% with only 3,500 recruitments of HIV infections from India. Conclusion Recruitment of HIV infections from India via seasonal labor-migrants is the key factor contributing to the HIV epidemic in Far-Western Nepal. Prevention programs focused on the general population are ineffective. Our finding highlights the urgency of developing prevention programs which reduce the

  15. Monitoring HIV Epidemic in Pregnant Women: Are the Current Measures Enough?

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    Purva Sarkate

    2015-01-01

    Full Text Available Introduction. Burden of HIV in pregnant women follows overall epidemic in India. Hence, it is imperative that prevalence calculations in this group be accurate. The present study was carried out to determine prevalence of HIV in pregnant women attending our hospital, to determine trend of HIV infection and to compare our results with reported prevalence. Methods. All pregnant women are routinely counselled for HIV testing using opt-out strategy. Year-wise positivity and trend were determined in these patients over a period of five years. The positivity in different age groups was determined. Results. 31,609 women were tested of which 279 (0.88% were positive. Positivity showed a declining trend over study period and significant quadratic trend (biphasic, P<0.05 was observed. The positivity in older age group ≥35 years (1.64% was significantly more than younger age groups (0.76% in 15–24-year and 0.94% in 25–34-year age group (P=0.0052. Conclusion. A significant decline in HIV positivity was seen over the study period. Taking into account heterogeneous nature of HIV epidemic even within the same district, analysis at local levels especially using the prevention of parent to child transmission of HIV program data is critical for HIV programming and resource allocation.

  16. Expanding HIV testing efforts in concentrated epidemic settings: a population-based survey from rural Vietnam.

    Directory of Open Access Journals (Sweden)

    Anastasia Pharris

    Full Text Available BACKGROUND: To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. METHODS: A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS. Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. RESULTS: The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01, higher economic status (aOR 3.4, 95% CI 2.21-5.22, and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66 were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. CONCLUSIONS: We found low testing uptake (6% among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider

  17. the protective role of schooling in the HIV epidemic in Swaziland

    African Journals Online (AJOL)

    (LGBT) community. Included in the terms of reference for the project was a review of the numbers and vulnerability. Mixed results: the protective role of schooling in the HIV epidemic in. Swaziland. Alan Whiteside*1, Andriana Vinnitchok2, Tengetile Dlamini3 and Khanya Mabuza3. 1Balsillie School of International Affairs, ...

  18. Modelling the spread of HIV/AIDS epidemic in the presence of ...

    African Journals Online (AJOL)

    Modelling the spread of HIV/AIDS epidemic in the presence of irresponsible infectives. Mohammed I. Daabo, Oluwole D. Makinde, Baba Seidu. Abstract. In this study, a non-linear mathematical model was proposed and analyzed to study the effect of irresponsible infectives in the spread of human immunodeficiency virus ...

  19. Factors affecting the HIV/AIDS epidemic: An ecological analysis of ...

    African Journals Online (AJOL)

    Backward multiple linear regression analysis identified the proportion of Muslims, physicians density, and adolescent fertility rate are as the three most prominent factors linked with the national HIV epidemic. Conclusions: The findings support the hypotheses that a higher adolescent fertility rate in the population is the ...

  20. Has the HIV/AIDS epidemic changed sexual behaviour of high risk ...

    African Journals Online (AJOL)

    These include commercial sex workers, street children, long haul truck drivers, bar maids and adolescents in three towns of Uganda (Kabale, Kampala, Lira). Results:Results indicate that despite the HIV/AIDS epidemic, these groups had only changed their sexual behaviour a little, and they reported to be continuing with ...

  1. The impact of the HIV epidemic on tuberculosis transmission in Tanzania

    NARCIS (Netherlands)

    Egwaga, Saidi M.; Cobelens, Frank G.; Muwinge, Hemed; Verhage, Corry; Kalisvaart, Nico; Borgdorff, Martien W.

    2006-01-01

    OBJECTIVE: To assess the impact of the HIV epidemic on tuberculosis transmission in Tanzania by estimating the trend in annual risk of tuberculosis infection (ARTI) over the period 1983-2003. DESIGN: Tuberculin survey among school children aged 6-14 years, randomly selected by cluster sampling.

  2. Oscillating migration and the epidemics of silicosis, tuberculosis, and HIV infection in South African gold miners.

    Science.gov (United States)

    Rees, David; Murray, Jill; Nelson, Gill; Sonnenberg, Pam

    2010-04-01

    Hundreds of thousands of men from rural areas of South Africa and neighboring countries have come to seek work in the gold mines. They are not immigrants in the usual sense as they work for periods in the mines, go home, and then return. This is termed oscillating or circular migration. Today we have serious interrelated epidemics of silicosis, tuberculosis, and HIV infection in the gold mining industry. This article discusses the role of oscillating migration in fuelling these epidemics, by examining the historical, political, social, and economic contexts of these diseases. The impact of silicosis, tuberculosis, and HIV infection extends beyond individual miners to their families and communities. Failure to control dust and tuberculosis has resulted in serious consequences decades later. The economic and political migrant labor system provided the foundations for the epidemics seen in southern Africa today. (c) 2009 Wiley-Liss, Inc.

  3. Understanding the epidemic of HIV in South Africa

    African Journals Online (AJOL)

    the epidemic. The age-dependent force of infection indicates how the risk of infection varies across age groups. ... distributions, which are especially important when the numbers are small. Estimating the asymptotic ..... (US Bureau of Census, Population Division, International. Programmes Center, HIVlAIDS Surveillance ...

  4. Phylodynamic and Phylogeographic Patterns of the HIV Type 1 Subtype F1 Parenteral Epidemic in Romania

    Science.gov (United States)

    Hué, Stéphane; Buckton, Andrew J.; Myers, Richard E.; Duiculescu, Dan; Ene, Luminita; Oprea, Cristiana; Tardei, Gratiela; Rugina, Sorin; Mardarescu, Mariana; Floch, Corinne; Notheis, Gundula; Zöhrer, Bettina; Cane, Patricia A.; Pillay, Deenan

    2012-01-01

    Abstract In the late 1980s an HIV-1 epidemic emerged in Romania that was dominated by subtype F1. The main route of infection is believed to be parenteral transmission in children. We sequenced partial pol coding regions of 70 subtype F1 samples from children and adolescents from the PENTA-EPPICC network of which 67 were from Romania. Phylogenetic reconstruction using the sequences and other publically available global subtype F sequences showed that 79% of Romanian F1 sequences formed a statistically robust monophyletic cluster. The monophyletic cluster was epidemiologically linked to parenteral transmission in children. Coalescent-based analysis dated the origins of the parenteral epidemic to 1983 [1981–1987; 95% HPD]. The analysis also shows that the epidemic's effective population size has remained fairly constant since the early 1990s suggesting limited onward spread of the virus within the population. Furthermore, phylogeographic analysis suggests that the root location of the parenteral epidemic was Bucharest. PMID:22251065

  5. The Silent Epidemic – Frailty and Aging with HIV

    Science.gov (United States)

    Willig, Amanda L.; Overton, Edgar T.; Saag, Michael S.

    2017-01-01

    As the number of older adults with HIV increases, this population is experiencing an increased risk for frailty. While there is no single definition or diagnostic criteria for frailty, it is generally recognized as an accumulation of deficits in functional capacity and ability to perform activities of daily living. Frailty may be present in up to half of older adults living with HIV, and is associated with significant morbidity and mortality risk in this group. Frailty in HIV can either be transient, and linked to the status of HIV infection, or resemble a more typical gradual decline in functional capacity. Frailty risk in HIV may be exacerbated by mitochondrial dysfunction, chronic inflammation, and oxidative stress. Several tools have been developed and adapted to assess different domains of frailty, yet medical treatment of this condition can be complex and should consider management of polypharmacy as well as nutrition and exercise interventions. However, few concrete strategies have been developed to prevent or treat frailty in the context of HIV infection. This review summarizes what is currently known about the prevalence, diagnosis, and management of frailty among older adults living with HIV. PMID:28386608

  6. False-positive HIV DNA PCR testing of infants: implications in a changing epidemic.

    Science.gov (United States)

    Feucht, Ute Dagmar; Forsyth, Brian; Kruger, Mariana

    2012-02-23

    To examine false-positive HIV DNA polymerase chain reaction (PCR) test results in children, and the potential implications for the paediatric HIV epidemic in sub-Saharan Africa. A review was done of records over a 6-year period of children less than 18 months old at an HIV treatment site in South Africa, to evaluate those with an initial 'false'-positive HIV DNA PCR result, but later proven to be HIV-uninfected with HIV DNA PCR and/or quantitative HIV RNA PCR tests. We calculated the influence of changing HIV transmission rates on predictive values (PV) of HIV DNA PCR tests in a hypothetical population of all HIV-exposed infants over a 1-year period. (Positive PV: proportion of individuals with a positive test with disease; negative PV: proportion of individuals with negative test and no disease). Of 718 children, 40 with an initial positive HIV DNA PCR test were subsequently proven to be HIV-uninfected, resulting in a positive PV of 94.4%. Most (75%) uninfected children had PMTCT interventions and were asymptomatic or mildly symptomatic (77.5%). Calculations using a test specificity of 99.4%, as reported previously, show a decrease in positive PV using a single-test strategy from 98.6% at 30% HIV transmission rate, to 94.8% at 10% transmission, to 62.5% at 1% transmission. Reduction in test specificity further decreases positive PV at low transmission rates. Decreasing mother-to-child HIV transmission rates reduce the positive predictive value of a single HIV DNA PCR test result, necessitating adaptations to diagnostic algorithms to avoid misdiagnosis and inappropriate treatment, especially with early initiation of antiretroviral therapy in asymptomatic infants.

  7. The HIV/AIDS Epidemic in the Dominican Republic: Key Contributing Factors.

    Science.gov (United States)

    Rojas, Patria; Malow, Robert; Ruffin, Beverly; Rothe, Eugenio M; Rosenberg, Rhonda

    2011-01-01

    This article reviews HIV/AIDS epidemiological data and recent research conducted in the Dominican Republic, with a focus on explaining the variability in estimated seroincidence and prevalence within the country. HIV seroprevalence estimates range from 1.0% (in the general population) to 11.0% among men who have sex with men (MSM). Some have indicated that the highest HIV seroprevalence occurs in Haitian enclaves called bateyes (US Agency for International Development [USAID], 2008), which are migrant worker shantytowns primarily serving the sugar industry in the Dominican Republic. Others report higher or comparable rates to the bateyes in areas related to the tourism and sex industries. As in other Caribbean and Latin American countries, reported HIV transmission in the Dominican Republic is predominantly due to unprotected heterosexual sex and the infection rate has been increasing disproportionally among women. The Dominican Republic represents two thirds of the Hispaniola island; the western one third is occupied by Haiti, the nation with the highest HIV prevalence in the western hemisphere. Although data is limited, it shows important differences in seroprevalence and incidence between these two countries, but commonalities such as poverty, gender inequalities, and stigma appear to be pivotal factors driving the epidemic. This article will discuss these and other factors that may contribute to the HIV epidemic in the Dominican Republic, as well as highlight the gaps in the literature and provide recommendations to guide further work in this area, particularly in the role of governance in sustainable HIV prevention.

  8. The HIV/AIDS Epidemic in the Dominican Republic: Key Contributing Factors

    Science.gov (United States)

    Rojas, Patria; Malow, Robert; Ruffin, Beverly; Rothe, Eugenio M.; Rosenberg, Rhonda

    2017-01-01

    This article reviews HIV/AIDS epidemiological data and recent research conducted in the Dominican Republic, with a focus on explaining the variability in estimated seroincidence and prevalence within the country. HIV seroprevalence estimates range from 1.0% (in the general population) to 11.0% among men who have sex with men (MSM). Some have indicated that the highest HIV seroprevalence occurs in Haitian enclaves called bateyes (US Agency for International Development [USAID], 2008), which are migrant worker shantytowns primarily serving the sugar industry in the Dominican Republic. Others report higher or comparable rates to the bateyes in areas related to the tourism and sex industries. As in other Caribbean and Latin American countries, reported HIV transmission in the Dominican Republic is predominantly due to unprotected heterosexual sex and the infection rate has been increasing disproportionally among women. The Dominican Republic represents two thirds of the Hispaniola island; the western one third is occupied by Haiti, the nation with the highest HIV prevalence in the western hemisphere. Although data is limited, it shows important differences in seroprevalence and incidence between these two countries, but commonalities such as poverty, gender inequalities, and stigma appear to be pivotal factors driving the epidemic. This article will discuss these and other factors that may contribute to the HIV epidemic in the Dominican Republic, as well as highlight the gaps in the literature and provide recommendations to guide further work in this area, particularly in the role of governance in sustainable HIV prevention. PMID:21368008

  9. Modeling the effect of information campaigns on the HIV epidemic in Uganda.

    Science.gov (United States)

    Joshi, Hem; Lenhart, Suzanne; Albright, Kendra; Gipson, Kevin

    2008-10-01

    The increasing prevalence of HIV/AIDS in Africa over the past twenty-five years continues to erode the continent's health care and overall welfare. There have been various responses to the pandemic, led by Uganda, which has had the greatest success in combating the disease. Part of Uganda's success has been attributed to a formalized information, education, and communication (IEC) strategy, lowering estimated HIV/AIDS infection rates from 18.5% in 1995 to 4.1% in 2003. We formulate a model to investigate the effects of information and education campaigns on the HIV epidemic in Uganda. These campaigns affect people's behavior and can divide the susceptibles class into subclasses with different infectivity rates. Our model is a system of ordinary differential equations and we use data about the epidemics and the number of organizations involved in the campaigns to estimate the model parameters. We compare our model with three types of susceptibles to a standard SIR model.

  10. The HIV type 1 epidemic in Belarus: predominance of Eastern European subtype A strains and circulation of subtype B viruses

    NARCIS (Netherlands)

    Lazouskaya, Natallia V.; Eremin, Vladimir F.; Adema, Karen W.; Gasich, Elena L.; Baan, Elly; Lukashov, Vladimir V.

    2005-01-01

    To study the molecular epidemiology of HIV-1 in Belarus, where the rapid spread of HIV-1 has been registered since 1996, we obtained HIV-1 sequences from 30 individuals living in five cities in both the main geographic areas of the epidemic (Gomel and Minsk regions) and territories where spreading

  11. The impact of antiretroviral treatment on the age composition of the HIV epidemic in sub-Saharan Africa

    NARCIS (Netherlands)

    J.A.C. Hontelez (Jan); S.J. de Vlas (Sake); R.M.P.M. Baltussen (Rob); M.-L. Newell (Marie-Louise); R. Bakker (Roel); F. Tanser (Frank); M.N. Lurie (Mark N.); T. Bärnighausen (Till)

    2012-01-01

    textabstractIntroduction: Antiretroviral treatment (ART) coverage is rapidly expanding in sub-Saharan Africa (SSA). Based on the effect of ART on survival of HIV-infected people and HIV transmission, the age composition of the HIV epidemic in the region is expected to change in the coming decades.

  12. The impact of antiretroviral treatment on the age composition of the HIV epidemic in sub-Saharan Africa

    NARCIS (Netherlands)

    Hontelez, J.A.C.; Vlas, S.J. de; Baltussen, R.; Newell, M.L.; Bakker, R.; Tanser, F.; Lurie, M.; Barnighausen, T.

    2012-01-01

    INTRODUCTION: Antiretroviral treatment (ART) coverage is rapidly expanding in sub-Saharan Africa (SSA). Based on the effect of ART on survival of HIV-infected people and HIV transmission, the age composition of the HIV epidemic in the region is expected to change in the coming decades. We quantify

  13. Know your epidemic, know your response: targeting HIV in Asia

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Curth, Nadja; Bridge, Jamie

    2010-01-01

    there have been many successes in the HIV response in Asia over the past decade, great challenges clearly remain - especially when addressing most-at-risk populations, who are often criminalized, marginalized, and discriminated against. These groups face significant legal and social barriers to accessing HIV...... prevention and treatment services. In order to reach the Millennium Development Goal of halting and reversing the spread of HIV by 2015 and to achieve universal access to HIV treatment, these barriers must be overcome across Asia. High-impact programs must be targeted at those in need, with continuous...... and predictable funding for a sustainable response that incorporates prevention and treatment scale-up. Strong political leadership and the involvement of affected communities are key to developing a systematic and comprehensive response. The potential consequences of inaction in Asia are enormous: even small...

  14. Krokodile Injectors in Ukraine: Fueling the HIV Epidemic?

    Science.gov (United States)

    Booth, Robert E; Davis, Jonathan M; Brewster, John T; Lisovska, Oksana; Dvoryak, Sergey

    2016-02-01

    This study was designed to assess the characteristics of krokodile injectors, a recent phenomenon in Ukraine, and HIV-related risk factors among people who inject drugs (PWID). In three Ukraine cities, Odessa, Donetsk and Nikolayev, 550 PWID were recruited between December 2012 and October 2013 using modified targeted sampling methods. The sample averaged 31 years of age and they had been injecting for over 12 years. Overall, 39 % tested positive for HIV, including 45 % of krokodile injectors. In the past 30 days, 25 % reported injecting krokodile. Those who injected krokodile injected more frequently (p < 0.001) and they injected more often with others (p = 0.005). Despite knowing their HIV status to be positive, krokodile users did not reduce their injection frequency, indeed, they injected as much as 85 % (p = 0.016) more frequently than those who did not know their HIV status or thought they were negative. This behavior was not seen in non-krokodile using PWID. Although only a small sample of knowledgeable HIV positive krokodile users was available (N = 12), this suggests that krokodile users may disregard their HIV status more so than nonkrokodile users. In spite of widespread knowledge of its harmful physical consequences, a growing number of PWID are turning to injecting krokodile in Ukraine. Given the recency of krokodile use the country, the associated higher frequency of injecting, a propensity to inject more often with others, and what could be a unique level of disregard of HIV among krokodile users, HIV incidence could increase in future years.

  15. Molecular typing of the local HIV-1 epidemic in Serbia.

    Science.gov (United States)

    Siljic, Marina; Salemovic, Dubravka; Jevtovic, Djordje; Pesic-Pavlovic, Ivana; Zerjav, Sonja; Nikolic, Valentina; Ranin, Jovan; Stanojevic, Maja

    2013-10-01

    Worldwide HIV-1 pandemic is becoming increasingly complex, with growing heterogeneity of subtypes and recombinant viruses. Previous studies have documented HIV-1 subtype B as the predominant one in Serbia, with limited presence and genetic diversity of non B subtypes. In recent years, MSM transmission has become the most frequently reported risk for HIV infection among newly diagnosed patients in Serbia, but very little is known of the network structure and dynamics of viral transmission in this and other risk groups. To gain insight about the HIV-1 subtypes distribution pattern as well as characteristics of HIV-1 transmission clusters in Serbia, we analyzed the genetic diversity of the pol gene segment in 221 HIV-1-infected patients sampled during 2002-2011. Subtype B was found to still be the most prevalent one in Serbia, accounting for over 90% of samples, while greater diversity of other subtypes was found than previously reported, including subtypes G, C, A, F, CRF01 and CRF02. In total, 41.3% of analyzed subtype B sequences were found associated in transmission clusters/network, that are highly related with MSM transmission route. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Are HIV epidemics among men who have sex with men emerging in the Middle East and North Africa?: a systematic review and data synthesis.

    Directory of Open Access Journals (Sweden)

    Ghina Mumtaz

    2010-08-01

    Full Text Available BACKGROUND: Men who have sex with men (MSM bear a disproportionately higher burden of HIV infection than the general population. MSM in the Middle East and North Africa (MENA are a largely hidden population because of a prevailing stigma towards this type of sexual behavior, thereby limiting the ability to assess infection transmission patterns among them. It is widely perceived that data are virtually nonexistent on MSM and HIV in this region. The objective of this review was to delineate, for the first time, the evidence on the epidemiology of HIV among MSM in MENA. METHODS AND FINDINGS: This was a systematic review of all biological, behavioral, and other related data on HIV and MSM in MENA. Sources of data included PubMed (Medline, international organizations' reports and databases, country-level reports and databases including governmental and nongovernmental organization publications, and various other institutional documents. This review showed that onsiderable data are available on MSM and HIV in MENA. While HIV prevalence continues at low levels among different MSM groups, HIV epidemics appear to be emerging in at least few countries, with a prevalence reaching up to 28% among certain MSM groups. By 2008, the contribution of MSM transmission to the total HIV notified cases increased and exceeded 25% in several countries. The high levels of risk behavior (4-14 partners on average in the last six months among different MSM populations and of biomarkers of risks (such as herpes simplex virus type 2 at 3%-54%, the overall low rate of consistent condom use (generally below 25%, the relative frequency of male sex work (20%-76%, and the substantial overlap with heterosexual risk behavior and injecting drug use suggest potential for further spread. CONCLUSIONS: This systematic review and data synthesis indicate that HIV epidemics appear to be emerging among MSM in at least a few MENA countries and could already be in a concentrated state among

  17. What happened to the HIV epidemic among non-injecting drug users in New York City?

    Science.gov (United States)

    Des Jarlais, Don C; Arasteh, Kamyar; McKnight, Courtney; Feelemyer, Jonathan; Campbell, Aimee N C; Tross, Susan; Cooper, Hannah L F; Hagan, Holly; Perlman, David C

    2017-02-01

    HIV has reached high prevalence in many non-injecting drug user (NIDU) populations. The aims of this study were to (1) examine the trend in HIV prevalence among non-injecting cocaine and heroin NIDUs in New York City, (2) identify factors potentially associated with the trend and (3) estimate HIV incidence among NIDUs. Serial-cross sectional surveys of people entering drug treatment programs. People were permitted to participate only once per year, but could participate in multiple years. Mount Sinai Beth Israel drug treatment programs in New York City, USA. We recruited 3298 non-injecting cocaine and heroin users from 2005 to 2014. Participants were 78.7% male, 6.1% white, 25.7% Hispanic and 65.8% African American. Smoking crack cocaine was the most common non-injecting drug practice. Trend tests were used to examine HIV prevalence, demographics, drug use, sexual behavior and use of antiretroviral treatment (ART) by calendar year; χ2 and multivariable logistic regression were used to compare 2005-10 versus 2011-14. HIV prevalence declined approximately 1% per year (P ART increased. HIV incidence among repeat participants was 1.2 per 1000 person-years (95% confidence interval = 0.03/1000-7/1000). HIV prevalence has declined and a high percentage of HIV-positive non-injecting drug users (NIDUs) are receiving antiretroviral treatment, suggesting an end to the HIV epidemic among NIDUs in New York City. These results can be considered a proof of concept that it is possible to control non-injecting drug use related sexual transmission HIV epidemics. © 2016 Society for the Study of Addiction.

  18. Women with HIV in Indonesia: are they bridging a concentrated epidemic to the wider community?

    Science.gov (United States)

    Rahmalia, Annisa; Wisaksana, Rudi; Meijerink, Hinta; Indrati, Agnes R; Alisjahbana, Bachti; Roeleveld, Nel; van der Ven, Andre J A M; Laga, Marie; van Crevel, Reinout

    2015-12-09

    Male injecting drug users drove the onset of the HIV epidemic in Indonesia but over time more women have been diagnosed. We examined the relative proportion of female patients in an HIV cohort and characterized their probable transmission route and reproductive profile. Prospective cohort study in a referral hospital in West Java. Interviews with standardized questionnaires, physical and laboratory examinations were done for 2622 individuals enrolled in HIV care between 2007 and 2012. The proportion of women in this cohort was compared with national estimates. The general characteristics of HIV-infected women and men as well as the sexual and reproductive health of HIV-infected women were described. The proportion of female patients enrolled in HIV care increased from 22.2 % in 2007 to 38.3 % in 2012, in line with national estimates. Women were younger than men, fewer reported a history of IDU (16.1 vs. 73.8 %, p < 0.001) and more were tested for HIV because of a positive partner (25.5 vs. 4.0 %, p < 0.001). The majority of women were in their reproductive age, had children, and were not using contraceptives at the time of enrolment. HIV-infected women in Indonesia have specific characteristics that differ them from women in the general population. Further research to elucidate the characteristics of women exposed to HIV, their access to testing and care and sexual and reproductive needs can help reduce transmission to women and children in the context of concentrated HIV epidemic in Indonesia.

  19. Review of the prevalence and drug resistance of tuberculosis in prisons: a hidden epidemic.

    Science.gov (United States)

    Biadglegne, F; Rodloff, A C; Sack, U

    2015-04-01

    SUMMARY The prison setting has been often cited as a possible reservoir of tuberculosis (TB) including multidrug-resistant (MDR)-TB. This is particularly true in low-income, high TB prevalence countries in Sub-Saharan Africa. A systemic literature review was done to assess the prevalence, drug resistance and risk factors for acquiring TB in the prison population. Our review indicated a high prevalence of TB in prisons which is reported to be 3- to 1000-fold higher than that found in the civilian population, indicating evidence and the need for public health policy formulation. In addition, high levels of MDR and extensively drug-resistant (XDR)-TB have been reported from prisons, which is a warning call to review prison TB control strategy. Multiple risk factors such as overcrowding, poor ventilation, malnutrition, human immunodeficiency virus (HIV), and others have fuelled the spread of TB in prisons. Furthermore, the impact extends beyond the prison walls; it affects the civilian population, because family visits, prison staff, and members of the judiciary system could be potential portals of exit for TB transmission. The health of prisoners is a neglected political and scientific issue. Within these background conditions, it is suggested that political leaders and scientific communities should work together and give special attention to the control of TB and MDR-TB in prisons. If not, TB in prisons will remain a neglected global problem and threatens national and international TB control programmes. Further researches are required on the prevalence and drug resistance of smear-negative TB in prisons. In addition, evidence of the circulating strains and transmission dynamics inside prisons is also warranted.

  20. Women hold up half the sky – and half the burden of the HIV epidemic

    Directory of Open Access Journals (Sweden)

    Shirin Heidari

    2013-03-01

    Full Text Available It has been said that women hold up half the sky. In the HIV epidemic, women carry half the burden of the epidemic, perhaps even more. The HIV burden on women is dramatically higher in some regions, certain age groups and among marginalized groups, such as female sex workers. Women's vulnerability to HIV is exacerbated by gender inequality and domestic violence. The global effort towards elimination of paediatric HIV and keeping mothers alive deserves applause. However, the needs of women go beyond their child-bearing age or potentials and/or reproductive desires and must be recognized in the global HIV agenda. In particular, more female-controlled prevention tools are urgently required to allow women to protect themselves. It is time to turn the tide through promoting gender equality and genuinely committing to gender-responsive policies and programmes, and encouraging a more gender-aware research agenda that can generate necessary evidence. In recognition of International Women's Day, the Journal of the International AIDS Society is pleased to launch a thematic series to highlight articles that address the different dimensions of HIV as they relate to women.

  1. Women hold up half the sky - and half the burden of the HIV epidemic.

    Science.gov (United States)

    Heidari, Shirin; Kippax, Susan; Sow, Papa Salif; Wainberg, Mark A

    2013-03-08

    It has been said that women hold up half the sky. In the HIV epidemic, women carry half the burden of the epidemic, perhaps even more. The HIV burden on women is dramatically higher in some regions, certain age groups and among marginalized groups, such as female sex workers. Women's vulnerability to HIV is exacerbated by gender inequality and domestic violence. The global effort towards elimination of paediatric HIV and keeping mothers alive deserves applause. However, the needs of women go beyond their child-bearing age or potentials and/or reproductive desires and must be recognized in the global HIV agenda. In particular, more female-controlled prevention tools are urgently required to allow women to protect themselves. It is time to turn the tide through promoting gender equality and genuinely committing to gender-responsive policies and programmes, and encouraging a more gender-aware research agenda that can generate necessary evidence. In recognition of International Women's Day, the Journal of the International AIDS Society is pleased to launch a thematic series to highlight articles that address the different dimensions of HIV as they relate to women.

  2. Modelling the Impact of Antiretroviral Therapy on the Epidemic of HIV

    Science.gov (United States)

    Williams, Brian G; Lima, Viviane; Gouws, Eleanor

    2011-01-01

    Thirty years after HIV first appeared it has killed close to 30 million people but transmission continues unchecked. In 2009, an estimated 1.8 million lives were lost and 2.6 million more people were infected with HIV [1]. To cut transmission, many social, behavioural and biomedical interventions have been developed, tested and tried but have had little impact on the epidemic in most countries. One substantial success has been the development of combination antiretroviral therapy (ART) that reduces viral load and restores immune function. This raises the possibility of using ART not only to treat people but also to prevent new HIV infections. Here we consider the impact of ART on the transmission of HIV and show how it could help to control the epidemic. Much needs to be known and understood concerning the impact of early treatment with ART on the prognosis for individual patients and on transmission. We review the current literature on factors associated with modelling treatment for prevention and illustrate the potential impact using existing models. We focus on generalized epidemics in sub-Saharan Africa, with an emphasis on South Africa, where transmission is mainly heterosexual and which account for an estimated 17% of all people living with HIV. We also make reference to epidemics among men who have sex with men and injection drug users where appropriate. We discuss ways in which using treatment as prevention can be taken forward knowing that this can only be the beginning of what must become an inclusive dialogue among all of those concerned to stop acquired immune deficiency syndrome (AIDS). PMID:21999772

  3. Halting HIV/AIDS with avatars and havatars: a virtual world approach to modelling epidemics

    Directory of Open Access Journals (Sweden)

    Smith? Robert J

    2009-11-01

    Full Text Available Abstract Background A major deficit of all approaches to epidemic modelling to date has been the need to approximate or guess at human behaviour in disease-transmission-related contexts. Avatars are generally human-like figures in virtual computer worlds controlled by human individuals. Methods We introduce the concept of a "havatar", which is a (human, avatar pairing. Evidence is mounting that this pairing behaves in virtual contexts much like the human in the pairing might behave in analogous real-world contexts. Results We propose that studies of havatars, in a virtual world, may give a realistic approximation of human behaviour in real-world contexts. If the virtual world approximates the real world in relevant details (geography, transportation, etc., virtual epidemics in that world could accurately simulate real-world epidemics. Havatar modelling of epidemics therefore offers a complementary tool for tackling how best to halt epidemics, including perhaps HIV/AIDS, since sexual behaviour is a significant component of some virtual worlds, such as Second Life. Conclusion Havatars place the control parameters of an epidemic in the hands of each individual. By providing tools that everyone can understand and use, we could democratise epidemiology.

  4. INTRODUCTION The global HIV epidemic continues to expand with ...

    African Journals Online (AJOL)

    the HIV disease itself.9 During pregnancy, dosing must be taken into consideration as blood volume and volume of distribution changes during pregnancy. In addition, there are potential toxic drug effects on the ... myopathy may dictate change of anesthetic techniques. Anemia and thrombocytopenia are major toxic side.

  5. HIV/AIDS Epidemic in the United States

    Science.gov (United States)

    ... health issues… CHIP Marketplaces Waivers menu KFF.org Facebook Twitter Email Twitter Facebook Email HIV/AIDS Search Graphics & Interactives Polls Home ... United States: The Basics Published: Dec 13, 2017 Facebook Twitter LinkedIn Email Print Key Facts The first ...

  6. The HIV/AIDS epidemic in South Africa: Convergence with ...

    African Journals Online (AJOL)

    Recent assessment reports suggest that climate change patterns are threatening social and ecological vulnerability and resilience, with the strong potential of negatively affecting human health. Persons living with HIV/AIDS (PLWHA) have weakened physiological responses and are immunologically vulnerable to ...

  7. The HIV epidemic in the Amazon Basin is driven by prototypic and recombinant HIV-1 subtypes B and F.

    Science.gov (United States)

    Vicente, A C; Otsuki, K; Silva, N B; Castilho, M C; Barros, F S; Pieniazek, D; Hu, D; Rayfield, M A; Bretas, G; Tanuri, A

    2000-04-01

    This paper describes genetic subtypes of HIV-1 found in blood samples from 31 HIV-1-infected people who visited the Counseling and Testing AIDS Center of Instituto de Medicina Tropical in Manaus, Brazil. Manaus, the main city in Brazil's Amazon Basin, is also the closest urban connection for more than 100,000 Indians living in the rain forests of this region. Although to date there is no evidence of increased incidence of HIV-1 infection among the indigenous population, our understanding of both the prevalence and nature of the epidemic in the region as a whole is limited. From the 31 samples analyzed by C2V3 sequencing, we found almost equal proportions of HIV-1 strains belonging to subtype B (n = 16; 51.6%) and subtype F (n = 15; 48.4%), a finding that differs from results from previous studies conducted in urban areas of southeastern Brazil. We also observed the presence of the GWGR amino-acid sequence in the critical tetra-peptide crown of the env V3 loop in the HIV-1 subtype B samples analyzed. Among these samples, we also found 14 mosaic genomes (45.16%) in which different combinations of subtypes B, C, and F were identified between the p24 gag, pro, and env regions. Our data support the hypothesis that the Amazonian HIV-1 infections linked to the urban epidemic in southeastern Brazil. The genetic diversity and the prevalence of mosaic genomes among the isolates in our study confirm an integral role of recombination in the complex Brazilian epidemic.

  8. A Population-Structured HIV Epidemic in Israel: Roles of Risk and Ethnicity.

    Directory of Open Access Journals (Sweden)

    Zehava Grossman

    Full Text Available HIV in Israel started with a subtype-B epidemic among men who have sex with men, followed in the 1980s and 1990s by introductions of subtype C from Ethiopia (predominantly acquired by heterosexual transmission and subtype A from the former Soviet Union (FSU, most often acquired by intravenous drug use. The epidemic matured over the last 15 years without additional large influx of exogenous infections. Between 2005 and 2013 the number of infected men who have sex with men (MSM increased 2.9-fold, compared to 1.6-fold and 1.3-fold for intravenous drug users (IVDU and Ethiopian-origin residents. Understanding contemporary spread is essential for effective public health planning.We analyzed demographic and virologic data from 1,427 HIV-infected individuals diagnosed with HIV-I during 1998-2012. HIV phylogenies were reconstructed with maximum-likelihood and Bayesian methods.Subtype-B viruses, but not A or C, demonstrated a striking number of large clusters with common ancestors having posterior probability ≥0.95, including some suggesting presence of transmission networks. Transmitted drug resistance was highest in subtype B (13%. MSM represented a frequent risk factor in cross-ethnic transmission, demonstrated by the presence of Israeli-born with non-B virus infections and FSU immigrants with non-A subtypes.Reconstructed phylogenetic trees demonstrated substantial grouping in subtype B, but not in non-MSM subtype-A or in subtype-C, reflecting differences in transmission dynamics linked to HIV transmission categories. Cross-ethnic spread occurred through multiple independent introductions, with MSM playing a prevalent role in the transmission of the virus. Such data provide a baseline to track epidemic trends and will be useful in informing and quantifying efforts to reduce HIV transmission.

  9. Short-Term Dynamic and Local Epidemiological Trends in the South American HIV-1B Epidemic.

    Science.gov (United States)

    Junqueira, Dennis Maletich; de Medeiros, Rubia Marília; Gräf, Tiago; Almeida, Sabrina Esteves de Matos

    2016-01-01

    The human displacement and sexual behavior are the main factors driving the HIV-1 pandemic to the current profile. The intrinsic structure of the HIV transmission among different individuals has valuable importance for the understanding of the epidemic and for the public health response. The aim of this study was to characterize the HIV-1 subtype B (HIV-1B) epidemic in South America through the identification of transmission links and infer trends about geographical patterns and median time of transmission between individuals. Sequences of the protease and reverse transcriptase coding regions from 4,810 individuals were selected from GenBank. Maximum likelihood phylogenies were inferred and submitted to ClusterPicker to identify transmission links. Bayesian analyses were applied only for clusters including ≥5 dated samples in order to estimate the median maximum inter-transmission interval. This study analyzed sequences sampled from 12 South American countries, from individuals of different exposure categories, under different antiretroviral profiles, and from a wide period of time (1989-2013). Continentally, Brazil, Argentina and Venezuela were revealed important sites for the spread of HIV-1B among countries inside South America. Of note, from all the clusters identified about 70% of the HIV-1B infections are primarily occurring among individuals living in the same geographic region. In addition, these transmissions seem to occur early after the infection of an individual, taking in average 2.39 years (95% CI 1.48-3.30) to succeed. Homosexual/Bisexual individuals transmit the virus as quickly as almost half time of that estimated for the general population sampled here. Public health services can be broadly benefitted from this kind of information whether to focus on specific programs of response to the epidemic whether as guiding of prevention campaigns to specific risk groups.

  10. Recombinant viruses initiated the early HIV-1 epidemic in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Peter N Fonjungo

    Full Text Available We analyzed genetic diversity and phylogenetic relationships among 124 HIV-1 and 19 HIV-2 strains in sera collected in 1986 from patients of the state hospital in Ouagadougou, Burkina Faso. Phylogenetic analysis of the HIV-1 env gp41 region of 65 sequences characterized 37 (56.9% as CRF06_cpx strains, 25 (38.5% as CRF02_AG, 2 (3.1% as CRF09_cpx, and 1 (1.5% as subtype A. Similarly, phylogenetic analysis of the protease (PR gene region of 73 sequences identified 52 (71.2% as CRF06_cpx, 15 (20.5% as CRF02_AG, 5 (6.8% as subtype A, and 1 (1.4% was a unique strain that clustered along the B/D lineage but basal to the node connecting the two lineages. HIV-2 PR or integrase (INT groups A (n = 17 [89.5%] and B (n = 2 [10.5%] were found in both monotypic (n = 11 and heterotypic HIV-1/HIV-2 (n = 8 infections, with few HIV-2 group B infections. Based on limited available sampling, evidence suggests two recombinant viruses, CRF06_cpx and CRF02_AG, appear to have driven the beginning of the mid-1980s HIV-1 epidemic in Burkina Faso.

  11. Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom.

    Directory of Open Access Journals (Sweden)

    Gareth J Hughes

    2009-09-01

    Full Text Available The heterosexual risk group has become the largest HIV infected group in the United Kingdom during the last 10 years, but little is known of the network structure and dynamics of viral transmission in this group. The overwhelming majority of UK heterosexual infections are of non-B HIV subtypes, indicating viruses originating among immigrants from sub-Saharan Africa. The high rate of HIV evolution, combined with the availability of a very high density sample of viral sequences from routine clinical care has allowed the phylodynamics of the epidemic to be investigated for the first time. Sequences of the viral protease and partial reverse transcriptase coding regions from 11,071 patients infected with HIV of non-B subtypes were studied. Of these, 2774 were closely linked to at least one other sequence by nucleotide distance. Including the closest sequences from the global HIV database identified 296 individuals that were in UK-based groups of 3 or more individuals. There were a total of 8 UK-based clusters of 10 or more, comprising 143/2774 (5% individuals, much lower than the figure of 25% obtained earlier for men who have sex with men (MSM. Sample dates were incorporated into relaxed clock phylogenetic analyses to estimate the dates of internal nodes. From the resulting time-resolved phylogenies, the internode lengths, used as estimates of maximum transmission intervals, had a median of 27 months overall, over twice as long as obtained for MSM (14 months, with only 2% of transmissions occurring in the first 6 months after infection. This phylodynamic analysis of non-B subtype HIV sequences representing over 40% of the estimated UK HIV-infected heterosexual population has revealed heterosexual HIV transmission in the UK is clustered, but on average in smaller groups and is transmitted with slower dynamics than among MSM. More effective intervention to restrict the epidemic may therefore be feasible, given effective diagnosis programmes.

  12. History and origin of the HIV-1 subtype C epidemic in South Africa and the greater southern African region.

    Science.gov (United States)

    Wilkinson, Eduan; Engelbrecht, Susan; de Oliveira, Tulio

    2015-11-17

    HIV has spread at an alarming rate in South Africa, making it the country with the highest number of HIV infections. Several studies have investigated the histories of HIV-1 subtype C epidemics but none have done so in the context of social and political transformation in southern Africa. There is a need to understand how these processes affects epidemics, as socio-political transformation is a common and on-going process in Africa. Here, we genotyped strains from the start of the epidemic and applied phylodynamic techniques to determine the history of the southern Africa and South African epidemic from longitudinal sampled data. The southern African epidemic's estimated dates of origin was placed around 1960 (95% HPD 1956-64), while dynamic reconstruction revealed strong growth during the 1970s and 80s. The South African epidemic has a similar origin, caused by multiple introductions from neighbouring countries, and grew exponentially during the 1980s and 90s, coinciding with socio-political changes in South Africa. These findings provide an indication as to when the epidemic started and how it has grown, while the inclusion of sequence data from the start of the epidemic provided better estimates. The epidemic have stabilized in recent years with the expansion of antiretroviral therapy.

  13. Testing the hypothesis that treatment can eliminate HIV

    DEFF Research Database (Denmark)

    Okano, Justin T; Robbins, Danielle; Palk, Laurence

    2016-01-01

    . The elimination threshold is one new HIV infection per 1000 individuals. Here, we test the hypothesis that TasP can substantially reduce epidemics and eliminate HIV. We estimate the impact of TasP, between 1996 and 2013, on the Danish HIV epidemic in men who have sex with men (MSM), an epidemic UNAIDS has...... identified as a priority for elimination. METHODS: We use a CD4-staged Bayesian back-calculation approach to estimate incidence, and the hidden epidemic (the number of HIV-infected undiagnosed MSM). To develop the back-calculation model, we use data from an ongoing nationwide population-based study......: the Danish HIV Cohort Study. FINDINGS: Incidence, and the hidden epidemic, decreased substantially after treatment was introduced in 1996. By 2013, incidence was close to the elimination threshold: 1·4 (median, 95% Bayesian credible interval [BCI] 0·4-2·1) new HIV infections per 1000 MSM and there were only...

  14. HIV/AIDS epidemic in the State of Amazonas: characteristics and trends from 2001 to 2012.

    Science.gov (United States)

    Oliveira, Romina do Socorro Marques de; Benzaken, Adele Schwartz; Saraceni, Valeria; Sabidó, Meritxell

    2015-01-01

    A scoping review was conducted to describe the epidemiological characteristics of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in the State of Amazonas, Brazil, from 2001 to 2012, and temporary patterns were estimated from surveillance data. The results suggest that in its third decade, the Amazon HIV/AIDS epidemic is far from being stabilized and displays rising AIDS incidence and mortality rates and late diagnoses. The data suggest that AIDS cases are hitting mostly young adults and have recently shifted toward men, both homosexual and heterosexual. AIDS cases among the indigenous people have remained stable and low. However, the epidemic has disseminated to the interior of the state, which adds difficulties to its control, given the geographical isolation, logistical barriers, and culturally and ethnically diverse population. Antiretroviral (ARV) therapy has been decentralized, but peripheral ARV services are still insufficient and too distant from people who need them. Recently, the expansion of point-of-care (POC) rapid HIV testing has been contributing to overcoming logistical barriers. Other new POC devices, such as the PIMA CD4 analyzer, will bring the laboratory to the patient. AIDS uniquely coexists with other tropical infections, sharing their epidemiological profiles. The increased demand for HIV/AIDS care services can only be satisfied through increased decentralization to peripheral health units, which can also naturally integrate care with other tropical infections and can promote a shift from vertical to integrated programming. Future challenges involve building surveillance data on HIV case notification and covering the spectrum of engagement in care, including adherence to treatment and follow-up loss.

  15. The HIV epidemic and prevention response in Tigrai, Ethiopia: a synthesis at sub-national level.

    Science.gov (United States)

    Barnabas, GebreAb; Pegurri, Elisabetta; Selassie, Hiwot Haile; Naamara, Warren; Zemariam, Samuel

    2014-06-20

    This study, the first of its kind carried out at sub-national level in Ethiopia, was conducted in order to understand the dynamics of HIV transmission at regional and district level in Tigrai, Ethiopia; and to assess the adequacy of the HIV prevention response. Routine data from health centres, data from available published and grey literature and studies, and primary qualitative information were triangulated to draw an updated picture of the HIV epidemic, HIV response and resource allocation in Tigrai. HIV prevalence in Tigrai was 1.8% in 2011 (EDHS). ANC data show that there has been a continuous decline in the prevalence of HIV in both urban and rural areas (urban: 14.9% in 2001 to 5.0% in 2009; rural: 5.2% in 2001 to 1.3% in 2009, ANC surveillance data). Variability in prevalence by zone and by district was observed. Possible reasons for higher prevalence include the presence of mobile seasonal workers, highly urbanized centres, a high concentration of economic activity and connecting roads and large commercial farms. Sex workers, seasonal farm workers and HIV negative partners in discordant couples were identified as being at higher risk. There is no evidence that programme planning is done on the basis of geographical variations in HIV prevalence and there are gaps in programmes and services for certain high risk population groups. Considerable efforts have been invested in the HIV prevention response in Tigrai however, these efforts do not fully respond to the actual needs. For a more effective and targeted HIV prevention response, studies and data syntheses need to be carried out at sub-national level in order to accurately identify local specificities and plan accordingly. Resources should be targeted towards areas where transmission is linked to sex work, mobility and the mobile labour workforce.

  16. The HIV epidemic and sexual and reproductive health policy integration: views of South African policymakers.

    Science.gov (United States)

    Cooper, Diane; Mantell, Joanne E; Moodley, Jennifer; Mall, Sumaya

    2015-03-04

    Integration of sexual and reproductive health (SRH) and HIV policies and services delivered by the same provider is prioritised worldwide, especially in sub-Saharan Africa where HIV prevalence is highest. South Africa has the largest antiretroviral treatment (ART) programme in the world, with an estimated 2.7 million people on ART, elevating South Africa's prominence as a global leader in HIV treatment. In 2011, the Southern African HIV Clinicians Society published safer conception guidelines for people living with HIV (PLWH) and in 2013, the South African government published contraceptive guidelines highlighting the importance of SRH and fertility planning services for people living with HIV. Addressing unintended pregnancies, safer conception and maternal health issues is crucial for improving PLWH's SRH and combatting the global HIV epidemic. This paper explores South African policymakers' perspectives on public sector SRH-HIV policy integration, with a special focus on the need for national and regional policies on safer conception for PLWH and contraceptive guidelines implementation. It draws on 42 in-depth interviews with national, provincial and civil society policymakers conducted between 2008-2009 and 2011-2012, as the number of people on ART escalated. Interviews focused on three key domains: opinions on PLWH's childbearing; the status of SRH-HIV integration policies and services; and thoughts and suggestions on SRH-HIV integration within the restructuring of South African primary care services. Data were coded and analysed according to themes. Participants supported SRH-HIV integrated policy and services. However, integration challenges identified included a lack of policy and guidelines, inadequately trained providers, vertical programming, provider work overload, and a weak health system. Participants acknowledged that SRH-HIV integration policies, particularly for safer conception, contraception and cervical cancer, had been neglected. Policymakers

  17. Global discourses and experiential speculation: Secondary and tertiary graduate Malawians dissect the HIV/AIDS epidemic

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    Myroniuk Tyler W

    2011-10-01

    Full Text Available Abstract Background Since the beginning of the HIV/AIDS epidemic, the perspectives of secondary and tertiary school graduates in sub-Saharan Africa regarding the effectiveness of government and international HIV/AIDS policies and programmes have not been thoroughly examined. When extensive monetary aid is directed toward "development" in a country like Malawi, it is the educated elites - secondary and tertiary graduates who are heavily involved and influential in the domestic re-distribution and implementation of millions of dollars worth of aid - on whom international expectations fall to decrease the transmission of HIV. Many Malawian jobs related to public health and HIV/AIDS are created as a direct result of this funding and are occupied by the few secondary and tertiary graduates. Thus, it is a practical venture to understand their perspectives on highly contentious and heavily funded HIV/AIDS issues that affect their nation. Methods Qualitative data was collected in this study in efforts to discover in-depth perspectives on the HIV/AIDS epidemic. Thirty-eight secondary and tertiary graduate Malawians took part in semi-structured interviews. Data was analysed using an early grounded theory approach and subsequent themes of "global discourses" and "experiential knowledge of HIV/AIDS" emerged. Results This group of Malawians frequently responded to questions regarding healthcare and access to medicine, sexual behaviours and methods of reducing the spread of HIV/AIDS by citing and explaining the widespread, international and "proper" responses. The secondary and tertiary graduate Malawians also discussed these same topics in terms of what they perceive or have experienced. Experiential responses, such as the counter-productivity of circumcision and condoms, the overestimation of HIV/AIDS prevalence, and calls for more authoritarian policing of commercial sex work, were remarkably divergent from the HIV/AIDS discourse. Conclusions The opinions

  18. HIV/AIDS epidemic in Eastern Europe: recent developments in the Russian Federation and Ukraine among women.

    Science.gov (United States)

    Burruano, Larissa; Kruglov, Yury

    2009-04-01

    The Russian Federation and the Ukraine are among the Eastern European countries with the fastest growing number of cases of HIV. According to data from the Joint United Nations Program on HIV/AIDS, nearly 90% of newly reported HIV diagnoses in Eastern Europe in 2006 were from the Russian Federation (66%) and the Ukraine (21%). A growing number of women are infected with HIV. The impact of gender on HIV/AIDS is an important factor in understanding the development and evolution of the HIV/AIDS epidemic in Eastern Europe. The aim of this study was to assess the importance of integrating gender consideration into the creation of HIV programs and to examine the effect of gender on HIV/AIDS. Reported HIV/AIDS cases from the official epidemiological register of the Ukrainian Centre for AIDS Prevention alongside data from the Russian Federal AIDS Center were analyzed. Joint United Nations Program on HIV/AIDS country fact sheets were reviewed and analyzed, and this information was supplemented with published HIV prevalence and sexually transmitted disease case reporting information, unpublished reports, and expert evaluations. Of the newly registered cases of HIV, the proportion of women rose from 13.0% in 1995 to 44.0% in 2006 in the Russian Federation, and from 37.2% in 1995 to 41.9% in 2006 in the Ukraine. There has also been a considerable increase in mother-to-child transmission of HIV since 1995. Between 1987 and 1994, the proportion of children among the people newly infected with HIV in the Ukraine was 2.2%; in 2006 it was 17.6%. In 2006, 16,078 new HIV cases were registered in the Ukraine and 39,652 new HIV cases in the Russian Federation. Large increases in the number of HIV-infected women were reported from both countries. The data examined in this study suggest subregional differences in the magnitude of the HIV/AIDS epidemic in the Russian Federation and the Ukraine and the importance of the impact of gender on the rapid spread of the HIV/AIDS epidemic among

  19. [Current status of HIV epidemic and prevention and control program in Cambodia].

    Science.gov (United States)

    Kihara, M; Tajima, K; Tomizawa, I; Ozaki, S; Soda, K

    1995-01-01

    The authors of this paper visited Cambodia in March 1994, as part of the Ministry of Education program of international cooperation in AIDS research, to investigate the current status of the AIDS epidemic and develop plans for prevention and control. Cambodia is faced with an HIV crisis; examples are the dramatic increase in HIV-positive blood donors (0.08% in 1990, 3.6% in 1994) and the high rate of infection among high-risk behavior groups. The route of infection in all cases in which it was traceable was heterosexual. While the heterosexual route is considered to be the major route of transmission, unclean needles used in medical services are also suspected. Since 1991, aided by the World Health Organization, HIV infection surveillance and a comprehensive national plan for AIDS prevention and control have been established. In cooperation with nongovernmental organizations, policies have been put into effect. With the decline of the country's socioeconomic structure, however, the level of public hygiene has been drastically reduced and HIV/AIDS prevention and control plans have been facing great difficulties. Now, at the onset of the epidemic, which is a crucial time, there is urgent need for international assistance.

