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Michaeli DT, Michaeli T, Albers S, Boch T, Michaeli JC. Special FDA designations for drug development: orphan, fast track, accelerated approval, priority review, and breakthrough therapy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:979-997. [PMID: 37962724 PMCID: PMC11283430 DOI: 10.1007/s10198-023-01639-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/02/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Over the past decades, US Congress enabled the US Food and Drug Administration (FDA) to facilitate and expedite drug development for serious conditions filling unmet medical needs with five special designations and review pathways: orphan, fast track, accelerated approval, priority review, and breakthrough therapy. OBJECTIVES This study reviews the FDA's five special designations for drug development regarding their safety, efficacy/clinical benefit, clinical trials, innovation, economic incentives, development timelines, and price. METHODS We conducted a keyword search to identify studies analyzing the impact of the FDA's special designations (orphan, fast track, accelerated approval, priority review, and breakthrough therapy) on the safety, efficacy/clinical benefit, trials, innovativeness, economic incentives, development times, and pricing of new drugs. Results were summarized in a narrative overview. RESULTS Expedited approval reduces new drugs' time to market. However, faster drug development and regulatory review are associated with more unrecognized adverse events and post-marketing safety revisions. Clinical trials supporting special FDA approvals frequently use small, non-randomized, open-label designs. Required post-approval trials to monitor unknown adverse events are often delayed or not even initiated. Evidence suggests that drugs approved under special review pathways, marketed as "breakthroughs", are more innovative and deliver a higher clinical benefit than those receiving standard FDA approval. Special designations are an economically viable strategy for investors and pharmaceutical companies to develop drugs for rare diseases with unmet medical needs, due to financial incentives, expedited development timelines, higher clinical trial success rates, alongside greater prices. Nonetheless, patients, physicians, and insurers are concerned about spending money on drugs without a proven benefit or even on drugs that turn out to be ineffective. While European countries established performance- and financial-based managed entry agreements to account for this uncertainty in clinical trial evidence and cost-effectiveness, the pricing and reimbursement of these drugs remain largely unregulated in the US. CONCLUSION Special FDA designations shorten clinical development and FDA approval times for new drugs treating rare and severe diseases with unmet medical needs. Special-designated drugs offer a greater clinical benefit to patients. However, physicians, patients, and insurers must be aware that special-designated drugs are often approved based on non-robust trials, associated with more unrecognized side effects, and sold for higher prices.
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Affiliation(s)
- Daniel Tobias Michaeli
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
- TUM School of Management, Technical University of Munich, Munich, Germany.
| | - Thomas Michaeli
- Department of Personalized Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
- DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
- Division of Personalized Medical Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Albers
- Department of Orthopaedics and Sport Orthopaedics, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Tobias Boch
- Department of Personalized Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
- DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
- Division of Personalized Medical Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Parker R. Epidemias de significação e políticas de saúde global: Do fim da AIDS ao fim da ampliação da resposta global da AIDS. Glob Public Health 2024; 19:2386920. [PMID: 39155786 DOI: 10.1080/17441692.2024.2386920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/02/2024] [Indexed: 08/20/2024]
Abstract
RESUMONas últimas quatro décadas e meia, a história da pandemia de HIV passou por várias fases que podem ser pensadas como ondas distintas em termos da resposta social e política que a pandemia gerou. Ao longo dessa história, houve batalhas importantes sobre os significados e interpretações que a resposta à pandemia produziu. Mas, especialmente na última década, parece haver uma crescente desconexão entre as alegações de sucesso feitas por muitas agências globais de saúde e formuladores de políticas e a realidade empírica que essas alegações encobrem. Este comentário argumenta que a 'ampliação' ('scale-up') da resposta à pandemia essencialmente chegou ao fim e enfatiza a importância de um debate político mais honesto sobre o estado atual da resposta global ao HIV. Argumenta que, a fim de melhor definir os rumos que tal resposta deve tomar no futuro, exige que pensemos criticamente sobre as formas como essa resposta se desenvolveu historicamente, que reconheçamos os avanços significativos alcançados nas últimas décadas, mas também que reconheçamos a encruzilhada a que chegou em meados da década de 2020.
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Affiliation(s)
- Richard Parker
- Associação Brasileira Interdisciplinar de AIDS (ABIA), Rio de Janeiro, Brasil
- Sexuality Policy Watch (SPW), Rio de Janeiro, Brasil
- Departamento de Ciências Sociomédicas, Columbia University, Nova York, NY, EUA
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Yang L, Sun Z. Are All Gay Men at Risk of Developing HIV/AIDS? Why China's Mass HIV Testing Has Majorly Targeted Gay Men in the Era of Biomedicalization. Am J Mens Health 2024; 18:15579883241230165. [PMID: 38321807 PMCID: PMC10851740 DOI: 10.1177/15579883241230165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
Global HIV/AIDS responses have been increasingly biomedically dominated over the past years. In line with this shifting paradigm, China has prioritized mass HIV testing as a practical approach to controlling its HIV/AIDS epidemics among at-risk populations, especially gay men and other men who have sex with men (MSM). This study analyzed why China's mass HIV testing mainly targeted gay men by understanding the perspectives of public health professionals, community-based organization (CBO) workers, and gay men. In addition, this study revealed the tensions and unintended consequences of HIV/AIDS prevention and the representation of gay men in China. The study involved fieldwork conducted in a major city in Eastern China from 2015 to 2019. Semi-structured interviews were held with participants from the three abovementioned groups (N = 25). The study identified four processes concerning why gay men are mainly targeted for HIV testing. Some public health professionals believe that being a gay man is equivalent to having HIV/AIDS risks. In addition, this study particularly noted tensions between public health professionals and gay men, including gay men-identified CBO workers, over whether mass HIV testing should target gay men or anyone who engaged in sexual risk behaviors. This study argued that a particular focus on gay men due to pursuing biomedical advances in HIV/AIDS prevention seems to have unintendedly stereotyped gay men based on the presumptions that they are at risk of developing HIV/AIDS. In addition, this study corresponded to the broader social scientific discussion concerning whether HIV/AIDS intervention should target specific sexual risk practices or sexual identity/population.
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Affiliation(s)
- Lei Yang
- School of Public Administration, Beihang University, Beijing, P.R. China
| | - Zhipeng Sun
- Shanghai Technician School; Higher Vocational and Technical College, Shanghai University of Engineering Science, Shanghai, P.R. China
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Grangeiro A, Ferraz D, Magno L, Zucchi EM, Couto MT, Dourado I. HIV epidemic, prevention technologies, and the new generations: trends and opportunities for epidemic response. CAD SAUDE PUBLICA 2023; 39Suppl 1:e00144223. [PMID: 38088648 DOI: 10.1590/0102-311xpt144223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 12/18/2023] Open
Abstract
The United Nations has underscored the possibility of ending the HIV epidemic as a public health problem. However, an increase in the incidence among adolescents and youth has indicated a greater distance between HIV responses and the specificities of the new generations, which can maintain the epidemic for an extended period. Regards this matter, it is debated that the provision of a range of preventive methods, even if highly effective, and a conservatism that has internalized stigma within government policies, hinder the proper and essential dialogue between current preventive policies and the needs of the new generations. These generations are marked by a social representation of AIDS as a mild disease, by new gender and sexuality performances, and by the search for a more critical role in affective and sexual encounters, which includes frequent use of dating apps and substances. The hierarchy of the delivery of prevention methods is presented as a proposal for a new policy, prioritizing pre-exposure prophylaxis (PrEP) and addressing the social determinants of the HIV epidemic, including strategies to mitigate stigma. The importance of the participation of adolescents and youth in constructing the policy and the need for an intersectoral response are also reinforced.
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Affiliation(s)
| | - Dulce Ferraz
- Diretoria Regional de Brasília, Fundação Oswaldo Cruz, Brasília, Brasil
| | - Laio Magno
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brasil
| | - Eliana Miura Zucchi
- Programa de Pós-graduação em Saúde Coletiva, Universidade Católica de Santos, Santos, Brasil
| | | | - Ines Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
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Ganbaatar D, Vaughan C, Akter S, Bohren MA. Exploring the identities and experiences of young queer people in Mongolia using visual research methods. CULTURE, HEALTH & SEXUALITY 2022; 24:1695-1712. [PMID: 34743678 DOI: 10.1080/13691058.2021.1998631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
There is limited evidence about the lives of queer Mongolian youth. This is despite mental health problems being a pressing concern among young Mongolians, and international evidence suggesting queer youth may experience more mental health challenges than their non-queer peers. We explored the experiences of queer youth in their immediate environments and navigation of their identities in Mongolian society. In this study, twelve young queer-identifying people aged 18-25 from Ulaanbaatar, Mongolia participated in photo-elicitation interviews. Visual research methods allowed participants to generate rich (visual, textual, and oral) data about their lived experiences. We analysed data using a thematic approach and identified three main themes, each with three sub-themes. Participants reported that peer bullying and gendered expectations at school, heteronormativity and gender role expectation in family settings, along with strong stereotypes about queerness in broader society, substantially impacted participants' mental and physical wellbeing. Mongolian queer youth need strong support from their immediate environments, such as school and family. Stigma and misconception around queerness remain persistent among the public but young people are continuously resisting the prejudice expressed towards them. Understanding these challenges is crucial to increasing inclusivity in policies and programmes to enhance the wellbeing of young queer Mongolians.
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Affiliation(s)
- Dorjjantsan Ganbaatar
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Health Programme, LGBT Centre (Mongolia), Ulaanbaatar, Mongolia
| | - Cathy Vaughan
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Shahinoor Akter
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
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Garney WR, Wilson KL, Garcia KM, Muraleetharan D, Esquivel CH, Spadine MN, Panjwani S, Ajayi KV. Supporting and Enabling the Process of Innovation in Public Health: The Framework for Public Health Innovation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10099. [PMID: 36011734 PMCID: PMC9407913 DOI: 10.3390/ijerph191610099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
This manuscript introduces a new framework for creating innovations in public health-the Framework for Public Health Innovation. The framework was developed through a longitudinal qualitative research study that investigated the process of creating innovative adolescent health programs. Interviews were conducted with a national sample of 26 organizations over two time points. Data collection focused on the process of innovative program development; organizational capacity; training; and technical assistance needs, successes, and barriers. The framework was developed and modified based on interview findings and expert advice; then, the final framework was validated with content experts. The framework illustrates a dynamic process of innovation that begins with dissatisfaction with the status quo, and then, illustrates three necessary components for innovation-space, process, and partnerships. Four categories of innovation, which range in complexity, are proposed: (1) creating a new component to an existing program, (2) adapting an existing program to meet new needs, (3) taking an alternative approach to addressing an existing program, and (4) reframing a health problem from a new perspective. As illustrated by a feedback loop, the resulting innovations disrupt the status quo. This model can be applied to any content area in public health and is useful for both research and practitioners.
