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.

Novelization of the provisions of the criminal legislation of Ukraine, which provide for liability for medical crimes and misdemeanors: issues of interpretation and enforcement

The problems of criminal law protection of life and health of a person in the field of medical care attract the special attention of scientists, because it is about the most valuable constitutional rights and freedoms of a person. At the same time, the results of the analysis of criminal statistics regarding registered medical crimes and misdemeanours, their further pretrial investigation and trial, give grounds for serious concern. The reasons for the negative investigative and judicial practice may be the shortcomings of the legal construction of the norms, numerous changes made to the Criminal Code, as well as the high latency of medical offenses. Therefore, the purpose of this article is a comprehensive study of the amendment of the criminal legislation of Ukraine, which provides for responsibility for medical offenses, identifying the shortcomings and advantages of such legislative decisions, as well as formulating separate recommendations for the enforcement of the norms of the Criminal Code. The following research methods were used to achieve the specified goals. The dialectical method of cognition made it possible to establish the norms of the Criminal Code of Ukraine, which provide for responsibility for medical offenses and to reveal the problems of their enforcement. The historical method made it possible to identify all normative acts that amended the norms of the Criminal Code, which provide for liability for medical offenses. The dogmatic method made it possible to clarify the true content of such concepts as "order of application of transplantation", "activity connected with transplantation", " substantial harm to the victim's health", etc. The systemic-structural method was used to analyse such evaluative concepts as "damage to the victim's health", " substantial damage to the victim's health", "severe consequences", etc., which are used in many provisions of the Criminal Code and are interpreted in different ways in judicial practice. The comparative legal method was used to compare the regulatory national legislation of Ukraine in the field of medical care and the relevant norms of the Criminal Code of Ukraine. The conducted research gave grounds for the conclusion that socially dangerous consequences in the form of "substantial harm to the victim's health", which are provided for in Part 1 of Art. 143 of the Criminal Code, cover the infliction of light physical injuries on the victim that caused a short-term health disorder or minor loss of working capacity, moderate physical injuries, severe physical injuries, as well as infection with the human immunodeficiency virus or other incurable infectious disease. At the same time, negligently causing the death of a recipient during an illegal transplantation requires additional qualification under a set of criminal offenses. The revealed cases of arbitrary and sometimes unsystematic use of different evaluation concepts of harm to human health in the norms of the Special Part of the Criminal Code point to the urgent need for unification in the criminal legislation of Ukraine, both the concept of "harm to health" and the normative consolidation of its types.

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

Influence of induction therapy and antiretroviral regimen on outcomes in kidney transplant recipients living with human immunodeficiency.

Kidney transplantation has a survival benefit for people with human immunodeficiency virus (HIV) and end-stage kidney disease, however increased rates of rejection remain an issue. Questions remain regarding the impact of induction immunosuppression therapy and antiretroviral (ARV) choice on long-term outcomes. We performed a multicenter retrospective analysis of outcomes in recipients with HIV who received kidneys from donors without HIV transplanted between 2004 and 2019. The association between induction and ARV regimens and long-term outcomes including rejection, graft, and recipient survival over 5 years was investigated using Cox regression modeling. Seventy-eight kidney transplants (KT) performed in 77 recipients at five US transplant centers were included, with median follow up of 7.1 (4.3-10.7) years. Overall recipient and graft survival were 83% and 67%, respectively. Rejection occurred in 37% (29/78). Recipients with rejection were more likely to be younger, recipients of deceased donor organs, and Black. Receipt of rabbit anti-thymocyte globulin (rATG) induction without protease-inhibitor (PI)-based ARVs was associated with 83% lower risk of rejection (adjusted hazard ratio (aHR) 0.17 (95% CI 0.05-0.63), p =.007) and a non-statistically significantly lower risk of graft failure (aHR 0.18 (0.03-1.16), p =.07) when compared to those who received other induction and ARV combinations. In this multicenter retrospective study, we found a trend toward lower rejection and improved graft survival among those who received both rATG for induction and PI-sparing ARVs.

