Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)最新文献

{"title":"Preliminary Evidence of Significant Gaps in Continuity of HIV Care among Excarcerated Populations in Puerto Rico.","authors":"Michael C Clatts,&nbsp;Carlos E Rodriguez-Díaz,&nbsp;Hermes García,&nbsp;Ricardo L Vargas-Molina,&nbsp;Gerardo G Jovet-Toledo,&nbsp;Lloyd A Goldsamt","doi":"10.1177/1545109711418833","DOIUrl":"https://doi.org/10.1177/1545109711418833","url":null,"abstract":"<p><strong>Objective: </strong>Puerto Rico has high HIV prevalence and incidence rates, including a large prison population living with HIV. While HIV treatment is available within the prisons, there are no linkages to care or treatment preparedness interventions following release.</p><p><strong>Methods: </strong>In an effort to assess the risk of treatment discontinuity in this group, we examined data from an ongoing epidemiological study in the largest, publicly funded HIV/sexually transmitted infection (STI) treatment center in the San Juan area.</p><p><strong>Results: </strong>Among the newly enrolled, HIV-positive patients with a history of incarceration, there was an average 4-year gap in reengagement in treatment. Drug and sexual risk behaviors were prevalent, as was evidence of significant immune impairment (including high viral load and low CD4 count).</p><p><strong>Conclusions: </strong>Treatment discontinuity may contribute to poor health outcomes in this group and also fuel new infections. There is an urgent need for interventions to retain HIV-positive inmates in community HIV care following release.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"339-41"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711418833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30098479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Events in HIV-Infected Patients.","authors":"Rosario Palacios,&nbsp;Tamara Moreno,&nbsp;Marisa Gallego,&nbsp;Alfonso Del Arco,&nbsp;Francisco Jiménez-Oñate,&nbsp;Jesús Santos González","doi":"10.1177/1545109711423072","DOIUrl":"https://doi.org/10.1177/1545109711423072","url":null,"abstract":"HIV infection is considered yet another cardiovascular risk factor (CVRF), particularly associated with immunosuppression. In addition, HIV-infected patients have a higher prevalence of CVRF than in the general population. The clinical importance of all this is the result of increase in the incidence of cardiovascular events in these patients. However, few data are available in Spain relating to coronary events (CEs) in patients with HIV infection. The aim, therefore, of this study was to estimate the incidence of CEs in HIV-infected patients on outpatient followup and to determine the associated characteristics. We undertook a cross-sectional, multicenter study involving outpatients seen between March 2007 and August 2007 at 5 hospitals. All the patients completed a questionnaire about CVRF and were asked about any prior cardiovascular event. Information was checked from the clinical histories of the patients. Coronary events included any acute coronary syndrome, acute myocardial infarction, placement of a coronary stent, or coronary surgery. The statistical analysis was done with SPSS 17.0 (SPSS, Chicago, Illinois). Continuous variables are expressed as medians (interquartile range [IQR]) and the categorical variables as numbers (percentages). A multivariate analysis was done to seek factors potentially associated with CEs. The study was designed and carried out in accordance with the principles of the Declaration of Helsinki and approved by the Research Ethics Committee of the Hospital Virgen de la Victoria, Málaga. The study included 1155 patients, with a mean follow-up of 11 422 patient-years. Of the 40 cardiovascular events recorded, 29 were CEs, representing an incidence of 2.53 events per 1000 patient-years. Table 1 shows the patients with and without CEs. The CEs were associated with older age (odds ratio [OR] 1.8; 95% confidence interval [CI], 1.78-1.96; P < .009), hypertension (OR 4.9; 95% CI, 1.7-4.9; P < .005), and a family history of ischemic heart disease (OR 4.7; 95% CI, 1.7-13; P < .006). The estimated incidence of CEs in our study was higher than the estimates reported for the general population in the meta-analysis of Medrano, which found an incidence of CEs of 1.3 to 2.1 per 1000 patient-years for men aged 25 to 74 and 0.29 to 0.61 for women of the same age. However, it is lower than that found in such cohort studies as Manresa (5 events per 1000 person-years) or ZACARIS-I (Zaragoza Cardiovascular Risk factors Study-I; 6.4 and 4.0 events per 1000 person-years in men and women, respectively), though it should be noted that both cohorts were labeled high risk. The reported incidence of CEs in HIV-infected patients ranges from 3.5 to 11.1 per 1000 patient-years. These variations are due to the different methods used in the various studies and the different types and end points considered. All these studies include mostly AngloSaxon patients, who usually have a greater incidence of CEs than Spanish people, as well as having a slig","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"337-8"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711423072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30316758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Interventions for Improving Antiretroviral Therapy Adherence in HIV/AIDS Cases at PIMS, Islamabad.","authors":"Qudsia Uzma,&nbsp;Faran Emmanuel,&nbsp;Uzma Ather,&nbsp;Shakila Zaman","doi":"10.1177/1545109710383175","DOIUrl":"https://doi.org/10.1177/1545109710383175","url":null,"abstract":"<p><p>It is imperative to prove efficacy of tailored interventions and translate the efficacious ones into