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Preventive Measures against Pandemics from the Beginning of Civilization to Nowadays—How Everything Has Remained the Same over the Millennia. J Clin Med 2022; 11:jcm11071960. [PMID: 35407571 PMCID: PMC8999828 DOI: 10.3390/jcm11071960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023] Open
Abstract
As of 27 March 2022, the β-coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 487 million individuals worldwide, causing more than 6.14 million deaths. SARS-CoV-2 spreads through close contact, causing the coronavirus disease 2019 (COVID-19); thus, emergency lockdowns have been implemented worldwide to avoid its spread. COVID-19 is not the first infectious disease that humankind has had to face during its history. Indeed, humans have recurrently been threatened by several emerging pathogens that killed a substantial fraction of the population. Historical sources document that as early as between the 10th and the 6th centuries BCE, the authorities prescribed physical–social isolation, physical distancing, and quarantine of the infected subjects until the end of the disease, measures that strongly resemble containment measures taken nowadays. In this review, we show a historical and literary overview of different epidemic diseases and how the recommendations in the pre-vaccine era were, and still are, effective in containing the contagion.
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Abstract
Rheumatic heart disease (RHD) is a complication of untreated throat infection by Group A beta-hemolytic streptococcus with a high prevalence among socioeconomically disadvantaged populations. Despite its high incidence and prevalence, RHD prevention is not a priority in major global health discussions. The reasons for the apparent neglect are multifactorial, including underestimated morbidity and mortality burden, underappreciated economic burden, lack of public awareness, and lack of sustainable investment. In this review, we recommend multisectoral collaboration to tackle the burden of RHD by engaging the public, health experts, and policymakers; augmenting funding for clinical care; improving distribution channels for prophylaxis, and increasing research and innovation as critical interventions to save millions of people from preventable morbidity and mortality.
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Nanotechnology Applications of Flavonoids for Viral Diseases. Pharmaceutics 2021; 13:pharmaceutics13111895. [PMID: 34834309 PMCID: PMC8625292 DOI: 10.3390/pharmaceutics13111895] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/14/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022] Open
Abstract
Recent years have witnessed the emergence of several viral diseases, including various zoonotic diseases such as the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Other viruses, which possess pandemic-causing potential include avian flu, Ebola, dengue, Zika, and Nipah virus, as well as the re-emergence of SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) coronaviruses. Notably, effective drugs or vaccines against these viruses are still to be discovered. All the newly approved vaccines against the SARS-CoV-2-induced disease COVID-19 possess real-time possibility of becoming obsolete because of the development of ‘variants of concern’. Flavonoids are being increasingly recognized as prophylactic and therapeutic agents against emerging and old viral diseases. Around 10,000 natural flavonoid compounds have been identified, being phytochemicals, all plant-based. Flavonoids have been reported to have lesser side effects than conventional anti-viral agents and are effective against more viral diseases than currently used anti-virals. Despite their abundance in plants, which are a part of human diet, flavonoids have the problem of low bioavailability. Various attempts are in progress to increase the bioavailability of flavonoids, one of the promising fields being nanotechnology. This review is a narrative of some anti-viral dietary flavonoids, their bioavailability, and various means with an emphasis on the nanotechnology system(s) being experimented with to deliver anti-viral flavonoids, whose systems show potential in the efficient delivery of flavonoids, resulting in increased bioavailability.
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Viljoen L, Hoddinott G, Malunga S, Vanqa N, Mhlakwaphalwa T, Marthinus A, Mcimeli K, Bond V, Seeley J, Bock P, Hayes R, Reynolds L. Women's sexual scripting in the context of universal access to antiretroviral treatment-findings from the HPTN 071 (PopART) trial in South Africa. BMC Womens Health 2021; 21:370. [PMID: 34689783 PMCID: PMC8543855 DOI: 10.1186/s12905-021-01513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 10/14/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND HIV treatment-based prevention modalities present new opportunities for women to make decisions around sex, intimacy, and prevention. The Universal test and treat (UTT) strategy, where widespread HIV testing is implemented and all people with HIV can access treatment, has the potential to change how sex is understood and HIV prevention incorporated into sexual relationships. We use the frame of sexual scripting to explore how women attribute meaning to sex relative to UTT in an HIV prevention trial setting. Exploring women's sexual narratives, we explored how HIV prevention feature in the sexual scripts for women who had access to UTT in South Africa (prior to treatment guideline changes) and increased HIV prevention messaging, compared to places without widespread access to HIV testing and immediate access to treatment. METHODS We employed a two-phased thematic analysis to explore longitudinal qualitative data collected from 71 women (18-35 years old) between 2016 and 2018 as part of an HIV prevention trial in the Western Cape Province, South Africa. Of the participants, 58/71 (82%) were from intervention communities while 13/71 (18%) lived in control communities without access to UTT. Twenty participants self-disclosed that they were living with HIV. RESULTS We found no narrative differences between women who had access to UTT and those who did not. HIV and HIV prevention, including treatment-based prevention modalities, were largely absent from women's thinking about sex. In their scripts, women idealised romantic sex, positioned sex as 'about relationships', and described risky sex as 'other'. When women were confronted by HIV risk (for example, when a partner disclosed his HIV-positive status) this created a point of disjuncture between this new perception of risk and their accepted relationship scripts. CONCLUSION These findings suggest that HIV-negative women did not include their partners' use of antiretroviral therapy in their sexual partnership choices. For these women, the preventive benefits of UTT are experienced passively-through community-wide viral suppression-rather than through their own behaviour change explicitly related to the availability of treatment as prevention. We propose that prevention-based modalities should be made available and supported and framed as an intervention to promote relationship well-being.
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Affiliation(s)
- Lario Viljoen
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
- Department of Sociology and Social Anthropology, Stellenbosch University, Stellenbosch, South Africa.
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Samantha Malunga
- AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Nosivuyile Vanqa
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Tembeka Mhlakwaphalwa
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Arlene Marthinus
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Khanyisa Mcimeli
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Virginia Bond
- Zambart, School of Public Health, Ridgeway Campus, University of Zambia, Lusaka, Zambia
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Janet Seeley
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter Bock
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Richard Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Lindsey Reynolds
- Department of Sociology and Social Anthropology, Stellenbosch University, Stellenbosch, South Africa
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Mwale M, Muula AS. Stakeholder acceptability of the risk reduction behavioural model [RRBM] as an alternative model for adolescent HIV risk reduction and sexual behavior change in Northern Malawi. PLoS One 2021; 16:e0258527. [PMID: 34665811 PMCID: PMC8525741 DOI: 10.1371/journal.pone.0258527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/29/2021] [Indexed: 11/30/2022] Open
Abstract
We sought to assess stakeholder acceptability of a risk reduction behavioural model [RRBM] designed for adolescent HIV risk reduction and whose efficacy we tested in selected schools in Northern Malawi. We used qualitative procedures in sampling, data collection and data analysis. Our data collection instrument was the semi-structured interview and we applied thematic content analysis to establish stakeholder evaluations of the RRBM model. The study population included10 experts working within key organizations and teachers from two schools. The organizations were sampled as providers, implementers and designers of interventions while schools were sampled as providers and consumers of interventions. Individual study participants were recruited purposively through snowball sampling. Results showed consensus among participants on the acceptability, potential for scale up and likelihood of model sustainability if implemented. In essence areas to consider improving and modifying included: focus on the rural girl child and inclusion of an economic empowerment component to target the underlying root causes of HIV risk taking behavior. Stakeholders also recommended intervention extension to out of school adolescent groups as well as involvement of traditional leaders. Involvement of parents and religious leaders in intervention scale up was also highlighted. The study serves as a benchmark for stakeholder involvement in model and intervention evaluation and as a link between researchers and project implementers, designers as well as policy makers to bridge the research to policy and practice gap.
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Affiliation(s)
- Marisen Mwale
- Department of Public Health, School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Education Foundations, Mzuzu University, Mzuzu, Malawi
| | - Adamson S. Muula
- Department of Public Health, School of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
- Africa Center of Excellence in Public Health and Herbal Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
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Donenberg GR, Atujuna M, Merrill KG, Emerson E, Ndwayana S, Blachman-Demner D, Bekker LG. An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa: IMARA-SA study protocol. BMC Public Health 2021; 21:1708. [PMID: 34544403 PMCID: PMC8454166 DOI: 10.1186/s12889-021-11727-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa has the world's largest HIV epidemic, but South African adolescent girls and young women (AGYW) acquire HIV at twice the rate of and seroconvert on average 5-7 years earlier than their male peers. Female caregivers (FC) are an untapped resource for HIV/STI prevention in South Africa and offer a novel opportunity to strengthen AGYW prevention efforts. This study will evaluate the effectiveness and cost-effectiveness of an evidence-based mother-daughter HIV/STI prevention program tested in the United States and adapted for South Africa, Informed Motivated Aware and Responsible Adolescents and Adults (IMARA), to decrease STI incident infections and increase HIV testing and counseling (HTC) and PrEP uptake in AGYW. METHODS This is a 2-arm individually randomized controlled trial comparing IMARA to a family-based control program matched in time and intensity with 525 15-19-year-old Black South African AGYW and their FC-dyads in Cape Town's informal communities. AGYW will complete baseline, 6-, and 12-month assessments. Following randomization, AGYW-FC dyads will participate in a 2-day group workshop (total 10 h) that includes joint and separate mother and daughter activities. Primary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 6 months. Secondary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 12 months, sexual behavior (e.g., condom use, number of partners), HIV incidence, and ART/PrEP adherence and intervention cost-effectiveness. AGYW who test positive for a STI will receive free treatment at the study site. HIV positive participants will be referred to ART clinics. DISCUSSION Primary prevention remains the most viable strategy to stem new STI and HIV transmissions. HIV and STI disparities go beyond individual level factors, and prevention packages that include supportive relationships (e.g., FC) may produce greater reductions in HIV-risk, improve HTC and PrEP uptake, and increase linkage, retention, and adherence to care. Reducing new HIV and STI infections among South African AGYW is global public health priority. TRIAL REGISTRATION ClinicalTrials.gov Number NCT04758390 , accepted 02/16/2021.