A cholangiocyte organoid system for Cryptosporidium parvum cultivation and transcriptomic studies of biliary cryptosporidiosis

Biliary cryptosporidiosis caused by Cryptosporidium is life-threatening in immunocompromised individuals, particularly those with acquired immune deficiency syndrome (AIDS), resulting in AIDS cholangiopathy. However, studies of biliary cryptosporidiosis have lagged due to the lack of in vitro models that allow complete pathogen development. Here we describe procedures for the generation of mouse cholangiocyte organoids (Chol-orgs). The Chol-orgs, which expressed stem and biliary cell markers, could be clonally expanded for three months and stored in liquid nitrogen for more than one year. Combined with cell differentiation using the air-liquid interface (ALI) approach, we established a culture system for Cryptosporidium parvum. ALI cultures using Chol-orgs have supported ∼50-fold amplification of the pathogen and generated viable oocysts in vitro. In addition, we analyzed the transcriptome of Chol-ALI cultures infected with the IId subtype of C. parvum to characterize host cell responses. RNA-seq analysis revealed that C. parvum upregulated immune and inflammatory responses and downregulated metabolic and cell proliferation signaling pathways in Chol-orgs. A similar system using bovine cholangiocytes also supported the complete development of C. parvum in vitro. These in vitro models provide convenient methods to study biliary cryptosporidiosis and other hepatic infections and to develop effective therapies for AIDS cholangiopathy.

Description Of The Usage Of Antiretroviral Medicine With Atc/Ddd Method In The Primary Health Care Centers Of Kediri 2021

AIDS (Acquired Immune Deficiency Syndrome) is a collection of symptoms and infections caused by damage to the human immune system, HIV (Human Immunodeficiency Virus ), a virus that can weaken human immunity. PLWHA patients must undergo antiretroviral virus (ARV) drug therapy, one of the drug use analysis classification systems is using the ATC/DDD system which is a means of researching drug use in an effort to improve the quality of drug use, one of these components is the presentation and comparison of drug consumption levels. international. The aim of this research is to determine the use of antiretroviral drug consumption in primary health care center in the Kediri City area for the 2021 period using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) method. The design of this research is quantitative descriptive, namely describing a particular event systematically and accurately and the treatment of this research is the process of collecting data and evaluating the use of antiretroviral drugs as well as verifying Primary health care center data by interviewing primary health care center pharmacists in the Kediri city area in 2021. Consumption of antiretroviral drugs (ARVs). ) is highest in the Campurejo primary health care center, namely Lamivudine (3TC) as much as 31.71%, Balowerti in primary health care center with Zidovudine (AZT) as much as 29.02% and Pesantren 1 primary health care center with the drug Nevirapine (NVP) as much as 32.62%, while the use of ARV drugs is low. At the Campurejo primary health care center, it was 0.0002% of the drug Dolutegravir (DTG), and at the Balowerti primary health care center, it was 0.0012% of the drug Dolutegravir (DTG), then at Pesantren 1 primary health care center , it was 0.0015% of the drug Dolutegravir (DTG). The incidence of HIV is still high in Indonesia, especially in the city of Kediri.

The Global Impact of HIV: A Comprehensive Review

The Human Immunodeficiency Virus (HIV) has been a significant global health challenge since its discovery in the 1980s, leading to the devastating Acquired Immunodeficiency Syndrome (AIDS). Despite advancements in medical research and antiretroviral therapies, HIV/AIDS remains a pressing public health concern, particularly in resource-limited regions. This comprehensive review provides updated data and scientific insights on the global impact of HIV, shedding light on the current state of the epidemic and the challenges faced in combating it. The review highlights the resurgence of HIV cases in Eastern European countries, such as Ukraine, Estonia, and Latvia, with surprising increases in AIDS cases observed in East Asian countries. However, it is in sub-Saharan Africa that the burden of HIV remains most acute, with high prevalence rates and a significant number of affected individuals. The region requires continued attention and resources to address the complex challenges associated with HIV prevention, treatment, and care. The article delves into the classification and structure of HIV, emphasizing its belonging to the Lentivirinae subfamily, specifically HIV-1 and HIV-2. HIV-1, the predominant viral species globally, exhibits a distinct clinical latency phase, contributing to its persistence and infectivity. The high replication rate and genetic variability of HIV, driven by the error-prone reverse transcriptase enzyme, result in the emergence of diverse subtypes and strains across different regions. Furthermore, the article explores the structural components of HIV-1, including the envelope glycoproteins (gp120 and gp41), matrix protein, and various enzymes critical to the viral life cycle. Despite progress in medical research and access to antiretroviral therapies, HIV/AIDS continues to present challenges such as limited resources, drug resistance, and regional disparities.

