AIDS Research and Treatment最新文献

{"title":"Scales to Assess Knowledge, Motivation, and Self-Efficacy for HIV PrEP in Colombian MSM: PrEP-COL Study.","authors":"Héctor F Mueses-Marín,&nbsp;Beatriz Alvarado-Llano,&nbsp;Julián Torres-Isasiga,&nbsp;Pilar Camargo-Plazas,&nbsp;Maria C Bolívar-Rocha,&nbsp;Ximena Galindo-Orrego,&nbsp;Jorge L Martínez-Cajas","doi":"10.1155/2021/4789971","DOIUrl":"https://doi.org/10.1155/2021/4789971","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the construct validity Spanish version of knowledge, stigma, norms, and self-efficacy scales regarding PrEP in MSM.</p><p><strong>Methods: </strong>Sample of 287 MSM. Exploratory confirmatory factor analysis and item response theory were used to validate the constructs. Correlations and confidence interval-based estimation of relevance analyses were conducted to correlate the scales with willingness and intention to use PrEP.</p><p><strong>Results: </strong>Attitude, stigma, and descriptive and subjective norms scales showed good construct validity and were related to intention and willingness to use PrEP. However, the knowledge scale and self-efficacy scales require further refinement.</p><p><strong>Conclusions: </strong>The study provides useful information for assessing information, motivation, and self-efficacy related to PrEP use. Our results could be used to test the scales and the theoretical model in other contexts to confirm their usefulness.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2021 ","pages":"4789971"},"PeriodicalIF":1.7,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39430530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Provider Screening Practices for Fracture Risk Assessment among Patients with HIV Disease.","authors":"Faryal Mirza,&nbsp;Sabina Zawadzka,&nbsp;Anne Abbate,&nbsp;Michael Thompson,&nbsp;Dorothy Wakefield,&nbsp;Lisa M Chirch","doi":"10.1155/2021/6672672","DOIUrl":"https://doi.org/10.1155/2021/6672672","url":null,"abstract":"<p><p>People living with HIV are known to have greater risk of low bone mineral density than HIV-negative peers. The reasons for this disparity are multifactorial. To address this increased risk, the Infectious Diseases Society of America (IDSA) released fracture risk screening recommendations in 2015, which differ significantly from recommendations that apply to the general population. A study was conducted at the University of Connecticut to assess for provider awareness and adherence to these recommendations. Electronic surveys were sent to providers, and patients were also surveyed for risk factors and prevalence of low bone mineral density. The results of the provider survey showed low rates of awareness of the IDSA screening recommendations. A substantial proportion of patients surveyed met criteria for low BMD screening but did not have dual-energy X-ray absorptiometry (DXA) ordered by their provider. As an intervention, providers were sent information via e-mail regarding current screening recommendations, as well as notifications if their patient met criteria for DXA screening. A twelve-month follow-up survey showed increased provider knowledge of screening recommendations and improved screening practices. Additionally, the results of a logistic regression analysis of patient factors showed that increasing age and male sex were positively associated with fragility fracture risk. Increased duration of antiretroviral therapy use was associated with a lower likelihood of fragility fracture.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2021 ","pages":"6672672"},"PeriodicalIF":1.7,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38964223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Recovery and Its Predictors among Adult HIV Patients on Therapeutic Feeding Program at Finote-Selam General Hospital, Northwest Ethiopia: A Retrospective Cohort Study.","authors":"Gedefaw Diress,&nbsp;Nurilign Abebe Moges","doi":"10.1155/2020/8861261","DOIUrl":"https://doi.org/10.1155/2020/8861261","url":null,"abstract":"<p><strong>Background: </strong>Undernutrition is a major public health problem in HIV patients in sub-Saharan Africa. To address the problem of malnutrition, the Ethiopian Ministry of Health implemented a therapeutic feeding program, which is the provision of nutritional treatment, care, and support for undernourished individuals. However, little is known about the outcome of a therapeutic feeding program. Therefore, this study aimed to assess nutritional recovery and its predictors among undernourished HIV patients enrolled in a therapeutic feeding program in Northwest Ethiopia.</p><p><strong>Methods: </strong>An institutional-based retrospective cohort study was conducted among 376 randomly selected adult undernourished HIV patients enrolled in the therapeutic feeding program from July 2010 to January 2017 at Finote-Selam General Hospital. Data were collected by reviewing patients' charts, follow-up cards, and undernutrition treatment registration books using a pretested structured checklist. The main outcome variable was nutritional recovery, defined based on body mass index. Bivariable and multivariable log-binomial regression models were used to identify the predictors of nutritional recovery.