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Affiliation(s)
- Geri R Donenberg
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA.
| | | | - Katherine G Merrill
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA
| | - Erin Emerson
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA
| | | | - Dara Blachman-Demner
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD, USA
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Safakish M, Hajimahdi Z, Aghasadeghi MR, Vahabpour R, Zarghi A. Design, Synthesis, Molecular Modeling and Anti-HIV Assay of Novel Quinazolinone Incorporated Coumarin Derivatives. Curr HIV Res 2021; 18:41-51. [PMID: 31820700 DOI: 10.2174/1570162x17666191210105809] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND The emergence of drug-resistant viral strains has created the need for the development of novel anti-HIV agents with a diverse structure that targets key enzymes in the HIV lifecycle. OBJECTIVE Considering the pharmacophore of integrase inhibitors, one of the validated targets for anti-HIV therapy, we designed a quinazolinone incorporated coumarin scaffold to affect HIV. METHODS Coumarin is a beta enol ester and also a well-known drug scaffold. Designed structures were prepared using a one-pot three-component reaction from 3-amino-4-hydroxycoumarin, isatoic anhydride and benzaldehyde derivatives. RESULTS In vitro anti-HIV and cytotoxicity assay indicated that more than half of the compounds had EC50 values lower than 50 µM. Unsubstituted phenyl derivative showed the highest activity and selectivity with an EC50 value of 5 µM and a therapeutic index of 7. Compounds were docked into the integrase active site to investigate the probable mechanism of action. Accordingly, the hydroxyl moiety of coumarin along with the carbonyl of the quinazolinone ring could function as the metal chelating group. Quinazolinone and phenyl groups interact with side chains of IN residues, as well. CONCLUSION Here, a novel anti-HIV scaffold is represented for further modification and in-vivo studies.
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Affiliation(s)
- Mahdieh Safakish
- Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Hajimahdi
- Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Rouhollah Vahabpour
- Medical Lab Technology Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afshin Zarghi
- Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Jahangiry L, Aliyari Z, Ponnet K. A Study on the Knowledge, Attitudes, and Behaviors of Pregnant Women Regarding HIV and Routine Rapid Testing: An Assessment in a High-Risk Marginal Area. Healthcare (Basel) 2021; 9:healthcare9070793. [PMID: 34202708 PMCID: PMC8303328 DOI: 10.3390/healthcare9070793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 11/18/2022] Open
Abstract
Acquired immunodeficiency syndrome (AIDS) is one of the main obstacles to communities’ development. The disease mostly involves active and productive population groups. This study aimed to determine the knowledge, attitudes, and behaviors of pregnant women regarding HIV prevention and rapid HIV tests. Pregnant women who were referred to the local health centers and who were willing to participate in the study were interviewed. To collect data, a standard questionnaire was used among 200 pregnant women in eight local health centers of Kermanshah, Iran. The survey contained 50 questions on demographic characteristics and the knowledge, attitudes, and behaviors regarding HIV/AIDS prevention and rapid tests for pregnant women. Although the majority (82.5%) of the pregnant women knew that mother-to-child HIV transmission during pregnancy was possible, fewer than half (48.2%) of them knew that HIV can be transmitted from mother to child through breastfeeding. Only 22.5% of pregnant women knew that a Cesarean section for HIV-positive mothers is recommended. The mean attitudes of pregnant women toward HIV prevention and HIV rapid testing were 4.5 (SD = 0.4) and 4 (SD = 0.3), respectively. Of the women, 11.5% had participated in an HIV rapid test counseling class, and 25.5% had participated in HIV education and counseling classes. The low knowledge of mothers regarding HIV transmission highlights the need for education and counseling classes and campaigns to improve knowledge and behaviors related to HIV prevention, especially during pregnancy for women in marginal regions.
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Affiliation(s)
- Leila Jahangiry
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran;
- Correspondence: (L.J.); (K.P.)
| | - Zahra Aliyari
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran;
| | - Koen Ponnet
- Department of Communication Sciences, Imec-Mict-Ghent University, 9000 Gent, Belgium
- Correspondence: (L.J.); (K.P.)
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15
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Hoang NT, Nguyen NTT, Nguyen QN, Bollinger JW, Tran BX, Do NT, Nguyen THT, Nguyen HLT, Nguyen TH, Latkin CA, Ho CSH, Ho RCM. Survival Outcomes of Vietnamese People with HIV after Initiating Antiretroviral Treatment: Role of Clinic-Related Factors. AIDS Behav 2021; 25:1626-1635. [PMID: 33244641 DOI: 10.1007/s10461-020-03079-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 01/04/2023]
Abstract
Given the rapid development of HIV clinics in Vietnam, this study evaluates the infrastructure surrounding this expansion, identifying clinic-related factors that impact survival outcomes. A retrospective longitudinal study was conducted among people living with HIV (PLWH) who initiated antiretroviral therapy (ART) between 2011 and 2015 among 62 ART clinics in 15 provinces. The mortality rate during the 717674.1 person-years of observation (PYO) was 0.29/100 PYO. Location in rural areas (versus urban) and in Central Vietnam (versus Northern Vietnam) were associated with higher risk of mortality. The risk was lower among clinics that had peer-educators. As Vietnam's HIV/AIDS program continues to expand, this data supports increasing resource allocation for rural clinics, incorporation of ART with the community's existing healthcare infrastructure in its efforts to decentralize, and integration of services to reflect patients' anticipated needs.
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Affiliation(s)
| | | | - Quang Nhat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Université, Claude Bernard Lyon 1, Villeurbanne, France
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nhan Thi Do
- Vietnam Authority of HIV/AIDS Control, Hanoi, Vietnam
| | - Trang Huyen Thi Nguyen
- Center of Excellence in Pharmacoeconomics and Management, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Huong Lan Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
- Faculty of Nursing, Duy Tan University, Da Nang, Vietnam.
| | - Trang Ha Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Nursing, Duy Tan University, Da Nang, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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16
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Janssen R, Engel N, Pant Pai N, Esmail A, Dheda K, Thomas R, Krumeich A. 'You're only there on the phone'? A qualitative exploration of community, affect and agential capacity in HIV self-testing using a smartphone app. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:591-606. [PMID: 33634889 PMCID: PMC8451867 DOI: 10.1111/1467-9566.13242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 05/08/2023]
Abstract
Mobile health (mHealth) technologies for HIV care are developed to provide diagnostic support, health education, risk assessment and self-monitoring. They aim to either improve or replace part of the therapeutic relationship. Part of the therapeutic relationship is affective, with the emergence of feelings and emotion, yet little research on mHealth for HIV care focuses on affect and HIV testing practices. Furthermore, most of the literature exploring affect and care relations with the introduction of mHealth is limited to the European and Australian context. This article explores affective dimensions of HIV self-testing using a smartphone app strategy in Cape Town, South Africa and Montréal, Canada. This study is based on observation notes, 41 interviews and 1 focus group discussion with study participants and trained HIV healthcare providers from two quantitative studies evaluating the app-based self-test strategy. Our paper reveals how fear, apathy, judgement, frustration and comfort arise in testing encounters using the app and in previous testing experiences, as well as how this relates to care providers and test materials. Attending to affective aspects of this app-based self-testing practice makes visible certain affordances and limitations of the app within the therapeutic encounter and illustrates how mHealth can contribute to HIV care.
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Affiliation(s)
- Ricky Janssen
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
| | - Nora Engel
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
| | - Nitika Pant Pai
- Division of Clinical EpidemiologyDepartment of MedicineMcGill University and Research Institute of the McGill University Health CentreMontréalQCCanada
| | - Aliasgar Esmail
- Division of PulmonologyDepartment of MedicineCentre for Lung Infection and ImmunityUniversity of Cape TownCape TownSouth Africa
| | - Keertan Dheda
- Division of PulmonologyDepartment of MedicineCentre for Lung Infection and ImmunityUniversity of Cape TownCape TownSouth Africa
- Faculty of Infectious and Tropical DiseasesDepartment of Immunology and InfectionLondon School of Hygiene and Tropical MedicineLondonUK
| | | | - Anja Krumeich
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
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A Qualitative Study of Community-Based HIV/AIDS Prevention Interventions, Programs, and Projects for Rural and Remote Regions in Canada: Implementation Challenges and Lessons Learned. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 26:E28-E37. [PMID: 31765353 DOI: 10.1097/phh.0000000000000878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Fifteen percent to 20% of the Canadian and American populations live outside urban areas, and despite growing regional HIV/AIDS-related health disparities, there is little published research specific to rural or remote (rural/remote) HIV/AIDS prevention programming. OBJECTIVE To document implementation challenges, lessons learned, and evaluation approaches of promising and proven HIV/AIDS prevention programs and interventions developed and delivered by organizations with rural/remote catchment areas in Canada to provide a foundation for information sharing among agencies. DESIGN Qualitative study design, using a community-based participatory research approach. We screened Canadian community-based organizations with an HIV/AIDS prevention mandate to determine whether they offered services for rural/remote populations and invited organizational representatives to participate in semistructured telephone interviews. Interviews were audio-recorded and transcribed. Content analysis was used to identify categories in the interview data. SETTING Canada, provinces (all except Prince Edward Island), and territories (all except Nunavut). PARTICIPANTS Twenty-four community-based organizations. RESULTS Screening calls were completed with 74 organizations, of which 39 met study criteria. Twenty-four (62%) interviews were conducted. Populations most frequently served were Indigenous peoples (n = 13 organizations) and people who use drugs (n = 8 organizations) (categories not mutually exclusive). Key lessons learned included the importance of involving potential communities served in program development; prioritizing community allies/partnerships; building relationships; local relevancy and appropriateness; assessing community awareness or readiness; program flexibility/adaptability; and addressing stigma. Evaluation activities were varied and used for funder reporting and organizational learning. CONCLUSIONS Rural/remote HIV/AIDS programs across Canada expressed similar challenges and lessons learned, suggesting that there is potential for knowledge exchange, and development of a community of practice. Top-down planning and evaluation models may fail to capture program achievements in rural/remote contexts. The long-term engagement practices that render rural/remote programs promising do not always conform to planning and implementation requirements of limited funding.