Analysis of Physiotherapy Practices using Deep Learning

Abstract: The proposed physiotherapy assessment system, utilizing deep learning, aims to enhance the accuracy and efficiency of assessments. Traditional manual methods used by physiotherapists are often time-consuming and prone to errors, potentially leading to incorrect diagnoses and treatment plans. This system tackles these challenges by employing advanced deep learning algorithms to detect angles and provide personalized audio feedback to patients based on their posture. The system commences by capturing the patient's video with a webcam and extracting frames using OpenCV. These frames are then analyzed through a media pipe library, which identifies key body points. These points are utilized to connect relevant body parts for specific exercises, calculating angles between them. Subsequently, the system evaluates posture correctness and delivers tailored audio feedback, counting reps if correct or providing guidance if incorrect. Each exercise receives unique audio feedback, offering precise guidance to improve posture. Moreover, the system tracks patient progress and displays visual representations of improvement over time. This feature aids patients in monitoring their progress and fosters motivation to adhere to therapy. By leveraging deep learning algorithms and the media pipe library, this system presents a precise, efficient, and economical approach to physiotherapy assessments.

Headache and Vision Loss as Initial Symptoms for an Acute Invasive Rhino-orbital-cerebral Mucormycosis

Background: Acute invasive rhino-orbital-cerebral mucormycosis (ROCM) is a rare fungal infection commonly caused by Rhizopus species. It occurs in immune- compromised individuals who have acquired immune deficiency syndrome (AIDS), leukemia, uncontrolled diabetes mellitus, or organ transplant patients who are on immunosuppressive therapy. Diagnosing invasive ROCM is challenging because its clinical presentation can be nonspecific, and it is not frequently observed in ophthalmic practices. Case Report: A 66-year-old Hispanic male with poorly controlled diabetes mellitus presented with the complaint of severe headache and retrobulbar pain in the right eye. An ophthalmic examination revealed normal ocular health in both eyes. Computerized tomography scan showed mild inflammatory mucosal thickening in the sinuses. Initially, he was diagnosed and treated for giant cell arteritis. The patient’s vision deteriorated to no light perception in the right eye with persistent 10 out of 10 headache and eye pain despite various treatments. Further evaluation revealed ROCM involving the sphenoid sinus. This was confirmed by a positive smear and culture of Rhizopus species from the sinus and from the patient’s symptoms improving with antifungal treatment. Conclusion: Sphenoid sinusitis is an unusual site of involvement with ROCM. The absence of nasal drainage adds to the difficulty of diagnosis without contrast imaging. Although rare, acute invasive ROCM should always be considered in any uncontrolled diabetic or immunosuppressed patient with acute headache and vision loss.

In Silico approach: Design an Optimized shRNA against RUNX1 Gene to Target HIV.

Human Immunodeficiency Virus (HIV) is a retrovirus with single-stranded RNA that leads to the challenging disease of acquired immunodeficiency syndrome (AIDS). Combination antiretroviral therapy (cART) can prevent the progression of the disease, but it is not capable of long-term HIV elimination. One of the significant obstacles to treating HIV-1-infected individuals is the creation of latent cell reservoirs early in the infection. Gene-based therapies that utilize RNA interference (RNAi) to silence host or viral gene expression are considered promising therapeutic approaches. It has been demonstrated that RUNX1, a T-cell-specific transcription factor, may significantly affect HIV replication and infection. According to accumulating evidence on the role of interfering RNA techniques in inhibiting gene expression and considering the role of RUNX1 in the replication of HIV-1. In this study, we aim to design shRNAs against RUNX1 that can target the replication of HIV-1. </P> Methods: Several computational methods, including target alignment, similarity search, and secondary structure prediction, have been employed in the design of shRNA against RUNX1. </P> Results: Seven shRNA molecules with the highest efficiency were designed and validated using computational methods to silence the RUNX1 gene. </P> Conclusions: In the present study, we designed shRNA against RUNX1, which can target latent cells infected with HIV. Suppression of RUNX1 by shRNA reactivates HIV in the latent cells and subsequently potentiates the immune response toward identifying accurate virus-infected cells. This process may lead to an effective and efficient reduction of the volume of cell reservoirs infected with HIV.