</p><p><strong>Result: </strong>From total undernourished HIV patients enrolled in the therapeutic feeding program, 61.2% were recovered with a median recovery time of 12 weeks (IQR 9-17 weeks) for moderate acute malnutrition and 25 weeks (IQR 22-31 weeks) for severe acute malnutrition. Rural residence (adjusted risk ratio (ARR) = 0.53, 95% CI: 0.27-0.85), no formal education (ARR = 0.24, 95% CI: 0.13-0.54), poor ART adherence level (ARR = 0.14, 95% CI; 0.08-0.32), and WHO clinical stage III or IV (ARR = 0.38, 95% CI; 0.17-0.59) decrease the probability of nutritional recovery.</p><p><strong>Conclusion: </strong>Nutritional supplementation plays a critical role in the nutritional care and treatment of malnourished patients. Healthcare providers should give more attention to persons with poor adherence levels, advanced WHO clinical stage, rural residence, and low educational status. Future prospective follow-up studies should be performed to assess important variables such as family income, food sharing at the household level, and distance to health institutions.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8861261"},"PeriodicalIF":1.7,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with HIV Status Disclosure to Orphans and Vulnerable Children Living with HIV: Results from a Longitudinal Study in Tanzania.","authors":"Shraddha Bajaria,&nbsp;Amon Exavery,&nbsp;Noreen Toroka,&nbsp;Asheri Barankena,&nbsp;John Charles,&nbsp;Levina Kikoyo","doi":"10.1155/2020/6663596","DOIUrl":"https://doi.org/10.1155/2020/6663596","url":null,"abstract":"<p><strong>Background: </strong>The Tanzanian national guideline for pediatric HIV disclosure recommends beginning disclosure as early as age 4-6 years; full disclosure is recommended at the age of 8-10 years. Despite clear procedures, the disclosure rate in Tanzania remains relatively low. This study assessed the factors associated with HIV status disclosure to orphans and vulnerable children living with HIV (OVCLHIV).</p><p><strong>Methods: </strong>Data for this analysis come from the USAID-funded Kizazi Kipya program in Tanzania that provides health and social services to OVC and caregivers of HIV-affected households. Data were collected between January 2018 and March 2019. Disclosure status was self-reported by caregivers of children aged 8 years or above. Beneficiary characteristics were included as independent variables. Generalized estimating equations took into account the clustering effect of the study design.</p><p><strong>Results: </strong>Of the 10673 OVCLHIV, most were females (52.43%), and 80.67% were enrolled in school. More than half (54.89%) were from households in rural areas. Caregivers were mostly females (70.66%), three quarters were between 31 and 60 years old and had a complete primary education (67.15%), and 57.75% were HIV-infected. Most of the OVCLHIV (87.31%) had a disclosed HIV status. Greater OVCLHIV age (<i>p</i> < 0.001), school enrollment (OR = 1.22; 95% CI 1.06, 1.41), urban location of household (OR = 1.64; 95% CI 1.44, 1.86), caregivers' higher education level (<i>p</i> < 0.001), and caregiver HIV-positive status (OR = 1.25; 95% CI 1.09, 1.43) were positively associated with disclosure status. OVCLHIV of female caregivers were 27% less likely to have been disclosed than those of male caregivers.</p><p><strong>Conclusion: </strong>The disclosure rate among OVCLHIV in this study was high. Disclosure of HIV status is crucial and beneficial for OVCLHIV continuum of care. Caregivers should be supported for the disclosure process through community-based programs and involvement of health volunteers. Policymakers should take into consideration the characteristics of children, their caregivers, and location of households in making disclosure guidelines as adaptable as possible.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"6663596"},"PeriodicalIF":1.7,"publicationDate":"2020-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39139552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study on the Affordable Care Act from the Perspective of People Living with HIV: The Interplay between Knowledge, Stigma, Trust, and Attitudes.","authors":"Christopher Kaperak,&nbsp;Sarah Elwood,&nbsp;Tamara Saint-Surin,&nbsp;Christopher Winstead-Derlega,&nbsp;Robert O Brennan,&nbsp;Rebecca Dillingham,&nbsp;Kathleen A McManus","doi":"10.1155/2020/6081721","DOIUrl":"https://doi.org/10.1155/2020/6081721","url":null,"abstract":"<p><strong>Background: </strong>Many AIDS Drug Assistance Programs (ADAPs) purchased Affordable Care Act (ACA) Qualified Health Plans (QHPs) for low-income people living with HIV (PLWH). To date, little has been published about PLWH's perspective on the ACA. We explored ACA knowledge, HIV stigma, trust in the healthcare system, and ACA attitudes among PLWH with ADAP-funded QHPs in Virginia.</p><p><strong>Methods: </strong>Participants were surveyed about demographic characteristics, ACA knowledge, HIV stigma, trust in various healthcare and government entities, and attitudes toward the ACA. Descriptive statistics were used. We assessed for associations (1) between baseline characteristics and correct ACA knowledge, HIV-related stigma, trust, and ACA attitudes and (2) between correct ACA knowledge and the following data: sources of ACA knowledge, HIV stigma, and trust.