Management Of Acquired Immunodeficiency Syndrome Research Articles

Deconstructing hegemonic masculinities and promoting prevention altruism and antiretroviral therapy adherence among couples

Through the use of a netnography research design, this research sets out to explore plausible strategies that can be adopted for adherence to antiretroviral therapy (ART) for the management of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The research posits that the successful management of HIV and AIDS is hindered by hegemonic masculinities, which accord power to men and subordinate women. Additionally, a number of societal beliefs linked with sociocultural masculine attitudes become repressive to men in terms of their health-seeking behaviour. This results in their disinclination towards disclosure of their HIV status and access to medicinal usage, which consequently affects the health and well-being of their female counterparts. This research acknowledges the importance of ART in managing HIV and AIDS. For HIV-positive persons, ART reduces the viral load and prolongs the timeframe between a diagnosis of the HIV and the AIDS. It prolongs the survival chances of the infected person. In order to promote adherence to ART and to minimise the risk of HIV infection for women, the research advocates for the promotion of prevention altruism as a mechanism for deconstructing hegemonic masculinities to enable the effective management of HIV and AIDS.Contribution: This research recognises the negative interface between hegemonic masculinities and adherence to ART. Hence, the research suggests the practice of prevention altruism for promoting adherence to ART as well as the effective management of HIV and AIDS in a bid to prolong longevity and to promote Sustainable Development Goal 3.

Machine learning and molecular simulation-based protocols to identify novel potential inhibitors for reverse transcriptase against HIV infections

Acquired immunodeficiency syndrome (AIDS) is a potentially fatal condition affecting the human immune system, which is attributed to the human immunodeficiency virus (HIV). The suppression of reverse transcriptase activity is a promising and feasible strategy for the therapeutic management of AIDS. In this study, we employed machine learning algorithms, such as support vector machines (SVM), k-nearest neighbor (k-NN), random forest (RF), and Gaussian naive base (GNB), which are fast and effective tools commonly used in drug design. For model training, we initially obtained a dataset of 5,159 compounds from BindingDB. The models were assessed using tenfold cross-validation to ensure their accuracy and reliability. Among these compounds, 1,645 compounds were labeled as active, having an IC50 below 0.49 µM, while 3,514 compounds were labeled “inactive against reverse transcriptase. Random forest achieved 86% accuracy on the train and test set among the different machine learning algorithms. Random forest model was then applied to an external ZINC dataset. Subsequently, only three hits-ZINC1359750464, ZINC1435357562, and ZINC1545719422-were selected based on the Lipinski Rule, docking score, and good interaction. The stability of these molecules was further evaluated by deploying molecular dynamics simulation and MM/GBSA, which were found to be −38.6013 ± 0.1103 kcal/mol for the Zidovudine/RT complex, −59.1761 ± 2.2926 kcal/mol for the ZINC1359750464/RT complex, −47.6292 ± 2.4206 kcal/mol for the ZINC1435357562/RT complex, and −50.7334 ± 2.5713 kcal/mol for the ZINC1545719422/RT complex. Communicated by Ramaswamy H. Sarma

Current ARTs, Virologic Failure, and Implications for AIDS Management: A Systematic Review.

Antiretroviral therapies (ARTs) have revolutionized the management of human immunodeficiency virus (HIV) infection, significantly improved patient outcomes, and reduced the mortality rate and incidence of acquired immunodeficiency syndrome (AIDS). However, despite the remarkable efficacy of ART, virologic failure remains a challenge in the long-term management of HIV-infected individuals. Virologic failure refers to the persistent detectable viral load in patients receiving ART, indicating an incomplete suppression of HIV replication. It can occur due to various factors, including poor medication adherence, drug resistance, suboptimal drug concentrations, drug interactions, and viral factors such as the emergence of drug-resistant strains. In recent years, extensive efforts have been made to understand and address virologic failure in order to optimize treatment outcomes. Strategies to prevent and manage virologic failure include improving treatment adherence through patient education, counselling, and supportive interventions. In addition, the regular monitoring of viral load and resistance testing enables the early detection of treatment failure and facilitates timely adjustments in ART regimens. Thus, the development of novel antiretroviral agents with improved potency, tolerability, and resistance profiles offers new options for patients experiencing virologic failure. However, new treatment options would also face virologic failure if not managed appropriately. A solution to virologic failure requires a comprehensive approach that combines individualized patient care, robust monitoring, and access to a range of antiretroviral drugs.