  20. When Statistical Literacy Really Matters: Understanding Published Information about the HIV/AIDS Epidemic in South Africa

    Science.gov (United States)

    Hobden, Sally

    2014-01-01

    Information on the HIV/AIDS epidemic in Southern Africa is often interpreted through a veil of secrecy and shame and, I argue, with flawed understanding of basic statistics. This research determined the levels of statistical literacy evident in 316 future Mathematical Literacy teachers' explanations of the median in the context of HIV/AIDS…

  1. The HIV/AIDS epidemic in Ukraine: its potential social and economic impact.

    Science.gov (United States)

    Barnett, T; Whiteside, A; Khodakevich, L; Kruglov, Y; Steshenko, V

    2000-11-01

    Present and immediately foreseeable medical knowledge suggest that HIV infection cannot be avoided by vaccination and that an affordable cure for the resulting syndrome, AIDS, is a long way off. There is a strong possibility that Ukraine is confronted by an HIV epidemic which will spread into the general population and that the most common mode of transmission will be through heterosexual intercourse. The epidemic in the Ukraine is currently concentrated among intravenous drug users. It is estimated that between 60,000 and 180,000 people may currently be infected. In present economic and social circumstances there are many features of Ukrainian society that may add to the probability of the epidemic becoming widespread in the general population. It is likely that this process may have already commenced. The result of this will be numerous additional deaths and illness over the short (5 year) (19,000-23,000 deaths), medium (10-15 year) (61,000-111,000), and longer terms (>20 year) (in excess of 40,000-160,000 deaths). The research reported here was undertaken in 1997-8 and describes the potential medium to long term social and economic impact of an HIV/AIDS epidemic in Ukraine. Using the concepts of risk environment, susceptibility and vulnerability, it reports the problems which might be expected to develop in relation to care of excess orphans, the elderly, vulnerable households and regions as well as among those working in the "third sector", a social sector upon which exponents of the importance of developing sound "civil society" in "transitional economies" place heavy emphasis.

  2. Research Notes ~ Combating HIV/AIDS Epidemic in Nigeria: Responses from National Open University of Nigeria (NOUN

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    Terhemba Nom Ambe-Uva

    2007-11-01

    Full Text Available Universities have come under serious attack because of their lackluster response to HIV/AIDS. This article examines the response of National Open University of Nigeria (NOUN and its strategic responses in combating HIV/AIDS epidemic. This is achieved by examining NOUN’s basic structures that position the University to respond to the epidemic; and second, by assessing HIV/AIDS strategies and policy framework the University has put in place. An interpretative epistemological stance was used for this study, and a qualitative research involving focus group discussion (FGD and analysis of secondary data was carried out. Results showed that NOUN has identified the impact the epidemic has on the university, although it has yet to institutionalize an HIV/AIDS policy. NOUN’s Draft Service Charter, however, has identified the fight against HIV/AIDS as a core mandate of the University, and the introduction of HIV/AIDS certification programs can be viewed as proactive policies in response to the epidemic. Results of this study are discussed in terms of their relevance to future research and the impact such policy frameworks may have on combating the epidemic, both within the University and the wider community.

  3. Rising HIV infection rates in Ho Chi Minh City herald emerging AIDS epidemic in Vietnam.

    Science.gov (United States)

    Lindan, C P; Lieu, T X; Giang, L T; Lap, V D; Thuc, N V; Thinh, T; Lurie, P; Mandel, J S

    1997-09-01

    To describe the epidemiology of HIV in Ho Chi Minh City in the context of current surveillance data from Vietnam. Since the late 1980s, HIV surveillance data have been collected in Ho Chi Minh City from centers for the treatment of venereal disease and tuberculosis, centers for the rehabilitation of injecting drug users and sex workers, prenatal clinics, blood banks and other sites. The first case of HIV infection in Vietnam was identified in 1990 in Ho Chi Minh City. The cumulative number of reported HIV infections in this city at the end of 1996 was 2774, about half of the number of cases in the country; 86% of infections were among men, 86% among injecting drug users, 2.5% among patients with sexually transmitted diseases and 2.5% among sex workers. The first HIV infection among antenatal women was detected in 1994. The prevalence of HIV among injecting drug users rose dramatically from 1% in 1992 to 39% in 1996, compared with 1.2% among sex workers, 0.3% among blood donors and 1.3% among tuberculosis patients in 1996. The populations of injecting drug users and sex workers in Ho Chi Minh City are estimated to be 30000 and 80000, respectively, and rates of sexually transmitted diseases are 2-3 per 1000 persons per year. By the end of December 1996, 42 out of 53 provinces had reported HIV infections, and border areas near China and Cambodia began identifying large numbers of HIV-seropositive people. Ho Chi Minh City is at the forefront of a new HIV epidemic in Vietnam. This epidemic shows similarities to that in Thailand nearly a decade ago, with rapidly rising HIV rates among injecting drug users and infection already established among sex workers. Prevention efforts should include the targeting of injecting drug users and sex workers outside rehabilitation centers, the availability of sterile needles and condoms, the establishment of anonymous testing sites, the control of sexually transmitted diseases and the coordination of programs within southeast Asia.

  4. Impact of HIV/aids epidemic on human capital development in West Africa.

    Science.gov (United States)

    Dauda, Rasaki Stephen

    2018-01-12

    West Africa occupies the third position with respect to the burden of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) globally, after Southern and East Africa. About 5 million adults and children are infected with the disease in the subregion, while HIV prevalence in the general population hovers around 2% and 5%. This paper attempts to investigate the impact of HIV/AIDS epidemic on human capital development in 11 West African countries over the period 1990 to 2011. The study used a dynamic panel data modeling approach, using first difference, difference generalized methods of moment, and system generalized methods of moment estimating techniques. Four measures of HIV/AIDS and 2 human capital measures were used in the study. The findings revealed that HIV/AIDS pandemic had negative and significant impact on human capital in West Africa. However, the statistical significance was more pronounced on life expectancy (a measure of human capital), while the negative impact on school enrolment (another human capital measure) was not significant. It is therefore recommended that the spread of HIV/AIDS disease in West Africa should be effectively controlled, while the number of infected persons undergoing antiretroviral therapy in the subregion should be increased to a near 100% coverage. Copyright © 2018 John Wiley & Sons, Ltd.

  5. Inferring epidemiological parameters from phylogenetic information for the HIV-1 epidemic among MSM

    Science.gov (United States)

    Quax, Rick; van de Vijver, David A. M. C.; Frentz, Dineke; Sloot, Peter M. A.

    2013-09-01

    The HIV-1 epidemic in Europe is primarily sustained by a dynamic topology of sexual interactions among MSM who have individual immune systems and behavior. This epidemiological process shapes the phylogeny of the virus population. Both fields of epidemic modeling and phylogenetics have a long history, however it remains difficult to use phylogenetic data to infer epidemiological parameters such as the structure of the sexual network and the per-act infectiousness. This is because phylogenetic data is necessarily incomplete and ambiguous. Here we show that the cluster-size distribution indeed contains information about epidemiological parameters using detailed numberical experiments. We simulate the HIV epidemic among MSM many times using the Monte Carlo method with all parameter values and their ranges taken from literature. For each simulation and the corresponding set of parameter values we calculate the likelihood of reproducing an observed cluster-size distribution. The result is an estimated likelihood distribution of all parameters from the phylogenetic data, in particular the structure of the sexual network, the per-act infectiousness, and the risk behavior reduction upon diagnosis. These likelihood distributions encode the knowledge provided by the observed cluster-size distrbution, which we quantify using information theory. Our work suggests that the growing body of genetic data of patients can be exploited to understand the underlying epidemiological process.

  6. Women's rights and women's health during HIV/AIDS epidemics: the experience of women in sub-Saharan Africa.

    Science.gov (United States)

    Dugassa, Begna F

    2009-08-01

    Twenty-five years have passed since HIV/AIDS was recognized as a major public health problem. Although billions of dollars are spent in research and development, we still have no medical cure or vaccination. In the early days of the epidemic, public health slogans suggested that HIV/AIDS does not discriminate. Now it is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalized, women, colonized, and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS demands the need to travel extra miles. My objective in this article is to promote the need to go beyond the biomedical model of "technical fixes" and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. In this article, I argue that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders.

  7. Increasing rates of obesity among HIV-infected persons during the HIV epidemic.

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    Nancy Crum-Cianflone

    2010-04-01

    Full Text Available The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV-infected persons are unknown.We evaluated prospective data from a U.S. Military HIV Natural History Study (1985-2004 consisting of early diagnosed patients. Statistics included multivariate linear regression and longitudinal linear mixed effects models.Of 1682 patients, 2% were underweight, 37% were overweight, and 9% were obese at HIV diagnosis. Multivariate predictors of a higher body mass index (BMI at diagnosis included more recent year of HIV diagnosis, older age, African American race, and earlier HIV stage (all p<0.05. The majority of patients (62% gained weight during HIV infection. Multivariate factors associated with a greater increase in BMI during HIV infection included more recent year of diagnosis, lower BMI at diagnosis, higher CD4 count, lower HIV RNA level, lack of AIDS diagnosis, and longer HIV duration (all p<0.05. Nucleoside agents were associated with less weight gain; other drug classes had no significant impact on weight change in the HAART era.HIV-infected patients are increasingly overweight/obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general population. Weight management programs may be important components of HIV care.

  8. Phylodynamic and Phylogeographic Profiles of Subtype B HIV-1 Epidemics in South Spain.

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    Santiago Pérez-Parra

    Full Text Available Since 1982, HIV-1 epidemics have evolved to different scenarios in terms of transmission routes, subtype distribution and characteristics of transmission clusters. We investigated the evolutionary history of HIV-1 subtype B in south Spain.We studied all newly diagnosed HIV-1 subtype B patients in East Andalusia during the 2005-2012 period. For the analysis, we used the reverse transcriptase and protease sequences from baseline resistance, and the Trugene® HIV Genotyping kit (Siemens, Barcelona, Spain. Subtyping was done with REGA v3.0. The maximum likelihood trees constructed with RAxML were used to study HIV-1 clustering. Phylogeographic and phylodynamic profiles were studied by Bayesian inference methods with BEAST v1.7.5 and SPREAD v1.0.6.Of the 493 patients infected with HIV-1 subtype B, 234 grouped into 55 clusters, most of which were small (44 clusters ≤ 5 patients, 31 with 2 patients, 13 with 3. The rest (133/234 were grouped into 11 clusters with ≥ 5 patients, and most (82%, 109/133 were men who have sex with men (MSM grouped into 8 clusters. The association with clusters was more frequent in Spanish (p = 0.02 men (p< 0.001, MSM (p<0.001 younger than 35 years (p = 0.001 and with a CD4+ T-cell count above 350 cells/ul (p<0.001. We estimated the date of HIV-1 subtype B regional epidemic diversification around 1970 (95% CI: 1965-1987, with an evolutionary rate of 2.4 (95%CI: 1.7-3.1 x 10-3 substitutions/site/year. Most clusters originated in the 1990s in MSMs. We observed exponential subtype B HIV-1 growth in 1980-1990 and 2005-2008. The most significant migration routes for subtype B went from inland cities to seaside locations.We provide the first data on the phylodynamic and phylogeographic profiles of HIV-1 subtype B in south Spain. Our findings of transmission clustering among MSMs should alert healthcare managers to enhance preventive measures in this risk group in order to prevent future outbreaks.

  9. Size matters: concurrency and the epidemic potential of HIV in small networks.

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    Nicole Bohme Carnegie

    Full Text Available BACKGROUND: Generalized heterosexual epidemics are responsible for the largest share of the global burden of HIV. These occur in populations that do not have high rates of partner acquisition, and research suggests that a pattern of fewer, but concurrent, partnerships may be the mechanism that provides the connectivity necessary for sustained transmission. We examine how network size affects the impact of concurrency on network connectivity. METHODOLOGY/PRINCIPAL FINDINGS: We use a stochastic network model to generate a sample of networks, varying the size of the network and the level of concurrency, and compare the largest components for each scenario to the asymptotic expected values. While the threshold for the growth of a giant component does not change, the transition is more gradual in the smaller networks. As a result, low levels of concurrency generate more connectivity in small networks. CONCLUSIONS/SIGNIFICANCE: Generalized HIV epidemics are by definition those that spread to a larger fraction of the population, but the mechanism may rely in part on the dynamics of transmission in a set of linked small networks. Examples include rural populations in sub-Saharan Africa and segregated minority populations in the US, where the effective size of the sexual network may well be in the hundreds, rather than thousands. Connectivity emerges at lower levels of concurrency in smaller networks, but these networks can still be disconnected with small changes in behavior. Concurrency remains a strategic target for HIV combination prevention programs in this context.

  10. Guarding against an HIV epidemic within an Aboriginal community and cultural framework; lessons from NSW.

    Science.gov (United States)

    Ward, James; Akre, Snehal P; Kaldor, John M

    2010-01-01

    The rate of HIV diagnosis in the Aboriginal and Torres Strait Islander population in Australia has been stable over the past 5 years. It is similar to the rate in non-Indigenous people overall, but there are major differences in the demographical and behaviour patterns associated with infection, with a history of injecting drug use and heterosexual contact much more prominent in Aboriginal people with HIV infection. Moreover there are a range of factors, such as social disadvantage, a higher incidence of sexually transmitted infections and poor access to health services that place Aboriginal people at special risk of HIV infection. Mainstream and Aboriginal community-controlled health services have an important role in preventing this epidemic. Partnerships developed within NSW have supported a range of services for Aboriginal people. There is a continuing need to support these services in their response to HIV, with a particular focus on Aboriginal Sexual Health Workers, to ensure that the prevention of HIV remains a high priority.

  11. Orphans of the HIV epidemic: the challenges from toddlerhood to adolescence and beyond.

    Science.gov (United States)

    Lala, Mamatha M

    2014-01-01

    This presentation focuses on the challenges and practical issues faced each day by orphans of the HIV epidemic and the holistic care that can be provided, as they continue to grow from toddlerhood to adolescence and beyond. An HIV Research Trust Scholarship enabled me to spend quality time in a sub-Saharan African province worst hit by the HIV epidemic and to interact with local experts and learn from mutual clinical experience. It was an immensely useful exercise as the clinical spectra of the diseases are very similar to ours and they have ongoing active research programs very relevant to our setting. India is arguably home to the largest number of orphans of the HIV epidemic. The responsibility of caring for orphaned children overwhelms and pushes many extended families beyond their ability to cope. Many countries are experiencing large increases in the number of families headed by women and grandparents, or even young children. These households are often unable to meet basic needs, and so the number of children living on the streets is rising. Orphaned children are disadvantaged in many devastating ways. In addition to the trauma of witnessing the sickness and death of one or both parents and perhaps siblings, they lack the necessary parental guidance through crucial life-stages of identity formation and transition into adulthood. They are more likely to suffer damage to their cognitive and emotional development and be subjected to; exploitation in terms of labour, social exclusion, extreme economic uncertainty, physical and sexual abuse, illiteracy, malnutrition and illness. Education remains a distant dream. With stigma and discrimination, they lack legal protection, lose inheritance rights, access to essential services available to other community members and professional help from doctors, teachers and lawyers. The implications for these unfortunate children are extraordinarily grave but governments, international agencies, non-governmental organizations

  12. Orphans of the HIV epidemic: the challenges from toddlerhood to adolescence and beyond

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    Mamatha M Lala

    2014-11-01

    Full Text Available This presentation focuses on the challenges and practical issues faced each day by orphans of the HIV epidemic and the holistic care that can be provided, as they continue to grow from toddlerhood to adolescence and beyond. An HIV Research Trust Scholarship enabled me to spend quality time in a sub-Saharan African province worst hit by the HIV epidemic and to interact with local experts and learn from mutual clinical experience. It was an immensely useful exercise as the clinical spectra of the diseases are very similar to ours and they have ongoing active research programs very relevant to our setting. India is arguably home to the largest number of orphans of the HIV epidemic. The responsibility of caring for orphaned children overwhelms and pushes many extended families beyond their ability to cope. Many countries are experiencing large increases in the number of families headed by women and grandparents, or even young children. These households are often unable to meet basic needs, and so the number of children living on the streets is rising. Orphaned children are disadvantaged in many devastating ways. In addition to the trauma of witnessing the sickness and death of one or both parents and perhaps siblings, they lack the necessary parental guidance through crucial life-stages of identity formation and transition into adulthood. They are more likely to suffer damage to their cognitive and emotional development and be subjected to; exploitation in terms of labour, social exclusion, extreme economic uncertainty, physical and sexual abuse, illiteracy, malnutrition and illness. Education remains a distant dream. With stigma and discrimination, they lack legal protection, lose inheritance rights, access to essential services available to other community members and professional help from doctors, teachers and lawyers. The implications for these unfortunate children are extraordinarily grave but governments, international agencies, non

  13. Analyzing hidden populations online: topic, emotion, and social network of HIV-related users in the largest Chinese online community.

    Science.gov (United States)

    Liu, Chuchu; Lu, Xin

    2018-01-05

    Traditional survey methods are limited in the study of hidden populations due to the hard to access properties, including lack of a sampling frame, sensitivity issue, reporting error, small sample size, etc. The rapid increase of online communities, of which members interact with others via the Internet, have generated large amounts of data, offering new opportunities for understanding hidden populations with unprecedented sample sizes and richness of information. In this study, we try to understand the multidimensional characteristics of a hidden population by analyzing the massive data generated in the online community. By elaborately designing crawlers, we retrieved a complete dataset from the "HIV bar," the largest bar related to HIV on the Baidu Tieba platform, for all records from January 2005 to August 2016. Through natural language processing and social network analysis, we explored the psychology, behavior and demand of online HIV population and examined the network community structure. In HIV communities, the average topic similarity among members is positively correlated to network efficiency (r = 0.70, p online services for HIV/AIDS consultation and diagnosis be improved to avoid privacy concerns and social discrimination in China.

  14. The HIV/AIDS epidemic in sub-Saharan Africa: thinking ahead on programmatic tasks and related operational research.

    Science.gov (United States)

    Zachariah, Rony; Van Damme, Wim; Arendt, Vic; Schmit, Jean Claude; Harries, Anthony D

    2011-07-06

    Until now, we have all been desperately trying to run behind the HIV/AIDS epidemic and catch up with it, but despite all our efforts, the epidemic remains well ahead of us. In 2010, the antiretroviral treatment (ART) gap was about 60%, AIDS-related deaths were almost two million a year, and on top of these figures, for every one person started on ART, there were two new HIV infections. What is needed to change this situation is to think ahead of the epidemic in terms of the programmatic tasks we will be faced with and try to act boldly in trying to implement those tasks. From a programmatic perspective, we: a) highlight what needs to fundamentally change in our thinking and overall approach to the epidemic; and b) outline a number of key task areas for implementation and related operational research.

  15. The HIV/AIDS epidemic in sub-Saharan Africa: thinking ahead on programmatic tasks and related operational research

    Directory of Open Access Journals (Sweden)

    Zachariah Rony

    2011-07-01

    Full Text Available Abstract Until now, we have all been desperately trying to run behind the HIV/AIDS epidemic and catch up with it, but despite all our efforts, the epidemic remains well ahead of us. In 2010, the antiretroviral treatment (ART gap was about 60%, AIDS-related deaths were almost two million a year, and on top of these figures, for every one person started on ART, there were two new HIV infections. What is needed to change this situation is to think ahead of the epidemic in terms of the programmatic tasks we will be faced with and try to act boldly in trying to implement those tasks. From a programmatic perspective, we: a highlight what needs to fundamentally change in our thinking and overall approach to the epidemic; and b outline a number of key task areas for implementation and related operational research.

  16. HIV-1 genetic subtype A/B recombinant strain causing an explosive epidemic in injecting drug users in Kaliningrad.

    Science.gov (United States)

    Liitsola, K; Tashkinova, I; Laukkanen, T; Korovina, G; Smolskaja, T; Momot, O; Mashkilleyson, N; Chaplinskas, S; Brummer-Korvenkontio, H; Vanhatalo, J; Leinikki, P; Salminen, M O

    1998-10-01

    To investigate the molecular epidemiology and genetic structure of the virus strain(s) causing an outbreak of HIV-1 infection in the Kaliningrad province of the Russian Federation and to investigate the relationship of this outbreak to some other emerging HIV-1 epidemics in the countries of the former Soviet Union. A molecular epidemiological investigation was conducted in the city of Kaliningrad amongst individuals recently diagnosed as HIV-1-positive. Samples were also collected from neighbouring Lithuania and from the Ukraine. Incident and population data was collected from official health statistics in Kaliningrad. A standardized questionnaire was administered to newly diagnosed individuals to assess risk factors for HIV-1 infection. For genotyping, two regions of the virus (env C2-V3 and gag NCp7) were directly sequenced. The number of newly diagnosed individuals testing seropositive for HIV-1 infection in Kaliningrad rose from less than one per month to more than 100 per month during the period of July-October 1996. A total of 1335 new infections were identified between 1 July 1996 and 30 June 1997. The main reported risk factor for HIV-1 infection (80%) was injecting drug use, in particular with a locally produced opiate. Sequence analysis of patient viruses in Kaliningrad (n = 50) showed that the epidemic was caused by a highly homogenous HIV-1 strain, recombinant between the genetic subtypes A and B. Comparison with subtype A strains prevalent amongst injecting drug users (IDU) in the Ukraine showed that one of these strains was the direct subtype A parent of the epidemic A/B recombinant strain in Kaliningrad. The HIV-1 epidemic in Kaliningrad probably started from a single source, with rapid spread of the virus through the IDU population. The origin of the epidemic strain is a recombination event occurring between the subtype A strain virus prevalent among IDU in some southern CIS countries, and a subtype B strain of unknown origin.

  17. Stability analysis of an HIV/AIDS epidemic model with treatment

    Science.gov (United States)

    Cai, Liming; Li, Xuezhi; Ghosh, Mini; Guo, Baozhu

    2009-07-01

    An HIV/AIDS epidemic model with treatment is investigated. The model allows for some infected individuals to move from the symptomatic phase to the asymptomatic phase by all sorts of treatment methods. We first establish the ODE treatment model with two infective stages. Mathematical analyses establish that the global dynamics of the spread of the HIV infectious disease are completely determined by the basic reproduction number [real]0. If [real]01. Then, we introduce a discrete time delay to the model to describe the time from the start of treatment in the symptomatic stage until treatment effects become visible. The effect of the time delay on the stability of the endemically infected equilibrium is investigated. Moreover, the delay model exhibits Hopf bifurcations by using the delay as a bifurcation parameter. Finally, numerical simulations are presented to illustrate the results.

  18. Religious and cultural traits in HIV/AIDS epidemics in sub-Saharan Africa.

    Science.gov (United States)

    Velayati, Ali-Akbar; Bakayev, Valerii; Bahadori, Moslem; Tabatabaei, Seyed-Javad; Alaei, Arash; Farahbood, Amir; Masjedi, Mohammad-Reza

    2007-10-01

    The pandemic of HIV/AIDS in sub-Saharan Africa and the rise of epidemics in Asia to the previously unforeseen level are likely to have global social, economic, and political impacts. In this emergency, it is vital to reappraise the weight of powerful religious and cultural factors in spreading the disease. The role of Islam in shaping values, norms, and public policies in North African states is to be appreciated for the lowest HIV prevalence in their populations. Yet, the place of religion in prevention of the disease diffusion is not fully understood nor worldwide acknowledged by the primary decision makers. Another topic, which has received little attention to date, despite the abundance of literature concerning the unfortunate Africa's anti-AIDS campaign, is an issue of colonial past. To better comprehend the share of both traits in diverse spread of HIV in sub-Saharan Africa, we studied the correlation between Muslim and Christian proportions in the state's population and HIV rate. By this method, Muslim percentage came out as a potential predictor of HIV prevalence in a given state. In another approach, most subcontinental countries were clustered by colocalization and similarity in their leading religion, colonial past, and HIV seroprevalence starting from barely noticeable (0.6 - 1.2%, for Mauritania, Senegal, Somalia, and Niger) and low levels (1.9 - 4.8%, for Mali, Eritrea, Djibouti, Guinea, Guinea-Bissau, Burkina-Faso, and Chad) for Muslim populated past possessions of France and Italy, in the northern part of the subcontinent. Former territories of France, Belgium, Portugal, and the UK formed two other groups of the countries nearing the equator with Catholic prevailing (Democratic Republic of Congo, Republic of Congo, Rwanda, Gabon, and Burundi) or mixed populations comprising Christian, Muslim, and indigenous believers (Benin, Ghana, Uganda, Togo, Angola, Nigeria, Liberia, Kenya, Cameroon, Côte d'Ivoire, and Sierra-Leone), which covered the HIV

  19. Understanding the dynamics of the HIV epidemic among Italian intravenous drug users: a cross-sectional versus a longitudinal approach.

    Science.gov (United States)

    Rezza, G; Nicolosi, A; Zaccarelli, M; Sagliocca, L; Nespoli, M; Gattari, P; Spizzichino, L; Ippolito, G; Lazzarin, A

    1994-05-01

    We studied annual human immunodeficiency virus (HIV) seroprevalence and incidence in a large number of intravenous drug users attending drug treatment centers in three Italian urban areas. We also evaluated risk factors for HIV seropositivity and for HIV seroconversion. The results showed that HIV prevalence and incidence are declining. HIV prevalence declined dramatically in study participants that were < 25 years old. Prevalent HIV cases were associated with older age and longer duration of intravenous drug use; however, short duration of drug use increased the risk of seroconversion. The findings of our study suggest that comparing cross-sectional and longitudinal data contributes to a better understanding of the dynamics of the HIV epidemic among intravenous drug users.

  20. Evolution of Primary HIV Drug Resistance in a Subtype C Dominated Epidemic in Mozambique

    Science.gov (United States)

    Bila, Dulce Celina Adolfo; Young, Peter; Merks, Harriet; Vubil, Adolfo Salvador; Mahomed, Mussagy; Augusto, Angelo; Abreu, Celina Monteiro; Mabunda, Nédio Jonas; Brooks, James I.; Tanuri, Amilcar; Jani, Ilesh Vinodrai

    2013-01-01

    Objective In Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emergence of transmitted viral resistance, and to produce evidence-based recommendations to support antiretroviral (ARV) policy in Mozambique. Methods World Health Organization (WHO) methodology was used to evaluate transmitted drug resistance (TDR) in newly diagnosed HIV-1 infected pregnant women attending ante-natal clinics in Maputo and Beira to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI). Subtypes were assigned using REGA HIV-1 subtyping tool and phylogenetic trees constructed using MEGA version 5. Results Although mutations associated with resistance to all three drug were detected in these surveys, transmitted resistance was analyzed and classified as <5% in Maputo in both surveys for all three drug classes. Transmitted resistance to NNRTI in Beira in 2009 was classified between 5–15%, an increase from 2007 when no NNRTI mutations were found. All sequences clustered with subtype C. Conclusions Our results show that the epidemic is dominated by subtype C, where the first-line option based on two NRTI and one NNRTI is still effective for treatment of HIV infection, but intermediate levels of TDR found in Beira reinforce the need for constant evaluation with continuing treatment expansion in Mozambique. PMID:23935858

  1. Needle Exchange and the HIV Epidemic in Vancouver: Lessons Learned from 15 years of research

    Science.gov (United States)

    Hyshka, Elaine; Strathdee, Steffanie; Wood, Evan; Kerr, Thomas

    2012-01-01

    During the mid-1990s, Vancouver experienced a well characterized HIV outbreak among injection drug users (IDU) and many questioned how this could occur in the presence of a high volume needle exchange program (NEP). Specific concerns were fuelled by early research demonstrating that frequent needle exchange program attendees were more likely to be HIV positive than those who attended the NEP less frequently. Since then, some have misinterpreted this finding as evidence that NEPs are ineffective or potentially harmful. In light of continuing questions about the Vancouver HIV epidemic, we review 15 years of peer-reviewed research on Vancouver’s NEP to describe what has been learned through this work. Our review demonstrates that: 1) NEP attendance is not causally associated with HIV infection, 2) frequent attendees of Vancouver’s NEP have higher risk profiles which explain their increased risk of HIV seroconversion, and 3) a number of policy concerns, as well as the high prevalence of cocaine injecting contributed to the failure of the NEP to prevent the outbreak. Additionally, we highlight several improvements to Vancouver’s NEP that contributed to declines in syringe sharing and HIV incidence. Vancouver’s experience provides a number of important lessons regarding NEP. Keys to success include refocusing the NEP away from an emphasis on public order objectives by separating distribution and collection functions, removing syringe distribution limits and decentralizing and diversifying NEP services. Additionally, our review highlights the importance of context when implementing NEPs, as well as ongoing evaluation to identify factors that constrain or improve access to sterile syringes. PMID:22579215

  2. Sampling dynamic networks with application to investigation of HIV epidemic drivers.

    Science.gov (United States)

    Goyal, Ravi; De Gruttola, Victor

    2015-09-01

    We propose a method for randomly sampling dynamic networks that permits isolation of the impact of different network features on processes that propagate on networks. The new methods permit uniform sampling of dynamic networks in ways that ensure that they are consistent with both a given cumulative network and with specified values for constraints on the dynamic network properties. Development of such methods is challenging because modifying one network property will generally tend to modify others as well. Methods to sample constrained dynamic networks are particularly useful in the investigation of network-based interventions that target and modify specific dynamic network properties, especially in settings where the whole network is unobservable and therefore many network properties are unmeasurable. We illustrate this method by investigating the incremental impact of changes in networks properties that are relevant for the spread of infectious diseases, such as concurrency in sexual relationships. Development of the method is motivated by the challenges that arise in investigating the role of HIV epidemic drivers due to the often limited information available about contact networks. The proposed methods for randomly sampling dynamic networks facilitate investigation of the type of network data that can best contribute to an understanding of the HIV epidemic dynamics as well as of the limitations of conclusions drawn in the absence of such information. Hence, the methods are intended to aid in the design and interpretation of studies of network-based interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Epidemiological bridging by injection drug use drives an early HIV epidemic

    Directory of Open Access Journals (Sweden)

    Erik Volz

    2010-09-01

    Full Text Available The risk of acquiring sexually transmitted infections (STIs depends on individual behavior and the network of risky partnerships in which an individual participates. STI epidemics often spread rapidly and primarily among individuals central to transmission networks; and thus they often defy the mass-action principle since incidence is not proportional to the infectious fraction of the population. Here, we estimate the contact network structure for an Atlanta, Georgia community with heterogeneous sexual and drug-related risk behaviors and build a detailed transmission model for HIV through this population. We show that accurate estimation of epidemic incidence requires careful measurement and inclusion of diverse factors including concurrency (having multiple partners, the duration of partnerships, serosorting (preference for partners with matching disease state, and heterogeneity in the number and kinds of partners. In the focal population, we find that injection drug users (IDUs do not directly cause many secondary infections; yet they bridge the heterosexual and men-who-have-sex-with-men (MSM populations and are thereby indirectly responsible for extensive transmission. Keywords: HIV, Networks, Serosorting, Concurrency

  4. Combination prevention for persons who inject drugs in the HIV epidemic in a transitional country: The case of Tallinn, Estonia

    Science.gov (United States)

    Uusküla, Anneli; Des Jarlais, Don C; Raag, Mait; Pinkerton, Steven D; Feelemyer, Jonathan

    2014-01-01

    The study was undertaken to assess the potential effectiveness of combination HIV prevention on the very high seroprevalence epidemic among persons who inject drugs (PWID) in Tallinn, Estonia, a transitional country. Data from community-based cross-sectional (respondent driven sampling) surveys of PWID in 2005, 2007, 2009 and 2011 were used together with mathematical modeling of injection-associated HIV acquisition to estimate changes in injection-related HIV incidence during this period.Utilization of one, two or three of the interventions available in the community (needle/syringes exchange, antiretroviral treatment (ART), HIV testing, opioid substitution therapy) was reported by 42.5%, 30.5%, 11.5% of HIV+ and 34.7%, 36.4%, 5.7% of HIV- PWIDs, respectively in 2011. The modeling results suggest that the combination of needle/syringe programs and provision of ART to PWID in Tallinn substantially reduced the incidence of HIV infection in this population, from an estimated 20.7/100 person-years in 2005 to 7.5/100 person-years in 2011. In conclusion, combination prevention targeting HIV acquisition and transmission-related risks among persons who inject drugs in Tallinn has paralleled the downturn of the HIV epidemic in this population. PMID:25054646

  5. Integrating Community-Based Interventions to Reverse the Convergent TB/HIV Epidemics in Rural South Africa

    Science.gov (United States)

    Gilbert, Jennifer A.; Long, Elisa F.; Brooks, Ralph P.; Friedland, Gerald H.; Moll, Anthony P.; Townsend, Jeffrey P.; Galvani, Alison P.; Shenoi, Sheela V.

    2015-01-01

    The WHO recommends integrating interventions to address the devastating TB/HIV co-epidemics in South Africa, yet integration has been poorly implemented and TB/HIV control efforts need strengthening. Identifying infected individuals is particularly difficult in rural settings. We used mathematical modeling to predict the impact of community-based, integrated TB/HIV case finding and additional control strategies on South Africa’s TB/HIV epidemics. We developed a model incorporating TB and HIV transmission to evaluate the effectiveness of integrating TB and HIV interventions in rural South Africa over 10 years. We modeled the impact of a novel screening program that integrates case finding for TB and HIV in the community, comparing it to status quo and recommended TB/HIV control strategies, including GeneXpert, MDR-TB treatment decentralization, improved first-line TB treatment cure rate, isoniazid preventive therapy, and expanded ART. Combining recommended interventions averted 27% of expected TB cases (95% CI 18–40%) 18% HIV (95% CI 13–24%), 60% MDR-TB (95% CI 34–83%), 69% XDR-TB (95% CI 34–90%), and 16% TB/HIV deaths (95% CI 12–29). Supplementing these interventions with annual community-based TB/HIV case finding averted a further 17% of TB cases (44% total; 95% CI 31–56%), 5% HIV (23% total; 95% CI 17–29%), 8% MDR-TB (68% total; 95% CI 40–88%), 4% XDR-TB (73% total; 95% CI 38–91%), and 8% TB/HIV deaths (24% total; 95% CI 16–39%). In addition to increasing screening frequency, we found that improving TB symptom questionnaire sensitivity, second-line TB treatment delays, default before initiating TB treatment or ART, and second-line TB drug efficacy were significantly associated with even greater reductions in TB and HIV cases. TB/HIV epidemics in South Africa were most effectively curtailed by simultaneously implementing interventions that integrated community-based TB/HIV control strategies and targeted drug-resistant TB. Strengthening

  6. Using verbal autopsy to track epidemic dynamics: the case of HIV-related mortality in South Africa

    Directory of Open Access Journals (Sweden)

    Mee Paul

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA has often been used for point estimates of cause-specific mortality, but seldom to characterize long-term changes in epidemic patterns. Monitoring emerging causes of death involves practitioners' developing perceptions of diseases and demands consistent methods and practices. Here we retrospectively analyze HIV-related mortality in South Africa, using physician and modeled interpretation. Methods Between 1992 and 2005, 94% of 6,153 deaths which occurred in the Agincourt subdistrict had VAs completed, and coded by two physicians and the InterVA model. The physician causes of death were consolidated into a single consensus underlying cause per case, with an additional physician arbitrating where different diagnoses persisted. HIV-related mortality rates and proportions of deaths coded as HIV-related by individual physicians, physician consensus, and the InterVA model were compared over time. Results Approximately 20% of deaths were HIV-related, ranging from early low levels to tenfold-higher later population rates (2.5 per 1,000 person-years. Rates were higher among children under 5 years and adults 20 to 64 years. Adult mortality shifted to older ages as the epidemic progressed, with a noticeable number of HIV-related deaths in the over-65 year age group latterly. Early InterVA results suggested slightly higher initial HIV-related mortality than physician consensus found. Overall, physician consensus and InterVA results characterized the epidemic very similarly. Individual physicians showed marked interobserver variation, with consensus findings generally reflecting slightly lower proportions of HIV-related deaths. Aggregated findings for first versus second physician did not differ appreciably. Conclusions VA effectively detected a very significant epidemic of HIV-related mortality. Using either physicians or InterVA gave closely comparable findings regarding the epidemic. The consistency between two

  7. Using verbal autopsy to track epidemic dynamics: the case of HIV-related mortality in South Africa.

    Science.gov (United States)

    Byass, Peter; Kahn, Kathleen; Fottrell, Edward; Mee, Paul; Collinson, Mark A; Tollman, Stephen M

    2011-08-05

    Verbal autopsy (VA) has often been used for point estimates of cause-specific mortality, but seldom to characterize long-term changes in epidemic patterns. Monitoring emerging causes of death involves practitioners' developing perceptions of diseases and demands consistent methods and practices. Here we retrospectively analyze HIV-related mortality in South Africa, using physician and modeled interpretation. Between 1992 and 2005, 94% of 6,153 deaths which occurred in the Agincourt subdistrict had VAs completed, and coded by two physicians and the InterVA model. The physician causes of death were consolidated into a single consensus underlying cause per case, with an additional physician arbitrating where different diagnoses persisted. HIV-related mortality rates and proportions of deaths coded as HIV-related by individual physicians, physician consensus, and the InterVA model were compared over time. Approximately 20% of deaths were HIV-related, ranging from early low levels to tenfold-higher later population rates (2.5 per 1,000 person-years). Rates were higher among children under 5 years and adults 20 to 64 years. Adult mortality shifted to older ages as the epidemic progressed, with a noticeable number of HIV-related deaths in the over-65 year age group latterly. Early InterVA results suggested slightly higher initial HIV-related mortality than physician consensus found. Overall, physician consensus and InterVA results characterized the epidemic very similarly. Individual physicians showed marked interobserver variation, with consensus findings generally reflecting slightly lower proportions of HIV-related deaths. Aggregated findings for first versus second physician did not differ appreciably. VA effectively detected a very significant epidemic of HIV-related mortality. Using either physicians or InterVA gave closely comparable findings regarding the epidemic. The consistency between two physician coders per case (from a pool of 14) suggests that double

  8. Distribution of HIV-1 and HSV-2 epidemics in Chad revealing HSV-2 hot-spot in regions of high-risk HIV spread.

    Science.gov (United States)

    Charpentier, Charlotte; Koyalta, Donato; Ndinaromtan, Montana; Tchobkréo, Bagamla; Jenabian, Mohammad-Ali; Day, Nesrine; Si-Mohamed, Ali; Weiss, Helen; Bélec, Laurent

    2011-02-01

    Herpes Simplex Virus-2 (HSV-2) is known to be a potent co-factor of Human Immunodeficiency type 1 virus (HIV-1) heterosexual transmission. We were interested in assessing the distribution of HIV-1 and HSV-2 epidemics at the national level in Chad. In 2007, a population-based anonymous serosurvey for HIV-1 and HSV-2 infections, using dried blood spots, was conducted. The study included 548 adults living in 15 regions of Chad. After specimen elution, serological testing for HIV and HSV-2 infections was performed. Countrywide, the HIV-1 and HSV-2 seroprevalences were 11.1% and 15.7%, respectively. A positive correlation was observed with the highest HIV-1 prevalence seen in regions of the highest HSV-2 prevalence, especially in two conflict-affected eastern provinces of Darfur. Urgent public health interventions are needed in regions of Chad where high HSV-2 prevalence may be increasing the risk of HIV propagation.

  9. Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions.

    Science.gov (United States)

    Mishra, Sharmistha; Boily, Marie-Claude; Schwartz, Sheree; Beyrer, Chris; Blanchard, James F; Moses, Stephen; Castor, Delivette; Phaswana-Mafuya, Nancy; Vickerman, Peter; Drame, Fatou; Alary, Michel; Baral, Stefan D

    2016-08-01

    In the context of generalized human immunodeficiency virus (HIV) epidemics, there has been limited recent investment in HIV surveillance and prevention programming for key populations including female sex workers. Often implicit in the decision to limit investment in these epidemic settings are assumptions including that commercial sex is not significant to the sustained transmission of HIV, and HIV interventions designed to reach "all segments of society" will reach female sex workers and clients. Emerging empiric and model-based evidence is challenging these assumptions. This article highlights the frameworks and estimates used to characterize the role of sex work in HIV epidemics as well as the relevant empiric data landscape on sex work in generalized HIV epidemics and their strengths and limitations. Traditional approaches to estimate the contribution of sex work to HIV epidemics do not capture the potential for upstream and downstream sexual and vertical HIV transmission. Emerging approaches such as the transmission population attributable fraction from dynamic mathematical models can address this gap. To move forward, the HIV scientific community must begin by replacing assumptions about the epidemiology of generalized HIV epidemics with data and more appropriate methods of estimating the contribution of unprotected sex in the context of sex work. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Selecting HIV infection prevention interventions in the mature HIV epidemic in Malawi using the mode of transmission model

    Directory of Open Access Journals (Sweden)

    Maleta Kenneth

    2010-08-01

    Full Text Available Abstract Background Malawi is reassessing its HIV prevention strategy in the light of a limited reduction in the epidemic. No community based incidence studies have been carried out in Malawi, so estimates of where new infections are occurring require the use of mathematical models and knowledge of the size and sexual behaviour of different groups. The results can help to choose where HIV prevention interventions are most needed. Methods The UNAIDS Mode of Transmission model was populated with Malawi data and estimates of incident cases calculated for each exposure group. Scenarios of single and multiple interventions of varying success were used to identify those interventions most likely to reduce incident cases. Results The groups accounting for most new infections were the low-risk heterosexual group - the discordant couples (37% and those who had casual sex and their partners (a further 16% and 27% respectively of new cases. Circumcision, condoms with casual sex and bar girls and improved STI treatment had limited effect in reducing incident cases, while condom use with discordant couples, abstinence and a zero-grazing campaign had major effects. The combination of a successful strategy to eliminate multiple concurrent partners and a successful strategy to eliminate all infections between discordant couples would reduce incident cases by 99%. Conclusions A revitalised HIV prevention strategy will need to include interventions which tackle the two modes of transmission now found to be so important in Malawi - concurrency and discordancy.

  11. An HIV epidemic model based on viral load dynamics: value in assessing empirical trends in HIV virulence and community viral load.

    Directory of Open Access Journals (Sweden)

    Joshua T Herbeck

    2014-06-01

    Full Text Available Trends in HIV virulence have been monitored since the start of the AIDS pandemic, as studying HIV virulence informs our understanding of HIV epidemiology and pathogenesis. Here, we model changes in HIV virulence as a strictly evolutionary process, using set point viral load (SPVL as a proxy, to make inferences about empirical SPVL trends from longitudinal HIV cohorts. We develop an agent-based epidemic model based on HIV viral load dynamics. The model contains functions for viral load and transmission, SPVL and disease progression, viral load trajectories in multiple stages of infection, and the heritability of SPVL across transmissions. We find that HIV virulence evolves to an intermediate level that balances infectiousness with longer infected lifespans, resulting in an optimal SPVL∼4.75 log10 viral RNA copies/mL. Adaptive viral evolution may explain observed HIV virulence trends: our model produces SPVL trends with magnitudes that are broadly similar to empirical trends. With regard to variation among studies in empirical SPVL trends, results from our model suggest that variation may be explained by the specific epidemic context, e.g. the mean SPVL of the founding lineage or the age of the epidemic; or improvements in HIV screening and diagnosis that results in sampling biases. We also use our model to examine trends in community viral load, a population-level measure of HIV viral load that is thought to reflect a population's overall transmission potential. We find that community viral load evolves in association with SPVL, in the absence of prevention programs such as antiretroviral therapy, and that the mean community viral load is not necessarily a strong predictor of HIV incidence.

  12. HIV epidemic and human rights among men who have sex with men in sub-Saharan Africa: Implications for HIV prevention, care, and surveillance.

    Science.gov (United States)

    Abara, Winston E; Garba, Ibrahim

    2017-04-01

    Recent research has presented evidence that men who have sex with men (MSM) bear a disproportionate burden of HIV and are at increased risk for HIV in sub-Saharan Africa (SSA). However, many countries in SSA have failed to address the needs of MSM in national HIV/AIDS programmes. Furthermore, many MSM face structural barriers to HIV prevention and care, the most significant of which include laws that criminalise male-to-male sexual contact and facilitate stigma and discrimination. This in turn increases the vulnerability of MSM to acquiring HIV and presents barriers to HIV prevention, care, and surveillance. This relationship illustrates the link between human rights, social justice, and health outcomes and presents considerable challenges to addressing the HIV epidemic among MSM in SSA. The response to the HIV epidemic in SSA requires a non-discriminatory human rights approach to all at-risk groups, including MSM. Existing international human rights treaties, to which many SSA countries are signatories, and a 'health in all policies' approach provides a strong basis to reduce structural barriers to HIV prevention, care, surveillance, and research, and to ensure that all populations in SSA, including MSM, have access to the full range of rights that help ensure equal opportunities for health and wellness.

  13. "The need for circumcised men" : the quest for transformed masculinities in African Christianity in the context of the HIV epidemic

    NARCIS (Netherlands)

    van Klinken, A.S.|info:eu-repo/dai/nl/305523244

    2011-01-01

    In sub-Saharan Africa, among others as a result of the HIV epidemic hegemonic forms of masculinity are contested and the need to change men and to transform masculinities is widely acknowledged. This thesis investigates this development in the context of African Christianity, making use of

  14. Estimation and prediction of the HIV-AIDS-epidemic under conditions of HAART using mixtures of incubation time distributions

    NARCIS (Netherlands)

    Heisterkamp, S. H.; de Vries, R.; Sprenger, H. G.; Hubben, G. A. A.; Postma, M. J.

    2008-01-01

    The estimation of the HIV-AIDS epidemic by means of back-calculation (BC) has been difficult since the introduction of highly active anti-retroviral therapy (HAART) because the incubation time distributions needed for BC were poorly known. Moreover, it has been assumed that if the general public is

  15. An Assessment of the Policies and Programmes of Zimbabwe in Addressing the HIV/Aids Epidemic in the Education Sector

    Science.gov (United States)

    Rembe, Symphorosa

    2006-01-01

    This study assessed the policies, strategic plans and structures that have been put in place in Zimbabwe to address the HIV/AIDS epidemic in the education sector. It also examined the comprehensiveness of projects and programmes currently being implemented by the government in collaboration with partner organisations and NGOs. The findings show…

  16. Ending the HIV/AIDS epidemic in low- and middle-income countries by 2030: is it possible? [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Anthony D. Harries

    2016-09-01

    Full Text Available The international community has committed to ending the epidemics of HIV/AIDS, tuberculosis, malaria, and neglected tropical infections by 2030, and this bold stance deserves universal support. In this paper, we discuss whether this ambitious goal is achievable for HIV/AIDS and what is needed to further accelerate progress. The joint United Nations Program on HIV/AIDS (UNAIDS 90-90-90 targets and the related strategy are built upon currently available health technologies that can diagnose HIV infection and suppress viral replication in all people with HIV. Nonetheless, there is much work to be done in ensuring equitable access to these HIV services for key populations and those who remain outside the rims of the traditional health services. Identifying a cure and a preventive vaccine would further help accelerate progress in ending the epidemic. Other disease control programmes could learn from the response to the HIV/AIDS epidemic.

  17. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics.

    Science.gov (United States)

    Baral, Stefan; Logie, Carmen H; Grosso, Ashley; Wirtz, Andrea L; Beyrer, Chris

    2013-05-17

    Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These factors are representative of social, economic, organizational and political inequities. Associated with an improved understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages. Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is often far more actionable than characterizing individual-level risks. We propose a modified social ecological model (MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM. The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic studies has traditionally been on

  18. The HIV/AIDS epidemic among young people in China between 2005 and 2012: results of a spatial temporal analysis.

    Science.gov (United States)

    Zhang, X; Tang, W; Li, Y; Mahapatra, T; Feng, Y; Li, M; Chen, F; Li, P; Xing, J; Qian, S; Ge, L; Bu, K; Mahapatra, S; Tang, S; Wang, L; Wang, N

    2017-03-01

    Despite a recent increase in the HIV/AIDS epidemic among young people in China, youth-specific HIV data are limited. In total, 56 621 individuals with HIV/AIDS, aged 15-24 years, registered in the Case Reporting System of China between 2005 and 2012 and having complete spatial information were included in the present analysis. Spatial autocorrelation (general and local) and space-time scanning were performed using the ArcGIS 10.2 and SaTScan 9.3 software, respectively. During 2005-2012, the number of reported HIV/AIDS cases and the proportion of HIV cases increased while the proportion of AIDS cases decreased. Sexual contact became the predominant route of transmission in later years. Spatial analysis showed marked geographical variations in HIV infection among young people throughout China during 2005-2012. The number of new hotspots increased over time. They were mainly localized to southeastern coastal areas, southwestern frontier provinces or autonomous regions (of Guangxi, Yunnan and Sichuan) and Beijing municipality. Later these hotspots disappeared and new hotspots were found in the northeast of the country. Significant clusters of HIV-positive cases were identified in three different time periods, which indicated high HIV transmission among young Chinese people in the recent past. The risk of HIV infection was highest in the first cluster (2009-2012; this cluster was the largest in size) covering the provinces of Guizhou and Yunnan, the Chongqing municipality, Guangxi, and the province of Sichuan. The second cluster (2010-2012) was mostly located in Shanghai, South Jiangsu, Zhejiang and South Anhui, while the third cluster (2010-2012) was located in Beijing and Tianjin. Target-specific comprehensive behavioural interventions are urgently needed to contain the HIV epidemic among young people. © 2016 British HIV Association.

  19. Origin of the HIV-1 group O epidemic in western lowland gorillas

    Science.gov (United States)

    D’arc, Mirela; Ayouba, Ahidjo; Esteban, Amandine; Learn, Gerald H.; Boué, Vanina; Liegeois, Florian; Etienne, Lucie; Tagg, Nikki; Leendertz, Fabian H.; Boesch, Christophe; Madinda, Nadège F.; Robbins, Martha M.; Gray, Maryke; Cournil, Amandine; Ooms, Marcel; Letko, Michael; Simon, Viviana A.; Sharp, Paul M.; Hahn, Beatrice H.; Delaporte, Eric; Mpoudi Ngole, Eitel; Peeters, Martine

    2015-01-01

    HIV-1, the cause of AIDS, is composed of four phylogenetic lineages, groups M, N, O, and P, each of which resulted from an independent cross-species transmission event of simian immunodeficiency viruses (SIVs) infecting African apes. Although groups M and N have been traced to geographically distinct chimpanzee communities in southern Cameroon, the reservoirs of groups O and P remain unknown. Here, we screened fecal samples from western lowland (n = 2,611), eastern lowland (n = 103), and mountain (n = 218) gorillas for gorilla SIV (SIVgor) antibodies and nucleic acids. Despite testing wild troops throughout southern Cameroon (n = 14), northern Gabon (n = 16), the Democratic Republic of Congo (n = 2), and Uganda (n = 1), SIVgor was identified at only four sites in southern Cameroon, with prevalences ranging from 0.8–22%. Amplification of partial and full-length SIVgor sequences revealed extensive genetic diversity, but all SIVgor strains were derived from a single lineage within the chimpanzee SIV (SIVcpz) radiation. Two fully sequenced gorilla viruses from southwestern Cameroon were very closely related to, and likely represent the source population of, HIV-1 group P. Most of the genome of a third SIVgor strain, from central Cameroon, was very closely related to HIV-1 group O, again pointing to gorillas as the immediate source. Functional analyses identified the cytidine deaminase APOBEC3G as a barrier for chimpanzee-to-gorilla, but not gorilla-to-human, virus transmission. These data indicate that HIV-1 group O, which spreads epidemically in west central Africa and is estimated to have infected around 100,000 people, originated by cross-species transmission from western lowland gorillas. PMID:25733890

  20. A jumping profile Hidden Markov Model and applications to recombination sites in HIV and HCV genomes

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    Korber Bette

    2006-05-01

    Full Text Available Abstract Background Jumping alignments have recently been proposed as a strategy to search a given multiple sequence alignment A against a database. Instead of comparing a database sequence S to the multiple alignment or profile as a whole, S is compared and aligned to individual sequences from A. Within this alignment, S can jump between different sequences from A, so different parts of S can be aligned to different sequences from the input multiple alignment. This approach is particularly useful for dealing with recombination events. Results We developed a jumping profile Hidden Markov Model (jpHMM, a probabilistic generalization of the jumping-alignment approach. Given a partition of the aligned input sequence family into known sequence subtypes, our model can jump between states corresponding to these different subtypes, depending on which subtype is locally most similar to a database sequence. Jumps between different subtypes are indicative of intersubtype recombinations. We applied our method to a large set of genome sequences from human immunodeficiency virus (HIV and hepatitis C virus (HCV as well as to simulated recombined genome sequences. Conclusion Our results demonstrate that jumps in our jumping profile HMM often correspond to recombination breakpoints; our approach can therefore be used to detect recombinations in genomic sequences. The recombination breakpoints identified by jpHMM were found to be significantly more accurate than breakpoints defined by traditional methods based on comparing single representative sequences.

