Reducing health disparities through culturally sensitive treatment for HIV+ adults in Haiti

There is a critical need to deliver empirically validated interventions to underserved populations. Haiti, the country most heavily affected by the AIDS epidemic in the Caribbean, accounts for approximately 50% of all cases in the region. Poverty, disparities in access to healthcare, and socio-political instability are among the reasons why the country has been ravaged by the disease. Ongoing projects in Haiti have shown that integrated prevention and care in resource poor settings are feasible and can be successful, as evidenced by a 50% drop in incidence among pregnant women since 1993. The AIDS prevention program has embarked on a comprehensive effort to culturally adapt a cognitive-behavioral stress management program for Haitian HIV+ individuals. The purpose of the program is to improve adherence to antiretroviral medication, reduce transmission to uninfected partners, and improve coping. This comprehensive approach is necessary to ensure the validity of the cross-cultural adaptation of this intervention.

An examination of the soluble oligomeric complexes extracted from the red cell membrane and their relation to the membrane cytoskeleton

A part of the spectrin extracted from red cell membranes at low ionic strength occurs in the form of a high-molecular weight oligomeric complex with actin and proteins 4.1 and 4.9. When the extraction is performed at 35 degrees, the spectrin is present in this complex as the dimer, all higher forms being dissociated. We have been unable to establish any correlation between the fraction of the spectrin thus complexed and the metabolic state of the cell. At least a large part of the complex appears to be a defined monodisperse species, sedimenting at 31S. The actin is present as short protofilaments. The average number of spectrin molecules associated with each molecule of complex has been studied by cytochalasin binding and electron microscopy. The complexes present the appearance in the electron microscope of spiders, in which the legs are spectrin dimers, attached to a globular element, containing by inference, actin and proteins 4.1 and 4.9; they are active in nucleating the polymerization of G-actin. The complexes are extremely stable, being resistant to dissociation under the conditions of the deoxyribonuclease assay, even after treatment with trypsin to degrade the actin-associated proteins. It is suggested that the complexes represent intact junctions of the membrane cytoskeletal network. Relevant structural features of the network are revealed by electron microscopy. The results lead to inferences concerning the mechanism of dissociation of the network from the membrane.