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Full-Text Articles in Medicine and Health Sciences

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha Mar 2023

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …


Proposing An Rna Interference (Rnai)-Based Treatment For Human Immunodeficiency Virus (Hiv) By Analyzing The Post-Transcriptional Gene Targeting Of Sars-Cov-2, Hepatitis C Virus, And A549 Lung Cancer Cells, Arjun Jagdeesh Jan 2023

Proposing An Rna Interference (Rnai)-Based Treatment For Human Immunodeficiency Virus (Hiv) By Analyzing The Post-Transcriptional Gene Targeting Of Sars-Cov-2, Hepatitis C Virus, And A549 Lung Cancer Cells, Arjun Jagdeesh

Undergraduate Research Posters

Human Immunodeficiency Virus (HIV) is a retrovirus that infects CD4+ T cell lymphocytes in humans, leading to the development of Acquired Immunodeficiency Syndrome (AIDS) if left untreated. While current treatment methods, including antiretroviral combination treatments, effectively limit HIV replication, HIV can evade these treatments due to its high mutation rate. Long-term antiretroviral treatment can also be toxic to patients, meaning patients would benefit from a new mechanism of HIV treatment. RNA interference (RNAi) is an antiviral pathway found in mammals, plants, and insects that involves a small-interfering RNA that is incorporated into a protein complex called the RNA-induced Silencing Complex …


Investigating The Pi3k/Akt/Atm Pathway, Telomeric Dna Damage, T Cell Death, And Crispr/Cas9-Mediated Gene Editing During Acute And Chronic Hiv Infection, Sushant Khanal Dec 2022

Investigating The Pi3k/Akt/Atm Pathway, Telomeric Dna Damage, T Cell Death, And Crispr/Cas9-Mediated Gene Editing During Acute And Chronic Hiv Infection, Sushant Khanal

Electronic Theses and Dissertations

Human Immunodeficiency Virus (HIV) infection initiates major metabolic and cell- survival complications. Anti-retroviral therapy (ART) is the current approach to suppress active HIV replication to a level of undetected viral load, but it is not a curative approach. Newer and sophisticated gene editing technologies could indeed be a potent antiviral therapy to achieve a clinical sterilization/cure of HIV infection. Chronic HIV patients, even under a successful ART regimen, exhibit a low-grade inflammation, immune senescence, premature aging, telomeric DNA attrition, T cell apoptosis, and cellular homeostasis. In this dissertation, we investigated CD4 T cell homeostasis, degree of T cell apoptosis, an …


Serpin-Derived Novel Peptide For The Treatment Against Hiv-Induced Inflammation In The Central Nervous System, Yemmy Soler Jun 2022

Serpin-Derived Novel Peptide For The Treatment Against Hiv-Induced Inflammation In The Central Nervous System, Yemmy Soler

FIU Electronic Theses and Dissertations

In the brain, HIV predominantly infects microglia/macrophages and astrocytes to a lesser extent. These cells form virus reservoirs with low levels of infection that are very hard to eradicate. Even though the use of cART increases survival rate in HIV patients, the virus persists as a chronic condition. cART is not able to effectively cross the BBB, control HIV replication, or attenuate inflammation in brain reservoirs. Therefore, the virus still causes neuronal dysfunction, pain-related pathology, and ultimately HAND. In this study, we decided to test the hypothesis that a serpin-derived small peptide, SP16, can serve as an anti-viral, anti-inflammatory, pro-survival, …


Gut Commensals Modulate Siv/Shiv Pathogenesis And Therapeutics, Samuel Johnson May 2022

Gut Commensals Modulate Siv/Shiv Pathogenesis And Therapeutics, Samuel Johnson

Theses & Dissertations

Despite significant advancements in combination antiretroviral therapy (cART), ongoing inflammation in the brain and gut remain two of the most significant hurdles in the health of people living with human immunodeficiency virus (HIV). Additionally, a viral reservoir in each compartment inhibits cure efforts by allowing rapid viral rebound following cART interruption. Emerging understanding of the gut-brain axis (GBA) implicates each compartment in the modulation of the other in a complex bi-directional interaction mediated by vagus innervation, circulating lymphocytes, and microbiome composition and biproducts. Using multiple models of the simian (and simian-human) immunodeficiency virus (SIV/SHIV) and therapeutic intervention, I present how …


Understanding Exosomal Extracellular Vesicles And Morphine In The Neuropathology Of Human Immunodeficiency Virus And Differential Zika Virus Strain-Associated Pathology, Allen Caobi Apr 2022