What drives older men who have sex with men in China away from AIDS information?

ABSTRACT A worrying phenomenon has emerged recently: more people are deliberately avoiding rather than seeking information regarding acquired immunodeficiency syndrome (AIDS). This is the first study to explore behaviors related to AIDS information avoidance and the potential influential factors among older men who have sex with men (MSM). We enrolled 11 older MSM from Wuhan, the largest city in central China, from January to March 2023 using a phenomenological method. This qualitative research was conducted using face-to-face semi-structured interviews. AIDS information avoidance was commonly observed among the respondents. Behaviors related to AIDS information avoidance included avoiding AIDS-related information, ignoring known AIDS information, and avoiding medical care. The main factors associated with AIDS information avoidance included information overload, high-risk sexual behaviors, over-optimism, fear of disclosure, and age. China should provide AIDS information in a manner suitable for older MSM, pay more attention to MSM over the age of 70 years, those who are not open about their sexual orientation and those who are too optimistic, and strengthen the censorship of AIDS information.

Bimetallic interface on an optical microfiber nucleic acid sensor: Early detection in body fluids

Nucleic acid detection, which is not limited by the “window period”, is an efficacious approach for detecting human immunodeficiency virus (HIV) infection at an early time. Here, method with a short turn-around time, portability, connectivity and cost-effectiveness is developed to suppress HIV disease in the early stage, especially in remote areas. Specifically, an optical microfiber sensor enhanced by a bimetallic interface is developed for the HIV-related DNA detection in body fluids. A bimetallic interface is constructed on the optical microfiber surface to ensure that target nucleic acid hybridization occurs between two gold nanostructures where the evanescent field is strongest. The selective enhancement of the evanescent field at the binding site prevents nonspecific amplification of the whole fiber surface, which may lead to false-positive results. With the enhancement in the bimetallic interface, the sensor can detect HIV-related DNA at concentrations from 1 aM to 0.1 pM, with a limit of detection (LOD) of 0.3 aM. The portability, flexibility and selectivity of the sensor enable its application in detecting in several body fluids, such as whole serum and artificial saliva, with LODs of 1.15 aM and 1.64 aM, respectively. This work provides a powerful tool for diagnosing HIV in early stages. Ultrasensitive nucleic acid detection in artificial saliva also provides a possibility for noninvasive detection.

Outcomes of Total Hip Arthroplasty Performed for HIV-Associated Osteonecrosis in China: A Retrospective Cohort Study.

In the post-epidemic era, Acquired Immune Deficiency Syndrome (AIDS) remains one of the most prevalent and detrimental infectious diseases worldwide. The incidence of osteonecrosis of the femoral head (ONFH) in AIDS patients is 100 times higher than that in healthy individuals. Although Total Hip Arthroplasty (THA) is ultimately necessary for most patients, there is still a dearth of evidence regarding its safety and efficacy in Chinese AIDS patients. The clinical data of 49 patients who met the inclusion and exclusion criteria were retrospectively analyzed. Simultaneously, we categorized patients whose hemoglobin and albumin met a specific threshold as the optimized group and performed group comparisons. There are statistical differences in Harris score and VAS score pre- and post-operation, with a low overall complication rate. Notably, no disparities were observed between the optimized group and the partial optimized group in terms of overall conditions, laboratory examination indicators, severity of ONFH, surgical outcomes, surgical complications, pain perception or functional limitations. Furthermore, no correlation was found between CD4+ T lymphocytes and hemoglobin levels, albumin levels, white blood cell count, or platelet count. THA is safe and effective in Chinese AIDS patients with ONFH. However, optimal treatment has limited efficacy in AIDS patients undergoing THA for ONFH. The reconsideration and evaluation of the predictive value of CD4+ T lymphocytes for postoperative complications in joint replacement procedures is warranted.

Experiences of patients living with HIV and AIDS on antiretroviral therapy in Accra, Ghana.