  1. The HIV epidemic in the Caribbean: meeting the challenges of achieving universal access to prevention, treatment and care.

    Science.gov (United States)

    Figueroa, J P

    2008-06-01

    The HIV prevalence in the Caribbean is estimated at 1.0% (0.9% - 2%) with 230,000 persons living with HIV/AIDS. HIV rates vary among countries with the Bahamas, Guyana, Haiti and Trinidad and Tobago having HIV rates of 2% or above while Cuba's rate is less than 0.2%. However throughout the Caribbean, HIV rates are significantly higher among those groups most at risk such as commercial sex workers, men who have sex with men and crack/cocaine users. The Caribbean Community (CARICOM) Heads of Governments declared AIDS to be a regional priority in 2001. The Pan Caribbean AIDS Partnership (PANCAP) was formed to lead the regional response to the HIV epidemic. National HIV Programmes have made definite progress in providing ARV treatment to persons with HIV/AIDS and reducing death rates due to AIDS, decreasing HIV mother-to-child transmission and providing a range ofHIVprevention programmes. However HIV stigma remains strong in the Caribbean and sexual and cultural practices put many youth, women and men at risk of HIV The Caribbean has set itself the goal of achieving universal access to HIV prevention, treatment and care. Several challenges need to be addressed. These include reducing HIV stigma, strengthening national responses, scaling-up better quality prevention programmes with greater involvement of vulnerable populations, more supportive HIV policies and wider access to ARV treatment with better adherence. In addition, there needs to be improved coordination among PANCAP partners at the regional level and within countries.

  2. Intersecting epidemics among pregnant women: alcohol use, interpersonal violence, and HIV infection in South Africa.

    Science.gov (United States)

    Russell, Beth S; Eaton, Lisa A; Petersen-Williams, Petal

    2013-03-01

    A critical factor for understanding negative health outcomes is acknowledging the synergistic quality that clusters of health problems create. An important step in addressing clusters of health problems involves gaining an awareness of the contextual factors that connect them. This paper considers the intersection of 3 mutually reinforcing health problems: alcohol use, interpersonal violence (IPV), and HIV infection among pregnant women residing in South Africa. We explore how SAVA (substance abuse, violence and AIDS) - a syndemics related theory - underscores the dire need to intervene in various areas of psycho-social health and general well-being. Based on World Health Organization data, we highlight the remarkably high rates of alcohol use, IPV, and HIV infection among South African women compared with women residing in other countries around the world. We conclude by highlighting the need for improved recognition of the intersection of these epidemics and for improved surveillance of the prevalence of alcohol use among pregnant women. Finally, based on the literature reviewed, we provide recommendations for future interventions.

  3. A simple model of HIV epidemic in Italy: The role of the antiretroviral treatment.

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    Papa, Federico; Binda, Francesca; Felici, Giovanni; Franzetti, Marco; Gandolfi, Alberto; Sinisgalli, Carmela; Balotta, Claudia

    2018-02-01

    In the present paper we propose a simple time-varying ODE model to describe the evolution of HIV epidemic in Italy. The model considers a single population of susceptibles, without distinction of high-risk groups within the general population, and accounts for the presence of immigration and emigration, modelling their effects on both the general demography and the dynamics of the infected subpopulations. To represent the intra-host disease progression, the untreated infected population is distributed over four compartments in cascade according to the CD4 counts. A further compartment is added to represent infected people under antiretroviral therapy. The per capita exit rate from treatment, due to voluntary interruption or failure of therapy, is assumed variable with time. The values of the model parameters not reported in the literature are assessed by fitting available epidemiological data over the decade 2003÷2012. Predictions until year 2025 are computed, enlightening the impact on the public health of the early initiation of the antiretroviral therapy. The benefits of this change in the treatment eligibility consist in reducing the HIV incidence rate, the rate of new AIDS cases, and the rate of death from AIDS. Analytical results about properties of the model in its time-invariant form are provided, in particular the global stability of the equilibrium points is established either in the absence and in the presence of infected among immigrants.

  4. Significant Reductions in Gag-Protease-Mediated HIV-1 Replication Capacity during the Course of the Epidemic in Japan

    Science.gov (United States)

    Nomura, Shigeru; Hosoya, Noriaki; Brumme, Zabrina L.; Brockman, Mark A.; Kikuchi, Tadashi; Koga, Michiko; Nakamura, Hitomi; Koibuchi, Tomohiko; Fujii, Takeshi; Carlson, Jonathan M.; Heckerman, David; Kawana-Tachikawa, Ai; Iwamoto, Aikichi

    2013-01-01

    Human immunodeficiency virus type 1 (HIV-1) evolves rapidly in response to host immune selection pressures. As a result, the functional properties of HIV-1 isolates from earlier in the epidemic may differ from those of isolates from later stages. However, few studies have investigated alterations in viral replication capacity (RC) over the epidemic. In the present study, we compare Gag-Protease-associated RC between early and late isolates in Japan (1994 to 2009). HIV-1 subtype B sequences from 156 antiretroviral-naïve Japanese with chronic asymptomatic infection were used to construct a chimeric NL4-3 strain encoding plasma-derived gag-protease. Viral replication capacity was examined by infecting a long terminal repeat-driven green fluorescent protein-reporter T cell line. We observed a reduction in the RC of chimeric NL4-3 over the epidemic, which remained significant after adjusting for the CD4+ T cell count and plasma virus load. The same outcome was seen when limiting the analysis to a single large cluster of related sequences, indicating that our results are not due to shifts in the molecular epidemiology of the epidemic in Japan. Moreover, the change in RC was independent of genetic distance between patient-derived sequences and wild-type NL4-3, thus ruling out potential temporal bias due to genetic similarity between patient and historic viral backbone sequences. Collectively, these data indicate that Gag-Protease-associated HIV-1 replication capacity has decreased over the epidemic in Japan. Larger studies from multiple geographical regions will be required to confirm this phenomenon. PMID:23152532

  5. [HIV/AIDS in South Africa and Haiti: the failure of epidemic governance and achievement of the MDGs].

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    Thelot, Fils-Lien Ely

    2009-01-01

    Since their adoption in 2000 by the United Nations, the Millennium Development Goals set for 2015 appear to have become a part of the policy agenda of all of the member states. Three of these eight objectives deal with health issues. "Combat HIV/AIDS, malaria and other diseases": this is the formulation of the sixth MDG. Observing that in many countries strongly affected by poverty and inequalities, the epidemic continues to spread, without really reversing at all, and that access to antiretrovirals is possible for only a small proportion of the patient who need them, we consider the problems of global governance in the field of health. Our intention is to explain that the failure to deal with the HIV/AIDS epidemic may constitute an obstacle to the achievement of the MDGs by 2015. Proposing a comprehensive sociology of HIV/AIDS, this article pays special attention to the dimension of the meaning of the disease, simultaneously as a policy issue, a social construction, and an object of study in the social sciences. Looking at the two countries most affected by the epidemic in Africa and in the Caribbean, we examine the different aspects that have determined the failure of governance and the effects of this failure on the populations concerned. The excessive conflictuality in South Africa and the biopolitics of "let them die" and the fragmentation of the networks involved in the combat in Haiti are considered to have contributed to a crisis in the epidemic's governance. In both cases, the consequences have been expressed by a reduced life expectancy, insufficient access to antiretroviral drugs, reinforcement of the socioeconomic inequalities of health, the production of new pockets of poverty, more fragile household and national economies, an increase in maternal and child mortality ... The failure of the governance of the HIV/AIDS epidemic in countries such as Haiti and South Africa appears to foretell the impossibility of achieving the MDGs by 2015.

  6. New evidence on the HIV epidemic in Libya: why countries must implement prevention programs among people who inject drugs.

    Science.gov (United States)

    Mirzoyan, Lusine; Berendes, Sima; Jeffery, Caroline; Thomson, Joanna; Ben Othman, Hussain; Danon, Leon; Turki, Abdullah A; Saffialden, Rabea; Valadez, Joseph J

    2013-04-15

    Libya had one of the world's largest nosocomial HIV outbreaks in the late 1990 s leading to the detention of 6 foreign medical workers. They were released in 2007 after the Libyan Government and the European Union agreed to humanitarian cooperation that included the development of Libya's first National HIV Strategy and the research reported in this article. Despite the absence of sound evidence on the status and dynamics of Libya's HIV epidemic, some officials posited that injecting drug use was the main mode of transmission. We therefore sought to assess HIV prevalence and related risk factors among people who inject drugs (PWID) in Tripoli. We conducted a cross-sectional survey among 328 PWID in Tripoli using respondent-driven sampling. We collected behavioral data and blood samples for HIV, hepatitis C virus, and hepatitis B virus testing. We estimate an HIV prevalence of 87%, hepatitis C virus prevalence of 94%, and hepatitis B virus prevalence of 5%. We detected injecting drug use-related and sexual risk factors in the context of poor access to comprehensive services for HIV prevention and mitigation. For example, most respondents (85%) reported having shared needles. In this first biobehavioral survey among PWID in Libya, we detected one of the highest (or even the highest) levels of HIV infection worldwide in the absence of a comprehensive harm-reduction program. There is an urgent need to implement an effective National HIV Strategy informed by the results of this research, especially because recent military events and related sociopolitical disruption and migration might lead to a further expansion of the epidemic.

  7. 'Taking care' in the age of AIDS: older rural South Africans' strategies for surviving the HIV epidemic.

    Science.gov (United States)

    Angotti, Nicole; Mojola, Sanyu A; Schatz, Enid; Williams, Jill R; Gómez-Olivé, F Xavier

    2017-07-25

    Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative environment in which they come to understand and make decisions about their health as they age in an HIV endemic setting. We analyse the dimensions of an inductively emerging theme: ku ti hlayisa (to take care of yourself). For older adults, 'taking care' in an age of AIDS represented: (1) an individualised pathway to achieving old-age respectability through the taking up of responsibilities and behaviours that characterise being an older person, (2) a set of gendered norms and strategies for reducing one's HIV risk, and (3) a shared responsibility for attenuating the impact of the HIV epidemic in the local community. Findings reflect the individual, interdependent and communal ways in which older rural South Africans understand HIV risk and prevention, ways that also map onto current epidemiological thinking for improving HIV-related outcomes in high-prevalence settings.

  8. Birth-death skyline plot reveals temporal changes of epidemic spread in HIV and hepatitis C virus (HCV).

    Science.gov (United States)

    Stadler, Tanja; Kühnert, Denise; Bonhoeffer, Sebastian; Drummond, Alexei J

    2013-01-02

    Phylogenetic trees can be used to infer the processes that generated them. Here, we introduce a model, the bayesian birth-death skyline plot, which explicitly estimates the rate of transmission, recovery, and sampling and thus allows inference of the effective reproductive number directly from genetic data. Our method allows these parameters to vary through time in a piecewise fashion and is implemented within the BEAST2 software framework. The method is a powerful alternative to the existing coalescent skyline plot, providing insight into the differing roles of incidence and prevalence in an epidemic. We apply this method to data from the United Kingdom HIV-1 epidemic and Egyptian hepatitis C virus (HCV) epidemic. The analysis reveals temporal changes of the effective reproductive number that highlight the effect of past public health interventions.

  9. The Emerging HIV Epidemic on the Mexico-US Border: An International Case Study Characterizing the Role of Epidemiology in Surveillance and Response

    Science.gov (United States)

    Strathdee, Steffanie A.; Magis-Rodriguez, Carlos; Mays, Vickie M.; Jimenez, Richard; Patterson, Thomas L.

    2012-01-01

    Purpose HIV/AIDS surveillance data are critical for monitoring epidemic trends, but can mask dynamic sub-epidemics, especially in vulnerable populations that under-utilize HIV testing. In this case study, we describe community-based epidemiologic data among injection drug users (IDU) and female sex workers (FSWs) in two northern Mexico-US Border States that identified an emerging HIV epidemic and generated a policy response. Methods We draw from quantitative and qualitative cross-sectional and prospective epidemiologic studies and behavioral intervention studies among IDUs and FSWs in Tijuana, Baja California and Ciudad Juarez, Chihuahua. Results Recognition that the HIV epidemic on Mexico’s northern border was already well established in subgroups where it had been presumed to be insignificant was met with calls for action and enhanced prevention efforts from researchers, NGOs and policy makers. Conclusions Successful policies and program outcomes included expansion of needle exchange programs, a nation-wide mobile HIV prevention program targeting marginalized populations, a successful funding bid from the Global Fund for HIV, TB and Malaria to scale up targeted HIV prevention programs and the establishment of binational training programs on prevention of HIV and substance use. We discuss how epidemiologic data informed HIV prevention policies and suggest how other countries may learn from Mexico’s experience. PMID:22626001

  10. From the Millennium Development Goals to Sustainable Development Goals.: The response to the HIV epidemic in Indonesia: challenges and opportunities.

    Science.gov (United States)

    Wijayanti, Fetty; Tarmizi, Siti Nadia; Tobing, Viny; Nisa, Tiara; Akhtar, Muhammad; Trihandini, Indang; Djuwita, Ratna

    2016-11-28

    Since the first case was reported in 1981, the Indonesian government and civil society have implemented many initiatives to respond to the HIV/AIDS epidemic. From an historical perspective, the country now has the means to rapidly diagnose cases of HIV infection and provide antiretroviral therapy. The concern expressed by international health agencies about a potential major HIV epidemic in the country has not been confirmed, as evidenced by a slowing down of the number cases. The threat from non-sterile needle sharing has been relatively well controlled through harm-reduction programmes; however, drug trafficking remains a challenge. It has reached worrying levels and involves law enforcement units at the forefront of the battle. In parallel, the level of condom use in high-risk behaviour groups seems unsuccessful in reducing infection rates, especially among heterosexuals. The lack of information and the high mobility of the groups at risk of acquiring HIV infection have created tremendous challenges for outreach programmes. Heterosexual transmission represents the most important route of transmission in the country. When reflecting on the country's 2014 Millennium Development Goals, condom use during high-risk sex only reaches 43.5%, and only 21.3% of young people have a comprehensive knowledge about HIV/AIDS. The 2030 Millennium Development Goal Agenda offers an opportunity to catch up on goals that still need to be achieved. Therefore, efforts are underway to try to halt the epidemic by 2030 and also to ensure that all high-risk populations are included in this effort.

  11. Sexual learning among East African adolescents in the context of generalized HIV epidemics: A systematic qualitative meta-synthesis.

    Science.gov (United States)

    Knopf, Amelia S; McNealy, Kim R; Al-Khattab, Halima; Carter-Harris, Lisa; Oruche, Ukamaka Marian; Naanyu, Violet; Draucker, Claire Burke

    2017-01-01

    AIDS-related illness is the leading cause of mortality for adolescents in sub-Saharan Africa. Together, Kenya, Tanzania, and Uganda account for 21% of HIV-infected adolescents in sub-Saharan Africa. The United Nations framework for addressing the epidemic among adolescents calls for comprehensive sexual and reproductive health education. These HIV prevention efforts could be informed by a synthesis of existing research about the formal and informal sexual education of adolescents in countries experiencing generalized epidemics. The purpose of this study was to describe the process of sexual learning among East African adolescents living in the context of generalized HIV epidemics. Qualitative metasynthesis, a systematic procedure for integrating the results of multiple qualitative studies addressing a similar phenomenon, was used. Thirty-two research reports met study inclusion criteria. The reports were assessed in a four-step analytic process: appraisal, classification of findings, synthesis of findings, and construction of a framework depicting the process of sexual learning in this population. The framework includes three phases of sexual learning: 1) being primed for sex, 2) making sense of sex, and 3) having sexual experiences. Adolescents were primed for sex through gender norms, cultural practices, and economic structures as well as through conversations and formal instruction. They made sense of sex by acquiring information about sexual intercourse, reproduction and pregnancy, sexually transmitted infections, and relationships and by developing a variety of beliefs and attitudes about these topics. Some adolescents described having sexual experiences that met wants or needs, but many experienced sex that was coerced or violent. Whether sex was wanted, coerced, or violent, adolescents experienced worry about sexually transmitted infections or premarital pregnancy. The three phases of sexual learning interact to shape adolescents' sexual lives and their risk

  12. Sexual learning among East African adolescents in the context of generalized HIV epidemics: A systematic qualitative meta-synthesis.

    Directory of Open Access Journals (Sweden)

    Amelia S Knopf

    Full Text Available AIDS-related illness is the leading cause of mortality for adolescents in sub-Saharan Africa. Together, Kenya, Tanzania, and Uganda account for 21% of HIV-infected adolescents in sub-Saharan Africa. The United Nations framework for addressing the epidemic among adolescents calls for comprehensive sexual and reproductive health education. These HIV prevention efforts could be informed by a synthesis of existing research about the formal and informal sexual education of adolescents in countries experiencing generalized epidemics. The purpose of this study was to describe the process of sexual learning among East African adolescents living in the context of generalized HIV epidemics.Qualitative metasynthesis, a systematic procedure for integrating the results of multiple qualitative studies addressing a similar phenomenon, was used. Thirty-two research reports met study inclusion criteria. The reports were assessed in a four-step analytic process: appraisal, classification of findings, synthesis of findings, and construction of a framework depicting the process of sexual learning in this population.The framework includes three phases of sexual learning: 1 being primed for sex, 2 making sense of sex, and 3 having sexual experiences. Adolescents were primed for sex through gender norms, cultural practices, and economic structures as well as through conversations and formal instruction. They made sense of sex by acquiring information about sexual intercourse, reproduction and pregnancy, sexually transmitted infections, and relationships and by developing a variety of beliefs and attitudes about these topics. Some adolescents described having sexual experiences that met wants or needs, but many experienced sex that was coerced or violent. Whether sex was wanted, coerced, or violent, adolescents experienced worry about sexually transmitted infections or premarital pregnancy.The three phases of sexual learning interact to shape adolescents' sexual lives

  13. Is the HIV epidemic stable among MSM in Mexico? HIV prevalence and risk behavior results from a nationally representative survey among men who have sex with men.

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    Sergio Bautista-Arredondo

    Full Text Available BACKGROUND: Recent evidence points to the apparent increase of HIV prevalence among men who have sex with men (MSM in different settings with concentrated epidemics, including the Latin American region. In 2011, Mexico implemented an ambitious HIV prevention program in all major cities, funded by the Global Fund to Fight Aids, Tuberculosis and Malaria. The program was intended to strengthen the prevention response for the most at risk populations: MSM and injecting drug users. This paper presents the HIV prevalence results of a nationally representative baseline survey in 24 Mexican cities throughout the 5 regions in the country and reports the socio-demographic and sexual risk behaviors that predict the probability of infection. METHODS: The survey was implemented in two phases. We first identified and characterized places where MSM gather in each city and then conducted in a second phase, a seroprevalence survey that included rapid HIV testing and a self-administered questionnaire. The prevalence of HIV was estimated by adjusting for positive predicted value. We applied a probit model to estimate the probability of having a positive result from the HIV test as a function of socio-demographic characteristics and self-reported sexual risk behaviors. RESULTS: We found an overall HIV prevalence among MSM gathering in meeting points of 16.9% [95% CI: 15.6-18.3], significantly higher than previously reported estimates. Our regression results suggest that the risk of infection increases with age, with the number of sexual partners, and among those who play a receptive sexual role, and the risk decreases with higher education. DISCUSSION: Our findings suggest a higher HIV prevalence among MSM than previously acknowledged and that a significant regional variability exist throughout the country. These two findings combined, signal an important dynamic in the epidemic that should be better understood and promptly addressed with strong prevention efforts

  14. IMPACT OF MIGRATION ON TUBERCULOSIS AND HIV EPIDEMIC SITUATION IN RUSSIA

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    O. B. Nechaeva

    2015-01-01

    Full Text Available The growing changes in migration and mobility of the population in Russia require additional study of the epidemic situation related to infectious diseases and evaluation of preparedness of specialized medical services and existing resources of the health care system. Assessment of the incidence rates shows the higher figures among foreign citizens compared to native population as regards tuberculosis (2013: 163.2 versus 61.6 per 100,000 population and lower figures for HIV-infection (107.5 versus 315.1 respectively.The study of behavioral risks of acquiring infectious diseases (HIV-infection, sexually transmitted diseases, tuberculosis and socio-economic living conditions and factors influencing on the self-referral to the Russian medical units conducted among labor migrants in St. Petersburg, showed fairly low level of awareness of socially important diseases and protection from infections in migrants. Due to the fear of deportation in case of detection of infectious diseases, high price of medical services and lack of motivation of the employer to pay for medical insurance, migrants often practice self-treatment. Very few migrants (10% present themselves for mandatory annual fluorography screening.A significant flow of refugees from Ukraine especially from the regions with high risk of infectious diseases require special attention from the Russian Ministry of Health and the relevant financial support.There is also a lack of cooperation between bodies of Rospotrebnadzor and medical units submitting data on notifications of HIV-infection and tuberculosis in foreign citizens. Coordination mechanisms have to be improved to overcome the found deficiencies. 

  15. Sexual risk factors for HIV infection in early and advanced HIV epidemics in sub-Saharan Africa: systematic overview of 68 epidemiological studies.

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    Li Chen

    2007-10-01

    Full Text Available It is commonly assumed that sexual risk factors for heterosexual HIV transmission in sub-Saharan Africa, such as multi-partner sex, paid sex and co-infections, become less important as HIV epidemics mature and prevalence increases.We conducted a systematic review of 68 African epidemiological studies from 1986 to 2006 involving 17,000 HIV positive adults and 73,000 controls. We used random-effects methods and stratified results by gender, time, background HIV prevalence rates and other variables. The number of sex partners, history of paid sex, and infection with herpes simplex virus (HSV-2 or other sexually-transmitted infections (STIs each showed significant associations with HIV infection. Among the general population, the odds ratio (OR of HIV infection for women reporting 3+ sex partners versus 0-2 was 3.64 (95%CI [2.87-4.62], with similar risks for men. About 9% of infected women reported ever having been paid for sex, versus 4% of control women (OR = 2.29, [1.45-3.62]. About 31% of infected men reported ever paying for sex versus 18% of uninfected men (OR = 1.75, [1.30-2.36]. HSV-2 infection carried the largest risk of HIV infection: OR = 4.62, [2.85-7.47] in women, and OR = 6.97, [4.68-10.38] in men. These risks changed little over time and stratification by lower and higher HIV background prevalence showed that risk ratios for most variables were larger in high prevalence settings. Among uninfected controls, the male-female differences in the number of sex partners and in paid sex were more extreme in the higher HIV prevalence settings than in the lower prevalence settings.Multi-partner sex, paid sex, STIs and HSV-2 infection are as important to HIV transmission in advanced as in early HIV epidemics. Even in high prevalence settings, prevention among people with high rates of partner change, such as female sex workers and their male clients, is likely to reduce transmission overall.

  16. Theorizing "Big Events" as a potential risk environment for drug use, drug-related harm and HIV epidemic outbreaks.

    Science.gov (United States)

    Friedman, Samuel R; Rossi, Diana; Braine, Naomi

    2009-05-01

    Political-economic transitions in the Soviet Union, Indonesia, and China, but not the Philippines, were followed by HIV epidemics among drug users. Wars also may sometimes increase HIV risk. Based on similarities in some of the causal pathways through which wars and transitions can affect HIV risk, we use the term "Big Events" to include both. We first critique several prior epidemiological models of Big Events as inadequately incorporating social agency and as somewhat imprecise and over-generalizing in their sociology. We then suggest a model using the following concepts: first, event-specific HIV transmission probabilities are functions of (a) the probability that partners are infection-discordant; (b) the infection-susceptibility of the uninfected partner; (c) the infectivity of the infected--as well as (d) the behaviours engaged in. These probabilities depend on the distributions of HIV and other variables in populations. Sexual or injection events incorporate risk behaviours and are embedded in sexual and injection partnership patterns and community networks, which in turn are shaped by the content of normative regulation in communities. Wars and transitions can change socio-economic variables that can sometimes precipitate increases in the numbers of people who engage in high-risk drug and sexual networks and behaviours and in the riskiness of what they do. These variables that Big Events affect may include population displacement; economic difficulties and policies; police corruption, repressiveness, and failure to preserve order; health services; migration; social movements; gender roles; and inter-communal violence--which, in turn, affect normative regulation, youth alienation, networks and behaviours. As part of these pathways, autonomous action by neighbourhood residents, teenagers, drug users and sex workers to maintain their economic welfare, health or happiness may affect many of these variables or otherwise mediate whether HIV epidemics follow

  17. The EuroSIDA study: Regional differences in the HIV-1 epidemic and treatment response to antiretroviral therapy among HIV-infected patients across Europe--a review of published results

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Bannister, Wendy; Mocroft, Amanda

    2008-01-01

    EuroSIDA is a pan-European observational study that follows 14,265 HIV-infected patients from 31 European countries, Israel and Argentina, of which 2,560 are patients from eastern Europe (EE). The study group has performed several analyses addressing regional differences in the HIV-epidemic across...

  18. What do young adults know about the HIV/AIDS epidemic? Findings from a population based study in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Johansson Eva

    2009-03-01

    Full Text Available Abstract Background HIVAIDS is spreading globally, hitting the younger generations. In Pakistan, the prevalence of HIV in high-risk subpopulations is five per cent or higher. This poses a serious threat of a generalised epidemic especially among the younger population. In the wake of HIVAIDS epidemic this is worrying as a well informed younger generation is crucial in restricting the spread of this epidemic. This study investigated Pakistani young adults' (male and female knowledge and awareness of the HIV/AIDS disease. Methods A population-based, cross-sectional study of 1,650 male and female adults aged 17–21 years living in Karachi was conducted using a structured questionnaire. A multi-stage cluster sampling design was used to collect data representative of the general population in an urban area. Bivariate and multivariate analyses were performed separately for males and females. Results Of 1,650 subjects, 24 per cent (n = 390 reported that they had not heard of HIV/AIDS. Among the males, those with a poor knowledge were younger (AOR = 2.20; 95 per cent CI, 1.38, 3.49, with less than six years of schooling (AOR = 2.46; 1.29 4.68 and no computer at home (AOR = 1.88; 1.06 3.34. Among the females, the risk factors for poor knowledge were young age (AOR = 1.74; 1.22, 2.50, low socio-economic status (AOR = 1.54; 1.06, 2.22, lack of enrolment at school/college (AOR = 1.61; 1.09, 2.39 and being unmarried (AOR = 1.85; 1.05, 3.26. Conclusion Alarming gaps in knowledge relating to HIV/AIDS were detected. The study emphasises the need to educate young adults and equip them with the appropriate information and skills to enable them to protect themselves from HIV/AIDS. However, taboos surrounding public discussions of sexuality remain a key constraint to preventive activities.

  19. Delaying sexual debut as a strategy for reducing HIV epidemic in ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    . *For correspondence: Email: oonsomu@gmail.com; Tel. #: 336-750-2279. Abstract. The study purpose was to determine the association between sexual debut and HIV sero-status, and factors contributing to a positive HIV sero-status.

  20. HIV/AIDS: epidemic update, new treatment strategies and impact on autoimmunity

    National Research Council Canada - National Science Library

    Croce, F; Piconi, S; Atzeni, F; Sarzi-Puttini, P; Galli, M; Clerici, M

    2008-01-01

    .... Highly active antiretroviral treatment (HAART) introduction has dramatically changed the mortality and morbidity of HIV-affected subjects in industrialized countries but has implied an evolution of many HIV-related aspects, both in the...

  1. Performance of the Liaison XL Murex HIV Ab/Ag Test on Clinical Samples Representing Current Epidemic HIV Variants

    OpenAIRE

    Lemee, Véronique; Leoz, Marie; Etienne, Manuel; De Oliveira, Fabienne; Plantier, Jean-Christophe

    2014-01-01

    Screening for HIV infection has improved since the first immunoassays. Today, diagnosis of HIV infection can be performed with fourth-generation tests that track both the patient's antibodies and HIV antigen. The objective of this study was to evaluate the clinical sensitivity and specificity of the new DiaSorin Liaison XL Murex HIV Ab/Ag assay compared to another fourth-generation assay, the Abbott Architect HIV Ag/Ab Combo kit. This work was performed on a large panel of 900 samples, includ...

  2. Population mobility and the changing epidemics of HIV-2 in Portugal

    DEFF Research Database (Denmark)

    Carvalho, A C; Valadas, E; França, L

    2012-01-01

    Portugal is the European country with the highest frequency of HIV-2 infection, which is mainly concentrated in West Africa. The cumulative number of notified HIV-2 infections in Portugal was 1813 by the end of December 2008. To better characterize the dynamics of HIV-2 infection in the country a...

  3. The hepatitis C epidemic among HIV-positive MSM: incidence estimates from 1990 to 2007

    NARCIS (Netherlands)

    van der Helm, Jannie J.; Prins, Maria; del Amo, Julia; Bucher, Heiner C.; Chêne, Geneviève; Dorrucci, Maria; Gill, John; Hamouda, Osamah; Sannes, Mette; Porter, Kholoud; Geskus, Ronald B.; Meyer, Laurence; Pillay, Deenan; Rosinska, Magda; Sabin, Caroline; Touloumi, Giota; Lodi, Sara; Coughlin, Kate; Walker, Sarah; Babiker, Abdel; de Luca, Andrea; Fisher, Martin; Muga, Roberto; Zangerle, Robert; Kelleher, Tony; Ramacciotti, Tim; Gelgor, Linda; Cooper, David; Smith, Don; Bruun Jørgensen, Louise; Nielsen, Claus; Pedersen, Court; Lutsar, Irja; Dabis, Francois; Thiebaut, Rodolphe; Masquelier, Bernard; Costagliola, Dominique; Guiguet, Marguerite; Vanhems, Philippe; Chaix, Marie-Laure; Ghosn, Jade; Boufassa, Faroudy; Kücherer, Claudia; Bartmeyer, Barbara; Pantazis, Nikos; Hatzakis, Angelos; Paraskevis, Dimitrios; Karafoulidou, Anastasia; Rezza, Giovanni; Balotta, Claudia; D'Arminio Monforte, Antonella; Cozzi-Lepri, Alessandro; Schuitemaker, Hanneke; Brubakk, Oddbjorn; Kran, Anne-Marte B.; Rosinska, Magdalena; Tor, Jordi; de Olalla, Patricia G.; Cayla, Joan; del Romero, Jorge; Pérez-Hoyos, Santiago; Rickenbach, Martin; Francioli, Patrick; Malyuta, Ruslan; Brettle, Ray; Murphy, Gary; Johnson, Anne; Phillips, Andrew; Delpech, Valerie; Jaffe, Harold; Morrison, Charles; Salata, Robert; Mugerwa, Roy; Chipato, Tsungai; Amornkul, Pauli

    2011-01-01

    Outbreaks of acute hepatitis C virus (HCV) infection among HIV-infected MSM have been described since 2000. However, phylogenetic analysis suggests that the spread of HCV started around 1996. We estimated the incidence of HCV in HIV-infected MSM with well estimated dates of HIV seroconversion from

  4. The Impact of Antiretroviral Therapy on the HIV Epidemic in South Africa

    NARCIS (Netherlands)

    J.A.C. Hontelez (Jan)

    2013-01-01

    textabstractThe Human Immunodeficiency Virus (HIV) is the cause of Acquired Immune Deficiency Syndrome (AIDS), a lethal disease characterized by the destruction of the immune system. At the end of 2010, there were about 34 million people infected with HIV worldwide. The epicenter of the HIV pandemic

  5. HIV-infection and psychiatric illnesses - A double edged sword that threatens the vision of a contained epidemic: The Greater Stockholm HIV Cohort Study.

    Science.gov (United States)

    Jallow, Amadou; Ljunggren, Gunnar; Wändell, Per; Wahlström, Lars; Carlsson, Axel C

    2017-01-01

    The Greater Stockholm HIV Cohort Study is an initiative to provide longitudinal information regarding the health of people living with HIV. Our aim was to explore the prevalence of HIV and its association with psychiatric co-morbidities. All patients with a recorded diagnosis of HIV (any position of the ICD-10 codes B20-B24) were identified during the period 2007-2014 and related to the total population in Stockholm by January 1, 2015, N = 2.21 million. The age at diagnosis, gender, and first occurrence of an HIV diagnosis was recorded. Analyses were done by age and gender. Prevalence of psychiatric co-morbidities amongst HIV patients were recorded. Age-adjusted odds ratios with 95% confidence intervals were calculated with logistic regression for prevalent psychiatric co-morbidities in HIV infected individuals compared to the prevalence in the general population. The total prevalence of HIV was 0.16%; females 0.10% (n = 1134) and males 0.21% (n = 2448). HIV-infected people were more frequently diagnosed with psychiatric illnesses and drug abuse. In females and males with HIV-diagnosis respectively, drug dependence disorder was 7.5 (7.76% vs 1.04%) and 5.1 (10.17% vs 1.98%) times higher, psychotic disorders were 6.3 (2.65% vs 0.42%) and 2.9 (1.43% vs 0.49%) times higher, bipolar disorder was 2.5 (1.41% vs 0.57%) and 3 (1.02% vs 0.34%) times higher, depression diagnosis was 1.5 (8.47% vs 5.82%) and 3.4 (10.17% vs 2.97%) higher, trauma-related disorder was 1.5 (6.00% vs 4.10%) respectively 2.9 (4.45% vs 1.56%) times higher, anxiety disorder was 1.2 (6.88% vs 5.72%) and 2.2 (6.54% vs 2.93%) times higher than in their non-infected peers. Despite effective ART, many individuals with HIV have an impaired mental health and a history of drug abuse that may threaten the vision of a contained epidemic. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  6. Targeting HIV services to male migrant workers in southern Africa would not reverse generalized HIV epidemics in their home communities: a mathematical modeling analysis.

    Science.gov (United States)

    Klein, Daniel J; Eckhoff, Philip A; Bershteyn, Anna

    2015-03-01

    Migrant populations such as mine workers contributed to the spread of HIV in sub-Saharan Africa. We used a mathematical model to estimate the community-wide impact of targeting treatment and prevention to male migrants. We augmented an individual-based network model, EMOD-HIV v0.8, to include an age-dependent propensity for males to migrate. Migrants were exposed to HIV outside their home community, but continued to participate in HIV transmission in the community during periodic visits. Migrant-targeted interventions would have been transformative in the 1980s to 1990s, but post-2015 impacts were more modest. When targetable migrants comprised 2% of adult males, workplace HIV prevention averted 3.5% of community-wide infections over 20 years. Targeted treatment averted 8.5% of all-cause deaths among migrants. When migrants comprised 10% of males, workplace prevention averted 16.2% of infections in the community, one-quarter of which were among migrants. Workplace prevention and treatment acted synergistically, averting 17.1% of community infections and 11.6% of deaths among migrants. These estimates do not include prevention of secondary spread of HIV or tuberculosis at the workplace. Though cost-effective, targeting migrants cannot collapse generalized epidemics in their home communities. Such a strategy would only have been possible prior to the early 1990s. However, migrant-targeted interventions synergize with general-population expansion of HIV services. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  7. Performance of the Liaison XL Murex HIV Ab/Ag test on clinical samples representing current epidemic HIV variants.

    Science.gov (United States)

    Lemee, Véronique; Leoz, Marie; Etienne, Manuel; De Oliveira, Fabienne; Plantier, Jean-Christophe

    2014-09-01

    Screening for HIV infection has improved since the first immunoassays. Today, diagnosis of HIV infection can be performed with fourth-generation tests that track both the patient's antibodies and HIV antigen. The objective of this study was to evaluate the clinical sensitivity and specificity of the new DiaSorin Liaison XL Murex HIV Ab/Ag assay compared to another fourth-generation assay, the Abbott Architect HIV Ag/Ab Combo kit. This work was performed on a large panel of 900 samples, including negative samples (n = 493) and HIV-positive (n = 407) representatives of HIV-1 group M subtypes and circulating recombinant forms (CRFs), HIV-1 group O, and HIV-2 variants. The results highlight the high specificity (98.9%) and sensitivity (100%) of this new fourth-generation assay, which are consistent with its use for the screening and diagnosis of HIV infections with the current circulating strains. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  8. Brief behavioural surveys in routine HIV sentinel surveillance: a new tool for monitoring the HIV epidemic in Viet Nam

    Directory of Open Access Journals (Sweden)

    Duong Cong Thanh

    2015-01-01

    Full Text Available In this report we describe a new approach in HIV sentinel surveillance that was piloted in Viet Nam in 2009 and is currently being rolled out in all provinces. It comprises a brief behavioural questionnaire added to the HIV sentinel surveillance surveys conducted routinely among people who inject drugs, female sex workers and men who have sex with men. Timely reporting of data from this system has resulted in improvements to HIV prevention efforts for most at-risk populations.

  9. HIV/AIDS among inmates of and releasees from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity.

    Directory of Open Access Journals (Sweden)

    Anne C Spaulding

    2009-11-01

    Full Text Available Because certain groups at high risk for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome come together in correctional facilities, seroprevalence was high early in the epidemic. The share of the HIV/AIDS epidemic borne by inmates of and persons released from jails and prisons in the United States (US in 1997 was estimated in a previous paper. While the number of inmates and releasees has risen, their HIV seroprevalence rates have fallen. We sought to determine if the share of HIV/AIDS borne by inmates and releasees in the US decreased between 1997 and 2006. We created a new model of population flow in and out of correctional facilities to estimate the number of persons released in 1997 and 2006. In 1997, approximately one in five of all HIV-infected Americans was among the 7.3 million who left a correctional facility that year. Nine years later, only one in seven (14% of infected Americans was among the 9.1 million leaving, a 29.3% decline in the share. For black and Hispanic males, two demographic groups with heightened incarceration rates, recently released inmates comprise roughly one in five of those groups' total HIV-infected persons, a figure similar to the proportion borne by the correctional population as a whole in 1997. Decreasing HIV seroprevalence among those admitted to jails and prisons, prolonged survival and aging of the US population with HIV/AIDS beyond the crime-prone years, and success with discharge planning programs targeting HIV-infected prisoners could explain the declining concentration of the epidemic among correctional populations. Meanwhile, the number of persons with HIV/AIDS leaving correctional facilities remains virtually identical. Jails and prisons continue to be potent targets for public health interventions. The fluid nature of incarcerated populations ensures that effective interventions will be felt not only in correctional facilities but also in communities to which releasees return.

  10. HIV/AIDS among inmates of and releasees from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity.

    Science.gov (United States)

    Spaulding, Anne C; Seals, Ryan M; Page, Matthew J; Brzozowski, Amanda K; Rhodes, William; Hammett, Theodore M

    2009-11-11

    Because certain groups at high risk for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) come together in correctional facilities, seroprevalence was high early in the epidemic. The share of the HIV/AIDS epidemic borne by inmates of and persons released from jails and prisons in the United States (US) in 1997 was estimated in a previous paper. While the number of inmates and releasees has risen, their HIV seroprevalence rates have fallen. We sought to determine if the share of HIV/AIDS borne by inmates and releasees in the US decreased between 1997 and 2006. We created a new model of population flow in and out of correctional facilities to estimate the number of persons released in 1997 and 2006. In 1997, approximately one in five of all HIV-infected Americans was among the 7.3 million who left a correctional facility that year. Nine years later, only one in seven (14%) of infected Americans was among the 9.1 million leaving, a 29.3% decline in the share. For black and Hispanic males, two demographic groups with heightened incarceration rates, recently released inmates comprise roughly one in five of those groups' total HIV-infected persons, a figure similar to the proportion borne by the correctional population as a whole in 1997. Decreasing HIV seroprevalence among those admitted to jails and prisons, prolonged survival and aging of the US population with HIV/AIDS beyond the crime-prone years, and success with discharge planning programs targeting HIV-infected prisoners could explain the declining concentration of the epidemic among correctional populations. Meanwhile, the number of persons with HIV/AIDS leaving correctional facilities remains virtually identical. Jails and prisons continue to be potent targets for public health interventions. The fluid nature of incarcerated populations ensures that effective interventions will be felt not only in correctional facilities but also in communities to which releasees return.

  11. Assessing the HIV-1 Epidemic in Brazilian Drug Users: A Molecular Epidemiology Approach.

    Directory of Open Access Journals (Sweden)

    Monick Lindenmeyer Guimarães

    Full Text Available Person who inject illicit substances have an important role in HIV-1 blood and sexual transmission and together with person who uses heavy non-injecting drugs may have less than optimal adherence to anti-retroviral treatment and eventually could transmit resistant HIV variants. Unfortunately, molecular biology data on such key population remain fragmentary in most low and middle-income countries. The aim of the present study was to assess HIV infection rates, evaluate HIV-1 genetic diversity, drug resistance, and to identify HIV transmission clusters in heavy drug users (DUs. For this purpose, DUs were recruited in the context of a Respondent-Driven Sampling (RDS study in different Brazilian cities during 2009. Overall, 2,812 individuals were tested for HIV, and 168 (6% of them were positive, of which 19 (11.3% were classified as recent seroconverters, corresponding to an estimated incidence rate of 1.58%/year (95% CI 0.92-2.43%. Neighbor joining phylogenetic trees from env and pol regions and bootscan analyses were employed to subtype the virus from132 HIV-1-infected individuals. HIV-1 subtype B was prevalent in most of the cities under analysis, followed by BF recombinants (9%-35%. HIV-1 subtype C was the most prevalent in Curitiba (46% and Itajaí (86% and was also detected in Brasília (9% and Campo Grande (20%. Pure HIV-1F infections were detected in Rio de Janeiro (9%, Recife (6%, Salvador (6% and Brasília (9%. Clusters of HIV transmission were assessed by Maximum likelihood analyses and were cross-compared with the RDS network structure. Drug resistance mutations were verified in 12.2% of DUs. Our findings reinforce the importance of the permanent HIV-1 surveillance in distinct Brazilian cities due to viral resistance and increasing subtype heterogeneity all over Brazil, with relevant implications in terms of treatment monitoring, prophylaxis and vaccine development.

  12. Practice points: Corporate response to the HIV/AIDS epidemic in ...

    African Journals Online (AJOL)

    In Uganda, while significant progress has been made by the government over the past decade in bringing down the rate of new infections, the HIV/AIDS ... or at least delay of HIV/AIDS related consequences such as: frequent absences from work, erosion of company skills and knowledge through key employee deaths, and ...

  13. Has the HIV epidemic in rural Mwanza, Tanzania reached a plateau ...

    African Journals Online (AJOL)

    Data from studies in Mwanza Region in Tanzania suggest stabilising HIV prevalence. The objective was to determine the factors that may have contributed to the relatively stable pattern of the HIV prevalence observed in the comparison communities of the Mwanza STD treatment trial in rural Mwanza Region, Tanzania ...

  14. HIV epidemic drivers in South Africa: A model-based evaluation of ...

    African Journals Online (AJOL)

    Background: HIV prevalence differs substantially between South Africa's provinces, but the factors accounting for this difference are poorly understood. Objectives: To estimate HIV prevalence and incidence trends by province, and to identify the epidemiological factors that account for most of the variation between provinces ...

  15. Modelling HIV/AIDS Epidemic among Men Who Have Sex with Men in China

    Directory of Open Access Journals (Sweden)

    Xiaodan Sun

    2013-01-01

    a higher transmission rate and a lower diagnose rate among MSM than those for another high-risk population. We compared the current treatment policy and immediate therapy once people are diagnosed with HIV, and numerical studies indicated that immediate antiviral therapy would lead to few HIV new infections conditional upon relatively low infectiousness; otherwise the current treatment policy would result in low HIV new infection. Further, increasing treatment coverage rate may lead to decline in HIV new infections and be beneficial to disease control, depending on the infectiousness of the infected individuals with antiviral therapy. The finding suggested that treatment efficacy (directly affecting infectiousness, behavior changes, and interventions greatly affect HIV new infection; strengthening intensity will contribute to the disease control.

  16. Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa.

    Directory of Open Access Journals (Sweden)

    Alastair Heffernan

    Full Text Available Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3% of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness.

  17. Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic

    Directory of Open Access Journals (Sweden)

    Vance D

    2011-05-01

    Full Text Available David E Vance1, Mark Brennan2, Comfort Enah1, Glenda L Smith1, Jaspreet Kaur31School of Nursing, University of Alabama at Birmingham (UAB, Birmingham, AL, USA; 2New York University College of Nursing, AIDS Community Research Initiative of America, New York, NY, USA; 3Department of Psychology and Edward R. Roybal Center for Translational Research in Aging and Mobility, University of Alabama at Birmingham (UAB, Birmingham, AL, USAAbstract: By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.Keywords: HIV, aging, spirituality, religion, stigma, coping, successful aging

  18. HIV Infection in Migrant Populations in the European Union and European Economic Area in 2007-2012: An Epidemic on the Move.

    Science.gov (United States)

    Hernando, Victoria; Alvárez-del Arco, Débora; Alejos, Belén; Monge, Susana; Amato-Gauci, Andrew J; Noori, Teymur; Pharris, Anastasia; del Amo, Julia

    2015-10-01

    Migrants are considered a key group at risk for HIV infection. This study describes the epidemiology of HIV and the distribution of late HIV presentation among migrants within the European Union/European Economic Area during 2007-2012. HIV cases reported to European Surveillance System (TESSy) were analyzed. Migrants were defined as people whose geographical origin was different than the reporting country. Multiple logistic regression was used to model late HIV presentation. Overall, 156,817 HIV cases were reported, of which 60,446 (38%) were migrants. Of these, 53% were from Sub-Saharan Africa, 12% from Latin America, 9% from Western Europe, 7% from Central Europe, 5% from South and Southeast Asia, 4% from East Europe, 4% from Caribbean, and 3% from North Africa and Middle East. Male and female migrants from Sub-Saharan Africa and Latin America had higher odds of late HIV presentation than native men and women. Migrants accounted for 40% of all HIV notifications in 2007 versus 35% in 2012. HIV cases in women from Sub-Saharan Africa decreased from 3725 in 2007 to 2354 in 2012. The number of HIV cases from Latin America peaked in 2010 to decrease thereafter. HIV diagnoses in migrant men who have sex with men increased from 1927 in 2007 to 2459 in 2012. Migrants represent two-fifths of the HIV cases reported and had higher late HIV presentation. HIV epidemic in migrant populations in European Union/European Economic Area member states is changing, probably reflecting the global changes in the HIV pandemic, the impact of large-scale ART implementation, and migration fluctuations secondary to the economic crisis in Europe.

  19. HIV epidemic drivers in South Africa: A model-based evaluation of ...

    African Journals Online (AJOL)

    Southern African Journal of HIV Medicine. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 18, No 1 (2017) >. Log in or Register to get access to full text downloads.

  20. The Prevalence of HIV/AIDS Epidemic in Anambra State, Nigeria ...

    African Journals Online (AJOL)

    /AID prevalence in Anambra State, Nigeria. Since the discovery of Human Immune Deficiency Virus (HIV) over three decades ago, it has plundered the global populations with impunity, resulting in the death of millions of people.

  1. What's to be done? Report on a bosberaad to discuss the HIV epidemic in South Africa

    CSIR Research Space (South Africa)

    Williams, BG

    2000-06-01

    Full Text Available Demographic forecasting models of the South African population, incorporating geographical distribution and age prevalence data on HIV infection, have been used to predict future mortality due to AIDS. In year 2010, approximately 500 000 AIDS...

  2. FISHing Out the Hidden Enemy: Advances in Detecting and Measuring Latent HIV-Infected Cells.

    Science.gov (United States)

    Prasad, Vinayaka R; Kalpana, Ganjam V

    2017-09-19

    The indomitable aspect of HIV-1 infection is not that HIV-1 proviral DNA is integrated into host DNA but that it can also turn itself off, remaining invisible to drug or immune surveillance. Thus, the goals of eradication include ways to precisely excise HIV-1 DNA or wake up the silent HIV-1 provirus and eliminate the infected cells thus identified. Methods to identify and fish out the latently infected cells or to delineate their characteristics are being rapidly developed. In 2016, Baxter et al. (A. E. Baxter, J. Niessl, R. Fromentin, J. Richard, F. Porichis, R. Charlebois, M. Massanella, N. Brassard, N. Alsahafi, G. G. Delgado, J. P. Routy, B. D. Walker, A. Finzi, N. Chomont, and D. E. Kaufmann, Cell Host Microbe 20:368-380, 2016, https://doi.org/10.1016/j.chom.2016.07.015) and Martrus et al. (G. Martrus, A. Niehrs, R. Cornelis, A. Rechtien, W. García-Beltran, M. Lütgehetmann, C. Hoffmann, and M. Altfeld, J Virol 90:9018-9028, 2016, https://doi.org/10.1128/JVI.01448-16) reported using the fluorescence in situ hybridization-flow cytometry technique to identify and quantify cells expressing HIV-1 RNA and Gag protein, as well as bearing unique cell surface markers. In a recent article in mBio , Grau-Expósito et al. (J. Grau-Expósito, C. Serra-Peinado, L. Miguel, J. Navarro, A. Curran, J. Burgos, I. Ocaña, E. Ribera, A. Torrella, B. Planas, R. Badía, J. Castellví, V. Falcó, M. Crespo, and M. J. Buzon, mBio 8:e00876-17, 2017, https://doi.org/10.1128/mBio.00876-17) reported a similar method that they claim to be more sensitive. With these methods, researchers are one step closer to measuring latent reservoirs and eliminating critical barriers to HIV eradication. Copyright © 2017 Prasad and Kalpana.

  3. Engineering behaviour change in an epidemic: the epistemology of NIH-funded HIV prevention science.

    Science.gov (United States)

    Green, Adam; Kolar, Kat

    2015-05-01

    Social scientific and public health literature on National Institutes of Health-funded HIV behavioural prevention science often assumes that this body of work has a strong biomedical epistemological orientation. We explore this assumption by conducting a systematic content analysis of all NIH-funded HIV behavioural prevention grants for men who have sex with men between 1989 and 2012. We find that while intervention research strongly favours a biomedical orientation, research into the antecedents of HIV risk practices favours a sociological, interpretive and structural orientation. Thus, with respect to NIH-funded HIV prevention science, there exists a major disjunct in the guiding epistemological orientations of how scientists understand HIV risk, on the one hand, and how they engineer behaviour change in behavioural interventions, on the other. Building on the extant literature, we suggest that the cause of this disjunct is probably attributable not to an NIH-wide positivist orientation, but to the specific standards of evidence used to adjudicate HIV intervention grant awards, including randomised controlled trials and other quantitative measures of intervention efficacy. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  4. Profile of the HIV epidemic in Cape Verde: molecular epidemiology and drug resistance mutations among HIV-1 and HIV-2 infected patients from distinct islands of the archipelago.