Understanding Exosomal Extracellular Vesicles And Morphine In The Neuropathology Of Human Immunodeficiency Virus And Differential Zika Virus Strain-Associated Pathology, Allen Caobi

FIU Electronic Theses and Dissertations

Exosomal Extracellular Vesicles (xEVs), integral to intercellular communication and regulation of immune responses, have functional effects based on their contents, which they transport to neighboring cells. However, in the context of infection, EV cargo can be modulated, by either infected or uninfected cells. We hypothesize that CNS-associated neuropathology, is partially, due to the cargo transported by the exosomes. We theorize that the cargo released from infected cell-derived xEVs may either facilitate or inhibit viral neuropathogenicity. Here we investigated xEVs in the case of two neurotropic viruses, Zika virus (ZIKV) and Human Immunodeficiency Virus (HIV). The hallmark characteristic of ZIKV-infection is …


Global, Regional, And National Sex Differences In The Global Burden Of Tuberculosis By Hiv Status, 1990-2019: Results From The Global Burden Of Disease Study 2019, Jorge R. Ledesma, Hmwe Hmwe Kyu, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Tuberculosis Collaborators, 328 Co-Authors Sep 2021

Global, Regional, And National Sex Differences In The Global Burden Of Tuberculosis By Hiv Status, 1990-2019: Results From The Global Burden Of Disease Study 2019, Jorge R. Ledesma, Hmwe Hmwe Kyu, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Tuberculosis Collaborators, 328 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019.

Methods

We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital …


Food Insecurity Is Associated With Nonalcoholic Fatty Liver Disease, Cognitive Impairment, And Immune Activation In People Living With Hiv, Javier A. Tamargo Mar 2021

Food Insecurity Is Associated With Nonalcoholic Fatty Liver Disease, Cognitive Impairment, And Immune Activation In People Living With Hiv, Javier A. Tamargo

FIU Electronic Theses and Dissertations

Food insecurity (FI) is a socioeconomic condition characterized by inadequate access to enough food and nutrition to sustain health and wellbeing. Food insecurity is a risk factor for chronic and age-related conditions, raising concerns for the aging population of people living with HIV (PLWH), in whom food insecurity is disproportionately prevalent. PLWH are at increased risk of nutrition-related complications and chronic co-morbidities, thus food insecurity may exacerbate adverse health outcomes in this population. This study investigated whether food insecurity was associated with nonalcoholic fatty liver disease (NAFLD), cognitive impairment, and immune activation among socioeconomically disadvantaged adults living with and without …


Sequence-Independent Assay For Hiv Viral Load Quantitation, Omar El Merhebi Jan 2021

Sequence-Independent Assay For Hiv Viral Load Quantitation, Omar El Merhebi

Honors Undergraduate Theses

Although nucleic acid tests (NATs) for human immunodeficiency virus (HIV) exhibit many advantages, such as early detection and viral load quantification, over immunological assays, their widespread use is limited by their demand for high-level infrastructure, sophisticated equipment, and advanced staff competence. Furthermore, when quantifying viral loads of patients, it has been reported that these assays can underestimate viral quantities by 22- to 100-fold due to primer-template mismatches in more divergent HIV subtypes. Therefore, we have developed a cost-effective and sequence-independent assay for the detection and quantification of HIV utilizing a modified nucleic acid sequence-based amplification (NASBA) protocol coupled to an …


Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve Jan 2021

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty Scholarship

Background:

Chronic immune activation and CD4+ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4+ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4+ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …


Investigating The Interactions Between Individual Calmodulin And Hiv-1 Protein Domains, Riley K. Kendall, Jerry Larue May 2020

Investigating The Interactions Between Individual Calmodulin And Hiv-1 Protein Domains, Riley K. Kendall, Jerry Larue

Student Scholar Symposium Abstracts and Posters

The World Health Organization found that 37.9 million people were living with HIV by the end of 2018. HIV is a virus that weakens the immune system through viral replication and the destruction of CD4+ T-cells, which are white blood cells that detect infection and make antibodies. A cure for HIV has not yet been discovered. HIV-1 contains a Gag polyprotein which regulates the stages of viral replication. Previous studies suggest that the myristoyl group of a matrix protein peptide found on the Gag polyprotein, MA, forms a complex with a calcium-binding, multifunctional regulatory protein called Calmodulin (CaM). CaM …