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18
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An overview of global epidemics and the challenges faced. LEVERAGING ARTIFICIAL INTELLIGENCE IN GLOBAL EPIDEMICS 2021. [PMCID: PMC8342595 DOI: 10.1016/b978-0-323-89777-8.00011-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this chapter, the global epidemiological events causing infections that ravaged humanity throughout its existence by bringing hardship to rich and poor nations alike are aggregated and presented. Among these, the largest known epidemics including the recent COVID-19 pandemic will be highlighted along with the analysis of the actual and common reason behind the occurring of all the epidemic scenarios. The epidemiological and nonepidemiological impacts of the most fatal pandemics recorded in history are also discussed. The vulnerable countries’ readiness for coping with epidemics is assessed in terms of different indices. Furthermore, the current and future challenges in fighting epidemiological events are on the frontline and a number of preparative measures and strategies have been suggested.
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19
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Slagman S, Fessner WD. Biocatalytic routes to anti-viral agents and their synthetic intermediates. Chem Soc Rev 2021; 50:1968-2009. [DOI: 10.1039/d0cs00763c] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
An assessment of biocatalytic strategies for the synthesis of anti-viral agents, offering guidelines for the development of sustainable production methods for a future COVID-19 remedy.
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Affiliation(s)
- Sjoerd Slagman
- Institut für Organische Chemie und Biochemie
- Technische Universität Darmstadt
- Germany
| | - Wolf-Dieter Fessner
- Institut für Organische Chemie und Biochemie
- Technische Universität Darmstadt
- Germany
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20
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Benzian H, Niederman R. A Dental Response to the COVID-19 Pandemic-Safer Aerosol-Free Emergent (SAFER) Dentistry. Front Med (Lausanne) 2020; 7:520. [PMID: 32903453 PMCID: PMC7434942 DOI: 10.3389/fmed.2020.00520] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022] Open
Abstract
Dental services are significantly impacted by the COVID-19 pandemic. Almost all dental procedures carry a high infection risk for providers and patients due to the spread of aerosols. As a consequence, public health agencies and professional associations have issued guidelines for enhanced infection control and personal protection equipment and have also limited care to urgent or emergency services. However, there is no dental service concept for pandemic disaster preparedness or response that might be applied. Moreover, pathways to dental care provision in a post-pandemic future with persisting risks are needed. We propose Safer Aerosol-Free Emergent Dentistry (SAFER Dentistry) as one approach to dental services during and emerging from the pandemic. The concept's starting point is the identification of the most common patient needs. The next step is to replace common treatments addressing the most frequent needs with alternative interventions involving a lower infection risk because they do not generate aerosols. SAFER Dentistry is innovative, avoids risk, and responds to the requirements of a pandemic and post-pandemic emergency where the risk of airborne disease transmission remains high. SAFER Dentistry thereby ensures continuity of dental services while protecting providers and patients from infectious pathogens. Moreover, SAFER Dentistry allows dental service providers to remain operational and generate income even under pandemic conditions. Potential implementation and policy options for SAFER Dentistry include universal availability without co-payments by patients and a uniform bundled payment scheme for providers to simplify budgeting, reimbursement, and administration during a pandemic. Adaptations and adjustments of the concept are possible and encouraged as long as the principle of avoiding aerosol-generating procedures is maintained.
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21
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Pichetsurnthorn P, Pankow S, Sweet D, Kallail KJ. HIV Care in Asian and Pacific Islanders in Kansas. J Int Assoc Provid AIDS Care 2020; 18:2325958218821650. [PMID: 30798680 PMCID: PMC6748497 DOI: 10.1177/2325958218821650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A complex cultural dynamic within the Asian and Pacific Islander (APIs) population contributes to barriers in HIV care. This qualitative narrative study investigated how awareness, resource accessibility, and cultural taboo impact HIV care in APIs in Kansas. Eleven HIV-infected API patients were interviewed. Two evaluators independently completed a qualitative themes analysis. Important themes impacting HIV care included lack of awareness, sex as a taboo topic, and misconceptions about HIV infection. These factors create a closed community regarding HIV prevention and care. Clinicians must be aware of these barriers and provide specific culturally sensitive information and care to this population.
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Affiliation(s)
- Pie Pichetsurnthorn
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Stephanie Pankow
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Donna Sweet
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Ken James Kallail
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
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22
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Abstract
PURPOSE OF REVIEW Partnerships between academia and the community led to historic advances in HIV and paved the way for ongoing community engagement in research. Three decades later, we review the state of community engagement in HIV research, discuss best practices as supported by literature, explore innovations, and identify ongoing gaps in knowledge. RECENT FINDINGS The community of people living with and at risk for HIV remains actively involved in the performance of HIV research. However, the extent of participation is highly variable despite long standing and established principles and guidelines of good participatory practices (GPP) and community-based participatory research (CBPR). Current literature reveals that known barriers to successful community engagement continue to exist such as power differences, and poor scientific or cultural competency literacy. Several high-quality studies share their experiences overcoming these barriers and demonstrate the potential of CBPR through reporting of qualitative and quantitative outcomes. SUMMARY Greater time and attention should be placed on the development of community engagement in HIV research. A large body of literature, including innovative cross-cutting approaches, exists to guide and inform best practices and mitigate common barriers. However, we recognize that true growth and expansion of CBPR within HIV and in other fields will require a greater breadth of research reporting qualitative and quantitative outcomes.
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Affiliation(s)
- Maile Y Karris
- Department of Medicine, University of California San Diego, San Diego, California
| | - Karine Dubé
- University of North Carolina Gillings School of Global Public Health Leadership Program, Chapel Hill, North Carolina, USA
| | - Alison A Moore
- Department of Medicine, University of California San Diego, San Diego, California
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23
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Okonko IO, Makinde TS, Okonko BJ, Ogbu O. Immunological and epidemiological evaluation of EBV infections among HIV-1 infected individuals in Abakaliki, Nigeria supports the potential use of neutrophils as a marker of EBV in HIV disease progression and as useful markers of immune activation. J Immunoassay Immunochem 2019; 41:158-170. [PMID: 31885335 DOI: 10.1080/15321819.2019.1705483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Human herpesvirus 4 which is commonly known as Epstein-Barr virus (EBV) is one of the opportunistic pathogens that affect human immunodeficiency virus (HIV) infected individuals and it is the leading cause of death and cancer in humans. The study was designed to evaluate the prevalence of EBV among HIV-1 infected individuals in Abakaliki metropolis, Ebonyi State, Nigeria. A total of 91 HIV-1 infected individuals were collected from Mile 4 Hospital, Abakaliki, Ebonyi State, Nigeria. ELISA was used to determine the Epstein-Barr Nuclear Antigen (EBNA) IgG and IgM antibodies. Full blood count (FBC), white cell count (WBC) and differential counts were also determined using standard hematological methods. Of the 91 serum samples obtained from HIV-1 infected individuals, 87(95.6%) and 20(22.0%) samples were found to be positive for EBVNA IgG and IgM antibody respectively. All the age groups had significant IgG prevalence, but age groups ≤ 20 years, and ≥ 41 had the highest prevalence while age group 21-30 years was found to have a less rate of prevalence. Also, the highest seropositivity for IgM antibodies was observed in the age group 31-40 years (32.4%) while the age groups ≤20 years (0.0%) is the lowest. However, these differences were not statistically associated with PVL and EBVNA IgG (p = .4311) and IgM antibodies (p = .4861).Higher seropositivity of EBVNA IgG occurred among those with PVL 41-10,000 copies/mL (100.0%) and PVL 10,001 copies/mL and above (100.0%) compared to those with PVL less than or equal to 40 copies/mL (95.0%). While regarding EBVNA IgM antibodies, higher seropositivity of EBVNA IgM occurred among those with PVL less than or equal to 40 copies/mL (25.0%) compared to those with PVL 41-10,000 copies/mL (20.0%) and PVL 10,001 copies/mL and above (8.3%). There was a significant difference in Neutrophils p < .026 between the mean of females and males (40.9 ± 11.7 and 36 ± 31.1) infected with EBV IgM in HIV individuals. There was also a significant positive correlation between CD4 counts and the WBC, Lymphocytes, Eosinophils and the neutrophil among the HIV-1 individuals used for this study. The correlations observed between both CD4+ count and neutrophil support the potential use of neutrophils as a marker of EBV in HIV disease progression and as useful markers of immune activation.
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Affiliation(s)
- Iheanyi Omezuruike Okonko
- Virus Research Unit, Department of Microbiology, University of Port Harcourt, Port Harcourt, Nigeria
| | | | | | - Ogbonnaya Ogbu
- Department of Applied Microbiology, Ebonyi State University, Abakaliki, Nigeria
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Rojas Castro D, Delabre RM, Morel S, Michels D, Spire B. Community engagement in the provision of culturally competent HIV and STI prevention services: lessons from the French experience in the era of PrEP. J Int AIDS Soc 2019; 22 Suppl 6:e25350. [PMID: 31468710 PMCID: PMC6715944 DOI: 10.1002/jia2.25350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/24/2019] [Indexed: 12/27/2022] Open
Affiliation(s)
- Daniela Rojas Castro
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | | | - Stéphane Morel
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,AIDES, Pantin, France
| | - David Michels
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,AIDES, Pantin, France
| | - Bruno Spire
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,AIDES, Pantin, France
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25
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Eagen-Torkko M, Altman MR. Adapting Sexual Configurations Theory to Nursing. J Obstet Gynecol Neonatal Nurs 2019; 48:468-477. [PMID: 31100211 DOI: 10.1016/j.jogn.2019.04.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 10/26/2022] Open
Abstract
Lesbian, gay, bisexual, transgender, and queer/questioning people in the United States experience multiple health disparities related to sexual and reproductive health. Attempts to address these disparities have focused on sexual orientation and gender identity rather than on the specific aspects of sexuality that may be more relevant to an individual's health outcomes. This focus is also incongruent with a holistic approach to health and wellness interventions. We propose an adaptation of sexual configurations theory, a psychological theory with which to accurately describe different aspects of sexuality, to better position nurses to address these important disparity issues. We position sexual configurations theory within a contextual framework that incorporates aspects of trauma theory as a new way to evaluate individual sexuality in a holistic nursing context.