clinical strategies for achieving good ART adherence. ART adherence among registered HIV/AIDS cases at HIV treatment centre, Pakistan Institute of Medical Sciences, Islamabad was assessed through RCT. Study duration was 10 weeks; eligible subjects (N = 76) were randomly halved; Intervention Group (IG) received trial interventions i.e. subject involvement, weekly phone reminders in addition to routine counselling, while Comparison group received routine counselling only. Self-reported adherence (SRA) questionnaire and pill identification test (PIT) conducted at both baseline and follow-up in addition to CD4 count and viral load. ITT using ANOVA; McNemar's test for variables with before-after assessments within a group. Results showed significant differences in ≥95% SRA, ≥95% Adherence on PIT, Viral load test of <50 copies per cubic mm. These interventions should be included in the overall treatment strategy for HIV/AIDS in Pakistan.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"373-83"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109710383175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29668539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningoencephalitis Due to HIV Replication Despite Plasmatic Viral Control.","authors":"Aurélien Dinh,&nbsp;Jérôme Salomon,&nbsp;Damien Le Du,&nbsp;Dominique Mathez,&nbsp;Robert Carlier,&nbsp;Louis Bernard,&nbsp;Pierre de Truchis","doi":"10.1177/1545109711402085","DOIUrl":"https://doi.org/10.1177/1545109711402085","url":null,"abstract":"<p><p>We report a symptomatic case of HIV replication in CSF (Cerebro Spinal Fluid) despite low plasmatic viral load. The patient, known HIV positive since 3 years, under HAART (Highly Active Antiretroviral therapy), presented an acute meningoencephalitis which was improved by optimization of treatment for a better CNS (Central Nervous System) penetration according to the CHARTER's (CNS HIV Antiretroviral Therapy Effects Research) score. CNS can be considered as a specific compartment for HIV replication and can be involved in acute or chronic neurologic impairment. As showed in this observation, CHARTER score could be helpful to optimize HAART penetration in CNS, but indication and use remain uncertain in current practice.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"345-8"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711402085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29829272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of an Automated and a Manual Method of Viral Load Determination in HIV-Infected Persons in Yaounde, Cameroon.","authors":"Peter M Ndumbe,&nbsp;Bechem Efuetnkeng,&nbsp;George M Ikomey,&nbsp;Julius Atashili","doi":"10.1177/1545109711398663","DOIUrl":"https://doi.org/10.1177/1545109711398663","url":null,"abstract":"<p><strong>Objectives: </strong>Although access to antiretroviral therapy is being improved in the resource-limited settings most affected by the HIV pandemic, the assessment of treatment success or failure remains a challenge. Methods of viral load determination that are inexpensive, easy to use, and practicable at peripheral health centers are required. This study aimed at evaluating the validity and relative cost of a manual method compared to an automated method of viral load quantification.</p><p><strong>Methods: </strong>HIV-1 viral load was determined by both the COBAS Amplicor HIV-1 Monitor and the Amplicor HIV-1 Monitor assays in 18 patients in Yaounde, Cameroon.</p><p><strong>Results: </strong>There was a strong correlation between values of viral load obtained by the automated method and the manual method (r = .83, P value < .0001). Also, both methods were not statistically different from each other (Wilcoxon rank-sum statistic P value .99).</p><p><strong>Conclusions: </strong>The manual method of determining HIV viral load was correlated with the automated method and should be considered as a viable alternative.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"342-4"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711398663","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29788984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Kaposi's Sarcoma during Primary HIV-1 Infection.","authors":"Marlous L Grijsen,&nbsp;Marion Cornelissen,&nbsp;Jan M Prins","doi":"10.1177/1545109711416509","DOIUrl":"https://doi.org/10.1177/1545109711416509","url":null,"abstract":"<p><p>The majority of cases of Kaposi's sarcoma (KS) occur at low CD4 counts during chronic HIV-1 infection. We present a case of KS which was diagnosed during primary HIV-1 infection. This report aims to draw attention that KS may occur early in the course of HIV-1 infection and that primary HIV-1 infection may rapidly progress to AIDS.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"349-50"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711416509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29949344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the Illicit Drug Economy Contributes to HIV Risk in St Vincent and the Grenadines.","authors":"Janet J Myers,&nbsp;Andre Maiorana,&nbsp;Katharine Chapman,&nbsp;Rosemary Lall,&nbsp;Nadine Kassie,&nbsp;Navindra Persaud","doi":"10.1177/1545109711418508","DOIUrl":"https://doi.org/10.1177/1545109711418508","url":null,"abstract":"<p><p>St Vincent and the Grenadines (SVG) is the largest marijuana producer in the Eastern Caribbean. As the European Union has phased out preferred access for its banana crop, marijuana has become one of the main sources of income and a safety net for many young men, in particular. HIV is a problem for youth in SVG where 60% of the population and 50% of cumulative AIDS cases are among individuals under 30 years of age. To explore the relationship between the economic context and HIV, we used rapid appraisal methods including field observations, interviews, and focus groups with 43 key informants. We found that the marijuana-related economy has contributed to social conditions favoring HIV transmission among young people in several interrelated ways. A lively youth culture exists which includes frequent parties, heavy drinking, sex with multiple partners, and the desire to be seen with the best material goods. Men with access to money are able to attract younger partners for parties and sex. Condoms are infrequently used. We conclude that reducing HIV risk will require structural interventions to reduce discrimination and increase economic opportunity.