    Science.gov (United States)

    de Pina-Araujo, Isabel Inês M; Guimarães, Monick L; Bello, Gonzalo; Vicente, Ana Carolina P; Morgado, Mariza G

    2014-01-01

    HIV-1 and HIV-2 have been detected in Cape Verde since 1987, but little is known regarding the genetic diversity of these viruses in this archipelago, located near the West African coast. In this study, we characterized the molecular epidemiology of HIV-1 and HIV-2 and described the occurrence of drug resistance mutations (DRM) among antiretroviral therapy naïve (ARTn) patients and patients under treatment (ARTexp) from different Cape Verde islands. Blood samples, socio-demographic and clinical-laboratory data were obtained from 221 HIV-positive individuals during 2010-2011. Phylogenetic and bootscan analyses of the pol region (1300 bp) were performed for viral subtyping. HIV-1 and HIV-2 DRM were evaluated for ARTn and ARTexp patients using the Stanford HIV Database and HIV-GRADE e.V. Algorithm Homepage, respectively. Among the 221 patients (169 [76.5%] HIV-1, 43 [19.5%] HIV-2 and 9 [4.1%] HIV-1/HIV-2 co-infections), 67% were female. The median ages were 34 (IQR = 1-75) and 47 (IQR = 12-84) for HIV-1 and HIV-2, respectively. HIV-1 infections were due to subtypes G (36.6%), CRF02_AG (30.6%), F1 (9.7%), URFs (10.4%), B (5.2%), CRF05_DF (3.0%), C (2.2%), CRF06_cpx (0.7%), CRF25_cpx (0.7%) and CRF49_cpx (0.7%), whereas all HIV-2 infections belonged to group A. Transmitted DRM (TDRM) was observed in 3.4% (2/58) of ARTn HIV-1-infected patients (1.7% NRTI, 1.7% NNRTI), but not among those with HIV-2. Among ARTexp patients, DRM was observed in 47.8% (33/69) of HIV-1 (37.7% NRTI, 37.7% NNRTI, 7.4% PI, 33.3% for two classes) and 17.6% (3/17) of HIV-2-infections (17.6% NRTI, 11.8% PI, 11.8% both). This study indicates that Cape Verde has a complex and unique HIV-1 molecular epidemiological scenario dominated by HIV-1 subtypes G, CRF02_AG and F1 and HIV-2 subtype A. The occurrence of TDRM and the relatively high level of DRM among treated patients are of concern. Continuous monitoring of patients on ART, including genotyping, are public policies to be implemented.

  5. Analysis of the origin and evolutionary history of HIV-1 CRF28_BF and CRF29_BF reveals a decreasing prevalence in the AIDS epidemic of Brazil.

    Science.gov (United States)

    Ristic, Natalia; Zukurov, Jean; Alkmim, Wagner; Diaz, Ricardo Sobhie; Janini, Luiz Mario; Chin, Mario P S

    2011-03-01

    HIV-1 subtype B and subtype F are prevalent in the AIDS epidemic of Brazil. Recombinations between these subtypes have generated at least four BF circulating recombinant forms (CRFs). CRF28_BF and CRF29_BF are among the first two BF recombinants being identified in Brazil and they contributed significantly to the epidemic. However, the evolution and demographic histories of the CRFs are unclear. A collection of gag and pol sequences sampled within Brazil was screened for CRF28_BF-like and CRF29_BF-like recombination patterns. A Bayesian coalescent framework was employed to delineate the phylogenetic, divergence time and population dynamics of the virus having CRF28_BF-like and CRF29_BF-like genotype. These recombinants were phylogenetically related to each other and formed a well-supported monophyletic clade dated to 1988-1989. The effective number of infections by these recombinants grew exponentially over a five-year period after their emergence, but then decreased toward the present following a logistic model of population growth. The demographic pattern of both recombinants closely resembles those previously reported for CRF31_BC. We revealed that HIV-1 recombinants of the CRF28_BF/CRF29_BF clade are still circulating in the Brazilian population. These recombinants did not exhibit a strong founder effect and showed a decreasing prevalence in the AIDS epidemic of Brazil. Our data suggested that multiple URFs may also play a role in shaping the epidemic of recombinant BF HIV-1 in the region.

  6. Sexual networks, partnership mixing, and the female-to-male ratio of HIV infections in generalized epidemics: An agent-based simulation study

    Directory of Open Access Journals (Sweden)

    Georges Reniers

    2015-09-01

    Full Text Available Background: Empirical estimates of the female-to-male ratio of infections in generalized HIV epidemics in sub-Saharan Africa range from 1.31 in Zambia to 2.21 in Ivory Coast. Inequalities in the gender ratio of infections can arise because of differences in exposure (to HIV-positive partners, susceptibility (given exposure, and survival (once infected. Differences in susceptibility have to date received most attention, but neither the relatively high gender ratio of infections nor the heterogeneity in empirical estimates is fully understood. Objective: Demonstrate the relevance of partnership network attributes and sexual mixing patterns to gender differences in the exposure to HIV-positive partners and the gender ratio of infections. Methods: Agent-based simulation model built in NetLogo. Results: The female-to-male ratio of infections predicted by our model ranges from 1.13 to 1.75. Gender-asymmetric partnership concurrency, rapid partnership turnover, elevated partnership dissolution in female-positive serodiscordant couples, and lower partnership re-entry rates among HIV-positive women can produce (substantial differences in the gender ratio of infections. Coital dilution and serosorting have modest moderating effects. Conclusions: Partnership network attributes and sexual mixing patterns can have a considerable effect on the gender ratio of HIV infections. We need to look beyond individual behavior and gender differences in biological susceptibility if we are to fully understand, and remedy, gender inequalities in HIV infection in generalized epidemics.

  7. Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016.

    Science.gov (United States)

    He, Huijing; Lv, Fan; Zhang, Nanci Nanyi; Wu, Zunyou; Liao, Qinghua; Chang, Zhanjun; Li, Yi; Xu, Huifang; OuYang, Lin; Huan, Xiping; Yang, Juan

    2017-01-01

    Current Chinese studies continue to view male homosexuality through a disease focused lens which pays limited attention to socio-cultural aspects of sexual behavior and HIV transmission. This qualitative study aimed to investigate how socio-cultural factors influence gay men's sexual beliefs and behaviors in contemporary China, and their implications for HIV epidemic. Qualitative methodology was used in this study. During 2015-2016, in-depth interviews were conducted with 61 self identified gay men in Jiangxi, Henan, Heilongjiang, Guangdong, Jiangsu provinces and Chongqing municipality of China. Our study revealed that: 1) influenced by Chinese traditional culture, gay men have conflicts on self-identity, which led to low self-acceptance and negative attitude on sex, and huge socio-psychological stress; 2) a generational differences within gay community was observed, reflected in varied sexual attitudes and practices as well as way for approaching new friends, both of which have implications and challenges on HIV control and prevention; 3) socio-cultural barriers, including open minds towards casual sex and nonmonogamous relationship, and low priority of health demands were widely observed and led to negative coping with AIDS among gay community. It is essential to take a holistic view into gay men's HIV epidemic in China. Socio-cultural barriers for HIV control and prevention found in this study call for serious and imperative consideration on integrated measures, including targeted efforts towards effective sex education and further inclusion of socio-cultural perspectives in HIV/AIDS interventions for gay men.

  8. New HIV testing technologies in the context of a concentrated epidemic and evolving HIV prevention: qualitative research on HIV self-testing among men who have sex with men and transgender women in Yangon, Myanmar.

    Science.gov (United States)

    Wirtz, Andrea L; Clouse, Emily; Veronese, Vanessa; Thu, Kaung Htet; Naing, Soe; Baral, Stefan D; Beyrer, Chris

    2017-04-25

    Global effort to increase early diagnosis and engagement in HIV care emphasize the importance of developing novel approaches to reaching those missed by traditional methods. Such needs are particularly great for men who have sex with men (MSM), transgender women (TW), and other populations who face stigma. Myanmar's HIV epidemic is concentrated among key populations and the revised National Strategy aims to reduce late diagnosis and barriers to care to curb HIV incidence among these groups. HIV self-testing (HIVST) may be one method to improve testing and diagnosis among key populations, by placing HIV testing and disclosure within the individual's control. Formative, qualitative research including in-depth interviews with adult MSM (N = 12) and TW (N = 13) and focus group discussions with MSM, TW, and community key informants (N = 35) were conducted in June-September 2015 in Yangon, Myanmar. To inform a subsequent HIV care continuum intervention, including HIVST, participants' opinions and perceptions about HIVST were elicited. The confidentiality and privacy of HIVST, particularly as it related to disclosure of HIV status and sexual behaviour, was widely recognized among participants. These major advantages were further supported by the opportunity to avoid stigma, convenience of self-testing (reduced need for transportation and time to go to clinics), and the availability of a pain-free testing option. Participants weighed these benefits against perceived disadvantages of HIVST, the majority of which centred on the perception that HIVST does not include counselling. Participants were concerned that potential lack of counselling would result in poor mental health outcomes, inadequate linkage to HIV care and surveillance, and reductions in disclosure of HIV status. Participants did not view these disadvantages as an impediment, but provided suggestions for future implementation of HIVST in Myanmar. MSM and TW are optimistic about the confidentiality and privacy

  9. Controlling the HIV/AIDS epidemic: current status and global challenges

    Directory of Open Access Journals (Sweden)

    Thorsten eDemberg

    2012-08-01

    Full Text Available This review provides an overview of the current status of the global HIV pandemic and strategies to bring it under control. It updates numerous preventive approaches including behavioral interventions, male circumcision, pre- and post-exposure prophylaxis, vaccines, and microbicides. The manuscript summarizes current anti-retroviral treatment options, their impact in the western world, and difficulties faced by emerging and resource-limited nations in providing and maintaining appropriate treatment regimens. Current clinical and pre-clinical approaches towards a cure for HIV are described, including new drug compounds that target viral reservoirs and gene therapy approaches aimed at altering susceptibility to HIV infection. Recent progress in vaccine development is summarized, including novel approaches and new discoveries.

  10. HIV/AIDS prevention, faith, and spirituality among black/African American and Latino communities in the United States: strengthening scientific faith-based efforts to shift the course of the epidemic and reduce HIV-related health disparities.

    Science.gov (United States)

    Sutton, Madeline Y; Parks, Carolyn P

    2013-06-01

    Black/African American and Latino communities are disproportionately affected by the domestic HIV/AIDS epidemic. Blacks/African Americans and Latinos are also more likely to report a formal, religious, or faith affiliation when compared with non-Hispanic whites. As such, faith leaders and their institutions have been identified in the National HIV/AIDS Strategy as having a vital role to serve in reducing: (1) HIV-related health disparities and (2) the number of new HIV infections by promoting non-judgmental support for persons living with and at risk for HIV/AIDS and by serving as trusted information resources for their congregants and communities. We describe faith doctrines and faith-science partnerships that are increasing in support of faith-based HIV prevention and service delivery activities and discuss the vital role of these faith-based efforts in highly affected black/African American and Latino communities.

  11. Immune reconstitution inflammatory syndrome in association with HIV/AIDS and tuberculosis: Views over hidden possibilities

    Directory of Open Access Journals (Sweden)

    Solomon Suniti

    2007-11-01

    Full Text Available Abstract Gut immune components are severely compromised among persons with AIDS, which allows increased translocation of bacterial lipopolysaccharides (LPS into the systemic circulation. These microbial LPS are reportedly increased in chronically HIV-infected individuals and findings have correlated convincingly with measures of immune activation. Immune reconstitution inflammatory syndrome (IRIS is an adverse consequence of the restoration of pathogen-specific immune responses in a subset of HIV-infected subjects with underlying latent infections during the initial months of highly active antiretroviral treatment (HAART. Whether IRIS is the result of a response to a high antigen burden, an excessive response by the recovering immune system, exacerbated production of pro-inflammatory cytokines or a lack of immune regulation due to inability to produce regulatory cytokines remains to be determined. We theorize that those who develop IRIS have a high burden of proinflammatory cytokines produced also in response to systemic bacterial LPS that nonspecifically act on latent mycobacterial antigens. We also hypothesize that subjects that do not develop IRIS could have developed either tolerance (anergy to persistent LPS/tubercle antigens or could have normal FOXP3+ gene and that those with defective FOXP3+ gene or those with enormous plasma LPS could be vulnerable to IRIS. The measure of microbial LPS, anti-LPS antibodies and nonspecific plasma cytokines in subjects on HAART shall predict the role of these components in IRIS.

  12. Practice points: Corporate response to the HIV/AIDS epidemic in ...

    African Journals Online (AJOL)

    A survey done by the s reveals that most programmes undertaken in the private sector are of limited scope. We argue that there is more the corporate sector can do to more equitably share the HIV/AIDS burden, without necessarily jeopardizing its primary role – namely to maximize returns to shareholders. This paper ...

  13. Demographic modelling of the HIV/AIDS epidemic on the Soweto ...

    African Journals Online (AJOL)

    HIV/AIDS on a decentralised basis. Supporl needs of primary care personnel must be defined, and training, management protocols and referral lines must be established. Increased numbers of patients will require terminal care. The roles of health centres, hospices and home-besed care facilities in providing this should be ...

  14. Estimating the size of the HIV epidemic among injecting drug users in Amsterdam

    NARCIS (Netherlands)

    van Haastrecht, H. J.; Bindels, P. J.; van den Hoek, A. A.; Coutinho, R. A.

    1997-01-01

    Aim of this study was to assess the cumulative incidence of HIV-infection, AIDS and pre-AIDS death in the population of injecting drug users (IDU) in Amsterdam. By assuming equivalence, between a cohort of IDU and the IDU population, of the ratios of incidences of AIDS and pre-AIDS death to the

  15. Medical Discrimination Affects the HIV/AIDS Epidemic Control: A Study of Self-Perceived Medical Discrimination on People Living with HIV or AIDS.

    Science.gov (United States)

    Pang, Minhui; Peng, Lin; Zhang, Siheng; Yang, Jianwei; Rao, Jiaming; Wang, Haiqing; Zhang, Jiayi; Chen, Xiongfei; Dong, Xiaomei

    2017-09-01

    People living with HIV or AIDS (PLWHA) experienced severe medical discrimination which is seriously affecting their lives. However, few studies examined the epidemic characteristics of self-perceived medical discrimination from the discrimination objects such as PLWHA. Therefore, we aimed to investigate the epidemiological status and analyze the influential factors of the self-perceived medical discrimination on PLWHA in South China. The self-designed questionnaire was used to investigate the medical discrimination status of the 443 infected persons, who were randomly recruited from the representative AIDS designated hospitals in Guangdong Province in South China. The results showed that 49.0% of PLWHA experienced medical discrimination, and 55.3% received discriminatory treatment, 48.4% experienced refusal of treatment, 36.4% had private information leaked and 12.9% received mandatory test. However, 52.2% patients chose to endure discrimination in silence. Compared with the Asymptomatic HIV-infected patients, AIDS patients perceived more medical discrimination. The Logistic regression analysis indicated that PLWHA self-perceived medical discrimination status was influenced by 4 factors: the voluntary of first medical detection, the route of transmission, the stage of the disease and the familiarity with the HIV/AIDS-related law. Additionally, the two dimensions of the life quality scale were influenced by medical discrimination, namely, overall function and disclosure worry. Ultimately, our study provides a better understanding of the relationship between infection status, quality of life and the medical discrimination they experienced or perceived. It will help health professionals and policy makers to develop tailored behavioral and policy-oriented intervention strategies for PLWHA to tackle different types of medical discrimination in high-risk settings.

  16. Multiple Introduction and Naturally Occuring Drug Resistance of HCV among HIV-Infected Intravenous Drug Users in Yunnan: An Origin of China's HIV/HCV Epidemics.

    Directory of Open Access Journals (Sweden)

    Min Chen

    Full Text Available The human immunodeficiency virus 1 (HIV-1 epidemic in China historically stemmed from intravenous drug users (IDUs in Yunnan. Due to a shared transmission route, hepatitis C virus (HCV/HIV-1 co-infection is common. Here, we investigated HCV genetic characteristics and baseline drug resistance among HIV-infected IDUs in Yunnan.Blood samples of 432 HIV-1/HCV co-infected IDUs were collected from January to June 2014 in six prefectures of Yunnan Province. Partial E1E2 and NS5B genes were sequenced. Phylogenetic, evolutionary and genotypic drug resistance analyses were performed.Among the 293 specimens successfully genotyped, seven subtypes were identified, including subtypes 3b (37.9%, 111/293, 3a (21.8%, 64/293, 6n (14.0%, 41/293, 1b (10.6%, 31/293, 1a (8.2%, 24/293, 6a (5.1%, 15/293 and 6u (2.4%, 7/293. The distribution of HCV subtypes was mostly related to geographic location. Subtypes 3b, 3a, and 6n were detected in all six prefectures, however, the other four subtypes were detected only in parts of the six prefectures. Phylogeographic analyses indicated that 6n, 1a and 6u originated in the western prefecture (Dehong and spread eastward and showed genetic relatedness with those detected in Burmese. However, 6a originated in the southeast prefectures (Honghe and Wenshan bordering Vietnam and was transmitted westward. These subtypes exhibited different evolutionary rates (between 4.35×10-4 and 2.38×10-3 substitutions site-1 year-1 and times of most recent common ancestor (tMRCA, between 1790.3 and 1994.6, suggesting that HCV was multiply introduced into Yunnan. Naturally occurring resistance-associated mutations (C316N, A421V, C445F, I482L, V494A, and V499A to NS5B polymerase inhibitors were detected in direct-acting antivirals (DAAs-naïve IDUs.This work reveals the temporal-spatial distribution of HCV subtypes and baseline HCV drug resistance among HIV-infected IDUs in Yunnan. The findings enhance our understanding of the characteristics and

  17. Dispersion of the HIV-1 Epidemic in Men Who Have Sex with Men in the Netherlands: A Combined Mathematical Model and Phylogenetic Analysis.

    Directory of Open Access Journals (Sweden)

    Daniela Bezemer

    2015-11-01

    Full Text Available The HIV-1 subtype B epidemic amongst men who have sex with men (MSM is resurgent in many countries despite the widespread use of effective combination antiretroviral therapy (cART. In this combined mathematical and phylogenetic study of observational data, we aimed to find out the extent to which the resurgent epidemic is the result of newly introduced strains or of growth of already circulating strains.As of November 2011, the ATHENA observational HIV cohort of all patients in care in the Netherlands since 1996 included HIV-1 subtype B polymerase sequences from 5,852 patients. Patients who were diagnosed between 1981 and 1995 were included in the cohort if they were still alive in 1996. The ten most similar sequences to each ATHENA sequence were selected from the Los Alamos HIV Sequence Database, and a phylogenetic tree was created of a total of 8,320 sequences. Large transmission clusters that included ≥10 ATHENA sequences were selected, with a local support value ≥ 0.9 and median pairwise patristic distance below the fifth percentile of distances in the whole tree. Time-varying reproduction numbers of the large MSM-majority clusters were estimated through mathematical modeling. We identified 106 large transmission clusters, including 3,061 (52% ATHENA and 652 Los Alamos sequences. Half of the HIV sequences from MSM registered in the cohort in the Netherlands (2,128 of 4,288 were included in 91 large MSM-majority clusters. Strikingly, at least 54 (59% of these 91 MSM-majority clusters were already circulating before 1996, when cART was introduced, and have persisted to the present. Overall, 1,226 (35% of the 3,460 diagnoses among MSM since 1996 were found in these 54 long-standing clusters. The reproduction numbers of all large MSM-majority clusters were around the epidemic threshold value of one over the whole study period. A tendency towards higher numbers was visible in recent years, especially in the more recently introduced clusters

  18. Short communication: Evidences of recent decline in the expansion rate of the HIV type 1 subtype C and CRF31_BC epidemics in southern Brazil.

    Science.gov (United States)

    Bello, Gonzalo; Guimarães, Monick L; Passaes, Caroline P B; Matos Almeida, Sabrina E; Veloso, Valdilea G; Morgado, Mariza G

    2009-11-01

    The HIV-1 epidemic in southern Brazil is characterized by the high prevalence of subtype C and CRF31_BC infections but little is known about the population dynamics of these strains over time. We used a total of 82 env and 72 pol HIV-1 subtype C sequences collected from 1991 to 2006 and 47 pol CRF31_BC sequences collected from 1998 to 2006 from Brazilian patients to reconstruct the demographic history of these HIV-1 strains. Estimations of demographic history were performed using a Bayesian Markov Chain Monte Carlo coalescent-based approach as implemented in the BEAST program. Our analyses indicate that subtype C and CRF31_BC epidemics experienced an initial period of fast exponential spread in the southern Brazilian population during the 1980s and early 1990s, but the spreading rate of these epidemics seems to have slowed down since the middle 1990s. The initial mean exponential growth rate of the subtype C epidemic was estimated to be around 0.70-0.90/year, whereas the estimated population growth rate of CRF31_BC was 1.3/year, more than two times higher than that previously described for this CRF. These results suggest for the first time that the growth rate of subtype C and CRF31_BC epidemics has been changing over time in southern Brazil with evidence for a deceleration in recent years. During the expansion phase, the CRF31_BC seems to have spread at a rate much higher than Brazilian parental subtypes B and C.

  19. The EuroSIDA study: Regional differences in the HIV-1 epidemic and treatment response to antiretroviral therapy among HIV-infected patients across Europe--a review of published results

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Bannister, Wendy; Mocroft, Amanda

    2008-01-01

    EuroSIDA is a pan-European observational study that follows 14,265 HIV-infected patients from 31 European countries, Israel and Argentina, of which 2,560 are patients from eastern Europe (EE). The study group has performed several analyses addressing regional differences in the HIV-epidemic across....... Significantly fewer HIV-infected patients in EE, who fulfilled the criteria for starting combination antiretroviral therapy (cART), actually received cART as compared with other regions of Europe. Those, receiving cART in EE had a lower initial virologic response rate irrespectively of the regimen used......, although it has improved within years. Besides, treatment failure was more common in this region. Thus, improvements in the clinical management of HIV patients in EE are urgently needed. Strategies include creating scientific collaborations for HIV clinicians as well as teaching clinicians about the most...

  20. [Decentralization of the HIV/AIDS epidemic and inter-municipal flow of hospital admissions in the Zona da Mata, Minas Gerais State, Brazil: a spatial analysis].

    Science.gov (United States)

    Reis, Cláudia Tartaglia; Czeresnia, Dina; Barcellos, Christovam; Tassinari, Wagner Souza

    2008-06-01

    The aim of this article was to analyze the decentralization of the HIV/AIDS epidemic (a shift towards rural areas or away from the coast) and to investigate access to HIV/AIDS services from 1988 to 2002 in the Zona da Mata, Minas Gerais State, Brazil. An ecological study was performed using temporal and spatial approaches. A hospital admissions flow between municipalities developed, and the reference group was AIDS patients over 15 years of age admitted in 1996 and 2004, residing in municipalities in the Zona da Mata. There were 2,469 reported AIDS cases in individuals over 15 during the period. Mean incidence and mortality rates were calculated and recalculated by a local empirical Bayesian method in order to more clearly represent the municipalities with the highest concentration of cases and deaths. Decentralization of the epidemic was observed. Juiz de Fora was the municipality with the most cases and may have acted as a hub for spread of HIV in the region. Hospital care for AIDS cases in the Zona da Mata was concentrated in that municipality. There is a strong need to further investigate why referral hospitals in other municipalities in the region have not participated in providing management and care for HIV/AIDS patients.

  1. An epidemic model for the transmission dynamics of HIV/AIDS with different clinical stages

    Directory of Open Access Journals (Sweden)

    Sandip Omar

    2010-06-01

    Full Text Available In this paper, a five–dimensional mathematical model is proposed for the transmission dynamics of HIV/AIDS within a population of varying size. In writing the model, we have divided the population under consideration into five sub classes of susceptible, infective, pre-AIDS, AIDS related complex and that of AIDS patients. The model has two non- negative equilibria namely, a disease free and the endemic equilibrium. The model has been studied using stability theory. It is shown that the positive non-trivial equilibrium is always locally stable but it may become globally stable under certain condition showing that the disease becomes endemic due to constant migration of the population into the habitat. The effect of various parameters on the spread of the disease has also been discussed.

  2. Multi-Sector Participation In The National Response To Prevent And Address The Hiv/Aids Epidemic In The Republic Of Cuba, 2007-2008

    Directory of Open Access Journals (Sweden)

    Isora Ramos Valle

    2010-12-01

    Full Text Available The development of a strong national response involving multiple sectors—including civil society—is an essential aspect of the social management of the HIV/AIDS epidemic. The goals of this response are to control the epidemic and improve the quality of life for people living with HIV/AIDS; this includes combating stigma and discrimination, as well as ensuring due compliance with the law. Cuba has a national program to prevent and control HIV/AIDS. Since 2003 Cuba’s national program has received material and financial support from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Program evaluation is carried out by an independent team at ENSAP (National School of Public Health. This paper reports on results of one part of that evaluation: an assessment of the agencies and sectors who made up the organized social and national response to the HIV/AIDS epidemic. The evaluation primarily used qualitative analyses of the activities and tasks proposed by sectors in their 2006-2008 work plans. Visits were made to the provinces of Ciudad de la Habana, Matanzas, and Holguín. Qualitative techniques included in-depth interviews, semi-structured interviews, observation, and review of documentary evidence of all kinds (videos, reports, minutes, protocols, results of social research, and radio broadcast messages and varied depending on the particular features of each sector. We noted improvements in multi-sector participation in the prevention and response to the national HIV/AIDS epidemic. Conscious of their role, sectors generally carried out their programmed activities and had improved their organization, planning, and systematization; integration among the sectors was also better. These local initiatives provided evidence of a multi-sector response characterized by autonomy, emotional involvement, and an identification with the goals of the project; this went beyond simply meeting targets. Cross-sector work showed a marked increase and a

  3. Look into the HIV Epidemic of Gay Community with a Socio-Cultural Perspective: A Qualitative Study in China, 2015-2016.

    Directory of Open Access Journals (Sweden)

    Huijing He

    Full Text Available Current Chinese studies continue to view male homosexuality through a disease focused lens which pays limited attention to socio-cultural aspects of sexual behavior and HIV transmission. This qualitative study aimed to investigate how socio-cultural factors influence gay men's sexual beliefs and behaviors in contemporary China, and their implications for HIV epidemic.Qualitative methodology was used in this study. During 2015-2016, in-depth interviews were conducted with 61 self identified gay men in Jiangxi, Henan, Heilongjiang, Guangdong, Jiangsu provinces and Chongqing municipality of China. Our study revealed that: 1 influenced by Chinese traditional culture, gay men have conflicts on self-identity, which led to low self-acceptance and negative attitude on sex, and huge socio-psychological stress; 2 a generational differences within gay community was observed, reflected in varied sexual attitudes and practices as well as way for approaching new friends, both of which have implications and challenges on HIV control and prevention; 3 socio-cultural barriers, including open minds towards casual sex and nonmonogamous relationship, and low priority of health demands were widely observed and led to negative coping with AIDS among gay community.It is essential to take a holistic view into gay men's HIV epidemic in China. Socio-cultural barriers for HIV control and prevention found in this study call for serious and imperative consideration on integrated measures, including targeted efforts towards effective sex education and further inclusion of socio-cultural perspectives in HIV/AIDS interventions for gay men.

  4. Increased HIV incidence in men who have sex with men despite high levels of ART-induced viral suppression: analysis of an extensively documented epidemic.

    Directory of Open Access Journals (Sweden)

    Andrew N Phillips

    Full Text Available There is interest in expanding ART to prevent HIV transmission, but in the group with the highest levels of ART use, men-who-have-sex-with-men (MSM, numbers of new infections diagnosed each year have not decreased as ARTcoverage has increased for reasons which remain unclear.We analysed data on the HIV-epidemic in MSM in the UK from a range of sources using an individual-based simulation model. Model runs using parameter sets found to result in good model fit were used to infer changes in HIV-incidence and risk behaviour.HIV-incidence has increased (estimated mean incidence 0.30/100 person-years 1990-1997, 0.45/100 py 1998-2010, associated with a modest (26% rise in condomless sex. We also explored counter-factual scenarios: had ART not been introduced, but the rise in condomless sex had still occurred, then incidence 2006-2010 was 68% higher; a policy of ART initiation in all diagnosed with HIV from 2001 resulted in 32% lower incidence; had levels of HIV testing been higher (68% tested/year instead of 25% incidence was 25% lower; a combination of higher testing and ART at diagnosis resulted in 62% lower incidence; cessation of all condom use in 2000 resulted in a 424% increase in incidence. In 2010, we estimate that undiagnosed men, the majority in primary infection, accounted for 82% of new infections.A rise in HIV-incidence has occurred in MSM in the UK despite an only modest increase in levels of condomless sex and high coverage of ART. ART has almost certainly exerted a limiting effect on incidence. Much higher rates of HIV testing combined with initiation of ART at diagnosis would be likely to lead to substantial reductions in HIV incidence. Increased condom use should be promoted to avoid the erosion of the benefits of ART and to prevent other serious sexually transmitted infections.

  5. Corporate social responsibility in public health: A case-study on HIV/AIDS epidemic by Johnson & Johnson company in Africa.

    Science.gov (United States)

    Chattu, Vijay Kumar

    2015-01-01

    HIV/AIDS has claimed millions of lives in the global workforce and continues to remain a threat to many businesses. An estimated 36.5 million of working people are living with HIV; the global workforce has lost 28 million people from AIDS since the beginning of the epidemic. In the absence of access to treatment, this number could grow to 74 million by 2015. The epidemic continues to affect the working population through absenteeism, sickness and death. Corporate Social Responsibility (CSR) is an obligation that corporates have toward their employees, community and society. A review and documentation of one such CSR by Johnson & Johnson (a multinational company) for HIV/AIDS in Africa is presented here. Johnson & Johnson Company is involved in numerous projects around the world to combat the HIV/AIDS epidemic. The company is working to fight the spread of the disease and improve the quality of life for those living with the illness through various donations of its products and sponsorship of local programs. This case study also highlights different categories of CSR activities such as Cause Promotion, Cause related Marketing, Corporate Philanthropy, Corporate Social Marketing, Corporate Volunteering and Socially responsible business practices, which are discussed with specific examples from different countries in Africa. CSR of any business encompasses the economic, legal, ethical & discretionary expectation placed on the organization by society at a given point of time. CSR is therefore the obligation that corporations have toward their stakeholders and society in general which horizons beyond what is prescribed by law or union contracts. Johnson & Johnson has a proved history of being committed to caring for people and a good example of a company with a long history of citizenship and sustainability.

  6. Estimation and Short-Term Prediction of the Course of the HIV Epidemic Using Demographic and Health Survey Methodology-Like Data.

    Directory of Open Access Journals (Sweden)

    Stéphanie Blaizot

    Full Text Available Mathematical models have played important roles in the understanding of epidemics and in the study of the impacts of various behavioral or medical measures. However, modeling accurately the future spread of an epidemic requires context-specific parameters that are difficult to estimate because of lack of data. Our objective is to propose a methodology to estimate context-specific parameters using Demographic and Health Survey (DHS-like data that can be used in mathematical modeling of short-term HIV spreading.The model splits the population according to sex, age, HIV status, and antiretroviral treatment status. To estimate context-specific parameters, we used individuals' histories included in DHS-like data and a statistical analysis that used decomposition of the Poisson likelihood. To predict the course of the HIV epidemic, sex- and age-specific differential equations were used. This approach was applied to recent data from Kenya. The approach allowed the estimation of several key epidemiological parameters. Women had a higher infection rate than men and the highest infection rate in the youngest age groups (15-24 and 25-34 years whereas men had the highest infection rate in age group 25-34 years. The immunosuppression rates were similar between age groups. The treatment rate was the highest in age group 35-59 years in both sexes. The results showed that, within the 15-24 year age group, increasing male circumcision coverage and antiretroviral therapy coverage at CD4 ≤ 350/mm3 over the current 70% could have short-term impacts.The study succeeded in estimating the model parameters using DHS-like data rather than literature data. The analysis provides a framework for using the same data for estimation and prediction, which can improve the validity of context-specific predictions and help designing HIV prevention campaigns.

  7. Public health triangulation: approach and application to synthesizing data to understand national and local HIV epidemics.

    Science.gov (United States)

    Rutherford, George W; McFarland, William; Spindler, Hilary; White, Karen; Patel, Sadhna V; Aberle-Grasse, John; Sabin, Keith; Smith, Nathan; Taché, Stephanie; Calleja-Garcia, Jesus M; Stoneburner, Rand L

    2010-07-29

    Public health triangulation is a process for reviewing, synthesising and interpreting secondary data from multiple sources that bear on the same question to make public health decisions. It can be used to understand the dynamics of HIV transmission and to measure the impact of public health programs. While traditional intervention research and meta-analysis would be ideal sources of information for public health decision making, they are infrequently available, and often decisions can be based only on surveillance and survey data. The process involves examination of a wide variety of data sources and both biological, behavioral and program data and seeks input from stakeholders to formulate meaningful public health questions. Finally and most importantly, it uses the results to inform public health decision-making. There are 12 discrete steps in the triangulation process, which included identification and assessment of key questions, identification of data sources, refining questions, gathering data and reports, assessing the quality of those data and reports, formulating hypotheses to explain trends in the data, corroborating or refining working hypotheses, drawing conclusions, communicating results and recommendations and taking public health action. Triangulation can be limited by the quality of the original data, the potentials for ecological fallacy and "data dredging" and reproducibility of results. Nonetheless, we believe that public health triangulation allows for the interpretation of data sets that cannot be analyzed using meta-analysis and can be a helpful adjunct to surveillance, to formal public health intervention research and to monitoring and evaluation, which in turn lead to improved national strategic planning and resource allocation.

  8. Public health triangulation: approach and application to synthesizing data to understand national and local HIV epidemics

    Directory of Open Access Journals (Sweden)

    Aberle-Grasse John

    2010-07-01

    Full Text Available Abstract Background Public health triangulation is a process for reviewing, synthesising and interpreting secondary data from multiple sources that bear on the same question to make public health decisions. It can be used to understand the dynamics of HIV transmission and to measure the impact of public health programs. While traditional intervention research and metaanalysis would be ideal sources of information for public health decision making, they are infrequently available, and often decisions can be based only on surveillance and survey data. Methods The process involves examination of a wide variety of data sources and both biological, behavioral and program data and seeks input from stakeholders to formulate meaningful public health questions. Finally and most importantly, it uses the results to inform public health decision-making. There are 12 discrete steps in the triangulation process, which included identification and assessment of key questions, identification of data sources, refining questions, gathering data and reports, assessing the quality of those data and reports, formulating hypotheses to explain trends in the data, corroborating or refining working hypotheses, drawing conclusions, communicating results and recommendations and taking public health action. Results Triangulation can be limited by the quality of the original data, the potentials for ecological fallacy and "data dredging" and reproducibility of results. Conclusions Nonetheless, we believe that public health triangulation allows for the interpretation of data sets that cannot be analyzed using meta-analysis and can be a helpful adjunct to surveillance, to formal public health intervention research and to monitoring and evaluation, which in turn lead to improved national strategic planning and resource allocation.

  9. Proportion of long-term injection drug users as an indicator to characterize the state and prognosis of HIV-epidemic within a certain territory

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    Andreeva, Tatiana

    2012-07-01

    Full Text Available BACKGROUND: Epidemics of drug use and thus the spread of HIV have different duration in different regions, and, therefore, the prognosis of these epidemics may differ. We aimed to assess indicators measuring the peculiarities of injection drug use epidemics by region, informative for prevention activities among vulnerable to HIV groups. METHODS: Data from cross-sectional survey of 4026 injection drug users (IDUs conducted in 2007 in Ukraine were analyzed. The outcome measure was a binary variable depicting whether a respondent injects drugs for 20 years and over. Binary Logistic Regression in SPSS software was used to test associations with socio-demographic characteristics. RESULTS: More respondents from Odessa, Mykolayiv, Dnipropetrovsk, Cherkassy, Poltava, and Crimea regions inject over 20 years. Older respondents were more likely to belong to the group of long-term users. Men were more likely to inject over 20 years than women. Those respondents who were married, but did not live with their spouse or other sexual partner were more likely to inject longer than 20 years compared to those single or in a stable marriage. Those respondents who use opiates or combine them with stimulants were more likely to inject over 20 years and those who use only stimulants were more likely to inject less than 20 years. CONCLUSION: Injection drug use in Ukraine started earlier among men, on certain territories and was associated with opiate use. Percentage of IDUs who inject for more than 20 years was found to be a good indicator to distinguish territories with long-lasting epidemics.

  10. Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan

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    Åstrøm Anne

    2009-11-01

    Full Text Available Abstract Background HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics, enabling (knowledge, attitudes and perceived risk related to HIV and need related factors (oral health status predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Methods Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH and University of Science and Technology (UST during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH were examined clinically (DMFT and participated in an interview. Results A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5 were associated with lower odds and females were associated with higher odds (OR = 2.0 for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6 and higher HIV related experience (OR = 0.7 were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3 were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8. Conclusion Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to

  11. Epidemiological study of phylogenetic transmission clusters in a local HIV-1 epidemic reveals distinct differences between subtype B and non-B infections

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    Chalmet Kristen

    2010-09-01

    Full Text Available Abstract Background The number of HIV-1 infected individuals in the Western world continues to rise. More in-depth understanding of regional HIV-1 epidemics is necessary for the optimal design and adequate use of future prevention strategies. The use of a combination of phylogenetic analysis of HIV sequences, with data on patients' demographics, infection route, clinical information and laboratory results, will allow a better characterization of individuals responsible for local transmission. Methods Baseline HIV-1 pol sequences, obtained through routine drug-resistance testing, from 506 patients, newly diagnosed between 2001 and 2009, were used to construct phylogenetic trees and identify transmission-clusters. Patients' demographics, laboratory and clinical data, were retrieved anonymously. Statistical analysis was performed to identify subtype-specific and transmission-cluster-specific characteristics. Results Multivariate analysis showed significant differences between the 59.7% of individuals with subtype B infection and the 40.3% non-B infected individuals, with regard to route of transmission, origin, infection with Chlamydia (p = 0.01 and infection with Hepatitis C virus (p = 0.017. More and larger transmission-clusters were identified among the subtype B infections (p Chlamydia infection (p = 0.013 and primary HIV (p = 0.017. Conclusions Combination of phylogenetics with demographic information, laboratory and clinical data, revealed that HIV-1 subtype B infected Caucasian men-who-have-sex-with-men with high prevalence of sexually transmitted diseases, account for the majority of local HIV-transmissions. This finding elucidates observed epidemiological trends through molecular analysis, and justifies sustained focus in prevention on this high risk group.

  12. Developing an adherence support intervention for patients on antiretroviral therapy in the context of the recent IDU-driven HIV/AIDS epidemic in Estonia.

    Science.gov (United States)

    Laisaar, Kaja-Triin; Uusküla, Anneli; Sharma, Anjali; DeHovitz, Jack A; Amico, K Rivet

    2013-01-01

    There is limited data on and experience with interventions for antiretroviral therapy (ART) adherence support for patients on ART in Eastern Europe. We sought to identify a feasible adherence support intervention for delivery amongst HIV-positive adults receiving care in Estonia, where the HIV/AIDS epidemic has been mainly concentrated among injection drug users (IDUs). Our application of intervention mapping (IM) strategies used existing literature, formative research and multidisciplinary team input to produce a brief clinic-based intervention entitled the Situated Optimal Adherence Intervention Estonia (sOAI Estonia) which uses both Next-Step Counseling (NSC) and Information-Motivation-Behavioral Skills (IMB) Model approach to facilitate integration of ART into the context and demands of daily life. We present the intervention development process, the resulting sOAI Estonia approach, and describe a randomized controlled trial (RCT) which is under way to evaluate the intervention (results due in spring 2013).

  13. Molecular typing of the recently expanding subtype B HIV-1 epidemic in Romania: evidence for local spread among MSMs in Bucharest area.

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    Paraschiv, Simona; Otelea, Dan; Batan, Ionelia; Baicus, Cristian; Magiorkinis, Gkikas; Paraskevis, Dimitrios

    2012-07-01

    HIV-1 subtype B is predominant in Europe except in some countries from Eastern Europe which are characterized by a high prevalence of non-B subtypes and circulating recombinant forms (CRFs). Romania is a particular case: the HIV-1 epidemic started with subtype F1 which is still the most prevalent. Previous studies have shown an increasing prevalence of subtype B which is the second most frequent one among the newly diagnosed individuals, followed by subtype C and several CRFs as well as unique recombinant forms (URFs). Our objective was to analyze in detail the characteristics (way of dispersal, association with transmission risk groups) of the subtype B infections in Romania by means of phylogenetic analysis. Among all the individuals sampled during 2003-2010, 71 out of 1127 patients (6.3%) have been identified to be infected with subtype B strains. The most frequent route of infection identified in HIV-1 subtype B patients in Romania was MSM transmission (39.6%), followed by the heterosexual route (35.2%). Many of the patients acquired the infection abroad, mainly in Western European countries. Phylogenetic analysis indicated the existence of a local transmission network (monophyletic clade) including 14 patients, mainly MSM living in the Bucharest area. We estimate the origin of the local transmission network that dates at the beginning of the 90s; the introduction of the F1 and C subtypes occurred earlier. The rest of the sequences were intermixed with reference strains sampled across Europe suggesting that single infection were not followed by subsequent dispersal within the local population. Although HIV-1 subtype B epidemic in Romania is recent, there is evidence for local spread among the MSMs, in addition to multiple introductions. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. HIV/AIDS epidemic in French Guiana: 1979-1997. Groupe d'Etude Clinique de l'Infection VIH en Guyane Française.

    Science.gov (United States)

    Sobesky, M; Dabis, F; Le Beux, P

    2000-06-01

    The incidence of AIDS in French Guiana remains one of the highest in Latin America and the Caribbean. The annual AIDS incidence rate increased continually from the start of the epidemic until 1995, when it reached 59.3/100,000 population declining thereafter to 26.6 in 1997. The prevalence of HIV in pregnant women was 0.9% in 1993, increasing to 1.3% in 1995, and that in individuals attending sexually transmitted disease (STD) clinics was 2.1% in 1996. We included 224 patients in a study of survival after AIDS diagnosis. The principal AIDS-defining diagnosis was tuberculosis in 20.5% of reported cases. The median duration of survival was 10.2 months. Multivariate analysis showed that, patients > or = 45 years at entry progressed more rapidly to AIDS than younger patients. HIV prevention and access to health care should be developed in the various ethnic communities and adapted to cultural status. The progressive implementation of multiple antiretroviral therapies since 1996 may further reduce progression of the disease but early HIV diagnosis is required to improve the overall prognosis of HIV-infected patients.

  15. A tale of two epidemics: gender differences in socio-demographic characteristics and sexual behaviors among HIV positive individuals in Mexico City.

    Science.gov (United States)

    Bautista-Arredondo, Sergio; Servan-Mori, Edson; Beynon, Fenella; González, Andrea; Volkow, Patricia

    2015-12-16

    To date, the HIV epidemic in Mexico has been concentrated mainly among men who have sex with men, butheterosexual transmission, particularly to women, is increasingly important. This study examine gender differences in socio-demographic characteristics and risk behaviors of HIV positive individuals in Mexico City. We analyzed data from a cross-sectional survey of 1,490 clinic patients (male:female ratio 8:1) with HIV inMexico City in 2010. We examined socio-demographic characteristics, risk behavior, and history of HIV infection.From multivariate non-linear probability (probit) models we calculated predicted probabilities by sex of several outcomes: marginalization, demographic and sexual risk behaviors. Significant differences were found between men and women. Multivariate models suggest that women had lower schooling levels; were less likely to have been employed in the past month and earn more than the minimal wage; more likely to have children, to have been sexually abused, to never have used condoms and to report having been infected by a stable partner. Additionally, women were less likely to report having a partner with a history of migration to the USA and to have engaged in transactional sex. Significant differences exist between men and women with HIV in Mexico City in terms of their socioeconomicand behavioral profiles, which translate into differences in terms of exposure to HIV infection. Women face social and economic vulnerability while men tend to have riskier sexual behavior. Gender issues must be approached in prevention and treatment efforts, using diverse methods to target those most vulnerable and at risk.

  16. Impacto da terapia anti-retroviral na magnitude da epidemia do HIV/AIDS no Brasil: diversos cenários Impact of antiretroviral therapy on the magnitude of the HIV/AIDS epidemic in Brazil: various scenarios

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    Maria Tereza S. Barbosa

    2003-04-01

    Full Text Available Neste trabalho, utilizaram-se os algoritmos EM e EMS aplicados ao método do Cálculo Retroativo para estimar a magnitude da epidemia do HIV no Brasil. Fazendo-se suposições a respeito do comportamento dos infectados, em relação à utilização da terapia combinada das drogas anti-retrovirais, construíram-se cinco cenários para a epidemia brasileira. O objetivo foi o de ilustrar os impactos que a utilização da terapia combinada das drogas anti-retrovirais possam estar tendo ou possam vir a ter na incubação do vírus e, por conseguinte, nas avaliações da epidemia realizadas a partir dos casos de Aids notificados.We applied the back-calculation method to estimate the magnitude of the HIV epidemic in Brazil, using the EM and EMS algorithms. Under certain assumptions regarding the behavior of infected patients towards combined antiretroviral therapy, we discuss five different scenarios applied to the Brazilian epidemic. Our objective was to illustrate the impact of combined antiretroviral treatment on the incubation period and thus on estimates of the size of the HIV-infected population, based on reported AIDS cases.

  17. Intersecting epidemics of HIV, HCV, and syphilis among soon-to-be released prisoners in Kyrgyzstan: Implications for prevention and treatment.

    Science.gov (United States)

    Azbel, Lyuba; Polonsky, Maxim; Wegman, Martin; Shumskaya, Natalya; Kurmanalieva, Ainura; Asanov, Akylbek; Wickersham, Jeffrey A; Dvoriak, Sergii; Altice, Frederick L

    2016-11-01

    correlated with syphilis infection. Drug injection, syphilis co-infection, and exposure to increased risk during incarceration are likely to be important contributors to HIV transmission among prisoners in Kyrgyzstan. Compared to the community, HIV is concentrated 34-fold higher in prisoners. A high proportion of undiagnosed syphilis and HIV infections presents a significant gap in the HIV care continuum. Findings highlight the critical importance of evidence-based responses within prison, including enhanced testing for HIV and sexually transmitted infections, to stem the evolving HIV epidemic in the region. Copyright © 2016. Published by Elsevier B.V.

  18. Quality of life of people living with HIV/AIDS under the new epidemic characteristics in China and the associated factors.

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    Wei Sun

    Full Text Available BACKGROUND: Improvement of quality of life has been one of goals in health care for people living with HIV/AIDS (PLWHA. In China, the epidemic characteristics have changed and transmission is now most commonly sexual contact. However, the assessment of quality of life of PLWHA under new characteristics has limited reporting. This study was designed to assess the quality of life among PLWHA who contracted disease mainly via sexual contact and to clarify the associated factors. METHODS: A cross-sectional study was performed in Liaoning Province. Sample size (800 was calculated based on the fatality rate and enlarged with consideration on the loss of response. Participants were sampled by tables of random numbers among all registered PLWHA. Questionnaires pertaining to quality of life (SF-36 and related factors (demographic characteristics, social support and network, HIV/AIDS awareness, and behavior factors were distributed during December 2010-April 2011. 783 effective responses were obtained. RESULTS: The average scores of physical component summary (PCS, mental component summary (MCS, and total score (TS were 66.8±21.9 (Mean±SD, 62.2±20.9, and 64.5±20.2. General linear model analysis revealed that, in standardized estimate (β sequence, PCS was significantly associated with monthly income, perceived social support, antiretroviral therapy, transmission, and ethnicity; MCS was associated with perceived social support, antiretroviral therapy, condom use, monthly income, transmission, ethnicity, and alcohol consumption; whereas TS was associated with perceived social support, antiretroviral therapy, monthly income, transmission, condom use, and ethnicity. CONCLUSIONS: Quality of life for PLWHA who contracted HIV mainly via sexual contact was worse and both physical conditions and social integration were impacted. Under current epidemic characteristics, efforts to increase social support and enhance the implementation of supporting policy are

  19. Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora.

    Science.gov (United States)

    Millett, Gregorio A; Jeffries, William L; Peterson, John L; Malebranche, David J; Lane, Tim; Flores, Stephen A; Fenton, Kevin A; Wilson, Patrick A; Steiner, Riley; Heilig, Charles M

    2012-07-28

    Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8·5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM across the African diaspora share common experiences such as discrimination, cultural norms valuing masculinity, concerns about confidentiality during HIV testing or treatment, low access to HIV drugs, threats of violence or incarceration, and few targeted HIV prevention resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Hidden from health: structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey.

    Science.gov (United States)

    Pachankis, John E; Hatzenbuehler, Mark L; Hickson, Ford; Weatherburn, Peter; Berg, Rigmor C; Marcus, Ulrich; Schmidt, Axel J

    2015-06-19

    Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N = 174 209). Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.

  1. Epidemic dispersion of HIV and HCV in a population of co-infected Romanian injecting drug users.

    Science.gov (United States)

    Paraschiv, Simona; Banica, Leontina; Nicolae, Ionelia; Niculescu, Iulia; Abagiu, Adrian; Jipa, Raluca; Pineda-Peña, Andrea-Clemencia; Pingarilho, Marta; Neaga, Emil; Theys, Kristof; Libin, Pieter; Otelea, Dan; Abecasis, Ana

    2017-01-01

    Co-infections with HIV and HCV are very frequent among people who inject drugs (PWID). However, very few studies comparatively reconstructed the transmission patterns of both viruses in the same population. We have recruited 117 co-infected PWID during a recent HIV outbreak in Romania. Phylogenetic analyses were performed on HIV and HCV sequences in order to characterize and compare transmission dynamics of the two viruses. Three large HIV clusters (2 subtype F1 and one CRF14_BG) and thirteen smaller HCV transmission networks (genotypes 1a, 1b, 3a, 4a and 4d) were identified. Eighty (65%) patients were both in HIV and HCV transmission chains and 70 of those shared the same HIV and HCV cluster with at least one other patient. Molecular clock analysis indicated that all identified HIV clusters originated around 2006, while the origin of the different HCV clusters ranged between 1980 (genotype 1b) and 2011 (genotypes 3a and 4d). HCV infection preceded HIV infection in 80.3% of cases. Coincidental transmission of HIV and HCV was estimated to be rather low (19.65%) and associated with an outbreak among PWID during detention in the same penitentiary. This study has reconstructed and compared the dispersion of these two viruses in a PWID population.

  2. HIV infection among female sex workers in concentrated and high prevalence epidemics: why a structural determinants framework is needed.

    Science.gov (United States)

    Shannon, Kate; Goldenberg, Shira M; Deering, Kathleen N; Strathdee, Steffaine A

    2014-03-01

    This article reviews the current state of the epidemiological literature on female sex work and HIV from the past 18 months. We offer a conceptual framework for structural HIV determinants and sex work that unpacks intersecting structural, interpersonal, and individual biological and behavioural factors. Our review suggests that despite the heavy HIV burden among female sex workers (FSWs) globally, data on the structural determinants shaping HIV transmission dynamics have only begun to emerge. Emerging research suggests that factors operating at macrostructural (e.g., migration, stigma, criminalized laws), community organization (e.g., empowerment) and work environment levels (e.g., violence, policing, access to condoms HIV testing, HAART) act dynamically with interpersonal (e.g., dyad factors, sexual networks) and individual biological and behavioural factors to confer risks or protections for HIV transmission in female sex work. Future research should be guided by a Structural HIV Determinants Framework to better elucidate the complex and iterative effects of structural determinants with interpersonal and individual biological and behavioural factors on HIV transmission pathways among FSWs, and meet critical gaps in optimal access to HIV prevention, treatment, and care for FSWs globally.

  3. HIV INFECTION AMONG FEMALE SEX WORKERS IN CONCENTRATED AND HIGH PREVALENCE EPIDEMICS: WHY A STRUCTURAL DETERMINANTS FRAMEWORK IS NEEDED

    Science.gov (United States)

    Shannon, Kate; Goldenberg, Shira M.; Deering, Kathleen N.; Strathdee, Steffanie A.

    2014-01-01

    Purpose of review This article reviews the current state of the epidemiological literature on female sex work and HIV from the past 18 months. We offer a conceptual framework for structural HIV determinants and sex work that unpacks intersecting structural, interpersonal, and individual biological and behavioural factors. Recent findings Our review suggests that despite the heavy HIV burden among female sex workers (FSWs) globally, data on the structural determinants shaping HIV transmission dynamics have only begun to emerge. Emerging research suggests that factors operating at macrostructural (e.g., migration, stigma, criminalized laws), community organization (e.g., empowerment) and work environment levels (e.g., violence, policing, access to condoms HIV testing, HAART) act dynamically with interpersonal (e.g., dyad factors, sexual networks) and individual biological and behavioural factors to confer risks or protections for HIV transmission in female sex work. Summary Future research should be guided by a Structural HIV Determinants Framework to better elucidate the complex and iterative effects of structural determinants with interpersonal and individual biological and behavioural factors on HIV transmission pathways among FSWs, and meet critical gaps in optimal access to HIV prevention, treatment, and care for FSWs globally. PMID:24464089

  4. Tennessee's In-State Vulnerability Assessment for a 'Rapid Dissemination of HIV or HCV Infection' Event Utilizing Data about the Opioid Epidemic.