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26
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Arnold EM, Swendeman D, Harris D, Fournier J, Kozina L, Abdalian S, Rotheram MJ. The Stepped Care Intervention to Suppress Viral Load in Youth Living With HIV: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e10791. [PMID: 30810536 PMCID: PMC6414817 DOI: 10.2196/10791] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/30/2018] [Accepted: 12/13/2018] [Indexed: 12/16/2022] Open
Abstract
Background Among youth living with HIV (YLH) aged 12-24 years who have health care in the United States, only 30% to 40% are virally suppressed. YLH must achieve viral suppression in order to reduce the probability of infecting others as well as increasing the length and quality of their own life. Objective This randomized controlled trial aimed to evaluate the efficacy of an Enhanced Standard Care condition (n=110) compared to an Enhanced Stepped Care intervention condition (n=110) to increase viral suppression among YLH aged 12-24 years with established infection (not acutely infected). Methods YLH (N=220) who are not virally suppressed will be identified at homeless shelters, health clinics, and gay-identified community-based organizations in Los Angeles, CA, and New Orleans, LA. Informed consent will be obtained from all participants. YLH will be randomly assigned to one of two study conditions: Enhanced Standard Care, which includes standard clinical care plus an automated messaging and monitoring intervention (AMMI), or an Enhanced Stepped Care, which includes three levels of intervention (AMMI, Peer Support via social media plus AMMI, or Coaching plus Peer Support and AMMI). The primary outcome is viral suppression of HIV, and YLH will be assessed at 4-month intervals for 24 months. For the Enhanced Stepped Care intervention group, those who do not achieve viral suppression (via blood draw, viral load<200 copies/mL) at any 4-month assessment will “step up” to the next level of intervention. Secondary outcomes will be retention in care, antiretroviral therapy adherence, alcohol use, substance use, sexual behavior, and mental health symptoms. Results Recruitment for this study began in June 2017 and is ongoing. We estimate data collection to be completed by the end of 2020. Conclusions This is the first known application of an Enhanced Stepped Care intervention model for YLH. By providing the lowest level of intervention needed to achieve viral suppression, this model has the potential to be a cost-effective method of helping YLH achieve viral suppression and improve their quality of life. Trial Registration ClinicalTrials.gov NCT03109431; https://clinicaltrials.gov/ct2/show/NCT03109431 International Registered Report Identifier (IRRID) DERR1-10.2196/10791
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Affiliation(s)
- Elizabeth Mayfield Arnold
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX, United States
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Danielle Harris
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jasmine Fournier
- Section of Adolescent Medicine, Department of Pediatrics, Tulane University, New Orleans, LA, United States
| | - Leslie Kozina
- Section of Adolescent Medicine, Department of Pediatrics, Tulane University, New Orleans, LA, United States
| | - Susan Abdalian
- Section of Adolescent Medicine, Department of Pediatrics, Tulane University, New Orleans, LA, United States
| | - Mary Jane Rotheram
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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27
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Schwartz J, Grimm J. Stigma Communication Surrounding PrEP: The Experiences of A Sample of Men Who Have Sex With Men. HEALTH COMMUNICATION 2019; 34:84-90. [PMID: 29048252 DOI: 10.1080/10410236.2017.1384430] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
HIV is a serious problem in the USA, particularly for men who have sex with men (MSM). A new means of HIV prevention, called pre-exposure prophylaxis (PrEP), has been shown to be highly effective. However, in spite of earning FDA approval, adoption of PrEP by MSM has been limited. The purpose of this study was to examine the experiences of a sample of 38 MSM who have adopted PrEP, focusing on communication with healthcare providers and social networks. In-depth interviews were used to collect data. Findings revealed that stigmatization by healthcare providers as well as stigmatization by other MSM was a relatively common experience for participants. Additionally, participants described that a high level of health literacy, health advocacy, and communication skill were necessary to adopt PrEP. Given these findings, strategies are suggested for improving MSM's healthcare and increasing rates of PrEP adoption.
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Affiliation(s)
- Joseph Schwartz
- a Department of Communication Studies , Northeastern University
| | - Josh Grimm
- b Manship School of Journalism , Louisiana State University
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O'Donnell A, Addison M, Spencer L, Zurhold H, Rosenkranz M, McGovern R, Gilvarry E, Martens M, Verthein U, Kaner E. Which individual, social and environmental influences shape key phases in the amphetamine type stimulant use trajectory? A systematic narrative review and thematic synthesis of the qualitative literature. Addiction 2019; 114:24-47. [PMID: 30176077 PMCID: PMC6519251 DOI: 10.1111/add.14434] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/04/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS There is limited evidence on what shapes amphetamine-type stimulant (ATS) use trajectories. This systematic narrative review and qualitative synthesis aimed to identify individual, social and environmental influences shaping key phases in the ATS use trajectory: initiation, continuation, increase/relapse and decrease/abstinence. METHODS MEDLINE, PsycINFO, EMBASE, and PROQUEST (social science premium collection) were searched from 2000 to 2018. Studies of any qualitative design were eligible for inclusion. Extracted data were analysed according to four key phases within drug pathways, and then cross-analysed for individual, social and environmental influences. RESULTS Forty-four papers based on 39 unique studies were included, reporting the views of 1879 ATS users. Participants were aged 14-58 years, from varied socio-economic and demographic groups, and located in North America, Europe, Australasia and South East Asia. Reasons for initiation included: to boost performance at work and in sexual relationships, promote a sense of social 'belonging' and help manage stress. Similar reasons motivated continued use, combined with the challenge of managing withdrawal effects in long-term users. Increased tolerance and/or experiencing a critical life event contributed to an increase in use. Reasons for decrease focused on: increased awareness of the negative health impacts of long-term use, disconnecting from social networks or relationships and financial instability. CONCLUSIONS Amphetamine-type stimulant users are a highly diverse population, and their drug use careers are shaped by a complex dynamic of individual, social and environmental factors. Tailored, joined-up interventions are needed to address users' overlapping economic, health and social care needs in order to support long-term abstinence.
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Affiliation(s)
- Amy O'Donnell
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Michelle Addison
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Liam Spencer
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Heike Zurhold
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Moritz Rosenkranz
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Ruth McGovern
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Eilish Gilvarry
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Marcus‐Sebastian Martens
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Uwe Verthein
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Eileen Kaner
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
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Mwale M, Muula AS. Effects of adolescent exposure to behaviour change interventions on their HIV risk reduction in Northern Malawi: a situation analysis. SAHARA J 2018; 15:146-154. [PMID: 30278823 PMCID: PMC6171447 DOI: 10.1080/17290376.2018.1529612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Understanding adolescents’ translation of HIV and AIDS-related behaviour change interventions (BCI) knowledge and skills into expected behavioural outcomes helps us appreciate behaviour change dynamics among young people and informs evidence-based programming. We explored the effects of adolescents’ exposure to BCI on their HIV risk reduction in selected schools in Nkhatabay and Mzimba districts and Mzuzu city in Northern Malawi. The study used questionnaires as instruments. Data were collected between January and April 2017. Adolescent boys and girls [n = 552], ages 11–19 were randomly sampled to participate. Data analysis was through multiple regression and content analysis. Respondents included 324 female [58.7%] and 228 male [41.3%]. Multiple regression analysis indicated that exposure to BCI did not affect risk reduction in the study area. The best stepwise model isolated sexual experience ([Beta = .727, p = .0001, p < .05]) as having the strongest correlation with the dependent variable – risk reduction. BCI exposure was stepwise excluded ([Beta = −.082, p = .053, p > .05]). There was therefore no evidence against the null hypothesis of no relationship between adolescent exposure to BCI and their HIV risk reduction. Overall there was limited BCI knowledge and skills translation to behavioural risk reduction. The study points to the need to evaluate and redesign adolescent BCI in line with current behavioural dynamics among young people in Malawi. The findings have been used to inform the design and programming of a model to be tested for feasibility through a quasi-experiment in the second phase of our project.
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Affiliation(s)
- M Mwale
- a Department of Public Health, School of Public Health and Family Medicine , University of Malawi College of Medicine , Blantyre , Malawi.,b Department of Education Foundations , Mzuzu University , Mzuzu , Malawi
| | - A S Muula
- a Department of Public Health, School of Public Health and Family Medicine , University of Malawi College of Medicine , Blantyre , Malawi.,c Africa Center of Excellence in Public Health and Herbal Medicine , University of Malawi , Zomba , Malawi
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Zhang Q, Zhong L, Gao S, Li X. Optimizing HIV Interventions for Multiplex Social Networks via Partition-Based Random Search. IEEE TRANSACTIONS ON CYBERNETICS 2018; 48:3411-3419. [PMID: 30010610 PMCID: PMC6309962 DOI: 10.1109/tcyb.2018.2853611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
There are multiple modes for human immunodeficiency virus (HIV) transmissions, each of which is usually associated with a certain key population (e.g., needle sharing among people who inject drugs). Recent field studies revealed the merging trend of multiple key populations, making HIV intervention difficult because of the existence of multiple transmission modes in such complex multiplex social networks. In this paper, we aim to address this challenge by developing a multiplex social network framework to capture the multimode transmission across two key populations. Based on the multiplex social network framework, we propose a new random search method, named partition-based random search with network and memory prioritization (PRS-NMP), to identify the optimal subset of high-value individuals in the social network for interventions. Numerical experiments demonstrated that the proposed PRS-NMP-based interventions could effectively reduce the scale of HIV transmissions. The performance of PRS-NMP-based interventions is consistently better than the benchmark nested partitions method and network-based metrics.