</p><p><strong>Results: </strong>Participants (<i>n</i> = 53) were a vulnerable population based on the assessment of social determinants of health, and 30% had correct ACA knowledge. Almost three-fourths of participants used HIV clinic case managers for ACA information. Participants who used websites for ACA information had correct ACA knowledge more often compared to those that did not (71% vs. 15%; <i>p</i> = 0.001). Those with correct ACA knowledge had lower stigma scores compared to those without correct ACA knowledge (93.8; SD: 15.4 vs. 108; SD: 20.3; <i>p</i> = 0.01). Participants trusted HIV clinicians more than general clinicians and insurance companies. No association was found between having correct ACA knowledge and endorsing having enough information about the ACA to understand how it will impact their HIV care.</p><p><strong>Conclusions: </strong>Websites imparted accurate ACA information. HIV clinic case managers were the most used source, and HIV clinicians were a trusted source of information. HIV clinicians and case managers should consider disseminating information about the ACA and its impact on HIV care delivery via internet videos. Lack of internet and stigma are a threat to PLWH gaining actionable healthcare information.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"6081721"},"PeriodicalIF":1.7,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39110632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Performance of Health Extension Workers in HIV-1/2 Screening Tests: A Comparative Cross-Sectional Study, Addis Ababa, Ethiopia.","authors":"Mulatu Gashaw,&nbsp;Samuel Kindie,&nbsp;Minale Fekadie,&nbsp;Kassu Desta,&nbsp;Dawit Wolday","doi":"10.1155/2020/7841352","DOIUrl":"https://doi.org/10.1155/2020/7841352","url":null,"abstract":"<p><strong>Background: </strong>Human resources for health-care delivery are essential for attaining global health and development goals. Especially in developing countries, health extension workers are frontline health personnel who can play a key role in preventing and controlling HIV/AIDS. This study aimed to evaluate the performance of health extension workers in HIV-1/2 screening tests. <i>Methodology</i>. A comparative cross-sectional study was carried out to evaluate the performance of health extension workers in HIV-1/2 screening tests. Study participants had performed HIV screening tests on the prepared sample panels. Finally, the percentage of accuracy, error rate, sensitivity, specificity, predictive values, and measure of agreement (kappa) were calculated using SPSS version 26.</p><p><strong>Result: </strong>Totally, 1600 HIV screening tests were performed, and of these, 684 and 235 tests were done by HEWs (<i>n</i> = 15) and laboratory personnel (<i>n</i> = 5), respectively, with three discordant results by HEWs from a single sample panel which was weak reactive for HIV antibody test. The sensitivity, specificity, PPV, and NPV of HIV screening tests by HEWs were 97.4%, 100%, 100%, and 97.22%, respectively, and 100% for all parameters when it is tested by laboratory professionals. The measure of kappa agreement was 0.971 (95% CI, 0.932-1) for HEWs and 1 for laboratory personnel compared with the reference result.</p><p><strong>Conclusion: </strong>Based on this evidence, we conclude that the potential contribution of HEWs can be invaluable in the expansion of HIV screening tests nationwide to compensate the shortage of laboratory personnel.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"7841352"},"PeriodicalIF":1.7,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38683907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV-Positive Status Disclosure and Associated Factors among HIV-Positive Adult Patients Attending Art Clinics at Public Health Facilities of Butajira Town, Southern Ethiopia.","authors":"Tamirat Melis Berhe,&nbsp;Lire Lemma,&nbsp;Addissu Alemayehu,&nbsp;Desalegn Ajema,&nbsp;Mustefa Glagn,&nbsp;Samuel Dessu","doi":"10.1155/2020/7165423","DOIUrl":"https://doi.org/10.1155/2020/7165423","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus-positive status disclosure is the process of informing one's HIV-positive status to others. It is the base for accessing care and treatment programs, attaining psychosocial support, reducing stigma, adhering to treatment, and promoting safer health. Even though different strategies were done in Ethiopia to increase the magnitude of HIV status disclosure among HIV-positive patients, the magnitude is still low. The magnitude of HIV-positive status disclosure was not assessed yet after initiation of the new strategy (test and treat strategy). The aim of this study is to assess the magnitude and factors associated with HIV-positive status disclosure among HIV-positive adults attending antiretroviral therapy clinic at the public health facilities of Butajira town.