    Science.gov (United States)

    Rickles, Michael; Rebeiro, Peter F; Sizemore, Lindsey; Juarez, Paul; Mutter, Mitchell; Wester, Carolyn; McPheeters, Melissa

    2017-12-07

    Knowing which factors contribute to county-level vulnerability to an HIV/Hepatitis C (HCV) outbreak, and which counties are most vulnerable, guide public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HCV/HIV outbreak vulnerability. Tennessee's 95 counties were the study sample. Predictors from 2012 and 2013 were used, mirroring prior methodology from the US Centers for Disease Control and Prevention (CDC). Acute HCV incidence was the proxy measure of county-level vulnerability. Seventy-eight predictors were identified as potentially predictive for HIV/HCV vulnerability. We used multiple dimension reduction techniques to determine predictors for inclusion and Poisson regression to generate a composite index score ranking county level vulnerability for HIV/HCV. There was overlap of high-risk counties with the national analysis (25 of 41 counties). The distribution of vulnerability reinforces earlier research indicating that Eastern Tennessee is at particularly high risk, but also demonstrates that the entire state has high vulnerability. Prior research placed Tennessee among the top states for opioid prescribing, acute HCV infection, and greatest risk for an HIV/HCV outbreak. Given this confluence of risk, the Tennessee Department of Health expanded upon prior work to include more granular, local data, including on opiate prescribing. We also explored opioid prescribing patterns and nonfatal and fatal overdoses. The more complete statewide view of risk generated, not only in Eastern counties but also in the Western corridor, will enable local officials to monitor vulnerability and better target resources.

  5. Evidence for localised HIV related micro–epidemics associated with the decentralised provision of antiretroviral treatment in rural South Africa: a spatio–temporal analysis of changing mortality patterns (2007–2010

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    Paul Mee

    2014-06-01

    Full Text Available In this study we analysed the spatial and temporal changes in patterns of mortality over a period when antiretroviral therapy (ART was rolled out in a rural region of north–eastern South Africa. Previous studies have identified localised concentrated HIV related sub–epidemics and recommended that micro–level analyses be carried out in order to direct focused interventions.

  6. The impact of pre-exposure prophylaxis (PrEP) on HIV epidemics in Africa and India: A simulation study

    NARCIS (Netherlands)

    D.C.J. Vissers (Debby); H.A.C.M. Voeten (Hélène); N.J.D. Nagelkerke (Nico); J.D.F. Habbema (Dik); S.J. de Vlas (Sake)

    2008-01-01

    textabstractBackground: Pre-exposure prophylaxis (PrEP) is a promising new HIV prevention method, especially for women. An urgent demand for implementation of PrEP is expected at the moment efficacy has been demonstrated in clinical trials. We explored the long-term impact of PrEP on HIV

  7. ¿Hacia dónde se encamina la epidemia de infección por VIH y sida? HIV and AIDS: where is the epidemic going?

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    T. E. Mertens

    1997-03-01

    los Estados Unidos de América. Si bien estos cambios pueden ocurrir como parte de la dinámica intrínseca de la epidemia, hay indicios de que las reducciones de la prevalencia de la infección por VIH están relacionadas con disminuciones de la incidencia, que se deben, al menos en parte, a las actividades de prevención. El actual reto de los métodos de vigilancia y evaluación radica en descubrir aquellos ingredientes que han llevado al éxito y que pueden ofrecer un rayo de esperanza.Routine surveillance of HIV (human immunodeficiency virus infection and AIDS has been established over the past decade in many countries around the world. HIV estimates derived from empirical data are essential to the assessment of the HIV situation in different parts of the world and trends are used in tracking the development of regional epidemics, thereby keeping intervention activities focused on realities. As of the end of 1995, and following an extensive country-by-country review of HIV/AIDS data, a cumulative total of 6 million AIDS cases were estimated to have occurred in adults and children worldwide and currently 20.1 million adults are estimated to be alive and infected with HIV or have AIDS. Of the total prevalent HIV infections, the majority remain concentrated in eastern, central and southern Africa, but the epidemic is evolving with spread of infection from urban to rural areas, as well as to West and South Africa, India and Southeast Asia, and to a lesser extent--with proportional shifts to heterosexual infections--in North America, Western Europe and Latin America. While the longer-term dimensions of the HIV epidemic at global level cannnot be forecast with confidence, WHO currently projects a cumulative total of close to 40 million HIV infections in men, women and children by the year 2000. By that time, the male:female ratio of new infections will be close to 1:1. Recent trends indicate that HIV prevalence levels may be stabilizing or even decreasing among

  8. Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data.

    Science.gov (United States)

    Nguyen, Thi Thuy Van; Sabin, Keith; Ho, Thi Quynh Trang; Le, Ai Kim Anh; Hayashi, Chika; Kato, Masaya

    2017-12-20

    The prevention of mother-to-child transmission (PMTCT) of HIV program was introduced in Vietnam in 2005. Despite the scaling up of PMTCT programs, the rate of mother-to-child HIV transmission in Vietnam was estimated as high as 20% in 2013. The objective of this study was to assess the outcomes of PMTCT and identified factors associated with mother-to-child transmission and infant survival using survey and program data in a high HIV burden province in Vietnam. This community-based retrospective cohort study observed pregnant women diagnosed with HIV infection in Thai Nguyen province from October 2008 to December 2012. Data were collected through interviews using a structured questionnaire and through reviews of log books and medical charts in antenatal care and HIV clinics. Logistic regression and survival analysis were used to analyze data using Stata (StataCorp). A total of 172 pregnant women living with HIV were identified between 2008 and 2012. Most of these women had acquired the HIV infection from their husband (77/119, 64.7%). Significant improvement in the PMTCT program was documented, including reduction in late diagnosis of HIV for pregnant women from 62.5% in 2008 to 30% in 2012. Access to antiretrovirals (ARVs) improved, increasing from a rate of 18.2% (2008) to 70.0% (2011) for mothers and from 36.4% (2008) to 93.3% (2012) for infants. For infants, early diagnosis within 2 months of birth reached 66.7% in 2012 compared with 16.7% in 2009. Transmission rate reduced from 27.3% in 2008 to 6.7% in 2012. Late diagnosis was associated with increased risk for HIV transmission (odds ratio [OR] 14.7, 95% CI 1.8-121.4, P=.01), whereas ARV therapy for mother and infant in combination with infant formula feeding were associated with reduced risk for HIV transmission (OR 0.01, 95% CI 0.001-0.1; P<.001). Overall survival rate for HIV-exposed infants at 12 months was 97.7%. A combination of program and survey data measured the impact of prevention of HIV transmission

  9. High burden of STI and HIV in male sex workers working as internet escorts for men in an observational study: a hidden key population compared with female sex workers and other men who have sex with men

    OpenAIRE

    Verhaegh-Haasnoot, Amanja; Dukers-Muijrers, Nicole H. T. M.; Christian J P A Hoebe

    2015-01-01

    Background Male sex work in the western countries has changed, including now a subculture of male sex workers who have paid sex with men arranged for via the internet. The men involved in this subculture do not easily identify themselves as sex workers nor as homosexual, and are therefore missed by regular health care and public health interventions. These male sex workers may form a hidden key population for sexually transmitted infections (STIs) and HIV, bridging towards other persons outsi...

  10. Impact of male circumcision on the HIV epidemic in Papua New Guinea: a country with extensive foreskin cutting practices.

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    Richard T Gray

    Full Text Available The degree to which adult medical male circumcision (MC programs can reduce new HIV infections in a moderate HIV prevalence country like Papua New Guinea (PNG are uncertain especially given the widespread prevalence of longitudinal foreskin cuts among adult males. We estimated the likely impact of a medical MC intervention in PNG using a mathematical model of HIV transmission. The model was age-structured and incorporated separate components for sex, rural/urban, men who have sex with men and female sex workers. Country-specific data of the prevalence of foreskin cuts, sexually transmitted infections, condom usage, and the acceptability of MC were obtained by our group through related studies. If longitudinal foreskin cutting has a protective efficacy of 20% compared to 60% for MC, then providing MC to 20% of uncut males from 2012 would require 376,000 procedures, avert 7,900 HIV infections by 2032, and require 143 MC per averted infection. Targeting uncut urban youths would achieve the most cost effective returns of 54 MC per HIV infection averted. These numbers of MC required to avert an HIV infection change little even with coverage up to 80% of men. The greater the protective efficacy of longitudinal foreskin cuts against HIV acquisition, the less impact MC interventions will have. Dependent on this efficacy, increasing condom use could have a much greater impact with a 10 percentage point increase averting 18,400 infections over this same period. MC programs could be effective in reducing HIV infections in PNG, particularly in high prevalence populations. However the overall impact is highly dependent on the protective efficacy of existing longitudinal foreskin cutting in preventing HIV.

  11. Concussion in Rugby: The Hidden Epidemic

    Science.gov (United States)

    Spencer, Richard J.

    2001-01-01

    Objective: To determine the incidence of concussion in high school rugby players and compare the findings with the relevant published literature. Design and Setting: Prospective data collection in one US high school rugby program. Subjects: Two teams followed for 3 years. Measurements: Injury rate, injury severity, and time withheld from competition. Results: Seventeen concussions were recorded, accounting for 25% of all reported injuries. The incidence rate for concussion was 3.8 per 1000 athlete-exposures (95% confidence interval, 2.0–5.7) or 11.3 per 100 player-seasons (95% confidence interval, 5.9–16.7). Of the 17 concussions, 14 were Cantu grade 1, 2 were grade 2, and 1 was grade 3. Concussions accounted for 25% of all days lost from rugby participation due to injury. Conclusions: The incidence of concussion in this study was higher than previously reported in other studies. Methodologic limitations and administrative rules that required suspension for injured players may have suppressed reporting in previous epidemiologic studies. The incidence of concussion in rugby is probably much higher than previously suggested. PMID:12937506

  12. The hidden epidemic: confronting sexually transmitted diseases

    National Research Council Canada - National Science Library

    Eng, Thomas R; Butler, William T

    1997-01-01

    ... of Sexually Transmitted Diseases INSTITUTE OF MEDICINE Division of Health Promotion and Disease Prevention NATIONAL ACADEMY PRESS Washington, D.C. 1997 Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from other this ...

  13. Fibroid Tumors in Women: A Hidden Epidemic?

    Science.gov (United States)

    ... It's estimated that about three-quarters of American women of childbearing age have fibroid tumors in their uteruses. These benign tumors can cause not only pain, anemia, excessive menstrual bleeding, and infertility — they are also responsible for a third of ...

  14. Ethical issues in research on control of the HIV/AIDS epidemic: report from a workshop of the world federation of scientists, Erice, Sicily, Italy, 22-24 August 2003.

    Science.gov (United States)

    de Thé, G; Buonaguro, F; Charpak, N; Franca Junior, I; Hutton, J L; Thorstensson, R; Valdas, E; Zetterström, R

    2004-08-01

    In research on control of the HIV/AIDS epidemic there are many ethical issues to be considered. The problem of personal autonomy versus the interest of society to prevent the spread of the disease in various settings makes it difficult to follow the regulations of the Declaration of Helsinki in all respects. This is particularly clear in the evaluation of trials aimed at preventing mother-to-child transmission of HIV. The interest of the child does not always conform to the policy of avoiding stigmatization of the mother. Programmes for the implementation of antiretroviral therapy and vaccine trials may differ in countries with different mean incomes of the inhabitants, and are also influenced by local patterns. For this reason, the Declaration of Helsinki should be changed in such a way that it conforms with the ways in which it may be possible to combat such a disastrous epidemic as that caused by HIV.

  15. HIV-1 Epidemic Among Female Bar And Hotel Workers in Northern Tanzania: Risk Factors and Opportunities for Prevention

    National Research Council Canada - National Science Library

    Kapiga, Saidi H; Sam, Noel E; Shao, John F; Renjifo, Boris; Masenga, Elisante J; Kiwelu, Ireen E; Manongi, Rachel; Fawzi, Wafaie; Essex, Max

    2002-01-01

    ...) who were working in the bars and hotels in Moshi, a town in northern Tanzania. Study subjects were interviewed to obtain information about HIV-1 risk factors and examined to collect samples for the diagnosis of sexually transmitted diseases (STDs...

  16. HIV/AIDS epidemic among older adults in China during 2005-2012: results from trend and spatial analysis.

    Science.gov (United States)

    Xing, Jiannan; Li, Yin-ge; Tang, Weiming; Guo, Wei; Ding, Zhengwei; Ding, Guowei; Wang, Liyan; Qin, Qianqian; Xu, Yan; Qian, Shasha; Mahapatra, Tanmay; Wang, Lu

    2014-07-15

    Recent studies have indicated an increasing burden of human immunodeficiency virus (HIV)/AIDS among older adults. All identified people living with HIV/AIDS (PLWHA) recorded through the Chinese HIV/AIDS CRS during 2005-2012 were included in the study, except for the cases that lacked specific spatial information. Trend tests and spatial analyses were conducted. Information about 73,521 PLWHA (aged ≥50 years) was collected during 2005-2012. Three provinces-Guangxi, Henan, and Yunnan-accounted for 54.4% of the identified cases during the study period. Compared with 2005, the ratio between residents and migrants among the study population decreased to 40.1% in 2012. The ratio of HIV-infected patients to AIDS patients and the ratio of males to females increased gradually among older infected adults. Results of spatial analysis indicate a clustered distribution of HIV/AIDS among older adults throughout the country. Hot spots were observed in 4 provinces (Guangxi, Henan, Yunnan, and Sichuan) and 1 municipality (Chongqing). A trend from central provinces toward southern provinces was also identified. The number and proportion of HIV/AIDS among older adults have increased in recent years. The hot spots showed movement from central to southern China. A focused intervention strategy targeting the older PLWHA is urgently required in China. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. The IWG (Interagency Working Group) model for the heterosexual spread of HIV and the demographic impact of the AIDS epidemic

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, E.A. (Los Alamos National Lab., NM (USA)); Seitz, S.T. (Illinois Univ., Urbana, IL (USA)); Way, P.O.; Johnson, P.D. (Bureau of the Census, Washington, DC (USA)); Curry, T.F. (Air Force Academy, CO (USA))

    1990-01-01

    This paper presents the State Department's Interagency Working Group (IWG) model for the spread of HIV. The model is fully operational for Pattern 2 (heterosexual blood transmission) and Pattern 3 (heterosexual, homosexual, and IV drug transmission) countries. This model was developed for various uses, including technical research, policy analysis, and support for decision making. Research uses include studying patterns of HIV spread, assessing the relative effect of different processes on the spread of HIV, examining the demographic impact of HIV infections, and comparing the potential impact of behavioral versus medical intervention strategies. The model will be used in workshops where policy makers and health officials can do hands-on scenario analyses, gain qualitative insights into the possible long-term-epidemiological and demographic impact of HIV, gauge the uncertainties in predictions for the future, and study the impact of HIV, gauge the uncertainties in predictions for the future, and study the impact that intervention strategies are likely to have. The computational model uses a deterministic system of differential equations and runs on a 286- or a 386-based IBM-compatible machine under Microsoft Windows. The program requires an input ASCII (text) file to run; all parameters used by the model are input through this file and, therefore, are user-accessible. The software is user-friendly, mouse-driven, and allows for interactive manipulation of input data and visualization and processing of model outputs. 15 refs., 13 figs., 1 tab.

  18. Structural bridging network position is associated with HIV status in a younger Black men who have sex with men epidemic

    Science.gov (United States)

    Shah, Nirav S.; Iveniuk, James; Muth, Stephen Q.; Michaels, Stuart; Jose, Jo-Anne; Laumann, Edward O.; Schneider, John A.

    2014-01-01

    Younger Black men who have sex with men (BMSM) ages 16–29 have the highest rates of HIV in the United States. Despite increased attention to social and sexual networks as a framework for biomedical intervention, the role of measured network positions, such as bridging and their relationship to HIV risk has received limited attention. A network sample (N=620) of BMSM respondents (n=154) and their MSM and transgendered person network members (n=466) was generated through respondent driven sampling of BMSM and elicitation of their personal networks. Bridging status of each network member was determined by a constraint measure and was used to assess the relationship between this bridging and unprotected anal intercourse (UAI), sex-drug use (SDU), group sex (GS) and HIV status within the network in South Chicago. Low, moderate and high bridging was observed in 411 (66.8%), 81 (13.2%) and 123 (20.0%) of the network. In addition to age and having sex with men only, moderate and high levels of bridging were associated with HIV status (AOR 3.19; 95% CI 1.58–6.45 and AOR 3.83; 95% CI 1.23–11.95, respectively). Risk behaviors observed including UAS, GS, and SDU were not associated with HIV status, however, they clustered together in their associations with one another. Bridging network position but not risk behavior was associated with HIV status in this network sample of younger BMSM. Socio-structural features such as position within the network may be important when implementing effective HIV prevention interventions in younger BMSM populations. PMID:24337699

  19. HIV-1 A1 Subtype Epidemic in Italy Originated from Africa and Eastern Europe and Shows a High Frequency of Transmission Chains Involving Intravenous Drug Users.

    Science.gov (United States)

    Lai, Alessia; Bozzi, Giorgio; Franzetti, Marco; Binda, Francesca; Simonetti, Francesco R; De Luca, Andrea; Micheli, Valeria; Meraviglia, Paola; Bagnarelli, Patrizia; Di Biagio, Antonio; Monno, Laura; Saladini, Francesco; Zazzi, Maurizio; Zehender, Gianguglielmo; Ciccozzi, Massimo; Balotta, Claudia

    2016-01-01

    Subtype A accounts for only 12% of HIV-1 infections worldwide but predominates in Russia and Former Soviet Union countries of Eastern Europe. After an early propagation via heterosexual contacts, this variant spread explosively among intravenous drug users. A distinct A1 variant predominates in Greece and Albania, which penetrated directly from Africa. Clade A1 accounts for 12.5% of non-B subtypes in Italy, being the most frequent after F1 subtype. Aim of this study was to investigate the circulation of A1 subtype in Italy and trace its origin and diffusion through phylogenetic and phylodynamic approaches. The phylogenetic analysis of 113 A1 pol sequences included in the Italian ARCA database, indicated that 71 patients (62.8%) clustered within 5 clades. A higher probability to be detected in clusters was found for patients from Eastern Europe and Italy (88.9% and 60.4%, respectively) compared to those from Africa (20%) (p Italy through three introduction events: directly from East Africa, from Albania and Greece, and from the area encompassing Moldavia and Ukraine. As in previously documented A1 epidemics of East European countries, HIV-1 A1 subtype spread in Italy in part through intravenous drug users. However, Eastern European women contributed to the penetration of such variant, probably through sex work.

  20. Addressing the dual health epidemics of HIV and sexual abuse among children and adolescents in Kenya: uptake of HIV counseling and post-exposure prophylaxis

    Directory of Open Access Journals (Sweden)

    Ajema C

    2017-12-01

    Full Text Available Carolyne Ajema,1 Charity Mbugua,2 Peter Memiah,3 Camille Wood,3 Courtney Cook,4 Ronald Kotut,2 Lina Digolo1 1Research and Strategic Information Department, LVCT Health, Nairobi, Kenya; 2Post Rape Care Department, LVCT Health, Nairobi, Kenya; 3Department of Public Health, University of West Florida, University Parkway, Pensacola, FL, USA; 4Biology Department, University of West Florida, University Parkway, Pensacola, FL, USA Purpose: Child sexual abuse and HIV are key health challenges in Kenya. In 2015, LVCT Health conducted a study aimed at assessing the quality of HIV-related services offered to child survivors of sexual violence in public health facilities.Materials and methods: A qualitative data collection approach was utilized. Qualitative data were collected through in-depth interviews with 31 providers. Quantitative methods included a retrospective review of 164 records of child survivors of rape who had accessed services 6 months prior to the commencement of the study. SPSS Version 22 was used in the descriptive analysis of the medical records. Client exit interviews and observation data were analyzed using MS Excel. In-depth interviews were analyzed using a thematic analytical approach.Results: Twenty-seven percent (n=164 survivors were documented to have received the first dose of postexposure prophylaxis (PEP. Providers did not conduct HIV pre- and posttest counseling for the survivors. There were no longitudinal follow-up mechanisms to ensure child survivors initiated on PEP adhered to the treatment plan. Less than 30% of survivors returned to the facility for PEP adherence counseling and follow-up HIV testing. Twenty providers cited capacity gaps in undertaking HIV risk assessment for child survivors. Limited availability of PEP is a barrier to HIV prevention, as most departments only offer services between 8 am and 5 pm. HIV tests were only available on weekdays before 5 pm. PEP being out of stock remains a barrier to HIV

  1. The HIV/AIDS epidemic and changes in injecting drug use in Buenos Aires, Argentina La epidemia de VIH/SIDA y los cambios en el uso inyectable de drogas en Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Diana Rossi

    2006-04-01

    Full Text Available This article discusses the changes in injecting drug use from 1998 to 2003 in Buenos Aires, Argentina. The Rapid Situation Assessment and Response methodology was used to obtain the information. Quantitative and qualitative techniques were triangulated: 140 current IDUs and 35 sex partners of injection drug users (IDUs were surveyed; 17 in-depth interviews with the surveyed IDUs and 2 focus groups were held, as well as ethnographic observations. The way in which risk and care practices among injecting drug users changed and the influence of the HIV/ AIDS epidemic on this process are described. In recent years, the frequency of injection practices and sharing of injecting equipment has decreased, while injecting drug use is a more hidden practice in a context of increasing impact of the disease in the injecting drug use social networks and changes in the price and quality of drugs. Knowledge about these changes helps build harm reduction activities oriented to IDUs in their particular social context.Este artículo refleja los cambios en el uso inyectable de drogas producidos entre 1998 y 2003 en Buenos Aires, Argentina. Para obtener la información se empleó la metodología de Evaluación y Respuesta Rápida, triangulando técnicas cuantitativas y cualitativas. Durante 2003-2004 se realizaron encuestas a 140 usuarios de drogas inyectables (UDIs actuales y a 35 parejas sexuales de UDIs. De este universo, 17 UDIs fueron entrevistados en profundidad; se formaron dos grupos de discusión y observaciones etnográficas. Se describe el modo en que cambiaron las prácticas de cuidado y riesgo en el uso inyectable y la influencia de la epidemia de VIH/SIDA en este proceso. En los últimos años disminuyó la frecuencia de uso y del uso compartido de material de inyección, se incrementó el ocultamiento del uso inyectable; en un contexto de fuerte impacto de la enfermedad en el entorno cercano a los UDIs y de un cambio en la relación precio-calidad de

  2. Hepatitis C virus infections among HIV-infected men who have sex with men: an expanding epidemic

    NARCIS (Netherlands)

    Urbanus, Anouk T.; van de Laar, Thijs J.; Stolte, Ineke G.; Schinkel, Janke; Heijman, Titia; Coutinho, Roel A.; Prins, Maria

    2009-01-01

    Background: Since 2000 outbreaks of sexually transmitted hepatitis C Virus (HCV) infections have been reported among HIV-infected men who have sex with men (MSM). We studied the prevalence and determinants of HCV-infection among MSM attending a large sexually transmitted infection (STI) clinic in

  3. Implications of differentiated care for successful ART scale-up in a concentrated HIV epidemic in Yangon, Myanmar.

    Science.gov (United States)

    Mesic, Anita; Fontaine, Julie; Aye, Theingy; Greig, Jane; Thwe, Thin Thin; Moretó-Planas, Laura; Kliesckova, Jarmila; Khin, Khin; Zarkua, Nana; Gonzalez, Lucia; Guillergan, Erwin Lloyd; O'Brien, Daniel P

    2017-07-21

    National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around the hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)-supported programmes and reports its outcomes. A descriptive cohort analysis of adult patients on antiretroviral treatment was performed. We assessed stability of patients as of 31 December 2014 and introduced an intervention of reduced frequency of physicians' consultations for stable patients, and fast tract ART refills. We measured a number of saved physician's visits as the result of this intervention. Main outcomes, remained under care, death, lost to follow up, treatment failure, were assessed on 31 December 2015 and reported as rates for different stable groups. On 31 December 2014, our programme counted 16, 272 adult patients enrolled in HIV care, of whom 80.34% were stable. The model allowed for an increase in the average number of patients one medical team could care for - from 745 patients in 2011 to 1, 627 in 2014 - and, thus, a reduction in the number of teams needed. An assessment of stable patients enrolled on ART one year after the implementation of the new model revealed excellent outcomes, aggregated for stable patients as 98.7% remaining in care, 0.4% dead, 0.8% lost to follow-up, 0.8% clinical treatment failure and 5.8% with immunological treatment failure. Implementation of a differentiated model reduced the number of visits between stable clients and physicians, reduced the medical resources required for treatment and enabled integrated treatment of the main co

  4. The HIV-1 epidemic in Bolivia is dominated by subtype B and CRF12_BF "family" strains

    Directory of Open Access Journals (Sweden)

    Guimarães Monick L

    2012-01-01

    Full Text Available Abstract Background Molecular epidemiological studies of HIV-1 in South America have revealed the occurrence of subtypes B, F1 and BF1 recombinants. Even so, little information concerning the HIV-1 molecular epidemiology in Bolivia is available. In this study we performed phylogenetic analyses from samples collected in Bolivia at two different points in time over a 10 year span. We analyzed these samples to estimate the trends in the HIV subtype and recombinant forms over time. Materials and methods Fifty one HIV-1 positive samples were collected in Bolivia over two distinct periods (1996 and 2005. These samples were genetically characterized based on partial pol protease/reverse transcriptase (pr/rt and env regions. Alignment and neighbor-joining (NJ phylogenetic analyses were established from partial env (n = 37 and all pol sequences using Mega 4. The remaining 14 env sequences from 1996 were previously characterized based on HMA-env (Heteroduplex mobility assay. The Simplot v.3.5.1 program was used to verify intragenic recombination, and SplitsTree 4.0 was employed to confirm the phylogenetic relationship of the BF1 recombinant samples. Results Phylogenetic analysis of both env and pol regions confirmed the predominance of "pure" subtype B (72.5% samples circulating in Bolivia and revealed a high prevalence of BF1 genotypes (27.5%. Eleven out of 14 BF1 recombinants displayed a mosaic structure identical or similar to that described for the CRF12_BF variant, one sample was classified as CRF17_BF, and two others were F1pol/Benv. No "pure" HIV-1 subtype F1 or B" variant of subtype B was detected in the present study. Of note, samples characterized as CRF12_BF-related were depicted only in 2005. Conclusion HIV-1 genetic diversity in Bolivia is mostly driven by subtype B followed by BF1 recombinant strains from the CRF12_BF "family". No significant temporal changes were detected between the mid-1990s and the mid-2000s for subtype B (76.2% vs 70

  5. The HIV-1 epidemic in Bolivia is dominated by subtype B and CRF12_BF "family" strains.

    Science.gov (United States)

    Guimarães, Monick L; Velarde-Dunois, Ketty G; Segurondo, David; Morgado, Mariza G

    2012-01-16

    Molecular epidemiological studies of HIV-1 in South America have revealed the occurrence of subtypes B, F1 and BF1 recombinants. Even so, little information concerning the HIV-1 molecular epidemiology in Bolivia is available. In this study we performed phylogenetic analyses from samples collected in Bolivia at two different points in time over a 10 year span. We analyzed these samples to estimate the trends in the HIV subtype and recombinant forms over time. Fifty one HIV-1 positive samples were collected in Bolivia over two distinct periods (1996 and 2005). These samples were genetically characterized based on partial pol protease/reverse transcriptase (pr/rt) and env regions. Alignment and neighbor-joining (NJ) phylogenetic analyses were established from partial env (n = 37) and all pol sequences using Mega 4. The remaining 14 env sequences from 1996 were previously characterized based on HMA-env (Heteroduplex mobility assay). The Simplot v.3.5.1 program was used to verify intragenic recombination, and SplitsTree 4.0 was employed to confirm the phylogenetic relationship of the BF1 recombinant samples. Phylogenetic analysis of both env and pol regions confirmed the predominance of "pure" subtype B (72.5%) samples circulating in Bolivia and revealed a high prevalence of BF1 genotypes (27.5%). Eleven out of 14 BF1 recombinants displayed a mosaic structure identical or similar to that described for the CRF12_BF variant, one sample was classified as CRF17_BF, and two others were F1pol/Benv. No "pure" HIV-1 subtype F1 or B" variant of subtype B was detected in the present study. Of note, samples characterized as CRF12_BF-related were depicted only in 2005. HIV-1 genetic diversity in Bolivia is mostly driven by subtype B followed by BF1 recombinant strains from the CRF12_BF "family". No significant temporal changes were detected between the mid-1990s and the mid-2000s for subtype B (76.2% vs 70.0%) or BF1 recombinant (23.8% vs 30.0%) samples from Bolivia.

  6. Contribution of transmission in HIV-positive men who have sex with men to evolving epidemics of sexually transmitted infections in England: an analysis using multiple data sources, 2009-2013.

    Science.gov (United States)

    Malek, R; Mitchell, H; Furegato, M; Simms, I; Mohammed, H; Nardone, A; Hughes, G

    2015-04-16

    HIV seroadaptive behaviours may have contributed to greater sexually transmitted infection (STI) transmission in HIV-positive men who have sex with men(MSM) and to the global increase in STIs. Using multiple national surveillance data sources and population survey data, we estimated the risk of STIs in HIV-positive MSM and assessed whether transmission in HIV-positive MSM has contributed to recent STI epidemics in England. Since 2009, an increasing proportion of STIs has been diagnosed in HIV-positive MSM, and currently, the population rate of acute bacterial STIs is up to four times that of HIV-negative or undiagnosed MSM. Almost one in five of all diagnosed HIV-positive MSM in England had an acute STI diagnosed in 2013. From 2009 to 2013, the odds of being diagnosed with syphilis increased from 2.71 (95% confidence interval (CI) 2.41–3.05, ptransmission in more dense sexual networks.These findings strongly suggest that the sexual health of HIV-positive MSM in England is worsening, which merits augmented public health interventions and continued monitoring.

  7. Predictors of bisexual behaviour among MSM attending intervention sites may help in prevention interventions for this bridge to the heterosexual epidemic in India: data from HIV sentinel surveillance.

    Directory of Open Access Journals (Sweden)

    Sheela Godbole

    Full Text Available Indian cultural tradition demanding marriage, many MSM howsoever they self-identify are likely to be married or have sex with women. To consolidate India's HIV prevention gains, it is important to understand and address the interaction between the MSM and heterosexual epidemics in India and create specific interventions for bisexual MSM. The challenge is to identify and intervene this hard to reach population. Data from HIV Sentinel Surveillance 2011 among MSM in four Indian states were analyzed to assess predictors and prevalence of bisexual behaviour in MSM.Between March-May 2011, 4682 men (15-49 years who had anal/oral sex with a male partner in the past month, attending intervention sites and consenting for an un-linked anonymous survey answered an 11- item questionnaire and provided blood for HIV test by finger stick at 19 designated surveillance sites.Of 4682 MSM tested overall, 5% were illiterate, 51% reported only receptive anal intercourse, 21% only penetrative and 28% both. 36% MSM had ever received money for sex. Overall 6.8% were HIV infected. 44% MSM were bisexual in the last six months. On multivariate analysis, 'being bisexual' was found to be independently associated with 'older age': 26-30 years [AOR = 3.1, 95% CI(2.7, 3.7], >30 years [AOR = 6.5, 95% CI(5.5, 7.7]; 'reporting penetrative behaviour alone' with other men [AOR = 5.8, 95% CI(4.8, 7.0, p<0.01] and 'reporting both penetrative and receptive behaviour' [AOR = 2.7, 95% CI(2.3, 3.1 p<0.01]. Those who both paid and received money for sex [AOR = 0.49, 95% CI (0.38, 0.62] were significantly less likely to be bisexual.A substantial proportion of men receiving services from Targeted Intervention programs are bisexual and the easy opportunity for intervention in this setting should be capitalised upon. Focusing on older MSM, as well as MSM who show penetrative behaviour with other men, could help in reaching this population.

  8. The choice of baby feeding mode within the reality of the HIV/AIDS epidemic: health education implications.

    Science.gov (United States)

    Minnie, C S; Greeff, M

    2006-11-01

    Avoidance of breast-feeding rules out the risk of HIV-transmission, but is not the best choice for all women. Pregnant women can be empowered by health education to make an informed decision. The aims of this study were to explore and describe the factors that should be considered in health education on HIV and baby feeding as well as the perceptions and knowledge-levels of midwives and pregnant women regarding these factors. The final aim was to compile guidelines for health education to pregnant women. A quantitative survey design utilizing structured questionnaires was used. An all-inclusive sample of 17 midwives working in antenatal clinics in the Potchefstroom district in South Africa and an availability sample of 93 pregnant women visiting these clinics participated. It was found that, although the midwives have a basic knowledge of HIV and baby feeding, there are specific knowledge-gaps related to the latest trends and research. The existing knowledge of the midwives was not efficiently conveyed to the pregnant women and they were not sufficiently empowered to make an informed decision. Recommendations were formulated for nursing education and research with the focus on recommendations for practice. These guidelines include factors conducive to a positive milieu, as well as the presentation and content of health education.

  9. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention

    Directory of Open Access Journals (Sweden)

    Jewkes Rachel

    2010-02-01

    Full Text Available Abstract Research shows that gender power inequity in relationships and intimate partner violence places women at enhanced risk of HIV infection. Men who have been violent towards their partners are more likely to have HIV. Men's behaviours show a clustering of violent and risky sexual practices, suggesting important connections. This paper draws on Raewyn Connell's notion of hegemonic masculinity and reflections on emphasized femininities to argue that these sexual, and male violent, practices are rooted in and flow from cultural ideals of gender identities. The latter enables us to understand why men and women behave as they do, and the emotional and material context within which sexual behaviours are enacted. In South Africa, while gender identities show diversity, the dominant ideal of black African manhood emphasizes toughness, strength and expression of prodigious sexual success. It is a masculinity women desire; yet it is sexually risky and a barrier to men engaging with HIV treatment. Hegemonically masculine men are expected to be in control of women, and violence may be used to establish this control. Instead of resisting this, the dominant ideal of femininity embraces compliance and tolerance of violent and hurtful behaviour, including infidelity. The women partners of hegemonically masculine men are at risk of HIV because they lack control of the circumstances of sex during particularly risky encounters. They often present their acquiescence to their partners' behaviour as a trade off made to secure social or material rewards, for this ideal of femininity is upheld, not by violence per se, by a cultural system of sanctions and rewards. Thus, men and women who adopt these gender identities are following ideals with deep roots in social and cultural processes, and thus, they are models of behaviour that may be hard for individuals to critique and in which to exercise choice. Women who are materially and emotionally vulnerable are least

  10. Looking upstream to prevent HIV transmission: can interventions with sex workers alter the course of HIV epidemics in Africa as they did in Asia?

    NARCIS (Netherlands)

    Steen, R. van der; Hontelez, J.A.; Veraart, A.; White, R.G.; Vlas, S.J. de

    2014-01-01

    BACKGROUND: High rates of partner change in 'upstream' sex work networks have long been recognized to drive 'downstream' transmission of sexually transmitted infections (STIs). We used a stochastic microsimulation model (STDSIM) to explore such transmission dynamics in a generalized African HIV

  11. Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era

    NARCIS (Netherlands)

    Eaton, J.W.; Bacaer, N.; Bershteyn, A.; Cambiano, V.; Cori, A.; Dorrington, R.E.; Fraser, C.; Gopalappa, C.; Hontelez, J.A.; Johnson, L.F.; Klein, D.J.; Phillips, A.N.; Pretorius, C.; Stover, J.; Rehle, T.M.; Hallett, T.B.

    2015-01-01

    BACKGROUND: Mathematical models are widely used to simulate the effects of interventions to control HIV and to project future epidemiological trends and resource needs. We aimed to validate past model projections against data from a large household survey done in South Africa in 2012. METHODS: We

  12. New emerging recombinant HIV-1 strains and close transmission linkage of HIV-1 strains in the Chinese MSM population indicate a new epidemic risk.

    Directory of Open Access Journals (Sweden)

    Jianjun Wu

    Full Text Available In recent years, the population of men who have sex with men (MSM have become the most significant increasing group of HIV-1 transmission in China. To identify new recombinant strains and transmission patterns of HIV-1 in Chinese MSM population, a cross-sectional investigation of MSM in Anhui Province (in south-eastern China was performed in 2011. The diagnosed AIDS case rate, CD4 T-cell counts, HIV subtypes, and origin of the recombinant strains were investigated in 138 collected samples. The phylogenetic and bootscan analyses demonstrated that, apart from three previously reported circulating strains (CRF07_BC, CRF01_AE, subtype B, various recombinant strains among subtype B, subtype C, CRF01_AE, and CRF07_BC were simultaneously identified in Chinese MSM for the first time. The introducing time of B subtype in Chinese MSM populations was estimated in 1985, CRF01_AE in 2000, and CRF07_BC in 2003; the latter two account for more than 85% of MSM infections. Notably, in comparison with B subtype infections in Anhui MSM, CRF01_AE, with the highest prevalence rate, may accelerate AIDS progression. Over half of patients (56% infected with new recombinant strains infection are diagnosed as progression into AIDS. Both Bayes and phylogenetic analyses indicated that there was active HIV transmission among MSM nationwide, which may facilitate the transmission of the new 01B recombinant strains in MSM. In conclusion, new recombinant strains and active transmission were identified in the Chinese MSM population, which may lead to a new alarming HIV pandemic in this population due to the increased pathogenesis of the newly emerging strains.

  13. HIV-infection in the South Ural region of Russia at the present stage: the analysis of the epidemiological situation and new approaches to evaluating the effectiveness of the response to the epidemic

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    A. B. Kon’kova-Rejdman

    2015-01-01

    Full Text Available The unsuccessful epidemiological situation on HIV infection with negative tendencies is observed in Chelyabinsk region (1034,1 on 100 thousand population. The big difference between estimated quantity of people living with HIV and the registered number of HIV-positive people increase (for 59,7% – in 2012, for 60,2% – in 2013, for 61,1% – in 2014. The cascade model of levels of medical care of people living with HIV of Chelyabinsk region is used in thearticle. Main «losses» of people living with HIV are noted at the following stages of the cascade in Chelyabinsk region: «HIV infection – Detection of HIV (-61,1% With»; «Detection of HIV – statement on the dispensary account (-22,4%»; «Medical examination – needs in the ART (-71,1%». The cascade of delivery of health care in Chelyabinsk region is distinguished from data on the Russian Federation with big percent of losses (-32,7% at the stage «receiving the ART-epidemiologically safe level of virus loading». Leaving of the patient from everyone «cascade steps» of delivery of health care reflect problems in the organization of medical care. Transition of epidemic from groups of risk in the general population, its feminization and generalization demands optimization of strategy of counteraction of epidemic of HIV infection. The cascade model reflecting «profile» of the organization of medical care in a period can be effectively used as an independent element of an information and analytical subsystem of epidemic supervision of HIV infection in regions of the Russian Federation.

  14. Sexual abstinence behavior among never-married youths in a generalized HIV epidemic country: evidence from the 2005 Côte d'Ivoire AIDS indicator survey

    Directory of Open Access Journals (Sweden)

    Kawahara Kazuo

    2008-12-01

    Full Text Available Abstract Background Sexual abstinence is the best available option for preventing both pregnancy and sexually transmitted infections, including HIV/AIDS. Identifying the factors associated with sexual abstinence among youths would have meaningful implications in a generalized HIV epidemic country such as the Côte d'Ivoire. Thus, we explored sexual abstinence behavior among never-married individuals aged 15 to 24 in Côte d'Ivoire and assessed factors that predict sexual abstinence. Methods We obtained data from the nationally representative and population-based 2005 Côte d'Ivoire AIDS Indicator Survey, conducted from September 2004 to October 2005. Our sample included 3041 never-married people aged 15 to 24. Of these, 990 reported never having sexual intercourse (primary abstinence and 137 reported sexual experience but not in the 12 months prior to the survey (secondary abstinence. In all, 1127 youths reported sexual abstinence practice. Results Of the 3041 never-married youths, 54.4% were male and 45.6% were female. About 33.0%, 6.7%, and 37.1% of them were practicing primary, secondary, and sexual abstinence behavior, respectively. Females of higher education level were significantly 11.14 times as likely as those of no education to practice either primary or secondary abstinence. Males who were animists, had no religion, or were practicing religions other than Christianity or Muslim were significantly less likely than other male youths to practice sexual abstinence (OR = 0.53, 95% CI = 0.30–0.95. Living in the north-west region of the country significantly decreased the odds of sexual abstinence among female youths. Similarly, female youths living in rural areas were significantly 0.42 times as likely as those in the urban zones to practice sexual abstinence. Conclusion HIV/AIDS prevention program components could include media campaigns, educational intervention improvement, as well as promoting policies that shape female youth

  15. Visual Mining of Epidemic Networks

    CERN Document Server

    Clémençon, Stéphan; Rossi, Fabrice; Tran, Viet Chi; 10.1007/978-3-642-21498-1_35

    2012-01-01

    We show how an interactive graph visualization method based on maximal modularity clustering can be used to explore a large epidemic network. The visual representation is used to display statistical tests results that expose the relations between the propagation of HIV in a sexual contact network and the sexual orientation of the patients.

  16. An integrated approach to care attracts people living with HIV who use illicit drugs in an urban centre with a concentrated HIV epidemic

    Directory of Open Access Journals (Sweden)

    S. Fernando

    2016-11-01

    Full Text Available Abstract Background People living with HIV (PLHIV who are also marginalized by social and structural inequities often face barriers to accessing and adhering to HIV treatment and care. The Dr. Peter Centre (DPC is a non-profit integrated care facility with a supervised injection room that serves PLHIV experiencing multiple barriers to social and health services in Vancouver, Canada. This study examines whether the DPC is successful in drawing in PLHIV with complex health issues, including addiction. Methods Using data collected by the Longitudinal Investigations into Supportive and Ancillary health services (LISA study from July 2007 to January 2010, linked with clinical variables available through the British Columbia Centre for Excellence in HIV/AIDS Drug Treatment Program, we identified DPC and non-DPC clients with a history of injection drug use. Bivariable and multivariable logistic regression analyses compared socio-demographic and clinical characteristics of DPC clients (n = 76 and non-DPC clients (n = 482 with a history of injection drug use. Results Of the 917 LISA participants included within this analysis, 100 (10.9% reported being a DPC client, of which 76 reported a history of injection drug use. Adjusted results found that compared to non-DPC clients with a history of injection drug use, DPC-clients were more likely to be male (AOR: 4.18, 95% CI = 2.09–8.37; use supportive services daily vs. less than daily (AOR: 3.16, 95% CI = 1.79–5.61; to have been diagnosed with a mental health disorder (AOR: 2.11; 95% CI: 1.12–3.99; to have a history of interpersonal violence (AOR: 2.76; 95% CI: 1.23–6.19; and to have ever experienced ART interruption longer than 1 year (AOR: 2.39; 95% CI: 1.38–4.15. Conclusions Our analyses suggest that the DPC operating care model engages PLHIV with complex care needs, highlighting that integrated care facilities are needed to support the multiple intersecting vulnerabilities faced

  17. Intentional Hidden Curriculum

    OpenAIRE

    氏原, 陽子

    2013-01-01

    This paper aims to make clear the existence of an intentional hidden curriculum and define the hidden curriculum. First, this paper criticizes hidden curriculum arguments thatregard hidden curriculum as unintentional learning outcome. Since these arguments can go up Bloom, this paper reviews Bloom and shows that the biggest problem is the difficulty injudging whether there is intention or not. Second, this paper investigates into intentional hidden curriculum. Portelli argues about the hidden...

  18. HIV-1 A1 Subtype Epidemic in Italy Originated from Africa and Eastern Europe and Shows a High Frequency of Transmission Chains Involving Intravenous Drug Users.

    Directory of Open Access Journals (Sweden)

    Alessia Lai

    Full Text Available Subtype A accounts for only 12% of HIV-1 infections worldwide but predominates in Russia and Former Soviet Union countries of Eastern Europe. After an early propagation via heterosexual contacts, this variant spread explosively among intravenous drug users. A distinct A1 variant predominates in Greece and Albania, which penetrated directly from Africa. Clade A1 accounts for 12.5% of non-B subtypes in Italy, being the most frequent after F1 subtype.Aim of this study was to investigate the circulation of A1 subtype in Italy and trace its origin and diffusion through phylogenetic and phylodynamic approaches.The phylogenetic analysis of 113 A1 pol sequences included in the Italian ARCA database, indicated that 71 patients (62.8% clustered within 5 clades. A higher probability to be detected in clusters was found for patients from Eastern Europe and Italy (88.9% and 60.4%, respectively compared to those from Africa (20% (p < .001. Higher proportions of clustering sequences were found in intravenous drug users with respect to heterosexuals (85.7% vs. 59.3%, p = .056 and in women with respect to men (81.4% vs. 53.2%, p < .006. Subtype A1 dated phylogeny indicated an East African origin around 1961. Phylogeographical reconstruction highlighted 3 significant groups. One involved East European and some Italian variants, the second encompassed some Italian and African strains, the latter included the majority of viruses carried by African and Italian subjects and all viral sequences from Albania and Greece.Subtype A1 originated in Central Africa and spread among East European countries in 1982. It entered Italy through three introduction events: directly from East Africa, from Albania and Greece, and from the area encompassing Moldavia and Ukraine. As in previously documented A1 epidemics of East European countries, HIV-1 A1 subtype spread in Italy in part through intravenous drug users. However, Eastern European women contributed to the penetration of

  19. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... between drug abuse and HIV/AIDS. In the early years of the HIV epidemic, it became clear ... HIV/AIDS and the discovery of promising treatment interventions for breaking the harmful links between them, we ...

  20. High burden of STI and HIV in male sex workers working as internet escorts for men in an observational study: a hidden key population compared with female sex workers and other men who have sex with men.

    Science.gov (United States)

    Verhaegh-Haasnoot, Amanja; Dukers-Muijrers, Nicole H T M; Hoebe, Christian J P A

    2015-07-29

    Male sex work in the western countries has changed, including now a subculture of male sex workers who have paid sex with men arranged for via the internet. The men involved in this subculture do not easily identify themselves as sex workers nor as homosexual, and are therefore missed by regular health care and public health interventions. These male sex workers may form a hidden key population for sexually transmitted infections (STIs) and HIV, bridging towards other persons outside this context. This clinic-based observational study included consultations by male sex workers (n = 212), female sex workers (n = 801) and in men having sex with men who did not report being paid for sexual contacts (MSM, n = 2703) who received STI and HIV testing and counselling at our clinic during the study period. In this study we compare the consultations in male sex workers to those in in female sex workers and MSM. Demographic characteristics and sexual behaviour of the male sex workers, female sex workers and MSM were compared using chi-square tests and non-parametric tests. Using univariate and multivariate regression analyses, determinants for STI positivity in male sex workers were evaluated. Male sex workers tested positive for STI (including HIV) in 40 % of the consultations; female sex workers and MSM respectively in 9 and 14 % of the consultations. A new HIV infection was found in 8 % of the consultations of male sex workers. Male sex workers were a young population of migrant sex workers from Eastern Europe. They reported more often to also have sex contacts with women and other sex workers. Male sex workers are at a higher risk for one or more new STI than female sex workers and other MSM, even after correction for age, ethnicity, known HIV positivity and behavioural variables. Male sex workers form a hidden key population that impacts the transmission of STI and HIV within the MSM population and, possibly, to the heterosexual population. They require specific targeted

  1. HIV-1

    African Journals Online (AJOL)

    the two major issues of stopping the AIDS epidemic and reducing poverty are addressed. Nevertheless ... affected by the same HIV epidemic as the general adult population. The resulting high absentee rates due to .... Streptococcus pneumoniae and non~typhoidal Salmonella. In the case of a Herxheimer-type reaction, ...

  2. The shape of the HIV/AIDS epidemic in Puerto Rico El estado de la epidemia de VIH/SIDA en Puerto Rico

    Directory of Open Access Journals (Sweden)

    Maria A. Gomez

    2000-06-01

    Full Text Available This study presents information on AIDS patients in Puerto Rico, including their general sociodemographic profile, some risk-related parameters, characteristics of vulnerable groups, and elements of the clinical spectrum of the disease. Data were analyzed from the Puerto Rico AIDS Surveillance Program and available studies about the HIV/AIDS epidemic in Puerto Rico. A total of 23 089 AIDS cases was reported to the Puerto Rico AIDS Surveillance Program from January 1981 through February 1999. The HIV/AIDS epidemic has affected mostly males and females between the ages of 30 and 49, though cases have also been reported for other age groups. The cumulative proportion of persons with AIDS who are women has increased tremendously, from 11.4% for the 1981-1986 period to 21.6% for the entire 1981-1999 period. In Puerto Rico the category of injecting drug users (IDUs accounts for the majority of the AIDS cases (52%, followed by heterosexual contact (22%, and men who have sex with men (17%. The three main diagnoses for AIDS on the island are wasting syndrome (30.7%; esophageal, bronchial, and lung candidiasis (29.4%; and Pneumocystis carinii pneumonia (26.8%. According to 1994 vital statistics for Puerto Rico, AIDS was the fourth-leading cause of death. The overall reported AIDS mortality rate was 42.0 per 100 000 persons, with the rate for males, 67.8, much higher than it was for females, 17.4. AIDS is the first cause of death among persons between 30 and 39 years old. Intense efforts are needed to better understand the epidemic in Puerto Rico and its biology, social and family impacts, and financial costs.Este estudio presenta información sobre los pacientes con sida en Puerto Rico, como su perfil sociodemográfico general, los factores de riesgo, las características de los grupos vulnerables y los elementos del espectro clínico de la enfermedad. Los datos analizados procedían del Programa de Vigilancia del sida en Puerto Rico y de estudios sobre

  3. O papel da mídia na prevenção do HIV/Aids e a representação da mulher no contexto da epidemia The paper of the media in the prevention of HIV/AIDS and the woman's representation in the context of the epidemic

    Directory of Open Access Journals (Sweden)

    Erli Helena Gonçalves

    2005-03-01

    Full Text Available O presente artigo questiona o papel da mídia diante da epidemia do HIV/Aids. Toda a discussão é travada à luz da bioética, tentando sempre apreender os dilemas morais subjacentes nas mensagens de prevenção do HIV/Aids. Pautar se a mídia considerou os rumos da epidemia na medida em que essa ia se modificando; refletir se as campanhas educativas do HIV/Aids ponderavam as assimetrias de gênero, a sexualidade e os processos de socialização.The present article tries to question the mission of the media before the epidemic of HIV/AIDS. The whole discussion is supposed, in the light of the bioethics, to try to apprehend the tenor of the messages transmitted in the context of the disease. To discuss if the media had considered the different ways of the epidemic while they were being modified; to think if the HIV/AIDS educative campaigns had considered the gender differences, the sexuality and the socialization process.

  4. Successes and gaps in uptake of regular, voluntary HIV testing for hidden street- and off-street sex workers in Vancouver, Canada.