Could Vhavenda initiation schools be a panacea for HIV and AIDS management in the Vhembe district of South Africa?

Several human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) prevention strategies have been implemented to counteract the impact of the disease, including the use of condoms, social marketing, testing, voluntary counselling and education programmes. One of the platforms which has not been fully explored is that of traditional initiation schools. This study aimed to explore and discuss Vhavenda traditional initiation schools, which can be used as panacea for HIV and AIDS management in the Vhembe district of South Africa. This ethnographic study was conducted in the Vhembe district of South Africa, among nine purposively sampled key informants drawn from a cohort of Vhavenda traditional healers and leaders. Data were collected using semistructured face-to-face interviews and analysed using ethnographic content analysis. The results indicate that Vhavenda traditional initiation schools positively affect the management of HIV and AIDS. Initiation schools are centres for cultural education and the formation of a cultural identity. During the initiation process, initiates are taught social norms, customs and values which will serve them well in adulthood. They are also taught matters of sexuality, courtship, marriage and respect for others. The positive attributes of Vhavenda initiation schools should be accommodated and implemented in curricula from the primary school level up to the tertiary level to reduce and curb the spread of HIV infection.Contribution:Improved expertise at the initiation schools will aid the Department of Health and Education and Training to develop and implement suitable cultural contextualised HIV and AIDS prevention strategies.

Evaluation of knowledge, attitude, and comfort concerning human immunodeficiency virus/acquired immunodeficiency syndrome field education understanding among Kanpur Dehat, Indian rural school educators

CONTEXT: Countries were left ravaged as the fastest increasing path of acquired immunodeficiency syndrome (AIDS) infection, hence the epidemic misconceptions surrounding the path of human immunodeficiency virus (HIV) infection in the populations. According to the latest national AIDS management organization survey on HIV/AIDS, North central India is regarded as low awareness and low prevalence area. AIMS: This study aims to evaluate the knowledge, attitude, and comfort regarding HIV/AIDS among Kanpur Dehat rural school educators. SETTINGS AND DESIGN: A cross-sectional descriptive survey was carried out on a total of 110 rural school educators of government and private schools. SUBJECTS AND METHODS: A pretested, self-structured, close-ended questionnaire was administered that consisted of 30 questions. STATISTICAL ANALYSIS USED: The information gathered was incorporated in a foundational way and t-test was applied and P value was determined. RESULTS: Among 110 school educators, females were more in number (56.36%). Private school educators scored more mean (standard deviation) in terms of knowledge (68 ± 5.83), attitude (50 ± 5.82), and comfort (49 ± 6.60) when compared to government school educators. Government school educators were uncertain about methods of transmitting AIDS. Maximum school educators were unaware of the different myths concerning AIDS. CONCLUSIONS: The knowledge, attitude, and comfort of rural school educators among the government school teachers were found to be unsatisfactory. Information is an effort to improve the high-risk conduct of every illness and to build an understanding of HIV/AIDS. We will seek to increase awareness among educators of rural schools by holding workshops at regular intervals and enhancing their comprehension.