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"396-406"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711418508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30108022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to Special Section on HIV/AIDS and Substance Use in the Caribbean (Part 3): Perspectives on Substance Abuse Treatment as HIV Prevention and Implementation Science in the Youth Culture of Web 2.0.","authors":"Robert M Malow,&nbsp;Rhonda Rosenberg,&nbsp;Jessy G Dévieux","doi":"10.1177/1545109711430924","DOIUrl":"https://doi.org/10.1177/1545109711430924","url":null,"abstract":"The Joint United Nations Programme on HIV/AIDS (UNAIDS) commemorated International Year of Youth with a synthesis report called \"Securing the Future Today\" about HIV and young people aged 15 to 24 years. The epidemiology of the report was clear: 41% of new infections occur among young people; 5 million are living with HIV; and more than half of the worlds sexually transmitted infections (STIs) are diagnosed in young people (in the United States it is approximately half). The Caribbean and Latin America constitute the fourth most HIV-prevalent region in the world preceded by Eastern and Southern Africa West and Central Africa and South Asia.","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"384-7"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1545109711430924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30316760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Achilles' Heel of HIV Treatment for Prevention: History of Sexually Transmitted Coinfections among People Living with HIV/AIDS Receiving Antiretroviral Therapies.","authors":"Seth C Kalichman, Chauncey Cherry, Denise White, Mich'l Jones, Moira Kalichman","doi":"10.1177/1545109711418120","DOIUrl":"10.1177/1545109711418120","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral therapies (ARTs) offer promising new avenues for HIV prevention. Unfortunately, people infected with HIV who have co-occurring sexually transmitted infections (STIs) are more infectious than suggested by the amount of virus in their peripheral blood. We examined the history of sexually transmitted coinfections in people living with HIV.</p><p><strong>Methods: </strong>People living with HIV/AIDS completed confidential computerized interviews that assessed history of STI, sexual behaviors, and STI knowledge.</p><p><strong>Results: </strong>Among 414 men and 156 women currently receiving ART, 53% had been diagnosed with at least 1 STI since testing HIV positive; 24% women, 19% men, and 11% transgender persons had been diagnosed with an STI in the past year. History of STI was associated with younger age, greater STI knowledge, substance use, and ART nonadherence.</p><p><strong>Conclusions: </strong>Aggressive strategies for detecting and treating STI in people receiving ART will be necessary to achieve protective benefits.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"365-72"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286333/pdf/nihms652458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30200333","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 Risk Behavior among Youth in the Dominican Republic: The Role of Alcohol and Other Drugs.","authors":"Vincent Guilamo-Ramos, James Jaccard, Viktor Lushin, Roberto Martinez, Bernardo Gonzalez, Katharine McCarthy","doi":"10.1177/1545109711419264","DOIUrl":"10.1177/1545109711419264","url":null,"abstract":"<p><p>Existing literature related to HIV in the Dominican Republic has tended to neglect the unique role of tourism areas as distinct ecologies facilitative of sexual risk behavior, particularly HIV vulnerability and transmission. Furthermore, limited attention has focused on Dominican adolescents living in close proximity to tourism areas who have become increasingly exposed to alcohol due to the expanding tourism industry in the Dominican Republic. While most previous analyses of the effects of alcohol on adolescent sexual risk behavior have focused on the transient effects of alcohol on judgment and decision making, the effects of chronic alcohol use on sexual behavior has been a neglected area of research. Our study explores the relationship between chronic alcohol use, the parent-adolescent relationship, affective factors such as self-esteem, and intentions to engage in sex. We examine the above factors within the context of tourism areas which represent a unique ecology of alcohol availability and consumption and HIV risk. We discuss implications for developing applied family-based programs to target Dominican adolescent alcohol use and sexual risk behavior in tourism areas of high alcohol exposure.</p>","PeriodicalId":86092,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)","volume":"10 6","pages":"388-95"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3319024/pdf/nihms359344.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30136874","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}