A Review Of Human Immunodeficiency Virus, Sophie Silver May 2020

A Review Of Human Immunodeficiency Virus, Sophie Silver

Senior Honors Theses

Human immunodeficiency virus, also referred to as HIV, is a devastating virus which has infected millions. Characterized as a retrovirus, HIV has an RNA genome, which is reverse transcribed into DNA upon entry into the host cell. HIV primarily affects CD4+ T cells and is diagnosed by the significant reduction of CD4+ T cells. While no cure has been discovered yet, antiretroviral therapy (ART) has been demonstrated as an effective treatment option. In the progression of HIV, additional HIV-associated diseases may arise, including HIV-associated psoriasis and sensory neuropathy. In addition to the use of ART, clinicians often prescribe …


Development Of A Lectin-Fc Fusion Protein With Antiviral And Anti-Cancer Activity., Matthew William Dent May 2019

Development Of A Lectin-Fc Fusion Protein With Antiviral And Anti-Cancer Activity., Matthew William Dent

Electronic Theses and Dissertations

This thesis describes the development of a novel lectin-Fc fusion protein and its antiviral and anti-cancer activity. The molecule, Avaren-Fc (AvFc), is a fusion of a variant of the actinomycete lectin actinohivin (Avaren) and the Fc region of human IgG1, and is selective for the terminal α1,2-mannose residues found at the ends of high-mannose-type glycans that can be found on the surface of certain heavily glycosylated viruses and cancer cells. Here, AvFc was found to be able to neutralize simian immunodeficiency virus as well as Hepatitis C virus with nanomolar IC50 values. Furthermore, AvFc recognizes a number of cell …


Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani Oct 2017

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …


Hiv Vaccines: Progress, Limitations And A Crispr/Cas9 Vaccine, Omar A. Garcia Martinez May 2016

Hiv Vaccines: Progress, Limitations And A Crispr/Cas9 Vaccine, Omar A. Garcia Martinez

Biology: Student Scholarship & Creative Works

ABSTRACT: The HIV-1 pandemic continues to thrive due to ineffective HIV-1 vaccines. Historically, the world’s most infectious diseases, such as polio and smallpox, have been eradicated or have come close to eradication due to the advent of effective vaccines. Highly active antiretroviral therapy is able to delay the onset of AIDS but can neither rid the body of HIV-1 proviral DNA nor prevent further transmission. A prophylactic vaccine that prevents the various mechanisms HIV-1 has to evade and attack our immune system is needed to end the HIV-1 pandemic. Recent advances in engineered nuclease systems, like the CRISPR/Cas9 system, have …


In Search Of Safety, Negotiating Everyday Forms Of Risk: Sex Work, Criminalization, And Hiv/Aids In The Slums Of Kampala, Serena Cruz Oct 2015

In Search Of Safety, Negotiating Everyday Forms Of Risk: Sex Work, Criminalization, And Hiv/Aids In The Slums Of Kampala, Serena Cruz

FIU Electronic Theses and Dissertations

This dissertation offers an in-depth descriptive account of how women manage daily risks associated with sex work, criminalization, and HIV/AIDS. Primary data collection took place within two slums in Kampala, Uganda over the course of fourteen months. The emphasis was on ethnographic methodologies involving participant observation and informal and unstructured interviewing. Insights then informed document analysis of international and national policies concerning HIV prevention and treatment strategies in the context of Uganda. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for …


Structural And Functional Interactions Between Bro1 Domain Of Human Alix Protein And Nucleocapsid Packaging Rna Complex From Hiv, Scott Gross May 2015

Structural And Functional Interactions Between Bro1 Domain Of Human Alix Protein And Nucleocapsid Packaging Rna Complex From Hiv, Scott Gross

Graduate School of Biomedical Sciences Theses and Dissertations

A virus is only as powerful as its ability to spread. Enveloped retroviruses, namely HIV-1, use exocytosis pathways that normal host cells use to release particles from the plasma membrane. The main pathways of interest in this study are the Endosomal Sorting Complex Required for Transport (ESCRT) and adjacent ALIX pathways. The ESCRT pathway is especially important for degradation of receptor/cargo complexes that form Multi-Vesicular Bodies (MVBs). Currently, there is no known therapy that targets this endosomal pathway, which would prevent the spread of the virus to other cells. The virus has adapted to jump from pathway to pathway when …


Placental Hpv Infection In Hiv Positive And Hiv Negative Zambian Women, Chrispin Chisanga Apr 2014

Placental Hpv Infection In Hiv Positive And Hiv Negative Zambian Women, Chrispin Chisanga