The human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) pandemic has greatly affected Africa, particularly Ghana. The pandemic remains a public health concern, particularly in terms of accessing essential medication and improving quality of life for people living with the disease. This study aimed to explore and describe the experiences of persons diagnosed and living with HIV who are on antiretroviral therapy. A qualitative, exploratory, descriptive, and contextual design was used. The research population included persons diagnosed with HIV who were receiving antiretroviral therapy at three public hospitals in Ghana. Data saturation was achieved after conducting 15 semi-structured interviews. Creswell's six steps of data analysis were used to analyse the data, which resulted in the emergence of one main theme and six sub-themes. The main theme identified by the researchers highlighted the participants' diverse experiences of being diagnosed and living with HIV. It was found that the study participants expressed shock, disbelief, surprise, and fear of death after being diagnosed with HIV. The participants also experienced stigmatisation, discrimination, and rejection. There is a need for further research on the extent of discrimination and stigmatisation and the effect on optimal adherence to antiretroviral therapy. Continuous public education on HIV is required to limit the extent of discrimination and stigmatisation.Contribution:The study has highlighted the various emotions related to stigma and discrimination expressed by persons living with HIV (PLHIV). The findings will guide policy on eliminating discrimination and stigmatisation for people living with HIV.

Improvement of epilepsy secondary to acquired immunodeficiency syndrome with intestinal microbiota preparations: a case report

Abstract Background Epilepsy secondary to acquired immunodeficiency syndrome (AIDS) can be challenging to manage. The potential interactions between antiretroviral drugs and antiepileptic drugs may result in the failure of both treatments. Therefore, it is crucial to develop more effective strategies to enhance the clinical outcomes of patients. Case presentation We report a case of epilepsy secondary to AIDS. After administration of Bacteroides Fragilis 839 (BF839), the secondary generalized tonic-clonic seizures disappeared, the frequency of complex partial seizures decreased by 70%, and the duration of each episode was shortened. Additionally, long-term diarrhea associated with antiretroviral therapy for AIDS resolved, and the syphilis serofast reaction turned negative. No serious adverse reactions were observed during the three-year follow up. Conclusions This case report suggests that the specific gut microbiota preparation could possibly improve refractory epilepsy in HIV patients while also potentially alleviating adverse reactions to antiretroviral drugs and concurrent syphilis infection. Our case may provide a new perspective for the treatment of HIV infection/AIDS.

The development, evaluation, performance, and validation of micro-PCR and extractor for the quantification of HIV-1 &-2 RNA

HIV infection has been a global public health threat and overall reported ~ 40 million deaths. Acquired immunodeficiency syndrome (AIDS) is attributed to the retroviruses (HIV-1/2), disseminated through various body fluids. The temporal progression of AIDS is in context to the rate of HIV-1 infection, which is twice as protracted in HIV-2 transmission. Q-PCR is the only available method that requires a well-developed lab infrastructure and trained personnel. Micro-PCR, a portable Q-PCR device, was developed by Bigtec Labs, Bangalore, India. It is simple, accurate, fast, and operationalised in remote places where diagnostic services are inaccessible in developing countries. This novel micro-PCR determines HIV-1 and HIV-2 viral load using a TruePrep™ extractor device for RNA isolation. Five ml blood samples were collected at the blood collection centre at AIIMS, New Delhi, India. Samples were screened for serology, and a comparison of HIV-1/2 RNA was done between qPCR and micro-PCR in the samples. The micro-PCR assay of HIV-RNA has compared well with those from real-time PCR (r = 0.99, i < 0.002). Micro-PCR has good inter and intra-assay reproducibility over a wide dynamic range (1.0 × 102–1.0 × 108 IU/ml). The linear dynamic range was 102–108 IU/ml. The clinical and analytical specificity of the assay was comparable, i.e., 100%. Intra-assay and inter-assay coefficients of variation ranged from 1.17% to 3.15% and from 0.02% to 0.46%, respectively. Moreover, due to the robust, simple, and empirical method, the Probit analysis has also been done for qPCR LODs to avoid uncertainties in target recoveries. The micro-PCR is reliable, accurate, and reproducible for early detection of HIV-1 and HIV-2 viral loads simultaneously. Thus, it can easily be used in the field and in remote places where quantification of both HIV-1/2 is not reachable.

HIV Infection, Antiretroviral Drugs, and the Vascular Endothelium.