    Science.gov (United States)

    Deering, K N; Montaner, J S; Chettiar, J; Jia, J; Ogilvie, G; Buchner, C; Feng, C; Strathdee, S A; Shannon, K

    2015-01-01

    Despite evidence globally of the heavy HIV burden among sex workers (SWs) as well as other poor health outcomes, including violence, SWs are often excluded from accessing voluntary, confidential and non-coercive health services, including HIV prevention, treatment, care and support. This study therefore assessed the prevalence and association with regular HIV testing among street- and off-street SWs in Vancouver, Canada. Cross-sectional baseline data were used from a longitudinal cohort known as "An Evaluation of Sex Worker's Health Access" (AESHA; January 2010-July 2012). This cohort included youth and adult SWs (aged 14+ years). We used multivariable logistic regression to assess the relationship between explanatory variables and having a recent HIV test (in the last year). Of the 435 seronegative SWs included, 67.1% reported having a recent HIV test. In multivariable logistic regression analysis, having a recent HIV test remained significantly independently associated with elevated odds of inconsistent condom use with clients [adjusted (multivariable) odds ratios, AOR: 2.59, 95% confidence intervals [95% CIs]: 1.17-5.78], injecting drugs (AOR: 2.33, 95% CIs: 1.17-4.18) and contact with a mobile HIV prevention programme (AOR: 1.76, 95% CIs: 1.09-2.84) within the last six months. Reduced odds of having a recent HIV test was also significantly associated with being a migrant/new immigrant to Canada (AOR: 0.33, 95% CIs: 0.19-0.56) and having a language barrier to health care access (AOR: 0.26, 95% CIs: 0.09-0.73). Our results highlight successes of reaching SWs at high risk of HIV through drug and sexual pathways. To maximize the effectiveness of including HIV testing as part of comprehensive HIV prevention and care to SWs, increased mobile outreach and safer-environment interventions that facilitate access to voluntary, confidential and non-coercive HIV testing remain a critical priority, in addition to culturally safe services with language support.

  5. Hidden risks for pneumonia in Malawi

    African Journals Online (AJOL)

    Hidden risks for pneumonia in Malawi. 06 Fullerton', SB Gordon2. 1. Department of ... cal but unseen risk factors for pneumonia. This paper reviews how recent research in Malawi and ..... Gyorkey F, Lahart C, Rossen RD. The effect of HIV infection on phagocytosis and killing of Staphylococcus aureus by human. 51. 52. 54.

  6. Gender-Based Power and Couples' HIV Risk In Uttar Pradesh and Uttarakhand, North India

    National Research Council Canada - National Science Library

    Alpna Agrawal; Shelah S. Bloom; Chirayath Suchindran; Siân Curtis; Gustavo Angeles

    2014-01-01

    Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic...

  7. Deep Sequencing of HIV-1 RNA and DNA in Newly Diagnosed Patients with Baseline Drug Resistance Showed No Indications for Hidden Resistance and Is Biased by Strong Interference of Hypermutation.

    Science.gov (United States)

    Dauwe, Kenny; Staelens, Delfien; Vancoillie, Leen; Mortier, Virginie; Verhofstede, Chris

    2016-06-01

    Deep sequencing of plasma RNA or proviral DNA may be an interesting alternative to population sequencing for the detection of baseline transmitted HIV-1 drug resistance. Using a Roche 454 GS Junior HIV-1 prototype kit, we performed deep sequencing of the HIV-1 protease and reverse transcriptase genes on paired plasma and buffy coat samples from newly diagnosed HIV-1-positive individuals. Selection was based on the outcome of population sequencing and included 12 patients with either a revertant amino acid at codon 215 of the reverse transcriptase or a singleton resistance mutation, 4 patients with multiple resistance mutations, and 4 patients with wild-type virus. Deep sequencing of RNA and DNA detected 6 and 43 mutations, respectively, that were not identified by population sequencing. A subsequently performed hypermutation analysis, however, revealed hypermutation in 61.19% of 3,188 DNA reads with a resistance mutation. The removal of hypermutated reads dropped the number of additional mutations in DNA from 43 to 17. No hypermutation evidence was found in the RNA reads. Five of the 6 additional RNA mutations and all additional DNA mutations, after full exclusion of hypermutation bias, were observed in the 3 individuals with multiple resistance mutations detected by population sequencing. Despite focused selection of patients with T215 revertants or singleton mutations, deep sequencing failed to identify the resistant T215Y/F or M184V or any other resistance mutation, indicating that in most of these cases there is no hidden resistance and that the virus detected at diagnosis by population sequencing is the original infecting variant. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  8. Mulheres com HIV/AIDS: fragmentos de sua face oculta Mujeres con HIV/AIDS: fragmentos de su faceta oculta Women with HIV/AIDS: fragments of their hidden face

    Directory of Open Access Journals (Sweden)

    Petronila Libana Cechim

    2007-04-01

    Full Text Available O estudo buscou conhecer fatores geradores do medo que assola as mulheres soropositivas e conseqüências nas relações do cotidiano familiar, do trabalho e do convívio social. O método empregado é de natureza qualitativa. Focalizou mulheres com HIV/AIDS que estão em acompanhamento na Unidade de Saúde do Município de São Leopoldo-RS. A coleta de dados foi por meio de entrevista semi-estruturada, atingindo 18 mulheres, de 23 a 55 anos. A discriminação no seio da família e no trabalho e a perda de amigos constituem fator de medo constante e exercem influência no comportamento social das mulheres. O medo está relacionado também com a imagem da mulher e o isolamento social.En el presente trabajo se buscó conocer a los factores generadores del miedo que asola las mujeres seropositivas y a las consecuencias en las relaciones del cotidiano de la familia, del trabajo y del convivio social. El método usado fue de naturaleza cualitativa. Se focalizó en mujeres con HIV/SIDA que están siendo acompañadas en la Unidad de Salud del Municipio de São Leopoldo-RS. La recogida de datos fue a través de entrevista semiestructurada, abarcando 18 mujeres, de 23 a 55 anos. La discriminación en el seno de la familia y en el trabajo y la pérdida de amigos constituyen factor de miedo permanente y ejercen influencia en el comportamiento social de las mujeres. El miedo también está relacionado con la imagen de la mujer y el aislamiento social.The study aimed at determining factors that generate the fear visiting upon HIV-positive women and consequences in routine family, work and social life relations. The method employed is of qualitative nature. Women with HIV/AIDS that were followed at the Health Clinic of São Leopoldo-RS were focused. Data collection was performed by a semi-structured interview, seeking 18 women, from 23 to 55 years old. Discrimination in the family and at the workplace and loss of friends constitute a factor of constant fear

  9. A Human-Centered Platform for HIV Infection Reduction in New York: Development and Usage Analysis of the Ending the Epidemic (ETE) Dashboard.

    Science.gov (United States)

    Joshi, Ashish; Amadi, Chioma; Katz, Benjamin; Kulkarni, Sarah; Nash, Denis

    2017-12-11

    Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment. We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York's progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020. The ETE dashboard was adapted from an existing human-centered geovisualization platform, SanaViz, an Internet-enabled, interactive app incorporating principles of human-centered design and cognitive fit theory to enhance visual exploration of population health data. Usage evaluation of the ETE geovisualization dashboard was conducted using Google Analytics over a 4-week period from March 19 to April 18, 2016. The aim was to monitor user activity and analyze traffic on the ETE dashboard using evidence-based metrics that can provide adequate feedback to enhance its utilization. Usage was characterized based on three metrics: (1) number of unique visits to each page, (2) average time on each page in seconds, and (3) page bounce rate (ie, percentage of visits where user left the site immediately after viewing just a single page). Further analysis was also conducted by cross-tabulating specific usage metrics. Of 860 sessions, 324 sessions were initiated by unique users (37.7%). The most common acquisition channels included direct source (353/860, 41.0%); followed by referral traffic (340/860, 39.5%) and organic search (134/860, 15.5%). Usage statistics indicate that for the 860 sessions initiated by both new and returning users, the average viewing time was 8 minutes, 51 seconds, and the bounce rate was 46%. These statistics reflect positive results given that prior literature estimates an

  10. Inferring epidemic contact structure from phylogenetic trees.

    Directory of Open Access Journals (Sweden)

    Gabriel E Leventhal

    Full Text Available Contact structure is believed to have a large impact on epidemic spreading and consequently using networks to model such contact structure continues to gain interest in epidemiology. However, detailed knowledge of the exact contact structure underlying real epidemics is limited. Here we address the question whether the structure of the contact network leaves a detectable genetic fingerprint in the pathogen population. To this end we compare phylogenies generated by disease outbreaks in simulated populations with different types of contact networks. We find that the shape of these phylogenies strongly depends on contact structure. In particular, measures of tree imbalance allow us to quantify to what extent the contact structure underlying an epidemic deviates from a null model contact network and illustrate this in the case of random mixing. Using a phylogeny from the Swiss HIV epidemic, we show that this epidemic has a significantly more unbalanced tree than would be expected from random mixing.

  11. HIV prevalence and gender differences among new injection-drug-users in Tallinn, Estonia: A persisting problem in a stable high prevalence epidemic.

    Science.gov (United States)

    Uusküla, Anneli; Raag, Mait; Marsh, Kristina; Talu, Ave; Vorobjov, Sigrid; Des Jarlais, Don

    2017-01-01

    New injectors / younger drug users are an important population to target for intervention because they are often at especially high risk of HIV and HCV infection. We examined HIV prevalence and gender differences in HIV prevalence and risk behavior among new injection-drug-users in Tallinn, Estonia. Respondent driven sampling (RDS) interview surveys and HIV testing were conducted in Tallinn in 2009, 2011 and 2013. We classified "new injectors" as persons who reported their first injection as occurring within three years of the study interview. Recruiting trees of the three individual RDS studies were joined to form one RDS dataset and RDS estimates for prevalence and means were derived. Bootstrap tests were used to compare data from men and women, HIV infected and uninfected. Among 110 new injectors (34 women and 76 men) the mean age was 24.5 (SD 7.5) years; 63% reported injecting mainly fentanyl, 34% injecting mainly amphetamine, 36% sharing syringes, 89% were sexually active, and, of these, 88% did not always use condoms in the last 6 months. HIV prevalence was 18% (95%CI 8-28%) (41% (95%CI 19-63%) among female and 7% (95%CI 2-12%) among male new injectors). Based on self-reports, 8.1% of all new injectors (and 22% of female new injectors) were HIV positive before starting to inject drugs. 40% of HIV infected reported receiving antiretroviral therapy. In multivariable analysis, gender (male: OR 0.12, 95% CI 0.03-0.45), main drug injected (fentanyl: OR 6.7, 95% CI 1.3-35.7) and syringe sharing (distributive: OR 0.11, 95% CI 0.02-0.55; and receptive: OR 3.7, 95% CI 1.0-13.5) were associated with the HIV seropositivity. New injectors exhibit high-risk behavior and correspondingly high HIV prevalence. Sexual transmission of HIV infection, including before injection initiation, is likely to be a significant contributor to HIV risk among female new injectors. This highlights the need to identify and target new injectors and their partners with gender specific

  12. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... between drug abuse and HIV/AIDS. In the early years of the HIV epidemic, it became clear ... Network TV Organizations: AIDS.gov AIDS Alliance for Children, Youth and Families The American Academy of Child & ...

  13. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... teens and young adults have never known a world without it. NIDA’s "Learn the Link" campaign continues ... drug abuse and HIV/AIDS. In the early years of the HIV epidemic, it became clear that ...

  14. HIV among People Who Inject Drugs in the Middle East and North Africa: Systematic Review and Data Synthesis

    Science.gov (United States)

    Mumtaz, Ghina R.; Weiss, Helen A.; Thomas, Sara L.; Riome, Suzanne; Setayesh, Hamidreza; Riedner, Gabriele; Semini, Iris; Tawil, Oussama; Akala, Francisca Ayodeji; Wilson, David; Abu-Raddad, Laith J.

    2014-01-01

    prevalence of sharing needles/syringes (18%–28% in the last injection), the low levels of condom use (20%–54% ever condom use), the high levels of having sex with sex workers and of men having sex with men (15%–30% and 2%–10% in the last year, respectively), and of selling sex (5%–29% in the last year), indicate a high injecting and sexual risk environment. The prevalence of HCV (31%–64%) and of sexually transmitted infections suggest high levels of risk behavior indicative of the potential for more and larger HIV epidemics. Conclusions Our study identified a large volume of HIV-related biological and behavioral data among PWID in the MENA region. The coverage and quality of the data varied between countries. There is robust evidence for HIV epidemics among PWID in multiple countries, most of which have emerged within the last decade and continue to grow. The lack of sufficient evidence in some MENA countries does not preclude the possibility of hidden epidemics among PWID in these settings. With the HIV epidemic among PWID in overall a relatively early phase, there is a window of opportunity for prevention that should not be missed through the provision of comprehensive programs, including scale-up of harm reduction services and expansion of surveillance systems. Please see later in the article for the Editors' Summary PMID:24937136

  15. The chemical bases of the various AIDS epidemics: recreational ...

    Indian Academy of Sciences (India)

    Why is there no vaccine against AIDS? Why is AIDS in the US and Europe not random like other viral epidemics? Why did AIDS not rise and then decline exponentially owing to antiviral immunity like all other viral epidemics? Why is AIDS not contagious? Why would only HIV carriers get AIDS who use either recreational or ...

  16. High HIV incidence in the postpartum period sustains vertical transmission in settings with generalized epidemics: a cohort study in Southern Mozambique

    Directory of Open Access Journals (Sweden)

    Caroline De Schacht

    2014-03-01

    Full Text Available Introduction: Acute infection with HIV in the postpartum period results in a high risk of vertical transmission through breastfeeding. A study was done to determine the HIV incidence rate and associated risk factors among postpartum women in Southern Mozambique, where HIV prevalence among pregnant women is 21%. Methods: A prospective cohort study was conducted in six rural health facilities in Gaza and Maputo provinces from March 2008 to July 2011. A total of 1221 women who were HIV-negative on testing at delivery or within two months postpartum were recruited and followed until 18 months postpartum. HIV testing, collection of dried blood spot samples and administration of a structured questionnaire to women were performed every three months. Infant testing by DNA-PCR was done as soon as possible after identification of a new infection in women. HIV incidence was estimated, and potential risk factors at baseline were compared using Poisson regression. Results: Data from 957 women were analyzed with follow-up after the enrolment visit, with a median follow-up of 18.2 months. The HIV incidence in postpartum women is estimated at 3.20/100 women-years (95% CI: 2.30–4.46, with the highest rate among 18- to 19-year-olds (4.92 per 100 women-years; 95% CI: 2.65–9.15. Of the new infections, 14 (34% were identified during the first six months postpartum, 11 (27% between 6 and 12 months and 16 (39% between 12 and 18 months postpartum. Risk factors for incident HIV infection include young age, low number of children, higher education level of the woman's partner and having had sex with someone other than one's partner. The vertical transmission was 21% (95% CI: 5–36 among newly infected women. Conclusions: Incidence of HIV is high among breastfeeding women in Southern Mozambique, contributing to increasing numbers of HIV-infected infants. Comprehensive primary prevention strategies targeting women of reproductive age, particularly pregnant and

  17. Screening for HIV, hepatitis B and syphilis on dried blood spots: A promising method to better reach hidden high-risk populations with self-collected sampling.

    Directory of Open Access Journals (Sweden)

    Inge H M van Loo

    Full Text Available Many people at high risk for sexually transmitted infections (STIs, e.g., men who have sex with men (MSM, are not optimally reached by current sexual health care systems with testing. To facilitate testing by home-based sampling or sampling in outreach setting we evaluated dried blood spots (DBS, a method for self-collected blood sampling for serological screening of HIV, hepatitis B (HBV and syphilis. The aims of this study were to assess the acceptability and feasibility of self-collected DBS and to compare the test results for screening of HIV, HBV and syphilis from DBS with blood drawn by venous puncture.DBS were collected from men who have sex with men (MSM, visiting the STI clinic of the public health service South Limburg (n = 183 and HIV positive and HBV positive patients (n = 34, visiting the outpatient clinics of the Maastricht University Medical Centre in the period January 2012-April 2015. The 93 first participating MSM visiting the STI clinic were asked to fill in a questionnaire about the feasibility and acceptability about self-collection of DBS in a setting without going to a health care facility and were asked to collect the DBS themselves. Serological screening tests for HIV (HIV combi PT, Roche, HBV (HBsAg, Roche and syphilis (Treponema pallidum Ig, Biokit 3.0 were performed on DBS and on blood drawn by venous puncture, which was routinely taken for screening.In total 217 participants were included in the study with a median age of 40 years (range between 17-80. Of MSM 84% agreed that it was clear and easy to do the finger-prick, while 53% agreed that it was clear and easy to apply the blood onto the DBS card. Also, 80% of MSM would use the bloodspot test again. In 91% (198 of DBS, sufficient material was collected to perform the three tests. No difference was observed in DBS quality between self-collected DBS and health care worker collected DBS. For HIV (n = 195 DBS-serum pairs sensitivity and specificity were 100%. For HBV

  18. Back-calculation and projection of the HIV/AIDS epidemic among homosexual/ bisexual men in three European countries: evalution of past projections and updates allowing for treatment effects.

    Science.gov (United States)

    Artzrouni, Marc

    2004-01-01

    This study critically evaluates the quality of 1990 back-calculations and long-term projections of the HIV/AIDS epidemic for homosexual/bisexual men in France, the Federal Republic of Germany, and the UK. The projection captured the general pattern observed in all three countries although the observed AIDS incidence peaked 2-3 years later and declined faster than had been projected. Total AIDS incidences from 1989 to 2000 were overestimated by 38.5% in France, and underestimated by 23.9 and 17.5% in western Germany and the UK. Updated back-calculations and projections to 2020 use AIDS incidence data up to 2000. The procedure incorporates an asymmetric long-tailed cumulative HIV curve as well as the increase in the median incubation period brought about by new therapies introduced during the 1990s. The results suggest that: (i) The rapid decrease in cases during the late 1990s was caused by a median incubation period that increased from 10 years to 21-23 years by the late 1990s. (ii) An imminent bottoming out followed by a protracted increase in AIDS cases from 2000 to at least 2010 could be the consequence of a leveling off of the median incubation period. (iii) A low variant of the projections shows that at least 40,000 homosexual men could develop AIDS in the three countries after 2000.

  19. Comparison of Sexual Knowledge, Attitude, and Behavior between Female Chinese College Students from Urban Areas and Rural Areas: A Hidden Challenge for HIV/AIDS Control in China

    Directory of Open Access Journals (Sweden)

    Min Chen

    2016-01-01

    Full Text Available Currently, research in sexual behavior and awareness in female Chinese college students (FCCSs is limited, particularly regarding the difference and the influencing factors between students from rural areas and urban areas. To fill the gap in available data, a cross-sectional study using anonymous questionnaires was conducted among 3193 female students from six universities located in Beijing, Shanghai, and Guangzhou, China, from February to June, 2013. Of the 2669 respondents, 20.6% and 20.9% of the students from urban and rural areas, respectively, reported being sexually experienced. The proportion of students who received safe-sex education prior to entering university from rural areas (22.4%, 134/598 was lower (P<0.0001 than the proportion from urban areas (41.8%, 865/2071. Sexual behavior has become increasingly common among FCCSs, including high-risk sexual behavior such as unprotected commercial sex. However, knowledge concerning human immunodeficiency virus (HIV/acquired immune deficiency syndrome (AIDS transmission and the risks is insufficient, particularly for those from rural areas, which is a challenge for HIV/AIDS control in China. The Chinese government should establish more specific HIV/AIDS prevention policies for Chinese young women, strengthen sex education, and continue to perform relevant research.

  20. HIV

    African Journals Online (AJOL)

    Introduction. The·human immunodeficiency virus (HIV) can be transmiHed from one person to onother through the use of non-sterile nee- dles, syringes, and other skin-piercing and invasive instruments. Proper .sterilization of all such instruments is therefore important to prevent its transmission. HIV is very sensitive to ...

  1. hiv

    African Journals Online (AJOL)

    2016-03-31

    Mar 31, 2016 ... Indexed By: African Journal Online (AJOL); Texila American University; Genamics; Scholarsteer; EIJASR; CAS-American Chemical. Society; and IRMS Informatics India (J-Gate). ABSTRACT. This study evaluated the effect of HIV infection on CD4 T-lymphocyte depletion in people living with HIV/AIDS.

  2. Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic

    Science.gov (United States)

    Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Initiative, Integra; Mayhew, Susannah H

    2014-01-01

    Objectives To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. PMID:24695990

  3. Trends in overall opportunistic illnesses, Pneumocystis carinii pneumonia, cerebral toxoplasmosis and Mycobacterium avium complex incidence rates over the 30 years of the HIV epidemic: a systematic review

    Directory of Open Access Journals (Sweden)

    Lara Coelho

    2014-03-01

    Conclusions: Opportunistic illnesses remain an important public health problem. To better guide health policies in low/middle-income settings, multicenter cohort studies should be encouraged. Studies from Brazil are urgently needed to assess the current burden of opportunistic illnesses in our population and to support the planning of HIV/AIDS health care services organization.

  4. Hidden Lineage Complexity of Glycan-Dependent HIV-1 Broadly Neutralizing Antibodies Uncovered by Digital Panning and Native-Like gp140 Trimer

    Directory of Open Access Journals (Sweden)

    Linling He

    2017-08-01

    Full Text Available Germline precursors and intermediates of broadly neutralizing antibodies (bNAbs are essential to the understanding of humoral response to HIV-1 infection and B-cell lineage vaccine design. Using a native-like gp140 trimer probe, we examined antibody libraries constructed from donor-17, the source of glycan-dependent PGT121-class bNAbs recognizing the N332 supersite on the HIV-1 envelope glycoprotein. To facilitate this analysis, a digital panning method was devised that combines biopanning of phage-displayed antibody libraries, 900 bp long-read next-generation sequencing, and heavy/light (H/L-paired antibodyomics. In addition to single-chain variable fragments resembling the wild-type bNAbs, digital panning identified variants of PGT124 (a member of the PGT121 class with a unique insertion in the heavy chain complementarity-determining region 1, as well as intermediates of PGT124 exhibiting notable affinity for the native-like trimer and broad HIV-1 neutralization. In a competition assay, these bNAb intermediates could effectively compete with mouse sera induced by a scaffolded BG505 gp140.681 trimer for the N332 supersite. Our study thus reveals previously unrecognized lineage complexity of the PGT121-class bNAbs and provides an array of library-derived bNAb intermediates for evaluation of immunogens containing the N332 supersite. Digital panning may prove to be a valuable tool in future studies of bNAb diversity and lineage development.

  5. Hidden Lineage Complexity of Glycan-Dependent HIV-1 Broadly Neutralizing Antibodies Uncovered by Digital Panning and Native-Like gp140 Trimer.

    Science.gov (United States)

    He, Linling; Lin, Xiaohe; de Val, Natalia; Saye-Francisco, Karen L; Mann, Colin J; Augst, Ryan; Morris, Charles D; Azadnia, Parisa; Zhou, Bin; Sok, Devin; Ozorowski, Gabriel; Ward, Andrew B; Burton, Dennis R; Zhu, Jiang

    2017-01-01

    Germline precursors and intermediates of broadly neutralizing antibodies (bNAbs) are essential to the understanding of humoral response to HIV-1 infection and B-cell lineage vaccine design. Using a native-like gp140 trimer probe, we examined antibody libraries constructed from donor-17, the source of glycan-dependent PGT121-class bNAbs recognizing the N332 supersite on the HIV-1 envelope glycoprotein. To facilitate this analysis, a digital panning method was devised that combines biopanning of phage-displayed antibody libraries, 900 bp long-read next-generation sequencing, and heavy/light (H/L)-paired antibodyomics. In addition to single-chain variable fragments resembling the wild-type bNAbs, digital panning identified variants of PGT124 (a member of the PGT121 class) with a unique insertion in the heavy chain complementarity-determining region 1, as well as intermediates of PGT124 exhibiting notable affinity for the native-like trimer and broad HIV-1 neutralization. In a competition assay, these bNAb intermediates could effectively compete with mouse sera induced by a scaffolded BG505 gp140.681 trimer for the N332 supersite. Our study thus reveals previously unrecognized lineage complexity of the PGT121-class bNAbs and provides an array of library-derived bNAb intermediates for evaluation of immunogens containing the N332 supersite. Digital panning may prove to be a valuable tool in future studies of bNAb diversity and lineage development.

  6. Hidden Lineage Complexity of Glycan-Dependent HIV-1 Broadly Neutralizing Antibodies Uncovered by Digital Panning and Native-Like gp140 Trimer

    Science.gov (United States)

    He, Linling; Lin, Xiaohe; de Val, Natalia; Saye-Francisco, Karen L.; Mann, Colin J.; Augst, Ryan; Morris, Charles D.; Azadnia, Parisa; Zhou, Bin; Sok, Devin; Ozorowski, Gabriel; Ward, Andrew B.; Burton, Dennis R.; Zhu, Jiang

    2017-01-01

    Germline precursors and intermediates of broadly neutralizing antibodies (bNAbs) are essential to the understanding of humoral response to HIV-1 infection and B-cell lineage vaccine design. Using a native-like gp140 trimer probe, we examined antibody libraries constructed from donor-17, the source of glycan-dependent PGT121-class bNAbs recognizing the N332 supersite on the HIV-1 envelope glycoprotein. To facilitate this analysis, a digital panning method was devised that combines biopanning of phage-displayed antibody libraries, 900 bp long-read next-generation sequencing, and heavy/light (H/L)-paired antibodyomics. In addition to single-chain variable fragments resembling the wild-type bNAbs, digital panning identified variants of PGT124 (a member of the PGT121 class) with a unique insertion in the heavy chain complementarity-determining region 1, as well as intermediates of PGT124 exhibiting notable affinity for the native-like trimer and broad HIV-1 neutralization. In a competition assay, these bNAb intermediates could effectively compete with mouse sera induced by a scaffolded BG505 gp140.681 trimer for the N332 supersite. Our study thus reveals previously unrecognized lineage complexity of the PGT121-class bNAbs and provides an array of library-derived bNAb intermediates for evaluation of immunogens containing the N332 supersite. Digital panning may prove to be a valuable tool in future studies of bNAb diversity and lineage development. PMID:28883821

  7. Causes of acute hospitalization in adolescence: burden and spectrum of HIV-related morbidity in a country with an early-onset and severe HIV epidemic: a prospective survey.

    Directory of Open Access Journals (Sweden)

    Rashida A Ferrand

    2010-02-01

    Full Text Available Survival to older childhood with untreated, vertically acquired HIV infection, which was previously considered extremely unusual, is increasingly well described. However, the overall impact on adolescent health in settings with high HIV seroprevalence has not previously been investigated.Adolescents (aged 10-18 y systematically recruited from acute admissions to the two public hospitals in Harare, Zimbabwe, answered a questionnaire and underwent standard investigations including HIV testing, with consent. Pre-set case-definitions defined cause of admission and underlying chronic conditions. Participation was 94%. 139 (46% of 301 participants were HIV-positive (median age of diagnosis 12 y: interquartile range [IQR] 11-14 y, median CD4 count = 151; IQR 57-328 cells/microl, but only four (1.3% were herpes simplex virus-2 (HSV-2 positive. Age (median 13 y: IQR 11-16 y and sex (57% male did not differ by HIV status, but HIV-infected participants were significantly more likely to be stunted (z-score<-2: 52% versus 23%, p<0.001, have pubertal delay (15% versus 2%, p<0.001, and be maternal orphans or have an HIV-infected mother (73% versus 17%, p<0.001. 69% of HIV-positive and 19% of HIV-negative admissions were for infections, most commonly tuberculosis and pneumonia. 84 (28% participants had underlying heart, lung, or other chronic diseases. Case fatality rates were significantly higher for HIV-related admissions (22% versus 7%, p<0.001, and significantly associated with advanced HIV, pubertal immaturity, and chronic conditions.HIV is the commonest cause of adolescent hospitalisation in Harare, mainly due to adult-spectrum opportunistic infections plus a high burden of chronic complications of paediatric HIV/AIDS. Low HSV-2 prevalence and high maternal orphanhood rates provide further evidence of long-term survival following mother-to-child transmission. Better recognition of this growing phenomenon is needed to promote earlier HIV diagnosis and care.

  8. Concurrent sexual partnerships and associated factors: a cross-sectional population-based survey in a rural community in Africa with a generalised HIV epidemic

    Directory of Open Access Journals (Sweden)

    Karabarinde Alex

    2011-08-01

    Full Text Available Abstract Background Although concurrent sexual partnerships may play an important role in HIV transmission in Africa, the lack of an agreed definition of concurrency and of standard methodological approaches has hindered studies. In a long-standing general population cohort in rural Uganda we assessed the prevalence of concurrency and investigated its association with sociodemographic and behavioural factors and with HIV prevalence, using the new recommended standard definition and methodological approaches. Methods As part of the 2010 annual cohort HIV serosurvey among adults, we used a structured questionnaire to collect information on sociodemographic and behavioural factors and to measure standard indicators of concurrency using the recommended method of obtaining sexual-partner histories. We used logistic regression to build a multivariable model of factors independently associated with concurrency. Results Among those eligible, 3,291 (66% males and 4,052 (72% females participated in the survey. Among currently married participants, 11% of men and 25% of women reported being in a polygynous union. Among those with a sexual partner in the past year, the proportion reporting at least one concurrent partnership was 17% in males and 0.5% in females. Polygyny accounted for a third of concurrency in men and was not associated with increased HIV risk. Among men there was no evidence of an association between concurrency and HIV prevalence (but too few women reported concurrency to assess this after adjusting for confounding. Regarding sociodemographic factors associated with concurrency, females were significantly more likely to be younger, unmarried, and of lower socioeconomic status than males. Behavioural factors associated with concurrency were young age at first sex, increasing lifetime partners, and a casual partner in the past year (among men and women and problem drinking (only men. Conclusions Our findings based on the new standard

  9. Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rissanen, Jorma

    1996-01-01

    Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression wher...

  10. Evidence base for children affected by HIV and AIDS in low prevalence and concentrated epidemic countries: applicability to programming guidance from high prevalence countries.

    Science.gov (United States)

    Franco, Lynne Miller; Burkhalter, Bart; de Wagt, Arjan; Jennings, Larissa; Kelley, Allison Gamble; Hammink, Marie-Eve

    2009-01-01

    As global commitment grows to protect and support children affected by HIV and AIDS, questions remain about how best to meet the needs of these children in low prevalence settings and whether information from high prevalence countries can appropriately guide programming in these settings. A 2007 search for the evidence in low prevalence settings on situational challenges of HIV and AIDS-affected children and interventions to address these challenges identified 413 documents. They were reviewed and judged for quality of documentation and scientific rigor. Information was compiled across eight types of challenges (health and health care, nutrition and food security, education, protection, placement, psychosocial development, socioeconomic status, and stigma/discrimination); and also assessed was strength of evidence for situational and intervention findings. Results were compared to three programming principles drawn from research in high prevalence countries: family-centered preventive efforts, treatment, and care; family-focused support to ensure capacity to care for and protect these children; and sustaining economic livelihood of HIV and AIDS-affected households. Findings show that children affected by HIV and AIDS in low prevalence settings face increased vulnerabilities similar to those in high prevalence settings. These findings support seeking and testing programmatic directions for interventions identified in high prevalence settings. However, low prevalence settings/countries are extremely diverse, and the strength of the evidence base among them was mixed (strong, moderate, and weak in study design and documentation), geographically limited, and had insufficient evidence on interventions to draw conclusions about how best to reduce additional vulnerabilities of affected children. Information on family, economic, sociocultural, and political factors within local contexts will be vital in the development of appropriate strategies to mitigate vulnerabilities.

  11. The risk of HIV transmission within HIV-1 sero-discordant couples appears to vary across sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Hiam Chemaitelly

    2014-03-01

    Conclusions: Empirical measures from cohort studies appear to underestimate HIV infectiousness in SSA. The risk of HIV transmission among SDCs appears also to vary across SSA, and this may have contributed to the contrasting HIV epidemic trajectories in this continent.

  12. Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa

    OpenAIRE

    Karim, Quarraisha Abdool; Kharsany, Ayesha BM; Frohlich, Janet A; Werner, Lise; Mashego, May; Mlotshwa, Mukelisiwe; Madlala, Bernadette T; Ntombela, Fanelesibonge; Abdool Karim, Salim S

    2010-01-01

    Background In mature generalized human immunodeficiency virus (HIV) epidemics, as survival from accessing antiretroviral treatment (ART) increases, HIV prevalence data may be suboptimal and difficult to interpret without HIV incidence rates.

  13. Effects of poverty on cognitive function: a hidden neurologic epidemic.

    Science.gov (United States)

    Bergen, Donna C

    2008-08-05

    Mental retardation is one of the most prevalent neurologic disorders globally. Surveys in high-income countries show 3 to 5 per 1,000 with severe intellectual disability, i.e., IQ below 55. Estimates from developing countries, however, have found prevalence rates from 5 to as much as 22 per 1,000. Protein-energy malnutrition, dietary micronutrient deficiencies, environmental toxins, and lack of early sensory stimulation or the ability to profit from it may contribute to neurodevelopmental disabilities. Tropical diseases such as parasitosis with resultant anemia, malaria, and other infections are major contributory causes. Reduction of poverty and its effects would reduce the present and future burden of mental retardation and cognitive dysfunction, especially in developing countries.

  14. Obesity and kidney disease: hidden consequences of the epidemic

    African Journals Online (AJOL)

    In 2014, over 600 million adults worldwide, 18 years and older, were obese. Obesity is a potent risk factor for the development of kidney disease. It increases the risk of developing major risk factors for Chronic Kidney Disease (CKD), like diabetes and hypertension, and it has a direct impact on the development of. CKD and ...

  15. Weighing in on the hidden Asian American obesity epidemic

    OpenAIRE

    Yi, Stella S.; Kwon, Simona C.; Wyatt, Laura; Islam, Nadia; Trinh-Shevrin, Chau

    2015-01-01

    According to national estimates, obesity prevalence is lower in Asian Americans compared to other racial/ethnic groups, but this low prevalence may be misleading for three reasons. First, a lower body mass index (BMI) cutoff as proposed by the World Health Organization may be more appropriate to use in Asian populations. However, evidence is limited to substantiate the potential costs and burden of adopting these cutoffs. Increasing BMI in Asians (as in other racial/ethnic groups) should be c...

  16. Obesity and kidney disease: hidden consequences of the epidemic

    African Journals Online (AJOL)

    obesity and a healthy lifestyle, including proper nutrition and exercise, can dramatically help in preventing obesity and kidney disease. This article reviews the ..... pressure47 or in the elderly.14;39. Obesity is associated with a number of risk ...

  17. Trends in overall opportunistic illnesses, Pneumocystis carinii pneumonia, cerebral toxoplasmosis andMycobacterium avium complex incidence rates over the 30 years of the HIV epidemic: a systematic review

    Directory of Open Access Journals (Sweden)

    Lara Coelho

    Full Text Available BACKGROUND: The natural history of HIV infection has changed dramatically after the introduction of highly active antiretroviral therapy. Currently, opportunistic illnesses still represent a major cause of death and hospitalization in this population. In this study, we review the trends in opportunistic illnesses incidence rates and compare the results observed in high-income settings with that for low/middle-income settings, with special attention given to studies from Brazil. METHODS: We systematically searched Pubmed, Web of Science, Lilacs and Google scholar for publications on HIV associated opportunistic illness. Studies reporting rates based on person-time for all opportunistic illnesses and/or the three opportunistic infections of interest, namely,Pneumocystis carinii pneumonia, cerebral toxoplasmosis, and Mycobacterium avium complex were included. RESULTS: Significant reductions in the incidence rates were demonstrated for opportunistic illnesses overall and also for the specific opportunistic infections included in the present study, both in high and low/middle-income settings. Out of the 37 studies included in the present review, almost 70% were from high-income settings. All the studies conducted in low/middle-income settings were single center studies and four were from Brazil. We found no study from Brazil reporting annual incidence rates of opportunistic illnesses. CONCLUSIONS: Opportunistic illnesses remain an important public health problem. To better guide health policies in low/middle-income settings, multicenter cohort studies should be encouraged. Studies from Brazil are urgently needed to assess the current burden of opportunistic illnesses in our population and to support the planning of HIV/AIDS health care services organization.

  18. Progress in Reversing the HIV Epidemic through Intensified Access to Antiretroviral Therapy: Results from a Nationally Representative Population-Based Survey in Kenya, 2012.

    Directory of Open Access Journals (Sweden)

    Andrea A Kim

    Full Text Available In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS called for 90% of persons living with HIV (PLHIV to know their status, 90% of these to be on antiretroviral therapy (ART, and 90% of these to be virally suppressed by 2020 (90-90-90. It is not clear whether planned ART scale-up in countries whose eligibility criteria for ART initiation are based on recommendations from the 2013 World Health Organization treatment guidelines will be sufficient to meet UNAIDS' new global targets.Using data from a nationally representative population-based household survey of persons in Kenya we compared coverage and unmet need associated with HIV diagnosis, ART, and viral suppression among PLHIV aged 15-64 years in 2012 based on criteria outlined in the 2014 national ART guidelines and UNAIDS' 90-90-90 goals. Estimates were weighted to account for sampling probability and nonresponse.Eight in ten PLHIV aged 15-64 years needed ART based on treatment eligibility. Need for treatment based on the national treatment policy was 97.4% of treatment need based on UNAIDS' 90-90-90 goals, requiring an excess of 24,000 PLHIV to access treatment beyond those eligible for ART to achieve UNAIDS' 90-90-90 treatment target. The gap in treatment coverage was high, ranging from 43.1% nationally to 52.3% in Nyanza among treatment-eligible PLHIV and 44.6% nationally to 52.4% in Nyanza among all PLHIV.Maintaining the current pace of ART scale-up in Kenya will result in thousands of PLHIV unreached, many with high viral load and at-risk of transmitting infection to others. Careful strategies for reaching 90-90-90 will be instrumental in determining whether intensified access to treatment can be achieved to reach all who require ART.

  19. Locating Hidden Servers

    National Research Council Canada - National Science Library

    Oeverlier, Lasse; Syverson, Paul F

    2006-01-01

    .... Announced properties include server resistance to distributed DoS. Both the EFF and Reporters Without Borders have issued guides that describe using hidden services via Tor to protect the safety of dissidents as well as to resist censorship...

  20. Methodological challenges in collecting social and behavioural data regarding the HIV epidemic among gay and other men who have sex with men in Australia.

    Directory of Open Access Journals (Sweden)

    Iryna B Zablotska

    Full Text Available BACKGROUND: Behavioural surveillance and research among gay and other men who have sex with men (GMSM commonly relies on non-random recruitment approaches. Methodological challenges limit their ability to accurately represent the population of adult GMSM. We compared the social and behavioural profiles of GMSM recruited via venue-based, online, and respondent-driven sampling (RDS and discussed their utility for behavioural surveillance. METHODS: Data from four studies were selected to reflect each recruitment method. We compared demographic characteristics and the prevalence of key indicators including sexual and HIV testing practices obtained from samples recruited through different methods, and population estimates from respondent-driven sampling partition analysis. RESULTS: Overall, the socio-demographic profile of GMSM was similar across samples, with some differences observed in age and sexual identification. Men recruited through time-location sampling appeared more connected to the gay community, reported a greater number of sexual partners, but engaged in less unprotected anal intercourse with regular (UAIR or casual partners (UAIC. The RDS sample overestimated the proportion of HIV-positive men and appeared to recruit men with an overall higher number of sexual partners. A single-website survey recruited a sample with characteristics which differed considerably from the population estimates with regards to age, ethnically diversity and behaviour. Data acquired through time-location sampling underestimated the rates of UAIR and UAIC, while RDS and online sampling both generated samples that underestimated UAIR. Simulated composite samples combining recruits from time-location and multi-website online sampling may produce characteristics more consistent with the population estimates, particularly with regards to sexual practices. CONCLUSION: Respondent-driven sampling produced the sample that was most consistent to population estimates

  1. Parsing social network survey data from hidden populations using stochastic context-free grammars.

    Directory of Open Access Journals (Sweden)

    Art F Y Poon

    Full Text Available BACKGROUND: Human populations are structured by social networks, in which individuals tend to form relationships based on shared attributes. Certain attributes that are ambiguous, stigmatized or illegal can create a OhiddenO population, so-called because its members are difficult to identify. Many hidden populations are also at an elevated risk of exposure to infectious diseases. Consequently, public health agencies are presently adopting modern survey techniques that traverse social networks in hidden populations by soliciting individuals to recruit their peers, e.g., respondent-driven sampling (RDS. The concomitant accumulation of network-based epidemiological data, however, is rapidly outpacing the development of computational methods for analysis. Moreover, current analytical models rely on unrealistic assumptions, e.g., that the traversal of social networks can be modeled by a Markov chain rather than a branching process. METHODOLOGY/PRINCIPAL FINDINGS: Here, we develop a new methodology based on stochastic context-free grammars (SCFGs, which are well-suited to modeling tree-like structure of the RDS recruitment process. We apply this methodology to an RDS case study of injection drug users (IDUs in Tijuana, México, a hidden population at high risk of blood-borne and sexually-transmitted infections (i.e., HIV, hepatitis C virus, syphilis. Survey data were encoded as text strings that were parsed using our custom implementation of the inside-outside algorithm in a publicly-available software package (HyPhy, which uses either expectation maximization or direct optimization methods and permits constraints on model parameters for hypothesis testing. We identified significant latent variability in the recruitment process that violates assumptions of Markov chain-based methods for RDS analysis: firstly, IDUs tended to emulate the recruitment behavior of their own recruiter; and secondly, the recruitment of like peers (homophily was dependent on

  2. HIV prevention in clinical practice.

    Science.gov (United States)

    Coates, T J

    1999-01-01

    Since early in the HIV epidemic, it has been known that HIV is transmitted in very specific ways. However, many personal and societal issues make it difficult to convince people that modifying behaviors can decrease their chances of infection. Physicians are in a unique position to slow the spread of the epidemic, but many are not comfortable discussing risky behaviors and sexual practices with their patients. HIV-positive individuals need tailored interventions that teach how to assume responsibility for preventing HIV transmission. The epidemiology of HIV transmission in the U.S. is discussed.

  3. Search for Hidden Particles

    CERN Multimedia

    Petrov, A; Dolmatov, A; Kurbatov, E; Khoriauli, G; Solovev, V

    The SHiP Experiment is a new general-purpose fixed target facility at the SPS to search for hidden particles as predicted by a very large number of recently elaborated models of Hidden Sectors which are capable of accommodating dark matter, neutrino oscillations, and the origin of the full baryon asymmetry in the Universe. Specifically, the experiment is aimed at searching for very weakly interacting long lived particles including Heavy Neutral Leptons - right-handed partners of the active neutrinos; light supersymmetric particles - sgoldstinos, etc.; scalar, axion and vector portals to the hidden sector. The high intensity of the SPS and in particular the large production of charm mesons with the 400 GeV beam allow accessing a wide variety of light long-lived exotic particles of such models and of SUSY. Moreover, the facility is ideally suited to study the interactions of tau neutrinos.

  4. Hidden-loop colostomy.

    Science.gov (United States)

    Rombeau, J L; Turnbul, R B

    1978-04-01

    Records of 15 patients having hidden-loop colostomies were reviewed. All patients had metastatic colonic cancers with impending obstructions. Six colostomies were subsequently opened because of obstructions due to cancer. All colostomy openings were done using local anesthesia in the emergency room. This technique prevented six major celiotomies and provided additional time of living without a stoma. There were two postoperative stomal prolapses, one of which necessitated reoperation. A hidden-loop colostomy is easily constructed and readily opened. It should be considered at celiotomy for selected patients who have metastatic colonic cancer with impending obstruction.

  5. Outpatient HIV care in the Netherlands

    NARCIS (Netherlands)

    Engelhard, E.A.N.

    2017-01-01

    HIV is now, as a result of cART, a treatable condition. Sadly, as reflected by the large number of annual HIV-related deaths and new infections, managing HIV infection and curbing the epidemic has proven extremely challenging. To achieve world without HIV and AIDS, we need to ensure that all

  6. A interiorização da epidemia de HIV/AIDS e o fluxo intermunicipal de internação hospitalar na Zona da Mata, Minas Gerais, Brasil: uma análise espacial Decentralization of the HIV/AIDS epidemic and inter-municipal flow of hospital admissions in the Zona da Mata, Minas Gerais State, Brazil: a spatial analysis

    Directory of Open Access Journals (Sweden)

    Cláudia Tartaglia Reis

    2008-06-01

    Full Text Available O objetivo deste artigo foi analisar o processo de interiorização da epidemia de AIDS e investigar o acesso aos serviços em HIV/AIDS, entre 1988-2002, na Zona da Mata, Minas Gerais, Brasil. Realizou-se estudo ecológico, com abordagem têmporo-espacial. Construiu-se um fluxo de internação hospitalar, tendo como referência pacientes maiores de 15 anos, internados pelo Sistema Único de Saúde, nos anos de 1996 e 2004, residentes nos municípios da região. Foram registrados 2.469 casos de AIDS em maiores de 15 anos no período; as taxas médias de incidência e mortalidade foram calculadas e reestimadas pelo estimador bayesiano empírico local para representar de maneira mais clara os municípios com maior concentração de casos e de óbitos. Verificou-se a interiorização da epidemia. Juiz de Fora é o município com maior número de casos e provável centro difusor da AIDS na região. A assistência hospitalar dos casos de AIDS da Zona da Mata está concentrada nesse município. Destaca-se necessidade de investigações adicionais sobre causas da não-participação de hospitais de referência em outros municípios da região na gerência e prestação de cuidados aos pacientes que vivem com HIV/AIDS.The aim of this article was to analyze the decentralization of the HIV/AIDS epidemic (a shift towards rural areas or away from the coast and to investigate access to HIV/AIDS services from 1988 to 2002 in the Zona da Mata, Minas Gerais State, Brazil. An ecological study was performed using temporal and spatial approaches. A hospital admissions flow between municipalities developed, and the reference group was AIDS patients over 15 years of age admitted in 1996 and 2004, residing in municipalities in the Zona da Mata. There were 2,469 reported AIDS cases in individuals over 15 during the period. Mean incidence and mortality rates were calculated and recalculated by a local empirical Bayesian method in order to more clearly represent the

  7. Modeling Epidemic Network Failures

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Fagertun, Anna Manolova

    2013-01-01

    This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...

  8. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada

    National Research Council Canada - National Science Library

    Logie, Carmen H; James, Llana; Tharao, Wangari; Loutfy, Mona R

    2011-01-01

    HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia...

  9. The hidden values

    DEFF Research Database (Denmark)

    Rasmussen, Birgitte; Jensen, Karsten Klint

    “The Hidden Values - Transparency in Decision-Making Processes Dealing with Hazardous Activities”. The report seeks to shed light on what is needed to create a transparent framework for political and administrative decisions on the use of GMOs and chemical products. It is our hope that the report...

  10. Hidden Markov models.

    Science.gov (United States)

    Eddy, S R

    1996-06-01

    'Profiles' of protein structures and sequence alignments can detect subtle homologies. Profile analysis has been put on firmer mathematical ground by the introduction of hidden Markov model (HMM) methods. During the past year, applications of these powerful new HMM-based profiles have begun to appear in the fields of protein-structure prediction and large-scale genome-sequence analysis.

  11. The neurobiology of HIV dementia: implications for practice in South ...

    African Journals Online (AJOL)

    In this review, the neuropathogenesis of HIV dementia (HIV-D) is discussed in the context of the local epidemic. HIV-D continues to be prevalent in the era of highly active anti-retroviral therapy. HIV neuro-invasion into the central nervous system may result in the development of separate HIV genotypes in an individual ...

  12. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    Science.gov (United States)

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  13. University students and HIV in Namibia: an HIV prevalence survey and a knowledge and attitude survey

    NARCIS (Netherlands)

    de Beer, Ingrid H.; Gelderblom, Huub C.; Schellekens, Onno; Gaeb, Esegiel; van Rooy, Gert; McNally, Alta; Wit, Ferdinand W.; Rinke de Wit, Tobias F.

    2012-01-01

    Background: With an overall adult HIV prevalence of 15.3%, Namibia is facing one of the largest HIV epidemics in Africa. Young people aged 20 to 34 years constitute one of the groups at highest risk of HIV infection in Namibia. However, little is known about the impact of HIV on this group and its

  14. Understanding the Opioid Epidemic

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Opioid Overdose Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Opioid Overdose Opioid Basics Understanding the Epidemic Commonly Used ...

  15. Dynamics of beneficial epidemics

    CERN Document Server

    Berdahl, Andrew; De Bacco, Caterina; Dumas, Marion; Ferdinand, Vanessa; Grochow, Joshua A; Hébert-Dufresne, Laurent; Kallus, Yoav; Kempes, Christopher P; Kolchinsky, Artemy; Larremore, Daniel B; Libby, Eric; Power, Eleanor A; Stern, Caitlin A; Tracey, Brendan

    2016-01-01

    Pathogens can spread epidemically through populations. Beneficial contagions, such as viruses that enhance host survival or technological innovations that improve quality of life, also have the potential to spread epidemically. How do the dynamics of beneficial biological and social epidemics differ from those of detrimental epidemics? We investigate this question using three theoretical approaches as well as an empirical analysis of concept propagation. First, in evolutionary models, we show that a beneficial horizontally-transmissible element, such as viral DNA, spreads super-exponentially through a population, substantially more quickly than a beneficial mutation. Second, in an epidemiological social network approach, we show that infections that cause increased connectivity lead to faster-than-exponential fixation in the population. Third, in a sociological model with strategic rewiring, we find that preferences for increased global infection accelerate spread and produce super-exponential fixation rates,...

  16. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... in recent years, HIV is no longer a death sentence, as it was when the epidemic began. ... Science USA Science & Engineering Festival Drug & Alcohol Chat Day HBO Addiction Project Learn the Link Videos NIDA ...

  17. Modularity promotes epidemic recurrence

    CERN Document Server

    Jesan, T; Sinha, Sitabhra

    2016-01-01

    The long-term evolution of epidemic processes depends crucially on the structure of contact networks. As empirical evidence indicates that human populations exhibit strong community organization, we investigate here how such mesoscopic configurations affect the likelihood of epidemic recurrence. Through numerical simulations on real social networks and theoretical arguments using spectral methods, we demonstrate that highly contagious diseases that would have otherwise died out rapidly can persist indefinitely for an optimal range of modularity in contact networks.

  18. Hidden neural networks

    DEFF Research Database (Denmark)

    Krogh, Anders Stærmose; Riis, Søren Kamaric

    1999-01-01

    A general framework for hybrids of hidden Markov models (HMMs) and neural networks (NNs) called hidden neural networks (HNNs) is described. The article begins by reviewing standard HMMs and estimation by conditional maximum likelihood, which is used by the HNN. In the HNN, the usual HMM probability...... parameters are replaced by the outputs of state-specific neural networks. As opposed to many other hybrids, the HNN is normalized globally and therefore has a valid probabilistic interpretation. All parameters in the HNN are estimated simultaneously according to the discriminative conditional maximum...... likelihood criterion. The HNN can be viewed as an undirected probabilistic independence network (a graphical model), where the neural networks provide a compact representation of the clique functions. An evaluation of the HNN on the task of recognizing broad phoneme classes in the TIMIT database shows clear...

  19. The San Francisco MSM Epidemic: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Brandy L. Rapatski

    2015-11-01

    Full Text Available We investigate various scenarios for ending the San Francisco MSM (men having sex with men HIV/AIDS epidemic (1978–1984. We use our previously developed model and explore changes due to prevention strategies such as testing, treatment and reduction of the number of contacts. Here we consider a “what-if” scenario, by comparing different treatment strategies, to determine which factor has the greatest impact on reducing the HIV/AIDS epidemic. The factor determining the future of the epidemic is the reproduction number R0; if R0 < 1, the epidemic is stopped. We show that treatment significantly reduces the total number of infected people. We also investigate the effect a reduction in the number of contacts after seven years, when the HIV/AIDS threat became known, would have had in the population. Both reduction of contacts and treatment alone, however, would not have been enough to bring R0 below one; but when combined, we show that the effective R0 becomes less than one, and therefore the epidemic would have been eradicated.

  20. Eclecticism Beyond Orthodoxies: African Social Science Research in the Fight Against HIV/AIDS

    OpenAIRE

    Ambe-Uva T. Nom

    2005-01-01

    This study examines the importance of social science research on HIV/AIDS in Africa. There is a dearth of social science research on HIV/AIDS epidemic in Africa as available literature focus essentially on biomedical and epidemiological aspect of HIV/AIDS research and behavioral changes. In Africa however, efforts at preventing and mitigating the impact of HIV/AIDS epidemic will have to consider the social dimension of the epidemic. This study argues for a distinct social science research on ...