</p><p><strong>Methods: </strong>Institution-based cross-sectional study was conducted at public health facilities of Butajira town. A total of 414 study participants were selected by systematic random sampling technique. Data were collected by using pretested interviewer-administered semistructured questionnaire. The collected data were entered into EpiData3.1 and exported to SPSS version 23. Bivariate and multivariable logistic regression analysis was used to identify factors associated with HIV-positive status disclosure. The strength of association was assessed by crude odds ratio and adjusted odds ratio for bivariate and multivariable logistic regression analysis, respectively. Statistically significance was declared at <i>p</i> value <0.05 and 95% CI.</p><p><strong>Results: </strong>The magnitude of HIV-positive status disclosure was 90%. Discussing about safer sex (AOR: 3.5; 95% CI: 1.3, 9.4), viral load suppression (AOR: 4; 95% CI: 1.5, 10.1), having good ART adherence (AOR: 6; 95% CI: 2.4, 14.0), receiving counseling (AOR: 2.5; 95% CI: 1.01, 6.3), and perceiving stigma (AOR: 0.25; 95% CI: 0.09, 0.60) were the independent factors associated with HIV-positive status disclosure.</p><p><strong>Conclusion: </strong>Although the majority of the participants (90%) of them disclosed their HIV-positive status, lack of disclosure by few people can tackle HIV prevention and control programs. Health programs could improve disclosure of HIV-positive status by providing counseling service, strengthening adherence of antiretroviral therapy, suppressing viral load, and avoiding (reducing) stigma on HIV-positive patients by their community.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"7165423"},"PeriodicalIF":1.7,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38613991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Metabolic Syndrome and 5-Year Cardiovascular Risk Estimates among HIV-Positive Individuals from an Indian Tertiary Care Hospital.","authors":"Sneha Deepak Mallya,&nbsp;Sravan Kumar Reddy T,&nbsp;Asha Kamath,&nbsp;Akhilesh Kumar Pandey,&nbsp;Kavitha Saravu","doi":"10.1155/2020/5019025","DOIUrl":"https://doi.org/10.1155/2020/5019025","url":null,"abstract":"<p><p>Longer survival due to use of antiretroviral therapy (ART) has made human immunodeficiency virus- (HIV-) infected individuals prone to chronic diseases such as diabetes, hypertension, and cardiovascular diseases (CVD). Metabolic syndrome (MS), a constellation of risk factors which increase chances of the cardiovascular disease and diabetes, can increase the morbidity and mortality among this population. Hence, the present study was conducted with the objectives of estimating the prevalence and determinants of MS among ART naïve and ART-treated patients and assess their 5-year CVD risk using the reduced version of Data Collection on Adverse Effects of Anti-HIV Drugs (D : A : D) risk prediction model (D : A : D(R)). This hospital-based cross-sectional study included 182 adults aged ≥ 18 years. MS was defined using the National Cholesterol Education Program-Adult Treatment Panel-3 (NCEP ATP-3) criteria. Univariate and multivariate logistic regressions were done to identify the factors associated with MS. Prevalence of MS was 40.1% (95% confidence interval (CI) = 33.0%-47.2%). About 24.7% of the participants had at least a single criterion for MS. Age >45 years (adjusted odds ratio (AOR) = 2.3; 95% CI = 1.1-4.9, <i>p</i> < 0.018) and body mass index (BMI) > 23 kg/m² (AOR = 6.4; 95% CI = 3.1-13.1, <i>p</i> < 0.001) were positively associated with MS, whereas daily consumption of high sugar items was inversely associated (AOR = 0.2; 95% CI = 0.1-0.5, <i>p</i> < 0.001). More than 50% of the participants were found to have moderate or high 5-year CVD risk. Observed prevalence of MS among HIV patients was higher than other studies done in India. Considering a sizeable number of participants to be having moderate to high CVD risk, culturally appropriate lifestyle interventions need to be planned.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"5019025"},"PeriodicalIF":1.7,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5019025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38608324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Comparison of Teen Clubs vs. Standard Care on Treatment Outcomes for Adolescents on Antiretroviral Therapy in Windhoek, Namibia.","authors":"Farai K Munyayi,&nbsp;Brian E van Wyk","doi":"10.1155/2020/8604276","DOIUrl":"https://doi.org/10.1155/2020/8604276","url":null,"abstract":"<p><strong>Background: </strong>Adolescents living with HIV (ALHIV) are challenged to adhere to antiretroviral therapy (ART) and achieve and maintain virologic suppression. Group-based adherence support interventions, such as adherence clubs, have been shown to improve long-term adherence in ART patients. The teen club intervention was introduced in 2010 in Namibia to improve treatment outcomes for ALHIV by providing adherence support in a peer-group environment. Adolescents who have completed the full HIV disclosure process can voluntarily join the teen clubs. The current study compared treatment outcomes of ALHIV receiving ART at a specialized paediatric HIV clinic between 1 July 2015 and 30 June 2017 in Windhoek, Namibia.