Endothelial cell activation, injury, and dysfunction underlies the pathophysiology of vascular diseases and infections associated with vascular dysfunction, including human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome. Despite viral suppression with combination antiretroviral therapy (ART), people living with HIV (PLWH) are prone to many comorbidities, including neurological and neuropsychiatric complications, cardiovascular and metabolic diseases, premature aging, and malignancies. HIV and viral proteins can directly contribute to the development of these comorbidities. However, with the continued high prevalence of these comorbidities despite viral suppression, it is likely that ART or some antiretroviral (ARVs) drugs contribute to the development and persistence of comorbid diseases in PLWH. These comorbid diseases often involve vascular activation, injury, and dysfunction. The purpose of this manuscript is to review the current literature on ARVs and the vascular endothelium in PLWH, animal models, and in vitro studies. I also summarize evidence of an association or lack thereof between ARV drugs or drug classes and the protection or injury/dysfunction of the vascular endothelium and vascular diseases.

Understanding HIV/AIDS dynamics: insights from CD4+T cells, antiretroviral treatment, and country-specific analysis.

In this article, we present a mathematical model for human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS), taking into account the number of CD4+T cells and antiretroviral treatment. This model is developed based on the susceptible, infected, treated, AIDS (SITA) framework, wherein the infected and treated compartments are divided based on the number of CD4+T cells. Additionally, we consider the possibility of treatment failure, which can exacerbate the condition of the treated individual. Initially, we analyze a simplified HIV/AIDS model without differentiation between the infected and treated classes. Our findings reveal that the global stability of the HIV/AIDS-free equilibrium point is contingent upon the basic reproduction number being less than one. Furthermore, a bifurcation analysis demonstrates that our simplified model consistently exhibits a transcritical bifurcation at a reproduction number equal to one. In the complete model, we elucidate how the control reproduction number determines the stability of the HIV/AIDS-free equilibrium point. To align our model with the empirical data, we estimate its parameters using prevalence data from the top four countries affected by HIV/AIDS, namely, Eswatini, Lesotho, Botswana, and South Africa. We employ numerical simulations and conduct elasticity and sensitivity analyses to examine how our model parameters influence the control reproduction number and the dynamics of each model compartment. Our findings reveal that each country displays distinct sensitivities to the model parameters, implying the need for tailored strategies depending on the target country. Autonomous simulations highlight the potential of case detection and condom use in reducing HIV/AIDS prevalence. Furthermore, we identify that the quality of condoms plays a crucial role: with higher quality condoms, a smaller proportion of infected individuals need to use them for the potential eradication of HIV/AIDS from the population. In our optimal control simulations, we assess population behavior when control interventions are treated as time-dependent variables. Our analysis demonstrates that a combination of condom use and case detection, as time-dependent variables, can significantly curtail the spread of HIV while maintaining an optimal cost of intervention. Moreover, our cost-effectiveness analysis indicates that the condom use intervention alone emerges as the most cost-effective strategy, followed by a combination of case detection and condom use, and finally, case detection as a standalone strategy.

Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome Prevention Behavior among Men Who Have Sex with Men (MSM) in the Gender Sexuality Group Community

Between January-August 2019, Central Sulawesi Province recorded 235 HIV and 94 AIDS cases. Data from the Gender Sexuality Group indicates that their community houses 28 MSM, 18 of whom are living with HIV/AIDS. This research seeks to understand HIV/AIDS prevention behaviors among MSM at the Gender Sexuality Group Community in Palu City. A qualitative case study approach was employed, with data collection through triangulation techniques including in-depth interviews, observation, and documentation using interview guides. Results show that MSM within the Gender Sexuality Group community demonstrate good knowledge of HIV/AIDS prevention. However, four out of seven informants still engage in risky behaviors. To address this, community and healthcare workers need to provide better infrastructure for HIV/AIDS prevention and treatment, especially for MSM living with HIV. Collaborative support from healthcare workers and the community is crucial in strengthening and assisting MSM. It's recommended that the Gender Sexuality Group community continues to conduct Communication, Information, and Education (CIE) activities to enhance MSM knowledge, particularly about HIV transmission and prevention. All MSM should undergo HIV testing at least twice a year. The community could organize seminars featuring disguised MSM PLWHA (People Living with HIV/AIDS) from outside the city as resource persons to increase awareness about HIV/AIDS within the key community

Assessing the Causal Relationship Between HIV Infection and AIDS Development: A scoping Review

In scoping review, the causal relationship between HIV infection and AIDS development using the Gordis criteria of Epidemiology was explored. The review aimed to provide a concise overview of existing literature and highlight key findings in this area.