Knowledge Risk Attitude Assessment Related To HIV/AIDS among BDS Students in Chennai, Tamil Nadu

Background: Acquired Immuno Deficiency Syndrome (AIDS) awareness is comparatively low in densely populated countries like India. India stands as the third largest country with HIV positive patients, with Tamil Nadu in the 6th position state wise. In this study a survey was conducted to assess the knowledge, attitude and risk related to AIDS among the undergraduate dental students in Chennai city, intended to create awareness among the youth thereby preventing the incidence of AIDS. Method: A dichotomous self-administered questionnaire consisting of 16 questions was approved by Institutional Human Ethical Committee and it was distributed to 432 dental students in Chennai, the filled forms were later evaluated. Result: This study reveals that the overall knowledge on AIDS among the study population was satisfactory. The knowledge on basics of AIDS is 84.12%, cause of AIDS is 88.3%, source of information about AIDS is 66.62% and knowledge on people at risk of developing AIDS is 79.72%, while knowledge on prevention and management of AIDS is 88.12%. Conclusion: This study infers that overall knowledge about AIDS is better among the boys than the girls. Health education must be made mandatory at schools, colleges, community level to defend from the globally endangering disease.

Designing a communication protocol for acquired immunodeficiency syndrome information exchange.

INTRODUCTION:Interoperability will provide similar understanding on the meaning of communicated messages to intelligent systems and their users. This feature is essential for controlling and managing contagious diseases which threaten public health, such as acquired immunodeficiency syndrome (AIDS). The aim of this study was also designing communication protocols for normalizing the content and structure of intelligent messages in order to optimize the interoperability.MATERIALS AND METHODS:This study used a checklist to extract information content compatible with minimum data set (MDS) of AIDS. After coding information content through selected classification and nomenclature systems, the reliability and validity of codes were evaluated by external agreement method. The MindMaple software was used for mapping the information content to Systematized Nomenclature of Medicine-Clinical Terminology (SNOMED-CT) integrated codes. Finally, the Clinical Document Architecture (CDA) format was used for standard structuring of information content.RESULTS:The information content standard format, compatible selected classification, or nomenclature system and their codes were determined for all information contents. Their corresponding codes in SNOMED-CT were structured in the form of CDA body and title.CONCLUSION:The complex and multidimensional nature of AIDS requires the participation of multidisciplinary teams from different organizations, complex analyzes, multidimensional and complex information modeling, and maximum interoperability. In this study, the use of CDA structure along with SNOMED-CT codes is completely compatible with optimal interoperability needs for AIDS control and management.

Changes in Lipids and Routine Haematological Parameters as Human Immunodeficiency Virus (HIV) Infection Progresses to Acquired Immunodeficiency Syndrome (AIDS)

This study was conducted to determine the changes in some lipids and routine haematological parameters that take place as immunodeficiency virus (HIV) infection progresses to Acquired Immunodeficiency Syndrome (AIDS). Fifty HIV positive asymptomatic adults were recruited for the study, out of whom 30 developed clinical AIDS. Statistically significant decreases were observed for packed cell volume (PCV), haemaglobin (Hb), total white blood cell count (WCC), absolute neutrophil count, absolute lymphocyte count, LDL-cholesterol (P < 0.001) total cholesterol (P < 0.002) and triglyceride (P < 0.005) in HIV infections when compared with age and sex-matched control subjects. However, erythrocyte sedimentation rate (ESR) increased significantly (P < 0.001) in HIV infection. During AIDS episodes, a further decrease was observed for PCV, Hb, LDL-cholesterol (P < 0.001), and HDL cholesterol (P < 0.02). Increased levels were observed for WCC, ESR and triglyceride (P < 0.001). Whereas there was hypocholesterolaemia in HIV infection, hypertriglyceridaemia was observed in AIDS. The understanding of these various modifications will be of importance in AIDS management, intervention, and patients\' education in order to minimize the effects of associated complications. Key words: HIV progression, AIDS, lipids, haematological profiles Journal of Medical Laboratory Science Vol.13(1) 2004: 23 - 29

Seeking the attitudes and perceptions of the Greek primary-care professionals on voluntary work in caring for people with HIV/AIDS.