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted on routine patient data extracted from the electronic Patient Monitoring System, individual Patient Care Booklets, and teen club attendance registers. A sample of 385 adolescents were analysed: 78 in teen clubs and 307 in standard care. Virologic suppression was determined at 6, 12, and 18 months from study start date, and compared by model of care, age, sex, disclosure status, and ART regimen. Comparisons between adolescents in teen clubs and those receiving standard care were performed using the chi-square test, and risk ratios were calculated to analyze differences in ART adherence and virologic suppression.</p><p><strong>Results: </strong>The average clinician-measured ART adherence was 89% good, 6% fair, and 5% poor amongst all adolescents, with no difference between teen club members and adolescents in standard care (<i>p</i> = 0.277) at 3 months. Virologic suppression over the 2-year observation period was 87% (68% fully suppressed <40 copies/ml and 19% suppressed between 40-999 copies/ml), with no difference between teen club members and those in standard care. However, there were statistically significant differences in virologic suppression levels between the younger (10-14 years) adolescents and older (15-19 years) adolescents at 6 months (<i>p</i> = 0.015) and at 12 months (<i>p</i> = 0.021) and between adolescents on first-line and second-line ART regimen at 6 months (<i>p</i> = 0.012), 12 months (<i>p</i> = 0.004), and 18 months (<i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>The teen club model delivering psychosocial support only did not improve adherence and virologic suppression levels for adolescents in a specialized paediatric ART clinic, neither were they inferior to standard care. Considering the limitations of this study, teen clubs may still hold potential for improving adherence and virologic suppression levels for older adolescents, and more robust research on adherence interventions for adolescents with higher methodological quality is required.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8604276"},"PeriodicalIF":1.7,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8604276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38591217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation, HIV, and Immune Quiescence: Leveraging on Immunomodulatory Products to Reduce HIV Susceptibility.","authors":"Ross Cromarty,&nbsp;Derseree Archary","doi":"10.1155/2020/8672850","DOIUrl":"https://doi.org/10.1155/2020/8672850","url":null,"abstract":"<p><p>The relationship between inflammation and HIV has been a focus of research over the last decade. In HIV-infected individuals, increased HIV-associated immune activation significantly correlated to disease progression. While genital inflammation (GI) has been shown to significantly increase the risk of HIV acquisition and transmission, immune correlates for reduced risk remain limited. In certain HIV-exposed seronegative individuals, an immune quiescent phenotype characterized reduced risk. Immune quiescence is defined by specific, targeted, highly regulated immune responses that hinder overt inflammation or immune activation. Targeted management of inflammation, therefore, is a plausible strategy to mitigate HIV risk and slow disease progression. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as hydroxychloroquine and aspirin have shown encouraging preliminary results in low-risk women by reducing systemic and genital immune activation. A topical NSAID, containing ibuprofen, is effective in treating vulvovaginal inflammation. Additionally, the glucocorticoids (GCs), prednisolone, and dexamethasone are used to treat HIV-associated immune activation. Collectively, these data inform on immune-modulating drugs to reduce HIV risk. However, the prolonged use of these pharmaceutical drugs is associated with adverse effects, both systemically and to a lesser extent topically. Natural products with their reduced side effects coupled with anti-inflammatory properties render them viable options. Lactic acid (LA) has immunomodulatory properties. LA regulates the genital microbiome by facilitating the growth of <i>Lactobacillus</i> species, while simultaneously limiting bacterial species that cause microbial dysbiosis and GI. Glycerol monolaurate, besides being anti-inflammatory, also inhibited SIV infections in rhesus macaques. The proposed pharmaceutical and natural products could be used in combination with either antiretrovirals for treatment or preexposure prophylaxis for HIV prevention. This review provides a summary on the associations between inflammation, HIV risk, and disease progression. Furthermore, we use the knowledge from immune quiescence to exploit the use of pharmaceutical and natural products as strategic interventions to manage inflammation, toward mitigating HIV infections.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8672850"},"PeriodicalIF":1.7,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8672850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38591220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}