School of Biological Sciences: Dissertations, Theses, and Student Research

Human papillomaviruses (HPVs) have been reported to infect epithelial trophoblastic cells of the placenta, induce cell death and even cause placental malfunction associated with spontaneous preterm delivery. To date, no study has been conducted to determine the role of HIV on HPV genotype distribution and pathogenesis in the placental compartment. This is despite the evidence that the human immunodeficiency virus (HIV) can decrease the cellular immune response and increase the incidence of malignant cancers in HPV patients. Therefore, in this study, we analyzed 200 genomic DNA (gDNA) samples extracted from paraffin embedded placental tissues of HIV positive and HIV negative …


Correlates Of Consistent Condom Use Among Female Entertainment Workers In Shanghai, China: A Repeated Measures Analysis, Xiushi Yang, Guomei Xia Jan 2013

Correlates Of Consistent Condom Use Among Female Entertainment Workers In Shanghai, China: A Repeated Measures Analysis, Xiushi Yang, Guomei Xia

Sociology & Criminal Justice Faculty Publications

Female entertainment workers (FEWs) in China are at increased risk of HIV and other sexually transmitted infections, but correlates of their risky sexual behaviour remain poorly understood. Using data from a series of four surveys, this paper employs repeated measures analysis to identify individual and social correlates of consistent condom use among FEWs in Shanghai. Results reveal that both individual cognitive and social influence factors are statistically significant in their bivariate relationships to consistent condom use with a stable or non-stable partner; only prevention motivation and perceived self-efficacy in condom use remain significant in the multiple regressions. When individual and …


Serum 25-Hydroxyvitamin D Levels And C-Reactive Protein In Persons With Human Immunodeficiency Virus Infection, C. Anderson Johnson, Kalpana Poudel-Tandukar, Krishna C. Poudel, Masamine Jimba, Jun Kobayashi, Paula Palmer Jan 2013

Serum 25-Hydroxyvitamin D Levels And C-Reactive Protein In Persons With Human Immunodeficiency Virus Infection, C. Anderson Johnson, Kalpana Poudel-Tandukar, Krishna C. Poudel, Masamine Jimba, Jun Kobayashi, Paula Palmer

CGU Faculty Publications and Research

Human immunodeficiency virus (HIV) infection has frequently been associated with vitamin D deficiency as well as chronic inflammatory response. We tested the hypothesis of an independent relationship between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and high-sensitivity C-reactive protein (CRP) in a cohort of HIV-positive people. A cross-sectional survey was conducted among 316 HIV-positive people (181 men and 135 women) aged 16 to 60 years residing in the Kathmandu Valley, Nepal. Serum high-sensitivity CRP concentrations and serum 25(OH)D levels were measured by the latex agglutination nephelometry method and the competitive protein-binding assay, respectively. The relationship between serum CRP concentrations and 25(OH)D …


Study Guide For United In Anger: A History Of Act Up, Matt Brim Jan 2012

Study Guide For United In Anger: A History Of Act Up, Matt Brim

Open Educational Resources

The United in Anger Study Guide facilitates classroom and activist engagement with Jim Hubbard’s 2012 documentary, United in Anger: A History of ACT UP. The Study Guide contains discussion sections, projects and exercises, and resources for further research about the activism of the New York chapter of ACT UP (AIDS Coalition to Unleash Power). The Study Guide is a free, interactive, multimedia resource for understanding the legacy of ACT UP, the film’s role in preserving that legacy, and its meaning for viewers' lives.


Risky Behaviour And Hiv Prevalence Among Zambian Men, Nisha Malhotra, Jonathan Young Jan 2011

Risky Behaviour And Hiv Prevalence Among Zambian Men, Nisha Malhotra, Jonathan Young

Nisha Malhotra

The objective of this paper is to identify demographic, social and behavioural risk factors for HIV infection among men in Zambia. In particular, the role of alcohol, condom use, and number of sex partners is highlighted as being significant in the prevalence of HIV. Multivariate Logistic Regressions were used to analyse the latest cross-sectional population-based demographic health survey for Zambia (2007). The survey included socio-economic variables and HIV serostatus for consenting men (N = 4,434). Risk for HIV was positively related to the wealth status. Men who considered themselves to be at high risk for HIV-positive were most likely to …


Preventing Mother-To-Child Transmission Of Human Immunodeficiency Virus-1 (Hiv-1): Effects Of Intrapartum And Neonatal Single-Dose Nevirapine Prophylaxis And Subsequent Hiv-1 Drug Resistance At Antiretroviral Treatment Initiation, Amanda L. Harmon Jan 2011

Preventing Mother-To-Child Transmission Of Human Immunodeficiency Virus-1 (Hiv-1): Effects Of Intrapartum And Neonatal Single-Dose Nevirapine Prophylaxis And Subsequent Hiv-1 Drug Resistance At Antiretroviral Treatment Initiation, Amanda L. Harmon

CMC Senior Theses

The prevention of mother-to-child transmission is one of the most powerful tools in human immunodeficiency virus type 1 (HIV-1) prevention and has huge potential to improve both maternal and child health. In the absence of any preventative measures, infants born to and breastfed by their HIV-positive mothers have roughly a one-in-three chance of acquiring the infection themselves. HIV can be passed on from mother-to-child during pregnancy, during labor and delivery, and even after during breastfeeding.