  1. Prevalence and indicators of HIV

    African Journals Online (AJOL)

    risen as the epidemic has worsened — for example, seropreva- lence among medical admissions to Kenyatta ..... impact of the epidemic on men is more severe [Gregson &. Garnett, 2000]. It has been suggested that ... salmonella bacteraemia as their first HIV related illness. Among surgical patients we found those with ...

  2. Socio-Demographic Variables Associated With Aids Epidemic ...

    African Journals Online (AJOL)

    Socio-Demographic Variables Associated With Aids Epidemic: Evidence From The Organization For Economic Cooperation And Development And The African Countries. ... The Human Immunodeficiency Virus (HIV) has been spreading rapidly worldwide for the past two decades, causing a variety of symptoms known as ...

  3. Hidden Photons in Extra Dimensions

    OpenAIRE

    Wallace, Chris J.; Jaeckel, Joerg; Roy, Sabyasachi

    2013-01-01

    Additional U(1) gauge symmetries and corresponding vector bosons, called hidden photons, interacting with the regular photon via kinetic mixing are well motivated in extensions of the Standard Model. Such extensions often exhibit extra spatial dimensions. In this note we investigate the effects of hidden photons living in extra dimensions. In four dimensions such a hidden photon is only detectable if it has a mass or if there exists additional matter charged under it. We note that in extra di...

  4. Le pluralisme médicamenteux face à l’épidémie de VIH/sida au Viêt Nam Drug Pluralism Confronted by HIV/AIDS Epidemic in Viêt Nam

    Directory of Open Access Journals (Sweden)

    Marie-Ève Blanc

    2010-10-01

    populaires.This article deals with the place of drug pluralism in Viêt Nam in the context of HIV/AIDS epidemic and the implementation of a new policy on pharmaceuticals which leads to the regulation of the traditional medicines. One of the principal problems in the management of HIV/AIDS in Viêt Nam was the absence of adapted, effective and accessible drugs. On the other hand, contrary to China, Viêt Nam moved towards a local production of generic drugs to meet the local needs and to lower the cost of HIV/AIDS treatment and care.Using a Vietnamese newspaper content analysis on this subject, we will try to understand economic, cultural and political issues behind the weak development of traditional drugs within the framework of HIV/AIDS management.We will show how the Westernisation during the colonial period, the opening of the country since the 1990’s, the globalisation (seen here like the multiplication of the exchanges with the Western countries and the integration of Viêt Nam to the rest of the world and the ASEAN and the life-cycle of pharmaceutical drugs, modified the recourse to drug pluralism as well as the national policy regarding health, with implications on the people’s practices (ways to heal in the medium and long term.

  5. HIV, Gender, Race, Sexual Orientation, and Sex Work: A Qualitative Study of Intersectional Stigma Experienced by HIV-Positive Women in Ontario, Canada

    OpenAIRE

    Logie, Carmen H.; James, LLana; Tharao, Wangari; Loutfy, Mona R.

    2011-01-01

    Editors' Summary Background HIV-related stigma and discrimination?prejudice, negative attitudes, abuse, and maltreatment directed at people living with HIV?is a major factor contributing to the global HIV epidemic. HIV-related stigma, which devalues and stereotypes people living with HIV, increases vulnerability to HIV infection by reducing access to HIV prevention, testing, treatment, and support. At the personal (micro) level, HIV-related stigma can make it hard for people to take tests to ...

  6. The hidden curriculum.

    Science.gov (United States)

    Rodriguez, Rechell G; Mai, Derek

    2012-09-01

    The Uniformed Services University of the Health Sciences Internal Medicine Third Year Clerkship Program recently instituted an academic exercise to be completed by medical students during the first 6 weeks of their 12 weeks of Internal Medicine. The academic exercise involves reflecting on professional values through art and being exposed to the hidden curriculum of professionalism. Students are instructed at the beginning of their clerkship to observe the professional activities of their teachers, peers, ancillary staff, and of themselves. Students are provided a selection of art pieces to choose from. They select one which best exemplifies the professional activity they observed and are then to write a structured, reflective article.

  7. Hidden bone erosions

    Directory of Open Access Journals (Sweden)

    F. Salaffi

    2011-09-01

    Full Text Available The aim of this pictorial essay was to demonstrate the diagnostic efficacy of high-resolution sonography in detecting bone erosions in a patient with rheumatoid arthritis. Standard X-Ray of the feet did not reveal clearly evident erosions. Ultrasonography was able to detect the presence of bone erosions of the metatarsal heads of both the first toes and of the V toe of the left foot. Because the appearance of bone erosions on radiographs of a patient with a recent onset arthritis indicates a poor prognosis, the possibility of demonstrating small hidden erosions at the level of the early targets of the disease is of relevant practical value.

  8. Configuring the autism epidemic

    DEFF Research Database (Denmark)

    Seeberg, Jens; Christensen, Fie Lund Lindegaard

    2017-01-01

    Autism has been described as an epidemic, but this claim is contested and may point to an awareness epidemic, i.e. changes in the definition of what autism is and more attention being invested in diagnosis leading to a rise in registered cases. The sex ratio of children diagnosed with autism...... is skewed in favour of boys, and girls with autism tend to be diagnosed much later than boys. Building and further developing the notion of ‘configuration’ of epidemics, this article explores the configuration of autism in Denmark, with a particular focus on the health system and social support to families...... with children diagnosed with autism, seen from a parental perspective. The article points to diagnostic dynamics that contribute to explaining why girls with autism are not diagnosed as easily as boys. We unfold these dynamics through the analysis of a case of a Danish family with autism....

  9. Configuring the autism epidemic

    DEFF Research Database (Denmark)

    Christensen, Fie Lund Lindegaard; Seeberg, Jens

    2017-01-01

    is skewed in favour of boys, and girls with autism tend to be diagnosed much later than boys. Building and further developing the notion of ‘configuration’ of epidemics, this article explores the configuration of autism in Denmark, with a particular focus on the health system and social support to families...... with children diagnosed with autism, seen from a parental perspective. The article points to diagnostic dynamics that contribute to explaining why girls with autism are not diagnosed as easily as boys. We unfold these dynamics through the analysis of a case of a Danish family with autism.......Autism has been described as an epidemic, but this claim is contested and may point to an awareness epidemic, i.e. changes in the definition of what autism is and more attention being invested in diagnosis leading to a rise in registered cases. The sex ratio of children diagnosed with autism...

  10. Discrete epidemic models.

    Science.gov (United States)

    Brauer, Fred; Feng, Zhilan; Castillo-Chavez, Carlos

    2010-01-01

    The mathematical theory of single outbreak epidemic models really began with the work of Kermack and Mackendrick about decades ago. This gave a simple answer to the long-standing question of why epidemics woould appear suddenly and then disappear just as suddenly without having infected an entire population. Therefore it seemed natural to expect that theoreticians would immediately proceed to expand this mathematical framework both because the need to handle recurrent single infectious disease outbreaks has always been a priority for public health officials and because theoreticians often try to push the limits of exiting theories. However, the expansion of the theory via the inclusion of refined epidemiological classifications or through the incorporation of categories that are essential for the evaluation of intervention strategies, in the context of ongoing epidemic outbreaks, did not materialize. It was the global threat posed by SARS in that caused theoreticians to expand the Kermack-McKendrick single-outbreak framework. Most recently, efforts to connect theoretical work to data have exploded as attempts to deal with the threat of emergent and re-emergent diseases including the most recent H1N1 influenza pandemic, have marched to the forefront of our global priorities. Since data are collected and/or reported over discrete units of time, developing single outbreak models that fit collected data naturally is relevant. In this note, we introduce a discrete-epidemic framework and highlight, through our analyses, the similarities between single-outbreak comparable classical continuous-time epidemic models and the discrete-time models introduced in this note. The emphasis is on comparisons driven by expressions for the final epidemic size.

  11. Higgs Portal into Hidden Sectors

    CERN Multimedia

    CERN. Geneva

    2007-01-01

    Several attractive theoretical ideas suggest the existence of one or more 'hidden sectors' consisting of standard model singlet fields, some of which may not be too heavy. There is a profound reason to think that the Higgs sector might provide the first access to these hidden sectors. This scenario could affect Higgs phenomenology in drastic ways.

  12. Human immunodeficiency virus (HIV) infection in tuberculosis ...

    African Journals Online (AJOL)

    BACKGROUND: In a country with a rapidly spreading HIV epidemic information regarding HIV and TB Co-infection are lacking. OBJECTIVES: To determine the prevalence of HIV infection in a representative sample of sputum-positive tuberculosis patients. METHODS: A cross-sectional survey whereby blood sample was ...

  13. The Manicaland HIV/STD Prevention Project: Studies on HIV ...

    African Journals Online (AJOL)

    ... challenges faced in the search for effective measures to control the HIV epidemic. We also emphasise the need to identify and develop HIV control strategies that reflect spatial and temporal variations in the local socio-economic and epidemiological context. The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 27-42 ...

  14. 'The epidemic in this country has the face of a woman' 1 : Gender ...

    African Journals Online (AJOL)

    Epidemiological data clearly show that the highest levels of HIV prevalence occur in sub-Saharan Africa. Less visible, however, is the complex combination of forces that fuel HIV epidemics in this region — these have been dubbed 'the lethal cocktail.' It is this 'cocktail' that creates an enabling environment for the spread of ...

  15. HIV-1 subtypes B and C unique recombinant forms (URFs and transmitted drug resistance identified in the Western Cape Province, South Africa.

    Directory of Open Access Journals (Sweden)

    Graeme Brendon Jacobs

    Full Text Available South Africa has the largest worldwide HIV/AIDS population with 5.6 million people infected and at least 2 million people on antiretroviral therapy. The majority of these infections are caused by HIV-1 subtype C. Using genotyping methods we characterized HIV-1 subtypes of the gag p24 and pol PR and RT fragments, from a cohort of female participants in the Western Cape Province, South Africa. These participants were recruited as part of a study to assess the combined brain and behavioural effects of HIV and early childhood trauma. The partial HIV-1 gag and pol fragments of 84 participants were amplified by PCR and sequenced. Different online tools and manual phylogenetic analysis were used for HIV-1 subtyping. Online tools included: REGA HIV Subtyping tool version 3; Recombinant Identification Program (RIP; Context-based Modeling for Expeditious Typing (COMET; jumping profile Hidden Markov Models (jpHMM webserver; and subtype classification using evolutionary algorithms (SCUEAL. HIV-1 subtype C predominates within the cohort with a prevalence of 93.8%. We also show, for the first time, the presence of circulating BC strains in at least 4.6% of our study cohort. In addition, we detected transmitted resistance associated mutations in 4.6% of analysed sequences. With tourism and migration rates to South Africa currently very high, we are detecting more and more HIV-1 URFs within our study populations. It is still unclear what role these unique strains will play in terms of long term antiretroviral treatment and what challenges they will pose to vaccine development. Nevertheless, it remains vitally important to monitor the HIV-1 diversity in South Africa and worldwide as the face of the epidemic is continually changing.

  16. Kanpur epidemic: Time course

    Indian Academy of Sciences (India)

    The first peak was related to water contamination which began in December 1990. The second peak was related to failure of municipal authorities to chlorinate water during the 2nd week of February 1991. The epidemic came under control quickly after water contamination was controlled, providing confirmation for role of ...

  17. The Obesity Epidemic

    Centers for Disease Control (CDC) Podcasts

    2011-07-18

    Learn about obesity and the community initiatives taking place to prevent and reduce this epidemic.  Created: 7/18/2011 by National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity.   Date Released: 7/18/2011.

  18. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... in recent years, HIV is no longer a death sentence, as it was when the epidemic began. ... at: http://www.drugabuse.gov/news-events/public-education-projects/learn-link-drugs-hiv . 120x90 460x80 486x60 ...

  19. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... the Director of the National Institute on Drug Abuse, Dr. Nora D. Volkow. Message from the Director The Link Between HIV/AIDS and Drug Misuse The HIV/AIDS epidemic has been with us for three decades now. Today's teens and young adults have never known a world without it. ...

  20. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... www.cdc.gov/actagainstaids/basics/whatishiv.html ). Atlanta, GA: CDC, DHHS. Retrieved November 2017. How are Drug Misuse and HIV Related? Drug misuse and addiction have been linked with HIV/AIDS since the beginning of the epidemic. Although injection drug use is well known in this ...

  1. HIV/AIDS Prevention Trials Capacity Building Grants - Phase II ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Canada's international response to the HIV/AIDS epidemic is largely built around the work of the Canadian HIV Vaccine Initiative (CHVI). CHVI proposes to increase the capacity of Canada and low- and middle-income countries to respond to the HIV/AIDS pandemic by developing new HIV vaccines and other preventive ...

  2. Evolution of HIV/AIDS in Southern Africa

    NARCIS (Netherlands)

    Lauwers, L.; Pruyt, E.; Hens, L.; Brans, J.p.

    2008-01-01

    This paper presents a system dynamics model to study the spread of HIV/AIDS in Southern Africa. The HIV/AIDS model includes important feedback mechanisms of the spread of HIV/AIDS, and partly explains the dynamics of the epidemic in a representative Southern African country. The HIV/AIDS model

  3. HIV prevalence and trends among pregnant women in Abuja, Nigeria

    African Journals Online (AJOL)

    Background: In the last decade there had been efforts to halt and reverse the high and increasing trends in HIV infection in sub-Saharan Africa. There is need to analyze trends in HIV prevalence to ascertain the current course of the HIV epidemic in our society. HIV prevalence among pregnant women attending Antenatal ...

  4. Epitope discovery with phylogenetic hidden Markov models.

    LENUS (Irish Health Repository)

    Lacerda, Miguel

    2010-05-01

    Existing methods for the prediction of immunologically active T-cell epitopes are based on the amino acid sequence or structure of pathogen proteins. Additional information regarding the locations of epitopes may be acquired by considering the evolution of viruses in hosts with different immune backgrounds. In particular, immune-dependent evolutionary patterns at sites within or near T-cell epitopes can be used to enhance epitope identification. We have developed a mutation-selection model of T-cell epitope evolution that allows the human leukocyte antigen (HLA) genotype of the host to influence the evolutionary process. This is one of the first examples of the incorporation of environmental parameters into a phylogenetic model and has many other potential applications where the selection pressures exerted on an organism can be related directly to environmental factors. We combine this novel evolutionary model with a hidden Markov model to identify contiguous amino acid positions that appear to evolve under immune pressure in the presence of specific host immune alleles and that therefore represent potential epitopes. This phylogenetic hidden Markov model provides a rigorous probabilistic framework that can be combined with sequence or structural information to improve epitope prediction. As a demonstration, we apply the model to a data set of HIV-1 protein-coding sequences and host HLA genotypes.

  5. Discovering hidden viral piracy.

    Science.gov (United States)

    Kim, Eddo; Kliger, Yossef

    2005-12-01

    Viruses and developers of anti-inflammatory therapies share a common interest in proteins that manipulate the immune response. Large double-stranded DNA viruses acquire host proteins to evade host defense mechanisms. Hence, viral pirated proteins may have a therapeutic potential. Although dozens of viral piracy events have already been identified, we hypothesized that sequence divergence impedes the discovery of many others. We developed a method to assess the number of viral/human homologs and discovered that at least 917 highly diverged homologs are hidden in low-similarity alignment hits that are usually ignored. However, these low-similarity homologs are masked by many false alignment hits. We therefore applied a filtering method to increase the proportion of viral/human homologous proteins. The homologous proteins we found may facilitate functional annotation of viral and human proteins. Furthermore, some of these proteins play a key role in immune modulation and are therefore therapeutic protein candidates.

  6. Epidemiological and demographic HIV/AIDS projections: South Africa

    African Journals Online (AJOL)

    The Epidemic Projection Package (EPP) recently developed by the UNAIDS Reference Group on Estimates, Models and Projections and the Spectrum model program developed by the Futures Group were used to model the South African HIV epidemic, project future trends in HIV/AIDS and estimate the demographic impact ...

  7. Colliding Epidemics and the Rise of Cryptococcosis

    Directory of Open Access Journals (Sweden)

    Christina C. Chang

    2015-12-01

    Full Text Available Discovered more than 100 years ago as a human pathogen, the Cryptococcus neoformans–Cryptococcus gattii (C. neoformans–C. gattii complex has seen a large global resurgence in its association with clinical disease in the last 30 years. First isolated in fermenting peach juice, and identified as a human pathogen in 1894 in a patient with bone lesions, this environmental pathogen has now found niches in soil, trees, birds, and domestic pets. Cryptococcosis is well recognized as an opportunistic infection and was first noted to be associated with reticuloendothelial cancers in the 1950s. Since then, advances in transplant immunology, medical science and surgical techniques have led to increasing numbers of solid organ transplantations (SOT and hematological stem cell transplantations being performed, and the use of biological immunotherapeutics in increasingly high-risk and older individuals, have contributed to the further rise in cryptococcosis. Globally, however, the major driver for revivification of cryptococcosis is undoubtedly the HIV epidemic, particularly in Sub-Saharan Africa where access to care and antiretroviral therapy remains limited and advanced immunodeficiency, poverty and malnutrition remains the norm. As a zoonotic disease, environmental outbreaks of both human and animal cryptococcosis have been reported, possibly driven by climate change. This is best exemplified by the resurgence of C. gattii infection in Vancouver Island, Canada, and the Pacific Northwest of the United States since 1999. Here we describe how the colliding epidemics of HIV, transplantation and immunologics, climate change and migration have contributed to the rise of cryptococcosis.

  8. Translating social and behavioral science research to the AIDS epidemic: a center for AIDS research perspective.

    Science.gov (United States)

    Curran, James W; Hoxie, James A

    2013-06-01

    Integration of innovative social and behavioral science with public health approaches for HIV prevention and treatment is of critical importance for slowing the global HIV epidemic. Strengthening and focusing social and behavioral research linking testing and treatment strategies to populations at greatest risk for HIV is crucial. The Social and Behavioral Science Research Network(SBSRN), originated in 2006, involves twenty NIH-funded CFAR Centers and is responding to this challenge.

  9. Managing Hidden Costs of Offshoring

    DEFF Research Database (Denmark)

    Larsen, Marcus M.; Pedersen, Torben

    2014-01-01

    This chapter investigates the concept of the ‘hidden costs’ of offshoring, i.e. unexpected offshoring costs exceeding the initially expected costs. Due to the highly undefined nature of these costs, we position our analysis towards the strategic responses of firms’ realisation of hidden costs. In......-by-doing process, where hidden costs motivate firms and their employees to search for new and better knowledge on how to successfully manage the organisation. We illustrate this thesis based on the case of the LEGO Group....

  10. Epidemics on interconnected networks

    Science.gov (United States)

    Dickison, Mark; Havlin, S.; Stanley, H. E.

    2012-06-01

    Populations are seldom completely isolated from their environment. Individuals in a particular geographic or social region may be considered a distinct network due to strong local ties but will also interact with individuals in other networks. We study the susceptible-infected-recovered process on interconnected network systems and find two distinct regimes. In strongly coupled network systems, epidemics occur simultaneously across the entire system at a critical infection strength βc, below which the disease does not spread. In contrast, in weakly coupled network systems, a mixed phase exists below βc of the coupled network system, where an epidemic occurs in one network but does not spread to the coupled network. We derive an expression for the network and disease parameters that allow this mixed phase and verify it numerically. Public health implications of communities comprising these two classes of network systems are also mentioned.

  11. Variational Infinite Hidden Conditional Random Fields

    NARCIS (Netherlands)

    Bousmalis, Konstantinos; Zafeiriou, Stefanos; Morency, Louis-Philippe; Pantic, Maja; Ghahramani, Zoubin

    2015-01-01

    Hidden conditional random fields (HCRFs) are discriminative latent variable models which have been shown to successfully learn the hidden structure of a given classification problem. An Infinite hidden conditional random field is a hidden conditional random field with a countably infinite number of

  12. Resilience of epidemics on networks

    CERN Document Server

    Lu, Dan; Zhang, Jiaquan; Wang, Huijuan; Li, Daqing

    2016-01-01

    Epidemic propagation on complex networks has been widely investigated, mostly with invariant parameters. However, the process of epidemic propagation is not always constant. Epidemics can be affected by various perturbations, and may bounce back to its original state, which is considered resilient. Here, we study the resilience of epidemics on networks, by introducing a different infection rate ${\\lambda_{2}}$ during SIS (susceptible-infected-susceptible) epidemic propagation to model perturbations (control state), whereas the infection rate is ${\\lambda_{1}}$ in the rest of time. Through simulations and theoretical analysis, we find that even for ${\\lambda_{2}<\\lambda_{c}}$, epidemics eventually could bounce back if control duration is below a threshold. This critical control time for epidemic resilience, i.e., ${cd_{max}}$ can be predicted by the diameter (${d}$) of the underlying network, with the quantitative relation ${cd_{max}\\sim d^{\\alpha}}$. Our findings can help to design a better mitigation stra...

  13. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    OpenAIRE

    Kiene, Susan M; Fisher, William A.; Shuper, Paul A.; CORNMAN, Deborah H.; Christie, Sarah; MacDonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D.

    2013-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV tr...

  14. AIDS: the hidden enemy.

    Science.gov (United States)

    Tinker, J; Sabatier, R

    1987-01-01

    This article discusses the acquired immunodeficiency syndrome (AIDS) epidemic an its effect on developing countries, with emphasis on Africa. The AIDS death toll will be high in the US: 180,000 by 1991, but it will be in the millions in developing countries. In Africa, AIDS is mainly transmitted heterosexually, is as prevalent among women as among men, and is taking a serious toll among professional classes and young wage earners. The social costs of funerals has increased, and company clinics and sick pay funds have been overwhelmed. In Uganda, the epidemic adds to the state of psychological shock people have sufferred because of the civil war. Medical professionals have been hard-pressed to acquire equipment for testing blood for the virus, although there have been efforts to protect blood supplies through exhaustive testing. Endemic tuberculosis becomes an even more serious problem in developing countries, since AIDS lowers resistance to it. AIDS also effects many developing country children, usually through infected mothers, who can transmit AIDS through breast milk or during pregnancy of birth. This poses a dilemma for promoters of breastfeeding. It is also feared that innoculation of immunosuppressed children may be dangerous. The global picture suggests that Africa is hardest hit: seropositivity prevalence ranges from 0.7% of Congo blood donors to 33% of male donors in Lusaka Zambia. Brazil's cases are mainly homosexual, and in Asia the prevalence is mostly low, although there is a great potential danger in countries where prostitution and heroin addiction are prevalent. The only effective weapon against AIDS is education and blood testing to prevent spread. Despite good education programs in some countries, e.g. Rwanda, there is still widespread ignorance of how AIDS is spread.

  15. Information Theoretic Adaptive Tracking of Epidemics in Complex Networks

    CERN Document Server

    Harrington, Patrick L

    2013-01-01

    Adaptively monitoring the states of nodes in a large complex network is of interest in domains such as national security, public health, and energy grid management. Here, we present an information theoretic adaptive tracking and sampling framework that recursively selects measurements using the feedback from performing inference on a dynamic Bayesian Network. We also present conditions for the existence of a network specific, observation dependent, phase transition in the updated posterior of hidden node states resulting from actively monitoring the network. Since traditional epidemic thresholds are derived using observation independent Markov chains, the threshold of the posterior should more accurately model the true phase transition of a network. The adaptive tracking framework and epidemic threshold should provide insight into modeling the dynamic response of the updated posterior to active intervention and control policies while monitoring modern complex networks.

  16. Hidden Risk Factors for Women

    Science.gov (United States)

    ... A.S.T. Quiz Hidden Stroke Risk Factors for Women Updated:Nov 22,2016 Excerpted from "What Women ... Cerebral Aneurysms 7 Types of Aphasia 8 Brain Stem Stroke 9 Cognitive Challenges After Stroke 10 Personality ...

  17. The Hidden Costs of Offshoring

    DEFF Research Database (Denmark)

    Møller Larsen, Marcus; Manning, Stephan; Pedersen, Torben

    2011-01-01

    of offshoring. Specifically, we propose that hidden costs can be explained by the combination of increasing structural, operational and social complexity of offshoring activities. In addition, we suggest that firm orientation towards organizational design as part of an offshoring strategy and offshoring...... of our study is to suggest how hidden costs of offshoring can be mitigated through an explicit orientation towards improving organizational processes and structures as well as experience with offshoring.......This study seeks to explain hidden costs of offshoring, i.e. unexpected costs resulting from the relocation of business tasks and activities outside the home country. We develop a model that highlights the role of complexity, design orientation and experience in explaining hidden costs...

  18. Hidden Statistics of Schroedinger Equation

    Science.gov (United States)

    Zak, Michail

    2011-01-01

    Work was carried out in determination of the mathematical origin of randomness in quantum mechanics and creating a hidden statistics of Schr dinger equation; i.e., to expose the transitional stochastic process as a "bridge" to the quantum world. The governing equations of hidden statistics would preserve such properties of quantum physics as superposition, entanglement, and direct-product decomposability while allowing one to measure its state variables using classical methods.

  19. epidemiological hiv surveys

    African Journals Online (AJOL)

    E J Smit, MB ChB, DTM&H, MMed (Cfin Viral), FCPath (SA) (Clin Viral). M de Beer, Not Dip Med Lab Tech. A D Steele, PhD ... PO Medunsa, 0204. The AIDS epidemic in South Africa has now reached the alarming level at ... with inactivated HIV-1 antigens are reconstituted according to the manufacturer's instructions ...

  20. The epidemic of methylisothiazolinone

    DEFF Research Database (Denmark)

    Schwensen, Jakob F; Uter, Wolfgang; Bruze, Magnus

    2017-01-01

    BACKGROUND: The use of methylisothiazolinone (MI) in cosmetic products has caused an unprecedented epidemic of MI contact allergy. Current data concerning exposures at a European level are required. OBJECTIVES: To describe demographics and MI exposures for European patients with MI contact allerg....... Fifteen patients (7.3%) had previously experienced allergic reactions when they were in newly painted rooms. CONCLUSION: Clinically relevant MI contact allergy remains prevalent across European countries, mainly because of exposure to rinse-off and leave-on cosmetic products....

  1. Laser irradiation reduces HIV-1 infection in TZM-bl cells

    CSIR Research Space (South Africa)

    Lugongolo, Masixole Y

    2016-10-01

    Full Text Available HIV-1 epidemic remains a major health challenge. This study explores the effects of low level laser therapy on HIV-1 infected cells. Infection is reduced by irradiation and the mechanism needs to be investigated further....

  2. Psychological Impacts among Older and Younger People Living with HIV/AIDS in Nanning, China

    National Research Council Canada - National Science Library

    Liu, Hongjie; He, Xin; Levy, Judith A; Xu, Yongfang; Zang, Chunpeng; Lin, Xinqin

    2014-01-01

    Objectives. The HIV epidemic has drastically increased among older adults in China, yet little research has examined the psychological impacts among older and younger people living with HIV/AIDS (PLWHAs...

  3. Hidden photons in connection to dark matter

    Energy Technology Data Exchange (ETDEWEB)

    Andreas, Sarah; Ringwald, Andreas [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Goodsell, Mark D. [CPhT, Ecole Polytechnique, Palaiseau (France)

    2013-06-15

    Light extra U(1) gauge bosons, so called hidden photons, which reside in a hidden sector have attracted much attention since they are a well motivated feature of many scenarios beyond the Standard Model and furthermore could mediate the interaction with hidden sector dark matter.We review limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay. In addition, we study the possibility of having dark matter in the hidden sector. A simple toy model and different supersymmetric realisations are shown to provide viable dark matter candidates in the hidden sector that are in agreement with recent direct detection limits.

  4. Stargate of the Hidden Multiverse

    Directory of Open Access Journals (Sweden)

    Alexander Antonov

    2016-02-01

    Full Text Available Concept of Monoverse, which corresponds to the existing broad interpretation of the second postulate of the special theory of relativity, is not consistent with the modern astrophysical reality — existence of the dark matter and the dark energy, the total mass-energy of which is ten times greater than the mass-energy of the visible universe (which has been considered as the entire universe until very recent . This concept does not allow to explain their rather unusual properties — invisibility and lack of baryon content — which would seem to even destroy the very modern understanding of the term ‘matter’. However, all numerous alternative concepts of Multiverses, which have been proposed until today, are unable to explain these properties of the dark matter and dark energy. This article describes a new concept: the concept of the hidden Multiverse and hidden Supermultiverse, which mutual invisibility of parallel universes is explained by the physical reality of imaginary numbers. This concept completely explains the phenomenon of the dark matter and the dark energy. Moreover, it is shown that the dark matter and the dark energy are the experimental evidence for the existence of the hidden Multiverse. Described structure of the hidden Multiverse is fully consistent with the data obtained by the space stations WMAP and Planck. An extremely important property of the hidden Multiverse is an actual possibility of its permeation through stargate located on the Earth.

  5. The global epidemiology of HIV/AIDS.

    Science.gov (United States)

    Morison, L

    2001-01-01

    In this paper, the ways in which HIV is transmitted and factors facilitating transmission are described, although we still do not fully understand why the HIV epidemic has spread so heterogeneously across the globe. Estimates of HIV prevalence vary in quality but give some idea of trends in different countries and regions. Of all regions in the world, sub-Saharan Africa is the hardest hit by HIV, containing around 70% of people living with HIV/AIDS. There are, however, recent signs of hope in Africa due to a slight reduction in the number of new HIV cases in the year 2000. Most countries in Asia have not seen explosive epidemics in the general population up to now but patterns of injecting drug use (IDU) and sex work are conducive to the spread of HIV so there is no room for complacency. Unpredictable epidemics among IDU in the former Soviet Union have the potential to spread into the general population. Some countries in Central America and the Caribbean have growing HIV epidemics with adult prevalences second only to sub-Saharan Africa. Reductions in morbidity and mortality through the use of highly active antiretroviral therapy are at present limited to high-income and some Latin American countries. Both the cost of these therapies and the poor health care delivery systems in many affected countries need to be addressed before antiretrovirals can benefit the majority of people living with HIV/AIDS.

  6. HIV, wages, and the skill premium.

    Science.gov (United States)

    Marinescu, Ioana

    2014-09-01

    The HIV epidemic has dramatically decreased labor supply among prime-age adults in Sub-Saharan Africa. Using within-country variation in regional HIV prevalence and a synthetic panel, I find that HIV significantly increases the capital-labor ratio in urban manufacturing firms. The impact of HIV on average wages is positive but imprecisely estimated. In contrast, HIV has a large positive impact on the skill premium. The impact of HIV on the wages of low skilled workers is insignificantly different from 0, and is strongly dampened by competition from rural migrants. The HIV epidemic disproportionately increases the incomes of high-skilled survivors, thus increasing inequality. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. HIV-Associated Tuberculosis

    Directory of Open Access Journals (Sweden)

    Kogieleum Naidoo

    2011-01-01

    Full Text Available The intersecting HIV and Tuberculosis epidemics in countries with a high disease burden of both infections pose many challenges and opportunities. For patients infected with HIV in high TB burden countries, the diagnosis of TB, ARV drug choices in treating HIV-TB coinfected patients, when to initiate ARV treatment in relation to TB treatment, managing immune reconstitution, minimising risk of getting infected with TB and/or managing recurrent TB, minimizing airborne transmission, and infection control are key issues. In addition, given the disproportionate burden of HIV in women in these settings, sexual reproductive health issues and particular high mortality rates associated with TB during pregnancy are important. The scaleup and resource allocation to access antiretroviral treatment in these high HIV and TB settings provide a unique opportunity to strengthen both services and impact positively in meeting Millennium Development Goal 6.

  8. Nutrition and HIV

    DEFF Research Database (Denmark)

    Friis, Henrik; Olsen, Mette Frahm; Filteau, Suzanne

    2017-01-01

    The impact of the global human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic is most severe in sub-Saharan African countries already affected by undernutrition and food insecurity. There is a two-way relationship between HIV and undernutrition and food insecurity......, which is mainly synergistic and operating at different levels. HIV infection increases energy and nutrient requirements, yet it reduces food security. The result is nutritional deficiencies, which increase progression of HIV infection. Both undernutrition and food insecurity may also lead to increased...... risk of transmission. Nutritional intake and status may affect metabolism of antiretroviral drugs, some of which may affect body composition, and increase risk of the metabolic syndrome. In addition, HIV is transmitted through breastfeeding, causing a serious infant feeding dilemma for which...

  9. Reconstructing the AIDS epidemic among injection drug users in Brazil

    Directory of Open Access Journals (Sweden)

    Mariana A. Hacker

    2006-04-01

    Full Text Available The HIV/AIDS epidemic among injection drug users (IDUs in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000 were used as the dependent variable, with a set of social indicators as independent variables (covariates. In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.

  10. Hidden worlds in quantum physics

    CERN Document Server

    Gouesbet, Gérard

    2014-01-01

    The past decade has witnessed a resurgence in research and interest in the areas of quantum computation and entanglement. This new book addresses the hidden worlds or variables of quantum physics. Author Gérard Gouesbet studied and worked with a former student of Louis de Broglie, a pioneer of quantum physics. His presentation emphasizes the history and philosophical foundations of physics, areas that will interest lay readers as well as professionals and advanced undergraduate and graduate students of quantum physics. The introduction is succeeded by chapters offering background on relevant concepts in classical and quantum mechanics, a brief history of causal theories, and examinations of the double solution, pilot wave, and other hidden-variables theories. Additional topics include proofs of possibility and impossibility, contextuality, non-locality, classification of hidden-variables theories, and stochastic quantum mechanics. The final section discusses how to gain a genuine understanding of quantum mec...

  11. Hepatitis E epidemics in India

    Indian Academy of Sciences (India)

    We compiled this slide in 1992. It shows dates, locations and number of cases for various epidemics reported from different parts of India till that time. The first well recorded epidemic was in 1955-56 here in Delhi with nearly 30000 cases. Large outbreaks occurred in 1978 in Kashmir. My interest in this disease began in ...

  12. Adaptive Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rasmussen, Tage

    1996-01-01

    Partially Hidden Markov Models (PHMM) have recently been introduced. The transition and emission probabilities are conditioned on the past. In this report, the PHMM is extended with a multiple token version. The different versions of the PHMM are applied to bi-level image coding.......Partially Hidden Markov Models (PHMM) have recently been introduced. The transition and emission probabilities are conditioned on the past. In this report, the PHMM is extended with a multiple token version. The different versions of the PHMM are applied to bi-level image coding....

  13. Epidemics after Natural Disasters

    Science.gov (United States)

    Gayer, Michelle; Connolly, Maire A.

    2007-01-01

    The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings. PMID:17370508

  14. Changing sexual attitudes and behaviour in China: implications for the spread of HIV and other sexually transmitted diseases.

    Science.gov (United States)

    Zhang, K; Li, D; Li, H; Beck, E J

    1999-10-01

    In Imperial China sexual behaviour was regarded as an indispensable activity to reach harmony with the universe, through the unity of the interaction of two opposing forces: yin and yang. Sexual intercourse was accepted when linked to procreation within a family context, while an individual's sexuality was not considered important. Homosexuality was tolerated although not advocated, while masturbation was denounced. Since the One Child Family and Open Door policies in the 1970s and the economic reforms of the 1980s, attitudes towards sexuality in China have changed. Premarital sex has become widely accepted among young people and people in China are now more tolerant toward extramarital sex. Nowadays young people consider that love should dominate marriage and the quality of an individual's sex life is currently more valued than it used to be. Attitudes towards masturbation have become more tolerant and though homosexuality has been hidden by society for a long time, in recent years it has begun to be considered as a legitimate lifestyle choice. Attitudes towards sex and sexual behaviour have become recognized as an individuals' responsibility as long as no offence occurs against society or the interests of other individuals, resulting in the recognition of diversity of sexual behaviour. As part of the changing attitudes to sex and sexual behaviour, heterosexual transmission is becoming the most important route of HIV transmission in China. This is complicated by the internal migration of an estimated 120 million labourers moving from the countryside to the cities as the result of economic reforms, most of whom are sexually active young men. Unless addressed directly, these factors may add to the estimated 300,000 HIV-infected Chinese, further fuelling an already rapidly spreading epidemic. The ramifications of the Chinese HIV epidemic will not only be felt within China, but also within the surrounding Asian countries thereby fuelling the HIV pandemic.

  15. Hidden Crises and Communication : An Interactional Analysis of Hidden Crises

    NARCIS (Netherlands)

    dr. Annette Klarenbeek

    2011-01-01

    In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in

  16. Hidden Crises and Communication: An Interactional Analysis of Hidden Crises

    NARCIS (Netherlands)

    dr. Annette Klarenbeek

    2011-01-01

    In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in

  17. [Epidemic process of gonorrhea in modern world].

    Science.gov (United States)

    Kostiukova, N N; Bekhalo, V A

    2009-01-01

    Gonorrhea in spite of its fully elucidated etiopathogenesis and available drugs for etiotropic therapy belongs to infections which are not controlled by vaccination due to absence of immunity formation. Analysis of scientific publication, statistical materials and WHO's data showed that epidemic process of gonorrhea infection depends mainly from people's behaviour, first of all, sexual. Modern epidemic process of gonorrhea infection consists from irregular increases and decreases of incidence due to various reasons. Reasons for increases of incidence appear to be simultaneous action of a range of biologic and anthropogenic factors. First reason--rapid increase of resistance of gonococci to widely used antibacterial preparations as well as synergy of pathogenic effects between HIV and gonococci; anthropogenic--wars, increase of high-risk groups due to urbanization, use of oral contraceptives, rise of prostitution, migration, inadequate access to medical care, poverty, intensification of intercourses (including hetero- and homosexual) between people, as well as demographic changes--increase of proportion of young people in population structure. Same but reciprocal factors lead to decrease of morbidity. Of them, the following were considered as most important: mass implementation of new effective antimicrobial drug as well as intensification of sanitary education, availability of early diagnostics and treatment, increase of material and cultural standards of life, decrease in number of persons belonging to high risk groups. Yet, capabilities of modern science expressed only in continuous development of new antibacterial drugs active against circulating population of gonococci, which is resistant to previously used drug.

  18. Insight: Exploring Hidden Roles in Collaborative Play

    OpenAIRE

    Tricia Shi; Bruno Tambasco

    2015-01-01

    This paper looks into interaction modes between players in co-located, collaborative games. In particular, hidden traitor games, in which one or more players is secretly working against the group mission, has the effect of increasing paranoia and distrust between players, so this paper looks into the opposite of a hidden traitor – a hidden benefactor. Rather than sabotaging the group mission, the hidden benefactor would help the group achieve the end goal while still having a reason to stay h...

  19. Knowledge and Practices about HIV/AIDS among Injecting Drug ...

    African Journals Online (AJOL)

    This study assessed the knowledge related to HIV/AIDS and preventive practices among Injecting Drug Users (IDUs) of Dhaka city in Bangladesh. Bangladesh is turning into one with concentrated epidemic due to the high HIV prevalence rate among IDUs (7%). IDUs are vulnerable of acquiring HIV/AIDS due to their ...

  20. HIV/AIDS-Related Stigma and Discrimination in Workplaces in ...

    African Journals Online (AJOL)

    Abstract. Background: Stigma and discrimination against people living with and affected by HIV/AIDS undermines the effectiveness of national efforts to prevent and control the HIV epidemic. In the context of Tanzania, evidence on the incidence of HIV/AIDS-related stigma and discrimination from the perspective of the ...

  1. Seroprevalence of HIV, hepatitis B infections and syphilis

    African Journals Online (AJOL)

    HIV, HBV infections and syphilis constitute a huge health and economic burden for developing countries. The importance of STls has been more widely recognized in the advent ofthe HIV/AIDS epidemic, and consequently there are good evidences that the control of. STls can contribute a great deal to the reduction of HIV-.

  2. Disclosure of HIV status: experiences of patients enrolled in an ...

    African Journals Online (AJOL)

    The convergence between the tuberculosis (TB) and HIV epidemics has led to studies investigating strategies for integrated HIV and TB care. We present the experiences of a cohort of 17 patients enrolled in the first integrated TB and HIV treatment pilot programme, conducted in Durban, South Africa, as a precursor to a ...

  3. HIV infection and the way forward for South Sudan

    African Journals Online (AJOL)

    EDITorIAL. HIV infection and the way forward for South Sudan. 75. In the last thirty-three years HIV infection has spread to all corners of the world, but the largest concentration of the epidemic is in ... is a critical aspect of HIV prevention, which in South Sudan leaves much to be desired. The prevention strategy has advanced ...

  4. My secret: The social meaning of HIV/AIDS stigma

    African Journals Online (AJOL)

    N. Judgeo

    2014-07-01

    Jul 1, 2014 ... Brown, Trujillo and Macintyre (2001) believed that the type and magnitude of people's reactions to this epidemic is largely due to HIV/AIDS stigma. HIV stigma remains the roadblock to a concerted action to reduce the transmission of HIV as it impedes prevention and treatment efforts (Campbell, Foulis, ...

  5. The impact of HIV: a closely-guarded secret.

    Science.gov (United States)

    Whiteside, A; Decosas, J

    1995-10-01

    More than ten million people in sub-Saharan Africa, almost 3% of the subcontinent's population, are infected with HIV. Some countries in the South of the subcontinent report prevalence rates of 9%. Many industries have hired analysts and forecasters to help guide them through the epidemic, while police and armed forces have conducted detailed investigations into the impact of HIV. Intelligence agencies routinely hire consultants to analyze and forecast the impact of HIV in selected regions. The results of these studies and forecasts, however, are closely guarded. The many studies on the health care costs of AIDS concur that the HIV/AIDS epidemic is expensive in economic terms. There are virtually no published studies on how the African epidemic of HIV will affect the supply, demand, and quality of healthcare. The demand for care has received the greatest attention. The authors discuss how the AIDS epidemic in sub-Saharan Africa may affect health care personnel.

  6. The Art of HIV Elimination: Past and Present Science.

    Science.gov (United States)

    Iwuji, Collins C; McGrath, Nuala; de Oliveira, Tulio; Porter, Kholoud; Pillay, Deenan; Fisher, Martin; Newport, Melanie; Newell, Marie-Louise

    2015-11-30

    Remarkable strides have been made in controlling the HIV epidemic, although not enough to achieve epidemic control. More recently, interest in biomedical HIV control approaches has increased, but substantial challenges with the HIV cascade of care hinder successful implementation. We summarise all available HIV prevention methods and make recommendations on how to address current challenges. In the early days of the epidemic, behavioural approaches to control the HIV dominated, and the few available evidence-based interventions demonstrated to reduce HIV transmission were applied independently from one another. More recently, it has become clear that combination prevention strategies targeted to high transmission geographies and people at most risk of infections are required to achieve epidemic control. Biomedical strategies such as male medical circumcision and antiretroviral therapy for treatment in HIV-positive individuals and as pre-exposure prophylaxis in HIV-negative individuals provide immense promise for the future of HIV control. In resource-rich settings, the threat of HIV treatment optimism resulting in increased sexual risk taking has been observed and there are concerns that as ART roll-out matures in resource-poor settings and the benefits of ART become clearly visible, behavioural disinhibition may also become a challenge in those settings. Unfortunately, an efficacious vaccine, a strategy which could potentially halt the HIV epidemic, remains elusive. Combination HIV prevention offers a logical approach to HIV control, although what and how the available options should be combined is contextual. Therefore, knowledge of the local or national drivers of HIV infection is paramount. Problems with the HIV care continuum remain of concern, hindering progress towards the UNAIDS target of 90-90-90 by 2020. Research is needed on combination interventions that address all the steps of the cascade as the steps are not independent of each other. Until these

  7. Laser Shearography Reveals Hidden "Unbonds"

    Science.gov (United States)

    Schaefer, Lloyd A.

    1992-01-01

    Flaws identified faster than in ultrasonic inspection. Holographic technique detects hidden "unbonds", and does not require elaborate provisions for suppression of vibrations. Laser-shearographic apparatus used to observe object while stress being applied. Shearographic image indicative of deflection caused by stress. Also used to inspect complexly contoured surfaces.

  8. Sexual Harrassment: A Hidden Problem.

    Science.gov (United States)

    Sandler, Bernice R.; And Others

    1981-01-01

    The hidden but serious problem of sexual harassment of students and employees by college faculty is discussed, some statistics are given, and legal and court opinions outlined. Harassment as a violation of Title IX is analyzed, and implications for institutional action to curb it are outlined. (MSE)

  9. Caring and government's HIV / AIDS programme.

    Science.gov (United States)

    Smart, R

    1997-01-01

    As the HIV/AIDS epidemic spreads throughout South Africa, we need to re-evaluate the traditional focus upon HIV prevention and consider a new direction which recognizes and responds to the impending needs of the infected and affected. All sectors involved in HIV/AIDS demand such a reorientation. The HIV/AIDS epidemic has been described as a series of interlinked epidemics, the silent, invisible one which is followed by the epidemic of persons who are sick and in need of care. Subsequently, the epidemic of dependency and those orphaned and the twin epidemics of tuberculosis and poverty emerge. The causes and consequences of HIV/AIDS must be understood in order to develop and implement appropriate and effective responses. The causes include poverty, low levels of literacy, underdevelopment, high levels of sexually transmitted diseases, social dislocation, mobility, and migrancy. The consequences occur at the individual, family, community, and societal levels and include poorer nutrition, the intensification of poverty, increased dependency, loss of income, labor directed to care for the sick, reserves spent upon health care and funeral costs, reduced levels of education as children are withdrawn from school, the reduced ability to pay for services, increased numbers of women entering prostitution, and an increased demand for welfare grants and services. An estimated 90,000 will become sick in 1997 and require care. The already overburdened health system cannot be allowed to be paralyzed by the impending flood of morbidity. The care and support strategy is discussed.

  10. EAMJ HIV/AIDS Nov 09.indd

    African Journals Online (AJOL)

    2009-11-11

    Nov 11, 2009 ... Background: HIV/AIDS epidemic is one of the major factors affecting women's health and impeding national efforts to ... up contraceptive uptake and utilisation, especially amongst the most vulnerable groups. INTRODUCTION ... factors HIV infection, poor socio-economic status, civil strife and weak health.

  11. Demographic and epidemiological characteristics of HIV ...

    African Journals Online (AJOL)

    Background: In view of the maturing HIV epidemic in sub-Saharan Africa, better understanding of its epidemiology among older adults is necessary in order to design appropriate care and treatment programmes for them. Objectives: To describe the demographic and epidemiological characteristics of HIV opportunistic ...

  12. Knowing the epidemic is the best way to define diagnosis and treatment strategies to reach the 90-90-90 goals: the experience of Portugal in using the ECDC HIV modelling tool

    OpenAIRE

    Diniz, António; Loff, José; Cortes Martins, Helena

    2016-01-01

    Introduction: Cognitive disorders and depression remain prevalent in people living with HIV (PLWH) [1, 2]; however, few studies have investigated the interaction between these comorbidities. We describe overall cognitive function in a large cohort of PLWH compared to an appropriate control population and explore factors associated with cognitive performance, including depression and lifestyle factors. Methods: One thousand two hundred and sixty-six individuals (643 PLWH aged ?50 years, 343 PLWH

  13. The epidemic of distraction.

    Science.gov (United States)

    Weksler, Marc E; Weksler, Babette B

    2012-01-01

    Multitasking is a rapidly growing phenomenon affecting all segments of the population but is rarely as successful as its proponents believe. The use of mobile electronic devices contributes importantly to multitasking and cognitive overload. Although personal electronic devices provide many benefits, their adverse effects are frequently overlooked. Personal observation and a review of the scientific literature supports the view that overuse or misuse of personal electronic devices promotes cognitive overload, impairs multitasking and lowers performance at all ages but particularly in the elderly. This phenomenon appears to be rapidly increasing and threatens to become a tsunami as spreading electronic waves cause an 'epidemic of distraction'. Mobile electronic devices often bring benefits to their users in terms of rapid access to information. However, there is a dark side to the increasing addiction to these devices that challenges the health and well-being of the entire population, targeting, in particular, the aged and infirm. New approaches to information gathering can foster creativity if cognitive overload is avoided. Copyright © 2012 S. Karger AG, Basel.

  14. The interesting cross-paths of HIV/AIDS and water in Southern Africa ...

    African Journals Online (AJOL)

    HIV/AIDS and water-borne diseases account for a substantial degree of morbidity and mortality in different age groups across the globe, but their ripple effects are more devastating in developing countries. Estimates of the HIV/AIDS epidemic in South Africa vary but attest to a mature and generalised epidemic. Antenatal ...

  15. The Role of Non-Governmental Organizations on HIV/AIDS ...

    African Journals Online (AJOL)

    HIV/AIDS pandemic has caused widespread negative socio-economic impacts in Tanzania. The epidemic is restraining development efforts of many households and the nation at large. Despite the mushrooming number of NGOs established to combat the epidemic, the prevalence of HIV infection is still high. This study was ...

  16. Stigma and Discrimination in HIV/AIDS; The greatest Challenge to ...

    African Journals Online (AJOL)

    From inception, the HIV/AIDS epidemic had been accompanied also by an epidemic of fear, ignorance and denial, leading to intense stigma and accompanying discriminatory practices against those living with HIV/AIDS. The greatest challenge to the efforts of the various agencies and governments in the care, support and ...

  17. Factors influencing the vulnerability of women to the risk of HIV ...

    African Journals Online (AJOL)

    In Africa, south of the Sahara, the HIV epidemic continues to be a threat to health, economic and social development. Women in this region bear the brunt of the epidemic than men. It is reported that women usually get infected with HIV ten years earlier than men of the same age group. Although there are biomedical ...

  18. Of 'prostitutes' and 'AIDS people': Feminization of HIV and AIDS in ...

    African Journals Online (AJOL)

    In sub-Saharan Africa, more women than men live with HIV and women bear the largest proportion of the burden of care that is due to the epidemic. Only a few studies have documented the precise details of how women in countries with low HIV prevalence became the worst affected by the epidemic. In Ghana, the historical ...

  19. Epidemic of neurolathyrism in Ethiopia.

    Science.gov (United States)

    Getahun, H; Mekonnen, A; TekleHaimanot, R; Lambein, F

    1999-07-24

    After a drought and famine, overconsumption of the drought-tolerant grasspea triggered an epidemic of neurodegenerative neurolathyrism in Northeast Ethiopia. Environmental, nutritional, and medical factors seem to affect the susceptibility.

  20. Epidemic cholera spreads like wildfire

    Science.gov (United States)

    Roy, Manojit; Zinck, Richard D.; Bouma, Menno J.; Pascual, Mercedes

    2014-01-01

    Cholera is on the rise globally, especially epidemic cholera which is characterized by intermittent and unpredictable outbreaks that punctuate periods of regional disease fade-out. These epidemic dynamics remain however poorly understood. Here we examine records for epidemic cholera over both contemporary and historical timelines, from Africa (1990-2006) and former British India (1882-1939). We find that the frequency distribution of outbreak size is fat-tailed, scaling approximately as a power-law. This pattern which shows strong parallels with wildfires is incompatible with existing cholera models developed for endemic regions, as it implies a fundamental role for stochastic transmission and local depletion of susceptible hosts. Application of a recently developed forest-fire model indicates that epidemic cholera dynamics are located above a critical phase transition and propagate in similar ways to aggressive wildfires. These findings have implications for the effectiveness of control measures and the mechanisms that ultimately limit the size of outbreaks.

  1. Agriculture, Trees and HIV/AIDS

    OpenAIRE

    World Bank

    2005-01-01

    For a long time, HIV/AIDS was viewed as purely a health issue. Yet HIV/AIDS has implications that reach far beyond health - including great impact on agricultural and food production systems. In Sub-Saharan Africa (SSA), most infected people live in rural areas and HIV/AIDS has become mostly a rural problem. In largely rural-based economies, it is unlikely that the epidemic can be controll...