During the last two decades Greece has moved towards a national health system. However, in a country with limited economic resources the necessity for reducing the increasing costs of the health care services by an effective use of available human resources, such as community volunteers, becomes inevitable. This paper reports the findings of a pilot study on attitudes and perceptions of primary-care staff towards voluntary work for human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. Of the 300 primary-care professionals who are serving the health centres of the largest area of Athens, a sample of 153 was selected. The population surveyed was predominately female (n = 104, 69.3%) and most of them (n = 77, 50.7%) were between 31 and 40 years of age. A 28-item questionnaire was used, especially designed to investigate attitudes and perceptions of primary health care (PHC) professionals regarding the contribution of volunteers to HIV/AIDS-related programmes. Most of the respondents (n = 131, 85.6%) reported little or no experience of caring for HIV/AIDS patients and only 14 (9%) reported participation in any voluntary programmes. Eighty-eight per cent of patients (n = 135) consider the participation of volunteers in AIDS programmes as very useful and the vast majority of the participants pointed out the usefulness of the participation of health professionals and other influencing persons in voluntary programmes. Participants also suggested that sharing time with HIV patients and families, offering emotional support and practical help and distributing information leaflets for the general population should be the volunteers' contribution in AIDS-related programmes. The PHC professionals' role in voluntary programmes is considered by the 91 respondents (59.5%) as 'planning and organizing', for 66 (43.1%), 'coordinating' and for 37 (24.2%), 'supporting'. Although the majority of the participants (n = 90, 58.8%) said they would participate as a volunteer in an AIDS-related programme, only one-third of the total sample (n = 48, 31.4%) agree with the statement that they have a professional duty to support such a type of programme. Primary-care workers present little experience in caring for HIV/AIDS patients or participating in volunteer programmes and mainly positive attitudes and perceptions to voluntary work. Continuing educational programmes together with awareness activities may increase the involvement of primary-care professionals in the effective management of AIDS in Greece.

The Effect of Driving Distance from Medical Treatment Facility and Short-Term Management Outcomes in Department of Defense Beneficiaries Newly Diagnosed with Human Immunodeficiency Virus

Access to experienced providers is an important part of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome management, especially for patients who are just starting a new or complicated treatment regimen. To date, few studies have addressed the potential barrier of geographic distance in access to care in the HIV/acquired immunodeficiency syndrome population. We performed a retrospective study examining the effects of driving distance from a major Naval medical treatment facility on clinical outcomes for Department of Defense beneficiaries recently diagnosed with HIV. The outcomes studied include attainment of undetectable HIV-1 RNA levels and change in mean CD4+ T cell counts 6 months after initiation of management in 132 Department of Defense beneficiaries. We found no significant associations between distance from a major medical treatment facility and these clinical outcomes through 6 months of follow-up. These findings suggest that stationing HIV-infected military personnel far from major Medical Treatment Facility does not interfere with initial successful HIV management.

Physicians' experience with the acquired immunodeficiency syndrome as a factor in patients' survival.

Previous studies have found that patients with the acquired immunodeficiency syndrome (AIDS) who are admitted to hospitals that admit many such patients have lower mortality rates than patients in hospitals with less experience with AIDS. We examined the relation between physicians' experience with AIDS and the survival of their patients with AIDS. We studied 403 adult male patients enrolled in a staff-model health maintenance organization in whom first AIDS-defining illnesses were diagnosed from 1984 through mid-1994; we determined that these illnesses met the 1987 case definition of the Centers for Disease Control. We defined three levels of experience for the patients' 125 primary care physicians according to their experience with AIDS during residency training and the cumulative number of patients with AIDS they had cared for in their practices. The median survival of the patients of physicians with the least experience in the management of AIDS was 14 months, as compared with 26 months for the patients of physicians with the most experience (P<0.001). Controlling for the severity of illness and the year of diagnosis, we found that the patients cared for by physicians with the most experience had a 31 percent lower risk of death than the patients cared for by physicians with the least experience (P<0.02). Among 244 patients with an AIDS-defining illness diagnosed from 1989 through 1994, after adjustment for the CD4+ cell count and the severity of illness, the risk of death was 44 percent lower for patients of the most experienced physicians than for patients of the least experienced (P<0.02). The experience of primary care physicians in the management of AIDS is significantly associated with survival among their patients.

