Suchergebnisse

The long‐term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD) appears to be common in perinatally HIV‐infected youth, especially outside of high‐income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight‐bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV‐infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood.

Employing annual time series data on the number of children (ages 0 – 14) newly infected with HIV in Kenya from 1990 – 2018, the study predicts the annual number of children who will be newly infected with HIV over the period 2019 – 2030. This piece of work applies the Box-Jenkins ARIMA methodology. The diagnostic ADF tests show that, V, the series under consideration is an I (1) variable. Based on the AIC, the study presents the ARIMA (1, 1, 4) model as the optimal model. The residual correlogram further shows that the residuals are not serially correlated and thus indicating that our model is stable and suitable for forecasting new HIV infections in children in Kenya. The results of the study indicate that the number of new pediatric HIV infections will increase from the estimated 8958 in 2019 to approximately 13591 new infections by 2030. A lot needs to be done in Kenya in order to save the lives of children from the HIV/AIDS epidemic. The study basically encourages the government of Kenya to intensively expand PMTCT coverage throughout the country.

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

The great success in the prevention and treatment of pediatric HIV in high resource countries, and now in low resource countries, has changed the face of the HIV epidemic in children from one of near certain mortality to that of a chronic disease. However, these successes pose new challenges as perinatally HIV‐infected youth survive into adulthood. Increased survival of HIV‐infected children is associated with challenges in maintaining adherence to what is likely life‐long therapy, and in selecting successive antiretroviral drug regimens, given the limited availability of pediatric formulations, limitations in pharmacokinetic and safety data of drugs in children, and the development of extensive drug resistance in multi‐drug‐experienced children. Pediatric HIV care must now focus on morbidity related to long‐term HIV infection and its treatment. Survival into adulthood of perinatally HIV‐infected youth in high resource countries provides important lessons about how the epidemic will change with increasing access to antiretroviral therapy for children in low resource countries. This series of papers will focus on issues related to management of perinatally infected youth and young adults.

A review of recent study in drug abuse treatment suggests that by the 1980s there had developed a concern about melding drug abuse treatment techniques with strategies drawn from the field of mental health. The emergence of AIDS has made it necessary to augment treatment objectives to include containment of HIV infection as an appropriate goal and develop innovative strategies appropriate to achieving that goal. There is a review of new models of service delivery that can be initiated and/or have been initiated in three areas: outreach/recruitment of IV drug users and their cohabitants, education/counseling with regard to risk-reducing behaviors, and extending the period of treatment influence. The impact of AIDS on program administrators and line staff is also discussed.

This paper deals with the analysis of the incidence of the disease caused by the human immunodeficiency virus (HIV infection), the dynamics of the incidence of this nosology have been traced, and the HIV-incidence of the population of the Republic of Mari El (RME) has been characterized in comparison with this indicator in the Russian Federation (RF). HIV is a socially significant disease, tends to increase in cases both in the RME and in the Russian Federation. This issue is a matter of concern and has been under consideration at the state level. In 2016, the Government of the Russian Federation approved the State Strategy for Counteracting the Spread of HIV Infection in Russia for the period to 2020 and further prospects. Implementation of this strategy requires a detailed approach, taking into account modern technologies, the capabilities of which should be used in an accurate and step-by-step manner. The study analyzed the epidemiological maps of the patients of the state budgetary institution of the Republic of Mari El "Republican Center for the Prevention and Control of AIDS and Infectious Diseases" (SBI RME RCPC AIDS and ID), calculated the incidence and prevalence of the population of the Republic using statistical methods (calculations of relative and average values, building of dynamic series and estimation of statistically significant differences), used graphicalanalytical methods and a retrospective epidemiologic analysis. According to the results of the study for the period 2007-2016, an increase in the incidence of 2.2 times was revealed in the RME. The cumulative number of HIV-positive patients in the RME during the study period increased 3.3 times. The prevalence index in 2016 in the RME is 1.7 times lower than the Russian average. The results of the study will help to conduct a comprehensive epidemiological diagnosis of the situation of HIV incidence in the RME, including mathematical simulation of the prognosis of the HIV incidence and prevalence of the population, which will allow diversifying ...

BackgroundOur objective was to describe the characteristics of acute and established HIV infections diagnosed in the Canadian province of British Columbia. Province‐wide HIV testing and surveillance data were analyzed to inform recommendations for targeted use of screening algorithms to detect acute HIV infections.MethodsAcute HIV infection was defined as a confirmed reactive HIV p24 antigen test (or HIV nucleic acid test), a non‐reactive or reactive HIV EIA screening test and a non‐reactive or indeterminate Western Blot. Characteristics of unique individuals were identified from the British Columbia HIV/AIDS Surveillance System. Primary drug resistance and HIV subtypes were identified by analyzing HIV pol sequences from residual sera from newly infected individuals.ResultsFrom February 2006 to October 2008, 61 individuals met the acute HIV infection case definition, representing 6.2% of the 987 newly diagnosed HIV infections during the analysis period. Acute HIV infection cases were more likely to be men who have sex with men (crude OR 1.71; 95% CI 1.01‐2.89], to have had a documented previous negative HIV test result (crude OR 2.89; 95% CI 1.52‐5.51), and to have reported a reason for testing due to suspected seroconversion symptoms (crude OR 5.16; 95% CI 2.88‐9.23). HIV subtypes and rates of transmitted drug resistance across all classes of drugs were similar in persons with both acute and established HIV infections.ConclusionsTargeted screening to detect acute HIV infection is a logical public health response to the HIV epidemic. Our findings suggest that acute HIV infection screening strategies, in our setting, are helpful for early diagnosis in men who have sex with men, in persons with seroconversion symptoms and in previously negative repeat testers.

AbstractAt the onset of AIDS in 1981, it caught everybody (by surprise), with their pants down, openly, scientifically and literally. Fear /Stigma associated with HIV/AIDS continues to avert responses to the epidemic. Data (obtained in Tshwane metropolis) were used to test stigma/fear dimensions of an instrument. Factor analysis identified five foci of fear and stigma. There were significant differences on the factor scale measuring fear of sex, with females and younger respondents having significantly greater fear. Results were interpreted within a cultural context that realises that decreasing AIDS stigma is a vital step in stemming the pandemic. Copyright © 2009 John Wiley & Sons, Ltd.