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Affiliation(s)
- Qingpeng Zhang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong SAR, China, and Shenzhen Research Institute of City University of Hong Kong, Shenzhen, Guangdong, China, e-mail:
| | - Lu Zhong
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong SAR, China, e-mail:
| | - Siyang Gao
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong SAR, China, e-mail:
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, e-mail:
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Grimm J, Schwartz J. "It's Like Birth Control for HIV": Communication and Stigma for Gay Men on PrEP. JOURNAL OF HOMOSEXUALITY 2018; 66:1179-1197. [PMID: 30052498 DOI: 10.1080/00918369.2018.1495978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study focuses on how gay men communicate about pre-exposure prophylaxis (PrEP), focusing on how they learned about PrEP, how they discussed adoption with health care providers, and to what extent they have encountered stigma on social networks. In this qualitative study, 39 gay PrEP users were interviewed about PrEP. A majority of the participants learned about PrEP via friends and potential sex partners, and a majority of the participants experienced stigma from their health care provider and from other gay men online, mainly referring to promiscuity and risks of STIs. The authors recommend that health care providers should be trained in minimizing the expression of stigmatizing attitudes and should increase their knowledge of PrEP.
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Affiliation(s)
- Josh Grimm
- a Manship School of Mass Communication , Louisiana State University , Baton Rouge , Louisiana , USA
| | - Joseph Schwartz
- b Communication Studies , Northeastern University , Boston , Massachusetts , USA
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Goodacre N, Devkota P, Bae E, Wuchty S, Uetz P. Protein-protein interactions of human viruses. Semin Cell Dev Biol 2018; 99:31-39. [PMID: 30031213 PMCID: PMC7102568 DOI: 10.1016/j.semcdb.2018.07.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 04/02/2018] [Accepted: 07/17/2018] [Indexed: 12/16/2022]
Abstract
Viruses infect their human hosts by a series of interactions between viral and host proteins, indicating that detailed knowledge of such virus-host interaction interfaces are critical for our understanding of viral infection mechanisms, disease etiology and the development of new drugs. In this review, we primarily survey human host-virus interaction data that are available from public databases following the standardized PSI-MS format. Notably, available host-virus protein interaction information is strongly biased toward a small number of virus families including herpesviridae, papillomaviridae, orthomyxoviridae and retroviridae. While we explore the reliability and relevance of these protein interactions we also survey the current knowledge about viruses functional and topological targets. Furthermore, we assess emerging frontiers of host-virus protein interaction research, focusing on protein interaction interfaces of hosts that are infected by different viruses and viruses that infect multiple hosts. Finally, we cover the current status of research that investigates the relationships of virus-targeted host proteins to other comorbidities as well as the influence of host-virus protein interactions on human metabolism.
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Affiliation(s)
- Norman Goodacre
- Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Prajwal Devkota
- Dept. of Computer Science, Univ. of Miami, Coral Gables, FL, 33146, USA
| | - Eunhae Bae
- Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Stefan Wuchty
- Dept. of Computer Science, Univ. of Miami, Coral Gables, FL, 33146, USA; Center for Computational Science, Univ. of Miami, Coral Gables, FL, 33146, USA; Dept. of Biology, Univ. of Miami, Coral Gables, FL, 33146, USA; Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA.
| | - Peter Uetz
- Center for the Study of Biological Complexity, Virginia Commonwealth University, Richmond, VA, 23284, USA.
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Kuleape JA, Tagoe EA, Puplampu P, Bonney EY, Quaye O. Homozygous deletion of both GSTM1 and GSTT1 genes is associated with higher CD4+ T cell counts in Ghanaian HIV patients. PLoS One 2018; 13:e0195954. [PMID: 29795558 PMCID: PMC5967833 DOI: 10.1371/journal.pone.0195954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/03/2018] [Indexed: 11/18/2022] Open
Abstract
Glutathione S-transferase (GST) family of enzymes are involved in a two-stage detoxification process of a wide range of environmental toxins, carcinogens and xenobiotics. The GST enzymes play important roles in oxidative stress pathways, and polymorphisms in the GSTM1 and GSTT1 genes mediate susceptibility and outcome in different diseases. Human immunodeficiency virus (HIV) infection is associated with oxidative stress, but there is limited data on the frequency of deleted GSTM1 and GSTT1 genes in HIV/AIDS patients and their effect on progression among Ghanaians. This study sought to investigate the association between homozygous deletion of GSTM1 and GSTT1 genes (both null deletion) with HIV/AIDS disease progression in Ghanaian patients. HIV-infected individuals on antiretroviral therapy (ART), ART-naïve HIV patients, and HIV seronegative individuals were recruited for the study. HIV/AIDS disease progression was assessed by measuring CD4+ cell count and viral load of the patients, and GST polymorphism was determined by amplifying the GSTT1 and GSTM1 genes using multiplex PCR, with CYP1A1 gene as an internal control. The mean CD4+ count of patients that were naïve to ART (298 ± 243 cells/mm3) was significantly lower than that of patients on ART (604 ± 294 cells/mm3), and viral load was significantly lower in the ART-experienced group (30379 ± 15073 copies/mm3) compared to the ART-naïve group (209882 ± 75045 copies/mm3). Frequencies of GSTM1 and GSTT1 deletions were shown to be 21.9% and 19.8%, respectively, in the HIV patients, and patients with homozygous deletion of both GSTM1 and GSTT1 were more likely to have their CD4+ count rising above 350 cells/mm3 (OR = 6.44, 95% CI = 0.81-51.49, p = 0.039) suggesting that patients with homozygous deletion of GSTM1 and GSTT1 genes have slower disease progression. The findings of this study show that double deletion of glutathione S-transferases M1 and T1 is statistically associated with normal CD4+ count in patients diagnosed with HIV/AIDS. Further study is required to investigate the clinical importance of the both null deletion in HIV patients.
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Affiliation(s)
- Joshua Agbemefa Kuleape
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Emmanuel Ayitey Tagoe
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Peter Puplampu
- Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Evelyn Yayra Bonney
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
- * E-mail:
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Zhong L, Zhang Q, Li X. Modeling the Intervention of HIV Transmission across Intertwined Key Populations. Sci Rep 2018; 8:2432. [PMID: 29402964 PMCID: PMC5799486 DOI: 10.1038/s41598-018-20864-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/26/2018] [Indexed: 11/23/2022] Open
Abstract
The HIV transmissions between multiple key populations make interventions difficult, particularly with multiple transmission behaviors. It remains unclear how significant the role of bridge individuals (who connect multiple communities) is in HIV transmission, and how to develop more effective intervention strategies targeting different transmission modes across key populations. In this research, we proposed a 2-layer social network framework to simulate the HIV transmissions across female sex workers (FSWs) and persons who inject drugs (PWID) through two behaviors: unprotected sex and needle-sharing. We proposed a set of intervention strategies based on the topological properties of individuals in the social network and estimated the efficacy of these strategies. Simulation studies demonstrated that bridge individuals played a significant role in HIV transmissions across the two networks. Prevention on such bridge individuals could help reduce both the scale and speed of HIV transmissions.
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Affiliation(s)
- Lu Zhong
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong, SAR, China
| | - Qingpeng Zhang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong, SAR, China.
- Shenzhen Research Institute of City University of Hong Kong, Shenzhen, Guangdong, China.
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Campeau L, Blouin K, Leclerc P, Alary M, Morissette C, Blanchette C, Serhir B, Roy E. Impact of sex work on risk behaviours and their association with HIV positivity among people who inject drugs in Eastern Central Canada: cross-sectional results from an open cohort study. BMJ Open 2018; 8:e019388. [PMID: 29391367 PMCID: PMC5829837 DOI: 10.1136/bmjopen-2017-019388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The objectives of this study were: (1) to examine the correlates of HIV positivity among participants who injected drugs and engaged in sex work (PWID-SWs) in the SurvUDI network between 2004 and 2016, after stratification by sex, and (2) to compare these correlates with those of sexually active participants who did not engage in sex work (PWID non-SWs). DESIGN AND SETTING This biobehavioural survey is an open cohort of services where participants who had injected in the past 6 months were recruited mainly through harm reduction programmes in Eastern Central Canada. PARTICIPANTS Data from 5476 participants (9223 visits in total; 785 not included in multivariate analyses due to missing values) were included. METHODS Participants completed an interviewer-administered questionnaire and provided saliva samples for anti-HIV antibody testing. Generalised estimating equations taking into account multiple participations were used. RESULTS Baseline HIV prevalence was higher among SWs compared with non-SWs (women: 13.0% vs 7.7%; P<0.001, and men: 17.4% vs 10.8%; P<0.001). PWID-SWs were particularly susceptible to HIV infection as a result of higher levels of vulnerability factors and injection risk behaviours. They also presented different risk-taking patterns than their non-SWs counterparts, as shown by differences in correlates of HIV positivity. Additionally, the importance of sex work for HIV infection varies according to gender, as suggested by a large proportion of injection risk behaviours associated with HIV among women and, conversely, a stronger association between sexual behaviours and HIV positivity observed among men. CONCLUSION These results suggest that sex work has an impact on the risk of HIV acquisition and that risk behaviours vary according to gender. Public health practitioners should take those specificities into account when designing HIV prevention interventions aimed at PWIDs.