The Medical Management of AIDS

Imagine being given an assignment to develop a book that is to provide clinicians with the latest knowledge concerning human immunodeficiency virus (HIV) infection and its consequences—immunodeficiency and opportunistic infections—as well as their treatment and prevention. Such a project could easily result in a book of 1000 pages, enough to strain the limits of the human body to carry from home to office. To accomplish the task in a handy, manageable, and readable volume of half that size is exactly what Sande and Vol-E berding have once again done. The secret is to enlist the aid of clinician-academicians who have seen the acquired immunodeficiency syndrome (AIDS) epidemic from its very beginnings in 1981 and have followed it through to to-day's domineering presence. Ask these clinicians to put on paper what is really key in managing HIV-infected individuals and to update their material frequently. The result is this

Considerations in the Treatment of Patients With Acquired Immunodeficiency Syndrome at Home

The rapidly growing acquired immunodeficiency syndrome (AIDS) population faces frequent, expensive hospitalization due to the debilitating sequelae of the disease. Home care offers these patients an opportunity to receive or complete their therapy in comfortable surroundings, allowing them to realize the psychosocial and financial benefits of outpatient care. A myriad of sophisticated drug therapies has been successfully administered in the home setting. Therapy for frequently occurring opportunistic infections often requires treatment with highly toxic drugs such as amphotericin, pentamidine, and ganciclovir. With thorough patient training and diligent monitoring by the home-care pharmacist and nurse, these agents can be safely administered at home. Conventional and investigational chemotherapy and immunomodulator therapy, such as interferon or erythropoietin, can also be administered at home. Providing total parenteral nutrition to AIDS patients is a controversial treatment modality, but if indicated, it can also be accomplished at home. Outpatient pain management has allowed many patients with terminal or chronic illnesses to minimize time spent in hospitals or extended care facilities, and it can offer the same advantages to patients with AIDS. The psychosocial ramifications of AIDS and its impact on patients and health care professionals must be understood in order to effectively provide total patient care at home. The challenge to the home-care pharmacist is to acquire and maintain a comprehensive knowledge of the treatment options currently available for the management of AIDS.

Treatment and Prophylaxis of Pneumocystis carinii Pneumonia in AIDS Patients

Summary Pneumocystis carinii pneumonia (PCP) is seen in people with a defect in cell-mediated immunity. Today the most common cause for this is the Acquired Immunodeficiency Syndrome (AIDS). There have been some remarkable advances recently in the development of new drug regimens to combat this otherwise fatal infection. Although cotripoxazole (trimethoprim-sulfamethoxazole) is still the drug of first choice it cannot be tolerated by a significant proportion of patients, and therapies such as pentamidine (pentamidine-isethionate) [intravenous or nebulised], dapsone-trimethoprim, eflornithine (DFMO; difluoromethylornithine), trimetrexate, and clindamycin-primaquine are finding therapeutic niches. The major advantage in these other agents is not improved efficacy but different toxicity profiles, enabling therapy to be most appropriately tailored to individual patients’ conditions. Although the majority of patients should now survive an attack of PCP, relapses will occur if prophylaxis is not used: There is also the capacity to predict accurately which patients are at risk for this pneumonia and prevent it through the use of chemoprophylaxis. These advances in the treatment and prevention of PCP, together with anti-retro viral therapy, mean that this is an area of AIDS management that has resulted in improved long term survival.