  2. Operations research in HIV/AIDS.

    Science.gov (United States)

    Kumar, Anant

    2013-01-01

    Operations research is mainly applied to decision making in industries and corporations using quantitative methods to optimize production. The applications of operations research in social sciences research or health research in HIV, service delivery, and program performance improvement are minimal. Considering the complexity of the HIV/AIDS epidemic, it is imperative to learn from operations research in scaling up HIV treatment, prevention, and intervention in resource-poor settings. In this article the author discusses the methodological issues in operations research within the context of HIV/AIDS research. The author also suggests a framework for using operations research in the field of HIV/AIDS research and program intervention.

  3. Drift of the HIV-1 envelope glycoprotein gp120 toward increased neutralization resistance over the course of the epidemic: a comprehensive study using the most potent and broadly neutralizing monoclonal antibodies.

    Science.gov (United States)

    Bouvin-Pley, M; Morgand, M; Meyer, L; Goujard, C; Moreau, A; Mouquet, H; Nussenzweig, M; Pace, C; Ho, D; Bjorkman, P J; Baty, D; Chames, P; Pancera, M; Kwong, P D; Poignard, P; Barin, F; Braibant, M

    2014-12-01

    Extending our previous analyses to the most recently described monoclonal broadly neutralizing antibodies (bNAbs), we confirmed a drift of HIV-1 clade B variants over 2 decades toward higher resistance to bNAbs targeting almost all the identified gp120-neutralizing epitopes. In contrast, the sensitivity to bNAbs targeting the gp41 membrane-proximal external region remained stable, suggesting a selective pressure on gp120 preferentially. Despite this evolution, selected combinations of bNAbs remain capable of neutralizing efficiently most of the circulating variants. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  4. Overview on Current HIV/AIDS in Asia: "Some Implications for Food and Nutrition Security".

    Science.gov (United States)

    Bellin-Sesay, Friederike

    2003-09-01

    Although Asian countries in general face relatively low national HIV/ AIDS prevalence rates, there are serious localized epidemics in some countries that have important implications for food and nutrition security. The rapid development of the HIV/AIDS epidemic in African countries should serve as a warning to Asian countries. While some of the important modes of transmission of relevance to Asia are highlighted, the focus of this article is on the impact of the HIV/AIDS epidemic on the food security and nutrition situation at the household and community levels. Acknowledging the fact that HIV/AIDS is not merely a medical problem, the impact of the epidemic on nutritional issues, food production, income and the difficulties of poor households in coping with the situation are discussed. The article concludes with some remarks in relation to possible actions to mitigate the HIV/AIDS epidemic before it escalates beyond control in Asia.

  5. AIDS among older children and adolescents in Southern Africa: projecting the time course and magnitude of the epidemic

    Science.gov (United States)

    Ferrand, Rashida A; Corbett, Elizabeth L; Wood, Robin; Hargrove, John; Ndhlovu, Chiratidzo E; Cowan, Frances M; Gouws, Eleanor; Williams, Brian G

    2012-01-01

    Objective An AIDS epidemic among older children and adolescents is clinically apparent in Southern Africa. We estimated the likely scale and time course of the epidemic in older survivors of vertical HIV infection. Design We modelled demographic, HIV prevalence, mother-to-child transmission (MTCT) and child survival data to project HIV burden among older children in two Southern African countries at different stages of severe HIV epidemics. Using measured survival data for children, we estimate that 64% of HIV-infected infants are fast-progressors with median survival=0.64 years and 36% are slow-progressors with median survival=16.0 years. We confirmed model validity by comparing model predictions to available epidemiological data. Findings Without treatment, HIV prevalence among 10-year olds in South Africa is expected to increase from 2.1% in 2008 to 3.3% in 2020 while in Zimbabwe, it will decrease from 3.2% in 2008 to 1.6% in 2020. Deaths among untreated slow-progressors will increase in South Africa from 7000/year in 2008 to 23,000/year in 2030, and in Zimbabwe from 8000/year in 2008 to peak at 9700/year in 2014. Drugs to prevent MTCT could reduce death rate in 2030 to 8700/year in South Africa and to 2800/year in Zimbabwe in 2014. Conclusions A substantial epidemic of HIV/AIDS in older survivors of MTCT is emerging in Southern Africa. The lack of direct observations of survival in slow-progressors has resulted in failure to anticipate the magnitude of the epidemic and to adequately address the clinical needs of HIV-infected older children and adolescents. Better HIV diagnostic and care services for this age-group are urgently required. PMID:19684508

  6. From HIV prevention to reproductive health choices: HIV/AIDS ...

    African Journals Online (AJOL)

    In South Africa, the private sector has responded to the HIV epidemic by providing treatment in the form of highly active antiretroviral therapy (HAART). The private sector has paved the way for policy and treatment regimens, while the public sector has reviewed health-systems capacity and the political will to provide ...

  7. HIV-ASSOCIATED VENOUS THROMBOEMBOLISM

    Directory of Open Access Journals (Sweden)

    Michele Bibas

    2011-01-01

    ="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis" /> Hidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference" /> Hidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference" /> Hidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title" />

    HIV infection has been recognized as a prothrombotic condition and this association has now been proven by a large number of studies with a reported VTE frequency among HIV-infected patients ranging from 0.19% to 7,63 %/year. HIV infection is associated with a two to tenfold increased risk of venous thrombosis in comparison with a general population of the same age. Some r

  8. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... depict the devastating consequences of compromised judgment and critical thinking that can result from drug use. Young women ... HIV epidemic. As we learn more about the critical connection between drug ... treatment interventions for breaking the harmful links between them, we ...

  9. Untangling the Gordian knot of HIV, stress, and cognitive impairment

    OpenAIRE

    Valdez, Arielle N.; Rubin, Leah H.; Neigh, Gretchen N.

    2016-01-01

    As individuals live longer with HIV, this ?graying of the HIV epidemic? has introduced a new set of challenges including a growing number of age and inflammation-related diseases such as cardiovascular disease, type II diabetes, cancer, and dementia. The biological underpinnings of these complex and co-morbid diseases are not fully understood and become very difficult to disentangle in the context of HIV and aging. In the current review we examine the contributions and interactions of HIV, st...

  10. Evolution of HIV/AIDS in Southern Africa

    OpenAIRE

    Lauwers, L.; Pruyt, E.; Hens, L.; Brans, J.p.

    2008-01-01

    This paper presents a system dynamics model to study the spread of HIV/AIDS in Southern Africa. The HIV/AIDS model includes important feedback mechanisms of the spread of HIV/AIDS, and partly explains the dynamics of the epidemic in a representative Southern African country. The HIV/AIDS model indicates that prevention to reduce risk behavior is crucial in all stages of the epidemic, but is most efficient in an early stage. Financial relief is most appropriate in a more advanced stage of the ...

  11. Does HIV/AIDS matter for economic growth in sub-Saharan Africa?

    DEFF Research Database (Denmark)

    Mveyange, Anthony Francis; Skovsgaard, Christian; Lesner, Tine

    -Saharan Africa during 2003–12. Our main finding shows that the impact of HIV/AIDS epidemic on economic growth is negative but statistically insignificant. Further investigation on the main channels through which HIV/AIDS may affect economic growth—namely human capital, population growth, and productivity......Estimating the impact of HIV/AIDS epidemic on economic growth is challenging because of endogeneity concerns. In this paper, we use novel data on male circumcision and distance from the first HIV outbreak as instrumental variables for the HIV/AIDS epidemic in 241 regions across 25 countries in sub......—finds no impacts of the HIV/AIDS epidemic on these channels....

  12. HIV avidity index performance using a modified fourth-generation immunoassay to detect recent HIV infections.

    Science.gov (United States)

    Suligoi, Barbara; Regine, Vincenza; Raimondo, Mariangela; Rodella, Anna; Terlenghi, Luigina; Caruso, Arnaldo; Bagnarelli, Patrizia; Capobianchi, Maria Rosaria; Zanchetta, Nadia; Ghisetti, Valeria; Galli, Claudio

    2017-10-26

    Detecting recent HIV infections is important to evaluate incidence and monitor epidemic trends. We aimed to evaluate the diagnostic performance and accuracy of the avidity index (AI) for discriminating for recent HIV infections. We collected serum samples from HIV-1 positive individuals: A) with known date of infection (midpoint in time between last HIV-negative and first HIV-positive test); B) infected for >1 year. Samples were divided into two aliquots: one diluted with phosphate buffered saline (PBS) and the other with 1 M guanidine. Both aliquots were assayed by the Architect HIV Ag/Ab Combo 4th generation assay (Abbott). We compared AI found in recent (RI=HIV subtype had no impact on AI misclassifications. All individuals in group A reached the AI threshold of 0.80 within 24 months after seroconversion. The AI is an accurate serological marker for discriminating recent from established HIV infections and meets WHO requirements for HIV incidence assays.

  13. Validation of the modes of transmission model as a tool to prioritize HIV prevention targets: a comparative modelling analysis.

    Directory of Open Access Journals (Sweden)

    Sharmistha Mishra

    Full Text Available The static Modes of Transmission (MOT model predicts the annual fraction of new HIV infections acquired across subgroups (MOT metric, and is used to focus HIV prevention. Using synthetic epidemics via a dynamical model, we assessed the validity of the MOT metric for identifying epidemic drivers (behaviours or subgroups that are sufficient and necessary for HIV to establish and persist, and the potential consequence of MOT-guided policies.To generate benchmark MOT metrics for comparison, we simulated three synthetic epidemics (concentrated, mixed, and generalized with different epidemic drivers using a dynamical model of heterosexual HIV transmission. MOT metrics from generic and complex MOT models were compared against the benchmark, and to the contribution of epidemic drivers to overall HIV transmission (cumulative population attributable fraction over t years, PAFt. The complex MOT metric was similar to the benchmark, but the generic MOT underestimated the fraction of infections in epidemic drivers. The benchmark MOT metric identified epidemic drivers early in the epidemics. Over time, the MOT metric did not identify epidemic drivers. This was not due to simplified MOT models or biased parameters but occurred because the MOT metric (irrespective of the model used to generate it underestimates the contribution of epidemic drivers to HIV transmission over time (PAF5-30. MOT-directed policies that fail to reach epidemic drivers could undermine long-term impact on HIV incidence, and achieve a similar impact as random allocation of additional resources.Irrespective of how it is obtained, the MOT metric is not a valid stand-alone tool to identify epidemic drivers, and has limited additional value in guiding the prioritization of HIV prevention targets. Policy-makers should use the MOT model judiciously, in combination with other approaches, to identify epidemic drivers.

  14. Prevalencia de infección por VIH en la población adulta en México: una epidemia en ascenso y expansión Prevalence of HIV infection among adult population in Mexico: an increasingly expanding epidemic

    Directory of Open Access Journals (Sweden)

    José Luis Valdespino

    2007-01-01

    from the National Health Survey (ENSA 2000, a probabilistic, multi-stage, stratified, cluster household survey conducted by the Mexican Ministry of Health between November 1999 and June 2000. Availability of information from the Seroepidemiological Survey conducted in 1987 allowed for the estimation of trends between the two surveys (1987-2000. MATERIAL AND METHODS: A total of 21 271 males and females 20 years or older included in the ENSA 2000 were randomly selected and studied for anti-HIV 1/2 IgG (ELISA, confirmed by immunoelectrotransference (WB, and for risk factors associated with HIV infection. Samples were processed in the National Institute of Public Health in 2005. RESULTS: Prevalence for HIV infection was 0.25%. The main factors associated with infection were younger ages, male gender, residence in the Federal District, college education or higher, and being single or divorced. CONCLUSIONS: Seroprevalence among adults shows a ten-fold increase as compared with the results of the national seroprevalence survey of 1987. Although the epidemic continues to be concentrated among men who have sex with men, results provide evidence of dissemination towards the heterosexual population.

  15. Managing HIV/AIDS in correctional settings.

    Science.gov (United States)

    Springer, Sandra A; Altice, Frederick L

    2005-11-01

    Approximately one quarter of people living with HIV/AIDS in the United States pass through the correctional system, resulting in a burden of infection on the correctional health care system that has challenged correctional and public health officials. The HIV epidemic behind bars results from the high prevalence of HIV risk behaviors among those incarcerated: illicit drug use, untreated mental illness, prostitution, homelessness, and poverty. Challenges to HIV care in correctional settings include management of comorbid conditions, remoteness from HIV care sites, organizational constraints, and access to effective therapies. Despite these challenges, prisoners with HIV have derived considerable benefit from HIV detection and treatment. In order to achieve parity in HIV outcomes among vulnerable populations, effective prison-release programs that incorporate effective case management with effective drug treatment and adherence strategies are required to extend the benefit of highly active antiretroviral therapy as prisoners transition back to community settings.

  16. [Pre-exposure prophylaxis for the prevention of sexual HIV transmission; new preventative strategy using tenofovir/emtricitabine

    NARCIS (Netherlands)

    Boot, J.; Rump, B.O.; Boucher, C.A.B.; Coul, E.L. Op de; Agtmael, M.A. van; Vijver, D.A. van de; Burger, D.M.; Fanoy, E.B.

    2013-01-01

    The Netherlands has approximately 20,000 registered HIV-infected patients. The current HIV prevention policy consisting of condom use and active HIV testing does not effectively mitigate the HIV epidemic in all risk groups. In July of 2012, tenofovir/emtricitabine (TDF/FTC) was approved by the

  17. ORIGINAL ARTICLES HIV/AIDS prevalence testing – merits ...

    African Journals Online (AJOL)

    2006-01-18

    Jan 18, 2006 ... estimated that the HIV/AIDS epidemic will cost South Africa. 17% in GDP growth by 2010.5 This epidemic .... However, from the outset one can create a target sample group, for example an entire shift. .... information was available for accurate costing and planning models, thus providing Anglo Platinum with ...

  18. HIV infection in India: Epidemiology, molecular epidemiology and ...

    Indian Academy of Sciences (India)

    2008-10-15

    Oct 15, 2008 ... http://www.ias.ac.in/article/fulltext/jbsc/033/04/0515-0525 ... Since then the epidemic has spread throughout the country. In the ... The absolute number of HIV infections in the country is expected to be close to 2.5 million and National AIDS Control Programme, phase III is geared to contain the epidemic.

  19. Networked SIS Epidemics With Awareness

    KAUST Repository

    Paarporn, Keith

    2017-07-20

    We study a susceptible-infected-susceptible epidemic process over a static contact network where the nodes have partial information about the epidemic state. They react by limiting their interactions with their neighbors when they believe the epidemic is currently prevalent. A node\\'s awareness is weighted by the fraction of infected neighbors in their social network, and a global broadcast of the fraction of infected nodes in the entire network. The dynamics of the benchmark (no awareness) and awareness models are described by discrete-time Markov chains, from which mean-field approximations (MFAs) are derived. The states of the MFA are interpreted as the nodes\\' probabilities of being infected. We show a sufficient condition for the existence of a

  20. Environmental Factors Influencing Epidemic Cholera

    Science.gov (United States)

    Jutla, Antarpreet; Whitcombe, Elizabeth; Hasan, Nur; Haley, Bradd; Akanda, Ali; Huq, Anwar; Alam, Munir; Sack, R. Bradley; Colwell, Rita

    2013-01-01

    Cholera outbreak following the earthquake of 2010 in Haiti has reaffirmed that the disease is a major public health threat. Vibrio cholerae is autochthonous to aquatic environment, hence, it cannot be eradicated but hydroclimatology-based prediction and prevention is an achievable goal. Using data from the 1800s, we describe uniqueness in seasonality and mechanism of occurrence of cholera in the epidemic regions of Asia and Latin America. Epidemic regions are located near regional rivers and are characterized by sporadic outbreaks, which are likely to be initiated during episodes of prevailing warm air temperature with low river flows, creating favorable environmental conditions for growth of cholera bacteria. Heavy rainfall, through inundation or breakdown of sanitary infrastructure, accelerates interaction between contaminated water and human activities, resulting in an epidemic. This causal mechanism is markedly different from endemic cholera where tidal intrusion of seawater carrying bacteria from estuary to inland regions, results in outbreaks. PMID:23897993

  1. The state of the epidemic

    African Journals Online (AJOL)

    jafricabrown

    2008-12-05

    Dec 5, 2008 ... Letter to the Editor. João Carapinha (BPharm, MM P&DM) is the owner of PharmaLogica, a consulting company active in South Africa and the USA. ... the South African government implemented a strategy to provide ART to HIV- .... strategic plan on the role of pharmacists in the management of HIV/AIDS, TB ...

  2. Epidemic Network Failures in Optical Transport Networks

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Katsikas, Dimitrios; Fagertun, Anna Manolova

    2013-01-01

    This paper presents a failure propagation model for transport networks which are affected by epidemic failures. The network is controlled using the GMPLS protocol suite. The Susceptible Infected Disabled (SID) epidemic model is investigated and new signaling functionality of GMPLS to support epid...... epidemic failure resolution is proposed. The results provide important input to service recovery mechanisms under epidemic failures.......This paper presents a failure propagation model for transport networks which are affected by epidemic failures. The network is controlled using the GMPLS protocol suite. The Susceptible Infected Disabled (SID) epidemic model is investigated and new signaling functionality of GMPLS to support...

  3. Food security and nutrition interventions in response to the AIDS epidemic: assessing global action and evidence.

    Science.gov (United States)

    Aberman, Noora-Lisa; Rawat, Rahul; Drimie, Scott; Claros, Joan M; Kadiyala, Suneetha

    2014-10-01

    The number of people receiving antiretroviral therapy in developing countries has increased dramatically. The last decade has brought an increased understanding of the interconnectedness between HIV/AIDS, food insecurity, and undernutrition and a surge of evidence on how to address the food security and nutrition dimensions of the epidemic. We review this evidence as well as the corresponding evolution of policy support for incorporating food security and nutrition concerns into HIV programming. The available evidence, although varied in scope and methodologies, shows that nutrition supplementation and safety nets in the form of food assistance and livelihood interventions have potential in certain contexts to improve food security and nutrition outcomes in an HIV/AIDS context. In the face of funding uncertainties and competing priorities, we must maintain momentum towards effective and sustainable solutions to the epidemic through continued systematic research to inform policy and through the strengthening of monitoring systems to dynamically inform intervention development.

  4. The narcissism epidemic is dead : Long live the narcissism epidemic

    NARCIS (Netherlands)

    Wetzel, Eunike; Brown, Anna; Hill, Patrick; Chung, J.M.H.; Robins, R.W.; Roberts, B.W.

    2017-01-01

    Are recent cohorts of college students more narcissistic than their predecessors? To address debates about the so-called “narcissism epidemic,” we used data from three cohorts of students (N1990s = 1,166; N2000s = 33,647; N2010s = 25,412) to test whether narcissism levels (overall and specific

  5. Discrete symmetries from hidden sectors

    Energy Technology Data Exchange (ETDEWEB)

    Anastasopoulos, Pascal [Institut für Theoretische Physik, Technische Universität Wien,A-1040 Vienna (Austria); Richter, Robert [II. Institut für Theoretische Physik, Hamburg University,Hamburg (Germany); Schellekens, A.N. [NIKHEF,Science Park 105, 1098 XG Amsterdam (Netherlands); IMAPP, Radboud Universiteit Nijmegen,Nijmegen (Netherlands); Instituto de Física Fundamental, CSIC,Madrid (Spain)

    2015-06-29

    We study the presence of abelian discrete symmetries in globally consistent orientifold compactifications based on rational conformal field theory. We extend previous work http://dx.doi.org/10.1016/j.nuclphysb.2012.08.008 by allowing the discrete symmetries to be a linear combination of U(1) gauge factors of the visible as well as the hidden sector. This more general ansatz significantly increases the probability of finding a discrete symmetry in the low energy effective action. Applied to globally consistent MSSM-like Gepner constructions we find multiple models that allow for matter parity or Baryon triality.

  6. A Holistic Approach to Addressing HIV Infection Disparities in Gay, Bisexual, and Other Men Who Have Sex with Men

    Science.gov (United States)

    Halkitis, Perry N.; Wolitski, Richard J.; Millett, Gregorio A.

    2013-01-01

    Gay, bisexual, and other men who have sex with men (MSM) have been disproportionately affected by HIV and AIDS since the beginning of the epidemic in the United States and in many other parts of the world. The HIV epidemic is inextricably tied to other health problems that disproportionately affect gay, bisexual, and other MSM including…

  7. HIV incidence on the increase among homosexual men attending an Amsterdam sexually transmitted disease clinic: using a novel approach for detecting recent infections

    NARCIS (Netherlands)

    Dukers, Nicole H. T. M.; Spaargaren, Joke; Geskus, Ronald B.; Beijnen, Jos; Coutinho, Roel A.; Fennema, Han S. A.

    2002-01-01

    Objective: Dramatic increases have occurred in sexually transmitted diseases (STD) and in sexual risk behaviour among homosexual men in Amsterdam and internationally. We investigated whether these trends indicate a resurgence of the HIV epidemic. Methods: HIV incidence was determined among

  8. AIDS in rural Africa: a paradigm for HIV-1 prevention.

    Science.gov (United States)

    Hudson, C P

    1996-07-01

    Networks of concurrent sexual partnerships may be the primary cause of epidemic spread of HIV-1 in parts of sub-Saharan Africa. This pattern of sexual behaviour increases the likelihood that individuals experiencing primary HIV-1 infection transmit the virus to other persons. Networks of concurrent partnerships are likely to be important in both the early ('epidemic') and late ('endemic') phases of HIV-1 transmission. Interventions should aim to break the sexual networks, whatever the stage of the epidemic. However, prevention of transmission in the endemic phase also requires a greater awareness of early clinical manifestations of HIV-1 infection in the general population. Such awareness, coupled with the availability of condoms and access to HIV-1 testing facilities, may reduce transmission in discordant couples.

  9. DEVELOPMENT OF TUBERCULOSIS EPIDEMIC PROCESS: INFLUENCE OF EXTERNAL AND INTERNAL FACTORS

    Directory of Open Access Journals (Sweden)

    G. S. Balasaniantc

    2014-01-01

    Full Text Available Tuberculosis epidemic process is characterized by decreasing in the basic epidemiological indexes which is possible the favorable tendency. Inside the process gradual and steady changing from drug sensitive on drug resistant Mycobacterium tuberculosis population has taken place that has the consequence various organizational and medical complexities of therapy of the patients. Simultaneously population of tuberculosis patients is also change with increasing the proportion of patients with a combination of tuberculosis and HIV-infection. Lacks of HIV early detection, growth of HIV patients with prolonged stages of HIV and wide spreading of tuberculosis contamination among population become the reason of fast transformation latent tuberculous infection to disease. Antiviral therapy actively appointed to HIV patients does not render influence on this process yet.  

  10. Structures of Care in the Clinics of the HIV Research Network

    OpenAIRE

    Yehia, Baligh R.; Gebo, Kelly A.; Hicks, Perrin B.; Korthuis, P. Todd; Moore, Richard D.; Ridore, Michelande; Mathews, William Christopher

    2008-01-01

    As the HIV epidemic has evolved to become a chronic, treatable condition the focus of HIV care has shifted from the inpatient to the outpatient arena. The optimal structure of HIV care in the outpatient setting is unknown. Using the HIV Research Network (HIVRN), a federally sponsored consortium of 21 sites that provide care to HIV-infected individuals, this study attempted to: (1) document key features of the organization of care in HIVRN adult clinics and (2) estimate variability among clini...

  11. Epidemic Synchronization in Robotic Swarms

    DEFF Research Database (Denmark)

    Schiøler, Henrik; Nielsen, Jens Frederik Dalsgaard; Ngo, Trung Dung

    2009-01-01

    Clock synchronization in swarms of networked mobile robots is studied in a probabilistic, epidemic framework. In this setting communication and synchonization is considered to be a randomized process, taking place at unplanned instants of geographical rendezvous between robots. In combination wit...

  12. A Framework for Epidemic Models

    NARCIS (Netherlands)

    Gielen, J.L.W.

    2003-01-01

    A framework is developed that enables the modeling of the various mechanisms of epidemic processes. A model within the framework is completely characterized by a set of transmission functions. These functions support the modeling of the infectivity of a new infective as a function of its

  13. Stochastic Processes in Epidemic Theory

    CERN Document Server

    Lefèvre, Claude; Picard, Philippe

    1990-01-01

    This collection of papers gives a representative cross-selectional view of recent developments in the field. After a survey paper by C. Lefèvre, 17 other research papers look at stochastic modeling of epidemics, both from a theoretical and a statistical point of view. Some look more specifically at a particular disease such as AIDS, malaria, schistosomiasis and diabetes.

  14. Hidden neural networks: application to speech recognition

    DEFF Research Database (Denmark)

    Riis, Søren Kamaric

    1998-01-01

    We evaluate the hidden neural network HMM/NN hybrid on two speech recognition benchmark tasks; (1) task independent isolated word recognition on the Phonebook database, and (2) recognition of broad phoneme classes in continuous speech from the TIMIT database. It is shown how hidden neural networks...

  15. Insight: Exploring Hidden Roles in Collaborative Play

    Directory of Open Access Journals (Sweden)

    Tricia Shi

    2015-06-01

    Full Text Available This paper looks into interaction modes between players in co-located, collaborative games. In particular, hidden traitor games, in which one or more players is secretly working against the group mission, has the effect of increasing paranoia and distrust between players, so this paper looks into the opposite of a hidden traitor – a hidden benefactor. Rather than sabotaging the group mission, the hidden benefactor would help the group achieve the end goal while still having a reason to stay hidden. The paper explores what games with such a role can look like and how the role changes player interactions. Finally, the paper addresses the divide between video game and board game interaction modes; hidden roles are not common within video games, but they are of growing prevalence in board games. This fact, combined with the exploration of hidden benefactors, reveals that hidden roles is a mechanic that video games should develop into in order to match board games’ complexity of player interaction modes.

  16. Hidden Variable Theories and Quantum Nonlocality

    Science.gov (United States)

    Boozer, A. D.

    2009-01-01

    We clarify the meaning of Bell's theorem and its implications for the construction of hidden variable theories by considering an example system consisting of two entangled spin-1/2 particles. Using this example, we present a simplified version of Bell's theorem and describe several hidden variable theories that agree with the predictions of…

  17. Hidden Curriculum in Continuing Medical Education

    Science.gov (United States)

    Bennett, Nancy; Lockyer, Jocelyn; Mann, Karen; Batty, Helen; LaForet, Karen; Rethans, Jan-Joost; Silver, Ivan

    2004-01-01

    In developing curricula for undergraduate and graduate medical education, educators have become increasingly aware of an interweaving of the formal, informal, and hidden curricula and their influences on the outcomes of teaching and learning. But, to date, there is little in the literature about the hidden curriculum of medical practice, which…

  18. UV Photography Shows Hidden Sun Damage

    Science.gov (United States)

    ... var c = 0; c UV photography shows hidden sun damage A UV photograph gives us a safe way to see how the sun damages our skin. In the UV photos that ... on the right, you can see what hidden sun damage looks like. Compare these UV photos with ...

  19. Building Simple Hidden Markov Models. Classroom Notes

    Science.gov (United States)

    Ching, Wai-Ki; Ng, Michael K.

    2004-01-01

    Hidden Markov models (HMMs) are widely used in bioinformatics, speech recognition and many other areas. This note presents HMMs via the framework of classical Markov chain models. A simple example is given to illustrate the model. An estimation method for the transition probabilities of the hidden states is also discussed.

  20. Opioids: The Prescription Drug & Heroin Overdose Epidemic

    Science.gov (United States)

    ... About the Epidemic Help, Resources and Information National Opioids Crisis Search Search National Helpline SAMHSA’s National Helpline ... 1-800-622-4357 Visit Helpline Website THE OPIOID EPIDEMIC IN NUMBERS 80% Nearly 80% of heroin ...

  1. Helioscope bounds on hidden sector photons

    Energy Technology Data Exchange (ETDEWEB)

    Redondo, J.

    2007-12-15

    The flux of hypothetical ''hidden photons'' from the Sun is computed under the assumption that they interact with normal matter only through kinetic mixing with the ordinary standard model photon. Requiring that the exotic luminosity is smaller than the standard photon luminosity provides limits for the mixing parameter down to {chi} hidden photon mass. Furthermore, it is pointed point out that helioscopes looking for solar axions are also sensitive to hidden photons. The recent results of the CAST collaboration are used to further constrain the mixing parameter {chi} at low masses (m{sub {gamma}}{sub '}<1 eV) where the luminosity bound is weaker. In this regime the solar hidden photon ux has a sizable contribution of longitudinally polarized hidden photons of low energy which are invisible for current helioscopes. (orig.)

  2. Heating up the Galaxy with hidden photons

    Energy Technology Data Exchange (ETDEWEB)

    Dubovsky, Sergei [Center for Cosmology and Particle Physics, Department of Physics, New York University,New York, NY, 10003 (United States); Hernández-Chifflet, Guzmán [Center for Cosmology and Particle Physics, Department of Physics, New York University,New York, NY, 10003 (United States); Instituto de Física, Facultad de Ingeniería, Universidad de la República,Montevideo, 11300 (Uruguay)

    2015-12-29

    We elaborate on the dynamics of ionized interstellar medium in the presence of hidden photon dark matter. Our main focus is the ultra-light regime, where the hidden photon mass is smaller than the plasma frequency in the Milky Way. We point out that as a result of the Galactic plasma shielding direct detection of ultra-light photons in this mass range is especially challenging. However, we demonstrate that ultra-light hidden photon dark matter provides a powerful heating source for the ionized interstellar medium. This results in a strong bound on the kinetic mixing between hidden and regular photons all the way down to the hidden photon masses of order 10{sup −20} eV.

  3. Características epidemiológicas de las nuevas infecciones causadas por el VIH comparadas con los casos de sida: La epidemia de VIH/ sida en el País Vasco Epidemiological characteristics of new HIV infections compared with AIDS cases: The HIV/AIDS epidemic in the Basque Country [Spain

    Directory of Open Access Journals (Sweden)

    Daniel Zulaika

    2004-04-01

    Full Text Available Objetivo: Describir las características epidemiológicas de los nuevos diagnósticos de infección por el VIH en el período 1997-2001 y comparlas con los casos de sida (1991-2001. Métodos: Se han recogido retrospectivamente los datos de las nuevas infecciones por el VIH ocurridas en el País Vasco (1997-2001 y se han comparado con los casos de sida (1991-2001. Resultados: Se han diagnosticado 912 nuevas infecciones por el VIH. El diagnóstico de VIH coincidió con el de sida en 299 (32,8% de las nuevas infecciones. Las relaciones heterosexuales han sido el mecanismo de transmisión más frecuente, seguido de la transmisión por vía parenteral y las relaciones homosexuales y bisexuales, con diferencias significativas (pObjective: To describe the epidemiological characteristics of new cases of HIV infection diagnosed from 1997-2001 and compare them with AIDS cases (1991-2001. Methods: Data were retrospectively collected on new cases of HIV infection detectad in the Basque Country (1997-2001 and were compared with AIDS cases (1991-2001. Results: A total of 912 new cases of HIV infection were diagnosed. In 299 of the new cases (32.8%, HIV and AIDS were diagnosed simultaneously. The most common mechanism of transmission was heterosexual transmission, followed by intravenous and homo/bisexual transmission. Significant epidemiological differences (p<0.001 were found with regard to AIDS cases. Conclusions: Sexual transmission has replaced intravenous drug use as the most common mechanism of HIV transmission. A large percentage of patients were simultaneously diagnosed with HIV and AIDS, indicating the need for new prevention strategies.

  4. Addressing the Unique Needs of African American Women in HIV Prevention

    Science.gov (United States)

    Caldeira, Nathilee A.; Ruglass, Lesia M.; Gilbert, Louisa

    2009-01-01

    African American women continue to be disproportionately affected by the HIV/AIDS epidemic, yet there are few effective HIV prevention interventions that are exclusively tailored to their lives and that address their risk factors. Using an ecological framework, we offer a comprehensive overview of the risk factors that are driving the HIV/AIDS epidemic among African American women and explicate the consequences of ignoring these factors in HIV prevention strategies. We also recommend ways to improve HIV prevention programs by taking into consideration the unique life experiences of adult African American women. PMID:19372518

  5. HIV Transmission

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... on HIV Syndicated Content Website Feedback HIV/AIDS HIV Transmission Language: English (US) Español (Spanish) Recommend on ...

  6. National Black HIV/AIDS Awareness Day

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    In observance of National Black HIV/AIDS Awareness Day, Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about the HIV/AIDS among African Americans and what steps can be taken on the national, state, local, and individual levels to address this epidemic.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  7. Drawing conceptual linkages: property rights and HIV.

    Science.gov (United States)

    Nanda, Priya

    2008-12-01

    An understanding of the impact of HIV/AIDS epidemic on broader social development necessitates a closer scrutiny of the relationship between HIV/AIDS and economic productivity. In this article, which is based on her presentation at a concurrent session at the conference, Priya Nanda describes the relationship between the widespread exclusion in developing countries of land ownership by women and their vulnerability to HIV and the effects of HIV. The author calls for more research on the complexity and diversity of land tenure systems and property laws.

  8. Update on HIV in Western Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-01-01

    living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. There are large differences across countries in HIV testing rates, proportions of people who present......HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people...... to care with low CD4+ cell counts, accessibility to treatment and care, and rates of retention once in care. Improved collection of HIV surveillance data will benefit countries and help to understand their epidemic better. However, social inequalities experienced by people with HIV still remain in some...

  9. Update on HIV in Western Europe.

    Science.gov (United States)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-06-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. There are large differences across countries in HIV testing rates, proportions of people who present to care with low CD4+ cell counts, accessibility to treatment and care, and rates of retention once in care. Improved collection of HIV surveillance data will benefit countries and help to understand their epidemic better. However, social inequalities experienced by people with HIV still remain in some regions and urgently need to be addressed.

  10. Update on HIV in Western Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-01-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people...... living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. There are large differences across countries in HIV testing rates, proportions of people who present...... to care with low CD4+ cell counts, accessibility to treatment and care, and rates of retention once in care. Improved collection of HIV surveillance data will benefit countries and help to understand their epidemic better. However, social inequalities experienced by people with HIV still remain in some...

  11. Mathematical models of the AIDS epidemic: An historical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, E.A.

    1988-01-01

    Researchers developing mathematical models of the spreading of HIV, the Human Immunodeficiency Virus that causes AIDS, hope to achieve a number of goals. These goals may be classified rather broadly into three categories: understanding, prediction, and control. Understanding which are the key biological and sociological processes spreading this epidemic and leading to the deaths of those infected will allow AIDS researchers to collect better data and to identify ways of slowing the epidemic. Predicting the groups at risk and future numbers of ill people will allow an appropriate allocation of health-care resources. Analysis and comparison of proposed control methods will point out unexpected consequences and allow a better design of these programs. The processes which lead to the spread of HIV are biologically and sociologically complex. Mathematical models allow us to organize our knowledge into a coherent picture and examine the logical consequences, therefore they have the potential to be extremely useful in the search to control this disease. 24 refs., 3 figs.

  12. Traditional healers and the “Fast-Track” HIV response: is success ...

    African Journals Online (AJOL)

    The rapid scale-up of effective HIV prevention strategies is a central theme of the post-2015 health and development agenda. All major global HIV and AIDS funders have aligned their policies and plans to achieve sharp reductions in new HIV infections and reach epidemic control by 2030. In these “fast-track” plans, ...

  13. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates

    NARCIS (Netherlands)

    Thanh, D. H.; Sy, D. N.; Linh, N. D.; Hoan, T. M.; Dien, H. T.; Thuy, T. B.; Hoa, N. P.; Tung, L. B.; Cobelens, F.

    2010-01-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of

  14. Incidence of HIV infection at the time of incident reporting,in victims ...

    African Journals Online (AJOL)

    Background: HIV/AIDS epidemic and sexual assault have emerged as the most serious public health problems in South Africa. The country has about 5-million HIV infected individuals. About a million women are raped every year. Objective: To study the incidence of HIV infection in victims of sexual assaults. Methods: This ...

  15. Modelling a traditional game as an agent in HIV/AIDS behaviour ...

    African Journals Online (AJOL)

    The level of HIV/AIDS awareness among the Luo of western Kenya is at its highest yet the epidemic continues unabated. While HIV/AIDS is locally recognised as an emergent deadly condition, people seem unconcerned. Deaths related to HIV/AIDS are often euphemistically explained in terms of tuberculosis, respiratory ...

  16. HIV/AIDS Contamination Risk, Savings and the Welfare Effects of Diagnostic Testing

    NARCIS (Netherlands)

    Lammers, J.; Meijdam, A.C.; Verbon, H.A.A.

    2007-01-01

    This paper models the effect of a HIV/AIDS epidemic on saving behavior and studies the welfare effects of testing for HIV. The model specifies a utility function that includes both regular consumption, and medical expenditures. Medical expenditures generate more utility if individuals are HIV

  17. Spatial analysis of HIV infection and associated individual characteristics in Burundi: indications for effective prevention

    National Research Council Canada - National Science Library

    Barankanira, Emmanuel; Molinari, Nicolas; Niyongabo, Théodore; Laurent, Christian

    2016-01-01

    ... for country-specific, in-depth analyses of HIV epidemic features to tailor national prevention responses to the people most at risk [3]. Because half HIV cases only are diagnosed in sub-Saharan Africa [4], most countries rely on Demographic and Health Surveys (DHS) to estimate HIV prevalence along with other data including social and behavio...

  18. HIV/AIDS Cancer and Impact on Surgical Practice: Implication for the ...

    African Journals Online (AJOL)

    Background: The most recent UNAIDS report on the global epidemic estimated the total number of people living with HIV in 2008 to be 33.4 million (31.1-35.8 million) world wide, two-third of known carriers of HIV are living in sub-Saharan Africa. Although HIV prevalence appears to be stable, much remains uncertain about ...

  19. The use of cash transfers for HIV prevention — are we there yet ...

    African Journals Online (AJOL)

    Poverty and social inequality are significant drivers of the HIV epidemic and are risk factors for acquiring HIV. As such, many individuals worldwide are at risk for new HIV infection, especially young women in East and Southern Africa. By addressing these drivers, social protection programmes may mitigate the impact of ...

  20. The when and how of male circumcision and the risk of HIV

    DEFF Research Database (Denmark)

    Rasmussen, Dlama Nggida; Wejse, Christian; Larsen, Olav

    2016-01-01

    is crucial and can increase insight into the HIV epidemic in Africa. Methods: We used data from two retrospective HIV surveys conducted in Guinea- Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (2006 cohort). Multivariate logistical models were used to investigate the relationships between HIV...

  1. A review of the response to HIV/AIDS in Trinidad and Tobago: 1983 ...

    African Journals Online (AJOL)

    This paper examines the character of the response to HIV/AIDS in Trinidad and Tobago and assesses the impact of the response on reducing the spread of the epidemic. The launch of the National HIV/AIDS Strategic Plan in 2004 signalled the intent of the government to take the response to HIV/AIDS to a different level.

  2. Combining social and genetic networks to study HIV transmission in mixing risk groups

    NARCIS (Netherlands)

    Zarrabi, N.; Prosperi, M.C.F.; Belleman, R.G.; Di Giambenedetto, S.; Fabbiani, M.; De Luca, A.; Sloot, P.M.A.

    2013-01-01

    Reconstruction of HIV transmission networks is important for understanding and preventing the spread of the virus and drug resistant variants. Mixing risk groups is important in network analysis of HIV in order to assess the role of transmission between risk groups in the HIV epidemic. Most of the

  3. Common skin and mucosal disorders in HIV/AIDS | Jordaan | South ...

    African Journals Online (AJOL)

    The human immunodeficiency virus (HIV) epidemic continues to spread and evolve on a worldwide basis. Currently more than five million patients in South Africa are living with HIV/AIDS. Cutaneous and mucosal complications eventually occur in nearly all individuals with HIV infection, and can be debilitating, disfiguring, ...

  4. Quantum computation and hidden variables

    CERN Document Server

    Aristov, V V

    2010-01-01

    Many physicists limit oneself to an instrumentalist description of quantum phenomena and ignore the problems of foundation and interpretation of quantum mechanics. This instrumentalist approach results to "specialization barbarism" and mass delusion concerning the problem, how a quantum computer can be made. The idea of quantum computation can be described within the limits of quantum formalism. But in order to understand how this idea can be put into practice one should realize the question: "What could the quantum formalism describe?", in spite of the absence of an universally recognized answer. Only a realization of this question and the undecided problem of quantum foundations allows to see in which quantum systems the superposition and EPR correlation could be expected. Because of the "specialization barbarism" many authors are sure that Bell proved full impossibility of any hidden-variables interpretation. Therefore it is important to emphasize that in reality Bell has restricted to validity limits of t...

  5. Burden of recurrent Chlamydia trachomatis infections in young women: further uncovering the "hidden epidemic".

    Science.gov (United States)

    Niccolai, Linda M; Hochberg, Abby L; Ethier, Kathleen A; Lewis, Jessica B; Ickovics, Jeannette R

    2007-03-01

    To determine the frequency and patterns of recurrent Chlamydia trachomatis infections, the most common bacterial sexually transmitted infection in young women. Cohort study using different data collection methods, including face-to-face interviews, medical record reviews, urine-based screening for C trachomatis infections, and a review of state health department reports of C trachomatis diagnoses. Ten community-based health centers that provided reproductive health care from June 1998 to September 2001. Eligibility criteria included being nulliparous, between the ages of 14 and 19 years, and human immunodeficiency virus-negative, all at the time of recruitment. This convenience sample (N = 411) was recruited by word of mouth, clinician referrals, and advertisements in the clinics. Prospective follow-up data were available for 93.9% (386/411) of the sample. The exposure of interest was prior chlamydia infection. Main Outcome Measure Diagnosis of recurrent C trachomatis infection. During the follow-up period of 23 318 person-months (mean, 4.7 years per person), 216 participants (52.6%) were diagnosed as having C trachomatis infection, and 123 participants (29.9% of the total sample and 56.9% of those with initial infections) were diagnosed as having recurrent C trachomatis infections. Of 456 C trachomatis diagnoses made during the study period, 241 (52.9%) were recurrent infections. The rate of recurrent infections was 42.1 per 1000 person-months. The median time to recurrent infection was 5.2 months. Recurrent C trachomatis infections comprise a substantial health burden among young women, possibly higher than previously recognized in this vulnerable population.

  6. Female genital mutilation : a hidden epidemic (statement from the European Academy of Paediatrics)

    NARCIS (Netherlands)

    Sauer, Pieter J. J.; Neubauer, David

    Female genital mutilation or female circumcision is frequently performed worldwide. It is estimated by the World Health Organisation that worldwide, 100-140 million girls and women currently have to live with the consequences of female genital mutilation. The article argues that the tradition is one

  7. The Hidden Epidemic of Firearm Injury: Increasing Firearm Injury Rates During 2001-2013.

    Science.gov (United States)

    Kalesan, Bindu; Adhikarla, Chandana; Pressley, Joyce C; Fagan, Jeffrey A; Xuan, Ziming; Siegel, Michael B; Galea, Sandro

    2017-04-01

    Investigating firearm injury trends over the past decade, we examined temporal trends overall and according to race/ethnicity and intent in fatal and nonfatal firearm injuries (FFIs and NFIs) in United States during 2001-2013. Counts of FFIs and estimated counts of NFIs were obtained from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System. Poisson regression was used to analyze overall and subgroup temporal trends and to estimate annual change per 100,000 persons (change). Total firearm injuries (n = 1,328,109) increased annually by 0.36 (Ptrend < 0.0001). FFIs remained constant (change = 0.02; Ptrend = 0.22) while NFIs increased (change = 0.35; Ptrend < 0.0001). Homicide FFIs declined (change = -0.05; Ptrend < 0.0001) while homicide NFIs increased (change = 0.43; Ptrend < 0.0001). Suicide FFIs increased (change = 0.07; Ptrend < 0.0001) while unintentional FFIs and NFIs declined (changes = -0.01 and -0.09, respectively; Ptrend < 0.0001 and 0.005). Among whites, FFIs (change = 0.15; Ptrend < 0.0001) and NFIs (change = 0.13; Ptrend < 0.0001) increased; among blacks, FFIs declined (change = -0.20; Ptrend < 0.0001). Among Hispanics, FFIs declined (change = -0.28; Ptrend < 0.0001) while NFIs increased (change = 0.55; Ptrend = 0.014). The endemic firearm-related injury rates during the first decade of the 21st century mask a shift from firearm deaths towards a rapid rise in nonfatal injuries. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Variational Infinite Hidden Conditional Random Fields.

    Science.gov (United States)

    Bousmalis, Konstantinos; Zafeiriou, Stefanos; Morency, Louis-Philippe; Pantic, Maja; Ghahramani, Zoubin

    2015-09-01

    Hidden conditional random fields (HCRFs) are discriminative latent variable models which have been shown to successfully learn the hidden structure of a given classification problem. An Infinite hidden conditional random field is a hidden conditional random field with a countably infinite number of hidden states, which rids us not only of the necessity to specify a priori a fixed number of hidden states available but also of the problem of overfitting. Markov chain Monte Carlo (MCMC) sampling algorithms are often employed for inference in such models. However, convergence of such algorithms is rather difficult to verify, and as the complexity of the task at hand increases the computational cost of such algorithms often becomes prohibitive. These limitations can be overcome by variational techniques. In this paper, we present a generalized framework for infinite HCRF models, and a novel variational inference approach on a model based on coupled Dirichlet Process Mixtures, the HCRF-DPM. We show that the variational HCRF-DPM is able to converge to a correct number of represented hidden states, and performs as well as the best parametric HCRFs-chosen via cross-validation-for the difficult tasks of recognizing instances of agreement, disagreement, and pain in audiovisual sequences.

  9. Epidemic thresholds for bipartite networks

    Science.gov (United States)

    Hernández, D. G.; Risau-Gusman, S.

    2013-11-01

    It is well known that sexually transmitted diseases (STD) spread across a network of human sexual contacts. This network is most often bipartite, as most STD are transmitted between men and women. Even though network models in epidemiology have quite a long history now, there are few general results about bipartite networks. One of them is the simple dependence, predicted using the mean field approximation, between the epidemic threshold and the average and variance of the degree distribution of the network. Here we show that going beyond this approximation can lead to qualitatively different results that are supported by numerical simulations. One of the new features, that can be relevant for applications, is the existence of a critical value for the infectivity of each population, below which no epidemics can arise, regardless of the value of the infectivity of the other population.

  10. [Mycoplasma pneumoniae epidemic as zoonosis].

    Science.gov (United States)

    Mikola, I; Balogh, G; Nagy, A; Mátyás, M; Glávits, R; Stipkovits, L

    1997-11-16

    At a secondary school in Budapest, in the first class, 30 students became sick with fever and upper respiratory catarrhal symptoms between September 19 and October 31, 1995. Two children were hospitalized with a diagnosis of pneumonia, in case of the two children treated at the Szent László Hospital, suspect of Mycoplasma infection raised which was also confirmed by cold agglutination test. During the epizootiological examination on the spot they found a terrarium in the classroom where the students raised a Syrian gold hamster family. Mycoplasmas were isolated from the lung samples of the hamsters during the pathological examination which proved to be Mycoplasma pneumoniae. Owing to the close etiologic relationships between epidemiological anamnesis, characteristics of the epidemic, as well as findings of patients and pathological or histological findings in the hamsters together with the results of bacteriological examinations, the epidemic should be considered as a zoonosis.

  11. The AIDS epidemic and economic input impact factors in Chongqing, China, from 2006 to 2012: a spatial-temporal analysis.

    Science.gov (United States)

    Zhang, Yanqi; Xiao, Qin; Zhou, Liang; Ma, Dihui; Liu, Ling; Lu, Rongrong; Yi, Dali; Yi, Dong

    2015-03-27

    To analyse the spatial-temporal clustering of the HIV/AIDS epidemic in Chongqing and to explore its association with the economic indices of AIDS prevention and treatment. Data on the HIV/AIDS epidemic and economic indices of AIDS prevention and treatment were obtained from the annual reports of the Chongqing Municipal Center for Disease Control for 2006-2012. Spatial clustering analysis, temporal-spatial clustering analysis, and spatial regression were used to conduct statistical analysis. The annual average new HIV infection rate, incidence rate for new AIDS cases, and rate of people living with HIV in Chongqing were 5.97, 2.42 and 28.12 per 100,000, respectively, for 2006-2012. The HIV/AIDS epidemic showed a non-random spatial distribution (Moran's I≥0.310; pAIDS and to the public awareness unit for the numbers of new HIV cases, new AIDS cases, and people living with HIV were 0.775, 0.976 and 0.816, and -0.188, -0.259 and -0.215 (pAIDS epidemic showed temporal-spatial clustering and was mainly clustered in the mid-western and south-western counties, showing an upward trend over time. The amount of special funds dedicated to AIDS and to the public awareness unit showed positive and negative relationships with HIV/AIDS spatial clustering, respectively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. HIV SERO- PREVALENCE TREND AMONG BLOOD DONORS IN ...

    African Journals Online (AJOL)

    User

    BACKGROUND: HIV/AIDS epidemics continue unchecked in African countries at all level of society bearing the heaviest burden of the scourge. Different researches have been done to see the progress of disease from time to time However, information that shows the trend of HIV among the healthy population over a period ...

  13. Location of development NGOs providing HIV and AIDS services to ...

    African Journals Online (AJOL)

    Development Non-Governmental Organisations (NGOs) have been crucial players in HIV and AIDS from the onset of the epidemic in South Africa. We examined development NGOs that provide HIV and AIDS services to young people within the Cape Metropole District of the Western Cape Province, with a view to analyse ...

  14. Employment discrimination and HIV stigma: survey results from civil ...

    African Journals Online (AJOL)

    The article presents findings from three surveys of people living with HIV (PLHIV) and civil society organisations about the experience of employment discrimination and stigma in the workplace. The work seeks to contribute to efforts by businesses and other organisations to effectively respond to the HIV epidemic within the ...

  15. Prevention of Prenatal HIV Transmission in Kazakhstan | Trumova ...

    African Journals Online (AJOL)

    . 31 of infected are children under 15 years, 12 of them are infected from the mother. The analysis and research of HIV/AIDS epidemic situation and prevention of a prenatal transmission of the HIV on territory of republic was held. Thus 311 ...

  16. Sexual Dysfunction among HIV Patients: Three Case Reports and ...

    African Journals Online (AJOL)

    This may affect individuals' quality of life, interpersonal relationships and HIV treatment. The sub-Saharan Africa (SSA) region is the epicentre of the HIV epidemic, majority of the patients being young (< 30 years old) and in long-term heterosexual relationships. With increased life expectancy due to expanded access to ...

  17. Public Libraries Participation In Hiv/Aids Awareness Campaign In ...

    African Journals Online (AJOL)

    The paper examines public libraries involvement in HIV/AIDS awareness campaign in South West Nigeria. These include the materials and services available on HIV/AIDS and challenges to their participation in the war against the epidemic. The study revealed that public libraries in South West Nigeria are not participating ...

  18. EPIDEMIOLOGY OF HIV/AIDS IN SOUTH AFRICA

    African Journals Online (AJOL)

    to HIV transmission in South Africa. Immediate determinants of the HIV/AIDS epidemic include behav- ioural factors such as the frequency of unprotected sexual intercourse and multiple sexual partners, and bio- logical factors such as the high prevalence of sexually transmitted diseases (STDs)' Underlying determinants.

  19. Macroeconomic Impact of HIV and AIDS on the Zimbabwean ...

    African Journals Online (AJOL)

    Zimbabwe is one of the countries severely affected by the HIV/AIDS epidemic. The high prevalence of the disease is not only a health problem but has become an economic problem, yet little effort had previously been directed at establishing the exact magnitude of HIV/AIDS' economic impact. Using a human capital ...

  20. infant feeding issues implications of formula feeding to reduce hiv

    African Journals Online (AJOL)

    2004-08-03

    Aug 3, 2004 ... The global HIV epidemic has a major impact on the health and survival of infants in sub-Saharan Africa.1. Recent advances in reducing HIV transmission from mother to child during the intrapartum period have been made by studies such as the 076 Study, the Thai Study, Petra, and the. HIVNET012 Study.