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Affiliation(s)
- Laurence Campeau
- Unité sur les Infections Transmissibles Sexuellement et par le Sang, Institut National de Santé Publique du Québec, Montréal, Québec, Canada
- École de santé publique, Université de Montréal, Montréal, Québec, Canada
| | - Karine Blouin
- Unité sur les Infections Transmissibles Sexuellement et par le Sang, Institut National de Santé Publique du Québec, Montréal, Québec, Canada
| | - Pascale Leclerc
- École de santé publique, Université de Montréal, Montréal, Québec, Canada
- Direction régionale de Santé Publique - CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Québec, Canada
| | - Michel Alary
- Unité sur les Infections Transmissibles Sexuellement et par le Sang, Institut National de Santé Publique du Québec, Montréal, Québec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Quebec – Université Laval, Québec City, Quebec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec City, Québec, Canada
| | - Carole Morissette
- Direction régionale de Santé Publique - CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Québec, Canada
| | - Caty Blanchette
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Quebec – Université Laval, Québec City, Quebec, Canada
| | - Bouchra Serhir
- Sérologie, Virologie et biologie moléculaire, Laboratoire de santé publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne de Bellevue, Québec, Canada
| | - Elise Roy
- Unité sur les Infections Transmissibles Sexuellement et par le Sang, Institut National de Santé Publique du Québec, Montréal, Québec, Canada
- Département des Sciences de la Santé Communautaire, Université de Sherbrooke - Campus de Longueuil, Longueuil, Québec, Canada
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Oystacher T, Blasco D, He E, Huang D, Schear R, McGoldrick D, Link B, Yang LH. Understanding stigma as a barrier to accessing cancer treatment in South Africa: implications for public health campaigns. Pan Afr Med J 2018; 29:73. [PMID: 29875954 PMCID: PMC5987085 DOI: 10.11604/pamj.2018.29.73.14399] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/02/2018] [Indexed: 11/26/2022] Open
Abstract
Introduction Cancer contributes to significant illness burden in South Africa, with delayed diagnosis resulting from limited knowledge of cancer, lack of biomedical treatment and stigma. This study examines ways in which people are identified as having cancer through perspectives of traditional healing or the biomedical model. Additionally, we sought to understand the stigma associated with cancer, including stereotypes, anticipated discrimination and coping styles. Methods Livestrong Foundation conducted 11 semi-structured focus groups with key community stakeholders in three South African townships. Interviews examined the negative consequences of being labeled with a cancer diagnosis as well as causes of, possible prevention of and barriers and methods to improve access to cancer treatment. Analyses were completed using directed content analysis. Results Revealed three main labeling mechanisms: physical appearance of perceived signs/symptoms of cancer, diagnosis by a traditional healer, or a biomedical diagnosis by a Western physician. Being labeled led to anticipated discrimination in response to prevalent cancer stereotypes. This contributed to delayed treatment, use of traditional healers instead of biomedical treatment and secrecy of symptoms and/or diagnosis. Further, perceptions of cancer were commonly conflated with HIV/TB owing to prior educational campaigns. Conclusion Our study deepens the understanding of the cancer labeling process in South Africa and the resulting negative effects of stigma. Future anti-stigma interventions should partner with traditional healers due to their respected community status and consider how previous health interventions may significantly impact current understandings of illness.
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Affiliation(s)
- Tatiana Oystacher
- Harris School of Public Policy, University of Chicago, Chicago, United States
| | - Drew Blasco
- College of Global Public Health, New York University, New York, United States
| | - Emily He
- Frances L Hiatt School of Psychology, Clark University, Worcester, United States
| | - Debbie Huang
- Mailman School of Public Health, Columbia University, New York, United States
| | | | | | - Bruce Link
- Department of Sociology, University of California, Riverside, United States
| | - Lawrence Hsin Yang
- College of Global Public Health, New York University, New York, United States.,Mailman School of Public Health, Columbia University, New York, United States
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Antibody detection by agglutination-PCR (ADAP) enables early diagnosis of HIV infection by oral fluid analysis. Proc Natl Acad Sci U S A 2018; 115:1250-1255. [PMID: 29358368 DOI: 10.1073/pnas.1711004115] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Oral fluid (OF) is a highly effective substrate for population-based HIV screening efforts, as it is noninfectious and significantly easier to collect than blood. However, anti-HIV antibodies are found at far lower concentrations in OF compared with blood, leading to poor sensitivity and a longer period of time from infection to detection threshold. Thus, despite its inherent advantages in sample collection, OF is not widely used for population screening. Here we report the development of an HIV OF assay based on Antibody Detection by Agglutination-PCR (ADAP) technology. This assay is 1,000-10,000 times more analytically sensitive than clinical enzyme-linked immunoassays (EIAs), displaying both 100% clinical sensitivity and 100% specificity for detecting HIV antibodies within OF samples. We show that the enhanced analytical sensitivity enables this assay to correctly identify HIV-infected individuals otherwise missed by current OF assays. We envision that the attributes of this improved HIV OF assay can increase testing rates of at-risk individuals while enabling diagnosis and treatment at an earlier time point.
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Rotheram-Borus MJ, Swendeman D, Rotheram-Fuller E, Youssef MK. Family Coaching as a delivery modality for evidence-based prevention programs. Clin Child Psychol Psychiatry 2018; 23:96-109. [PMID: 28849666 PMCID: PMC5858574 DOI: 10.1177/1359104517721958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Family Coaching is proposed as a new delivery format for evidence-based prevention programs (EBPPs). Three recent developments in health promotion support the potential efficacy of Family Coaching: (1) renewed interest in integrated prevention programs for multiple risk factors and behavior changes, (2) broad and long-term impacts of family-based interventions, and (3) popular acceptance of "coaching" as a nonstigmatizing, goal-focused intervention strategy. Family coaches are community members and paraprofessionals trained in common elements of EBPP. Family Coaching has specific goals, is short term, and has definable outcomes. Coaches frame the program's goals to be consistent with the family's values, normalize the family's experience, assess their strengths, and help the family set goals and develop skills and routines to problem solve challenging situations. Broad dissemination of EBPP will be facilitated with delivery formats that are flexible to meet families' priorities and providers' desires and capacities to tailor programs to local contexts.
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Affiliation(s)
- Mary Jane Rotheram-Borus
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles; 10920 Wilshire Blvd., Suite 350, Los Angeles, California 90024 USA
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles; 10920 Wilshire Blvd., Suite 350, Los Angeles, California 90024 USA
| | - Erin Rotheram-Fuller
- Mary Lou Fulton Teachers College, Arizona State University, PO Box 871811, Tempe, AZ 85287
| | - Maryann K Youssef
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles; 10920 Wilshire Blvd., Suite 350, Los Angeles, California 90024 USA
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Nunes AA, Caliani LS, Nunes MS, da Silva AS, de Mello LM. Profile analysis of patients with HIV/AIDS hospitalized after the introduction of antiretroviral therapy. CIENCIA & SAUDE COLETIVA 2017; 20:3191-8. [PMID: 26465860 DOI: 10.1590/1413-812320152010.03062015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/18/2015] [Indexed: 11/21/2022] Open
Abstract
Since the introduction of highly active antiretroviral therapy (HAART) in 1996, there have been worldwide shifts in the causes of hospitalization for patients with HIV/AIDS. The aim of this study was to describe the characteristics of HIV/AIDS patient hospitalizations between 1997 and 2012. This cross-sectional study used a hospital database that centralizes records of admissions in 31 hospitals, both public and private, across 26 municipalities in the interior of São Paulo. In order to verify associations between the variables, we used the prevalence ratio (PR) and a 95% confidence interval. Among 9,797 adults and children, 10,696 admissions were registered, which was equal to 1.09 admissions per patient. Most (62%) of the patients were male, and the predominant age group was 21 and 50 years (63.5%). Mortality was higher among male patients from all age groups (PR= 1.42 [95% CI: 1.28-1.57]; p < 0.05). The main cause of hospitalization (54.5% of the total) was infectious disease, whether opportunistic or not. This was true, even in the post-HAART era. Furthermore, gender and age differences were noted in patient mortality rates.
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Affiliation(s)
- Altacílio Aparecido Nunes
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil,
| | | | | | - Anderson Soares da Silva
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil,
| | - Luane Marques de Mello
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil,
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40
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Rethinking prevention: Shifting conceptualizations of evidence and intervention in South Africa’s AIDS epidemic. BIOSOCIETIES 2017. [DOI: 10.1057/s41292-017-0062-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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41
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Nakano Y, Aso H, Soper A, Yamada E, Moriwaki M, Juarez-Fernandez G, Koyanagi Y, Sato K. A conflict of interest: the evolutionary arms race between mammalian APOBEC3 and lentiviral Vif. Retrovirology 2017; 14:31. [PMID: 28482907 PMCID: PMC5422959 DOI: 10.1186/s12977-017-0355-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/27/2017] [Indexed: 01/06/2023] Open
Abstract
Apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3 (APOBEC3) proteins are mammalian-specific cellular deaminases and have a robust ability to restrain lentivirus replication. To antagonize APOBEC3-mediated antiviral action, lentiviruses have acquired viral infectivity factor (Vif) as an accessory gene. Mammalian APOBEC3 proteins inhibit lentiviral replication by enzymatically inserting G-to-A hypermutations in the viral genome, whereas lentiviral Vif proteins degrade host APOBEC3 via the ubiquitin/proteasome-dependent pathway. Recent investigations provide evidence that lentiviral vif genes evolved to combat mammalian APOBEC3 proteins. In corollary, mammalian APOBEC3 genes are under Darwinian selective pressure to escape from antagonism by Vif. Based on these observations, it is widely accepted that lentiviral Vif and mammalian APOBEC3 have co-evolved and this concept is called an "evolutionary arms race." This review provides a comprehensive summary of current knowledge with respect to the evolutionary dynamics occurring at this pivotal host-virus interface.
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Affiliation(s)
- Yusuke Nakano
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Hirofumi Aso
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
- Faculty of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Andrew Soper
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Eri Yamada
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Miyu Moriwaki
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
- Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Guillermo Juarez-Fernandez
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Yoshio Koyanagi
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
| | - Kei Sato
- Laboratory of Systems Virology, Department of Biosystems Science, Institute for Frontier Life and Medical Sciences, Kyoto University, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 6068507 Japan
- CREST, Japan Science and Technology Agency, Saitama, Japan
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Abstract
On May 14, 2014 the Centers for Disease Control and Prevention (CDC) endorsed the drug Truvada as an HIV preventative, called pre-exposure prophylaxis (PrEP). PrEP has been shown to dramatically reduce the risk of HIV infection, but its rate of adoption has been slow, and discourse surrounding it has been marked by stigma and uncertainty. The purpose of this study was to investigate how PrEP was discussed on Twitter. Our analysis focused on barriers to PrEP adoption and stigmatization of PrEP users. We analyzed a random sample of 1,093 top tweets about PrEP posted to Twitter a year before and a year after the CDC's endorsement. Our results showed that tweets likely reinforced uncertainty about barriers to PrEP adoption and that users employed Twitter's functionality to counter stigmatizing narratives about PrEP. We suggest that our findings illuminate both the limitations and strengths of Twitter as a mechanism for health promotion.