Treatment of human immunodeficiency virus-infected infants and young children with dideoxynucleosides

The safety and activity of several antiretroviral agents are being evaluated for treatment of acquired immunodeficiency syndrome (AIDS) in infants and children. Intermittent oral and intravenous regimens and continuous intravenous infusion of the dideoxynucleoside, 3′-azido-3′-deoxythymidine (zidovudine, AZT), have been shown to be beneficial in improving neurodevelopmental function and growth velocity in pediatric patients with AIDS. AZT, however, is limited by the associated development of neutropenia and anemia, which frequently necessitates transfusions. Another dideoxynucleoside, 2′,3′-dideoxycytidine (ddC), also shows theoretical promise in the treatment of the pediatric AIDS population. This agent is not associated with the hematologic toxicity induced by AZT but does produce a painful sensory peripheral neuropathy. Sequential therapy with AZT and ddC may limit the toxic effects associated with the use of these drugs individually. Dideoxyinosine and soluble recombinant CD4 are two newer antiretroviral agents that are under investigation for the management of AIDS in infants and children. The activity of recombinant CD4 in preventing the transplacental transmission of human immunodeficiency virus is also being evaluated.

Considerations in the Treatment of Acquired Immunodeficiency Syndrome Patients at Home

The rapidly growing acquired immunodeficiency syndrome (AIDS) population faces frequent, expensive hospitalization due to the debilitating sequelae of the disease. Home care offers these patients an opportunity to receive or complete their therapy in comfortable surroundings, allowing them to realize the psychosocial and financial benefits of outpatient care. A myriad of sophisticated drug therapies has been successfully administered in the home setting. Therapy for frequently occurring opportunistic infections often requires treatment with highly toxic drugs such as amphotericin, pentamidine, and ganciclovir. With thorough patient training and diligent monitoring by the home-care pharmacist and nurse, these agents can be safely administered at home. Conventional and investigational chemotherapy and immunomodulator therapy, such as interferon or erythropoeitin, can also be administered at home. Providing total parenteral nutrition to AIDS patients is a controversial treatment modality, but if indicated, it can also be accomplished at home. Outpatient pain management has allowed many patients with terminal or chronic illnesses to minimize time spent in hospitals or extended care facilities, and it can offer the same advantages to patients with AIDS. The psychosocial ramifications of AIDS and its impact on patients and health care professionals must be understood in order to effectively provide total patient care at home. The challenge to the homecare pharmacist is to acquire and maintain a comprehensive knowledge of the treatment options currently available for the management of AIDS.

Approaches to HIV counselling in a Zambian rural community

The counselling experience at Chikankata hospital for the first year of the AIDS care and prevention programme is described. People in the counselling team are selected according to specific criteria. Counselling is conducted in integrated AIDS management context, at the individual family and community levels. Counselling emphases differ according to the clinical expression of the disease. Some cultural issues require specific counselling approaches, such as ritual cleansing, and dealing with seropositive women of childbearing age. Counselling is integral to comprehensive AIDS management which is inclusive of the disciplines of clinical care, education, counselling, pastoral care and administration.

AIDS and Patient Management: Legal, Ethical, and Social Issues

<h3>Mobilizing Against AIDS: The Unfinished Story of a Virus, by Eve K. Nichols, 212 pp, with illus, $15, paper $7.95, Cambridge, Mass, Harvard University Press, 1986.</h3> The proliferation of books dealing with the medical, legal, ethical, and social policy aspects of the acquired immunodeficiency syndrome (AIDS) has necessitated scrutiny of the nature, function, and goals of each text. In a rapidly changing field such as AIDS, there must be a careful balancing of the rights and needs of the public to have accurate and timely data and of the dangers of premature and contradictory reporting. As one reviews these texts, one first asks who the intended audience for the book is and, second, what new or useful information is transmitted and for what purpose. <i>AIDS and Patient Management</i>, though wide in scope and ambitious in its undertaking, suffers from a lack of defined audience and from a multiauthored and conference