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Affiliation(s)
- Joseph Schwartz
- a Department of Communication Studies , Northeastern University
| | - Josh Grimm
- b Manship School of Mass Communication , Louisiana State University
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Willmott L. Social sustainability as the seventh tenant: a reflection on Oberth and Whiteside's sustainability in the HIV and AIDS response. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2017; 15:311-3. [PMID: 27681155 DOI: 10.2989/16085906.2016.1238084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Lacey Willmott
- a Department of Geography & Environmental Management , University of Waterloo , Waterloo , Canada
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Raifman JRG, Flynn C, German D. Healthcare Provider Contact and Pre-exposure Prophylaxis in Baltimore Men Who Have Sex With Men. Am J Prev Med 2017; 52:55-63. [PMID: 27662698 PMCID: PMC5833975 DOI: 10.1016/j.amepre.2016.07.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 06/22/2016] [Accepted: 07/11/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Pre-exposure prophylaxis (PrEP) safely and effectively prevents HIV in populations at high risk, including men who have sex with men (MSM). PrEP scale-up depends upon primary care providers and community-based organizations (CBOs) sharing PrEP information. This study aimed to determine whether healthcare provider or CBO contact was associated with PrEP awareness among Baltimore MSM. METHODS This study used 2014 Baltimore MSM National HIV Behavioral Surveillance data, which included data on health care, HIV and sexually transmitted infection testing, and receipt of condoms from CBOs. In 2015, associations were estimated between healthcare contacts and PrEP awareness through logistic regression models controlling for age, race, and education and clustering by venue. Comparative analyses were conducted with HIV testing as outcome. RESULTS There were 401 HIV-negative participants, of whom 168 (42%) were aware of PrEP. Visiting a healthcare provider in the past 12 months, receiving an HIV test from a provider, and having a sexually transmitted infection test in the past 12 months were not significantly associated with PrEP awareness. PrEP awareness was associated with being out to a healthcare provider (OR=2.97, 95% CI=1.78, 4.96, p<0.001); being tested for HIV (OR=1.50, 95% CI=1.06, 2.13, p=0.023); and receiving condoms from an HIV/AIDS CBO (OR=2.59, 95% CI=1.43, 4.64, p=0.001). By contrast, HIV testing was significantly associated with most forms of healthcare contact. CONCLUSIONS PrEP awareness is not associated with most forms of healthcare contact, highlighting the need for guidelines and trainings to support provider discussion of PrEP with MSM.
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Affiliation(s)
- Julia R G Raifman
- Epidemiology Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Colin Flynn
- Center for HIV Surveillance, Epidemiology, and Evaluation, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
| | - Danielle German
- Department of Health Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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45
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Zorrilla CD, Mosquera AM, Rabionet S, Rivera-Viñas J. HIV and ZIKA in Pregnancy: Parallel Stories and New Challenges. OBSTETRICS & GYNECOLOGY INTERNATIONAL JOURNAL 2016; 5:180. [PMID: 28529970 PMCID: PMC5436707 DOI: 10.15406/ogij.2016.05.00180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
On February 1, 2016, the World Health Organization (WHO) declared the Zika virus outbreak a Public Health Emergency of International Concern (PHEIC). Because Zika virus is a relatively new infection with several transmission routes that include mosquito bites, sexual and possibly blood-related, we present the case for a parallel between the Zika epidemic and the AIDS epidemic for issues that relate particularly to pregnancy and epidemic response. We will discuss the many similarities between both epidemics while acknowledging that the viruses are different and the pathophysiology and disease manifestation are also different. What can we learn of the three decades of awareness campaigns, community involvement, clinical, behavior and prevention research, activism and policy-making related to HIV/AIDS? How can the lessons and experience of dealing with the HIV epidemic can help us deal with the ongoing Zika epidemic? Is there a roadmap that we can follow? Our position is that we can and we should. Parallels between the Zika and HIV/AIDS epidemics particularly in relation to pregnancy can be established. Lessons and successes from the HIV/AIDS epidemic control efforts can guide us towards comprehensive approaches to improve the health of women and infants at risk for Zika.
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Affiliation(s)
- Carmen D Zorrilla
- Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | - Ana María Mosquera
- Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | | | - Juana Rivera-Viñas
- Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
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46
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Palma AM, Rabkin M, Nuwagaba-Biribonwoha H, Bongomin P, Lukhele N, Dlamini X, Kidane A, El-Sadr WM. Can the Success of HIV Scale-Up Advance the Global Chronic NCD Agenda? Glob Heart 2016; 11:403-408. [PMID: 27938826 PMCID: PMC5157698 DOI: 10.1016/j.gheart.2016.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 11/30/2022] Open
Abstract
Noncommunicable diseases (NCD) are the leading causes of death and disability worldwide but have received suboptimal attention and funding from the global health community. Although the first United Nations General Assembly Special Session (UNGASS) for NCD in 2011 aimed to stimulate donor funding and political action, only 1.3% of official development assistance for health was allocated to NCD in 2015, even less than in 2011. In stark contrast, the UNGASS on human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) in 2001 sparked billions of dollars in funding for HIV and enabled millions of HIV-infected individuals to access antiretroviral treatment. Using an existing analytic framework, we compare the global responses to the HIV and NCD epidemics and distill lessons from the HIV response that might be utilized to enhance the global NCD response. These include: 1) further educating and empowering communities and patients to increase demand for NCD services and to hold national governments accountable for establishing and achieving NCD targets; and 2) evidence to support the feasibility and effectiveness of large-scale NCD screening and treatment programs in low-resource settings. We conclude with a case study from Swaziland, a country that is making progress in confronting both HIV and NCD.
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Affiliation(s)
- Anton M Palma
- Department of Epidemiology, Columbia University, New York, NY, USA; ICAP at Columbia University, New York, NY, USA.
| | - Miriam Rabkin
- Department of Epidemiology, Columbia University, New York, NY, USA; ICAP at Columbia University, New York, NY, USA; Department of Medicine, Columbia University, New York, NY, USA
| | - Harriet Nuwagaba-Biribonwoha
- Department of Epidemiology, Columbia University, New York, NY, USA; ICAP at Columbia University, New York, NY, USA
| | - Pido Bongomin
- Department of Epidemiology, Columbia University, New York, NY, USA; ICAP at Columbia University, New York, NY, USA
| | | | | | | | - Wafaa M El-Sadr
- Department of Epidemiology, Columbia University, New York, NY, USA; ICAP at Columbia University, New York, NY, USA; Department of Medicine, Columbia University, New York, NY, USA
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47
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Abstract
The purpose of this study was to analyze the frequency of incidents of uncertainty in online news articles about Truvada, a drug used to prevent HIV infection. Using a coding scheme that synthesized uncertainty research from health disciplines and communication studies, we analyzed 235 articles from the most-read United States-based news websites. Our results showed that 80.4% of articles contained at least one incident of uncertainty, that articles contained significantly more incidents of uncertainty before the Centers for Disease Control and Prevention (CDC) endorsed Truvada compared to after the CDC endorsed the drug, and that articles mentioning men who have sex with men (MSM) contained significantly more incidents of uncertainty than articles in which they were not mentioned.
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Affiliation(s)
- Joseph Schwartz
- a Department of Communication Studies , Northeastern University
| | - Josh Grimm
- b Manship School of Mass Communication , Louisiana State University
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48
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Choi SKY, Holtgrave DR, Bacon J, Kennedy R, Lush J, McGee F, Tomlinson GA, Rourke SB. Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs. AIDS Behav 2016; 20:1143-56. [PMID: 26152607 PMCID: PMC4867003 DOI: 10.1007/s10461-015-1109-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.
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Affiliation(s)
- Stephanie K Y Choi
- The Ontario HIV Treatment Network, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David R Holtgrave
- Department of Health, Behaviour and Society, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Jean Bacon
- The Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | - Rick Kennedy
- The Ontario AIDS Network, Toronto, Ontario, Canada
| | - Joanne Lush
- AIDS Bureau, Ontario Ministry of Health and Long-term Care, Toronto, Ontario, Canada
| | - Frank McGee
- AIDS Bureau, Ontario Ministry of Health and Long-term Care, Toronto, Ontario, Canada
| | - George A Tomlinson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| | - Sean B Rourke
- The Ontario HIV Treatment Network, Toronto, Ontario, Canada.
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St., Toronto, Ontario, M5B 1W8, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Williams TT, Pichon LC, Davey-Rothwell M, Latkin CA. Church Attendance as a Predictor of Number of Sexual Health Topics Discussed Among High-Risk HIV-Negative Black Women. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:451-8. [PMID: 25966802 PMCID: PMC4644119 DOI: 10.1007/s10508-015-0506-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 12/12/2014] [Accepted: 02/13/2015] [Indexed: 06/04/2023]
Abstract
Research suggests that sexual health communication is associated with safer sex practices. In this study, we examined the relationship between church attendance and sexual health topics discussed with both friends and sexual partners among a sample of urban Black women. Participants were 434 HIV-negative Black women who were at high risk for contracting HIV through heterosexual sex. They were recruited from Baltimore, Maryland using a network-based sampling approach. Data were collected through face-to-face interviews and Audio-Computer-Assisted Self-Interviews. Fifty-four percent of the participants attended church once a month or more (regular attendees). Multivariate logistic regression analyses revealed that regular church attendance among high-risk HIV-negative Black women was a significant predictor of the number of sexual health topics discussed with both friends (AOR = 1.85, p = .003) and sexual partners (AOR = 1.68, p = .014). Future efforts to reduce HIV incidence among high-risk Black women may benefit from partnerships with churches that equip faith leaders and congregants with the tools to discuss sexual health topics with both their sexual partners and friends.
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Affiliation(s)
- Terrinieka T Williams
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA.
| | | | - Melissa Davey-Rothwell
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA
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50
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Mwangala S, Musonda KG, Monze M, Musukwa KK, Fylkesnes K. Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System. PLoS One 2016; 11:e0146700. [PMID: 26745508 PMCID: PMC4706302 DOI: 10.1371/journal.pone.0146700] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 12/21/2015] [Indexed: 11/19/2022] Open
Abstract
Background Despite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia. Methods Accuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT) exercises conducted in 2009 (n = 282 sites) and 2010 (n = 488 sites). Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS) were issued to testing sites by the national reference laboratory (NRL). Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively. Results Overall accuracy level was 93.1% (95% CI: 91.2–94.9) in 2009 and 96.9% (95% CI: 96.1–97.8) in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy. Conclusion The study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently strengthened.
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Affiliation(s)
- Sheila Mwangala
- Virology Laboratory, Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- * E-mail:
| | - Kunda G. Musonda
- Virology Laboratory, Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
- Pathogen Molecular Biology Department, London school of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Mwaka Monze
- Virology Laboratory, Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
| | - Katoba K. Musukwa
- Virology Laboratory, Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
| | - Knut Fylkesnes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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