Intrapartum and neonatal single-dose nevirapine (sd-NVP) is the foundation of preventing mother-to-child transmission in lower resource settings where it has been used alone or as …


Do Hospitalists Or Physicians With Greater Inpatient Hiv Experience Improve Hiv Care In The Era Of Highly Active Antiretroviral Therapy? Results From A Multicenter Trial Of Academic Hospitalists, John A. Schneider, Qi Zhang, Andrew Auerbach, David Gonzales, Peter Kaboli, Jeffrey Schnipper, Tosha B. Wetterneck, David L. Pitrak, David O. Meltzer Jan 2008

Do Hospitalists Or Physicians With Greater Inpatient Hiv Experience Improve Hiv Care In The Era Of Highly Active Antiretroviral Therapy? Results From A Multicenter Trial Of Academic Hospitalists, John A. Schneider, Qi Zhang, Andrew Auerbach, David Gonzales, Peter Kaboli, Jeffrey Schnipper, Tosha B. Wetterneck, David L. Pitrak, David O. Meltzer

Community & Environmental Health Faculty Publications

Background. Little is known about the effect of provider type and experience on outcomes, resource use, and processes of care of hospitalized patients with human immunodeficiency virus (HIV) infection. Hospitalists are caring for this population with increasing frequency.

Methods. Data from a natural experiment in which patients were assigned to physicians on the basis of call cycle was used to study the effects of provider type—that is, hospitalist versus non hospitalist—and HIV-specific inpatient experience on resource use, outcomes, and selected measures of processes of care at 6 academic institutions. Administrative data, inpatient interviews, 30-day follow-up interviews, and the National Death …


Editor's Note, Padraig O'Malley Jan 1988

Editor's Note, Padraig O'Malley

New England Journal of Public Policy

On occasion, the New England Journal of Public Policy will devote an entire issue to consideration of a public policy matter of major importance. The AIDS epidemic is such a matter, with a likely impact of overwhelming consequence well into the twenty-first century. The epidemic raises fundamental questions regarding the nature of individual freedom, our responsibilities to others, the always delicate balance between private rights and the public interest, and society's obligation to its "out" groups — whose members it has stigmatized, discriminated against, ridiculed, and treated as less than full and equal citizens. Indeed, it requires us to ask …


The Acquired Immunodeficiency Syndrome In New England: An Epidemiological Review Of The First Six Years, Laureen M. Kunches, Jeanne M. Day Jan 1988

The Acquired Immunodeficiency Syndrome In New England: An Epidemiological Review Of The First Six Years, Laureen M. Kunches, Jeanne M. Day

New England Journal of Public Policy

Between 1981 and 1987 — the six-year period following initial recognition of the acquired immunodeficiency syndrome (AIDS) — 1,475 cases were reported among residents of the six New England states. Of nearly 40,000 cases nationwide, 3.8 percent occurred among New England residents, though the region 's population represents 5.5 percent ofthe total United States population. The groups most affected include homosexual or bisexual men (65 percent) and intravenous drug users (20 percent). However, in the two southernmost states — Rhode Island and Connecticut — 32 to 40 percent of all cases have used intravenous drugs. In these states, the male:female …


The Quest For An Aids Vaccine, Robert T. Schooley Jan 1988

The Quest For An Aids Vaccine, Robert T. Schooley

New England Journal of Public Policy

More than fifty thousand cases of AIDS have been reported in the United States since the disease wasfirst described in 1981. Many times this number of people are infected with human immunodeficiency virus (HIV), which has been identified as the agent responsible for the illness. The seriousness of the disease, coupled with the relatively rapid spread of HIV, has fueled the effort for development of an effective vaccine.

Much is now known about the life cycle of the virus, and about its structural components. This information, and information about methods of transmission of the virus, form the basis for a …


Aids: Prophecy And Present Reality, Victor De Gruttola, William Ira Bennett Jan 1988

Aids: Prophecy And Present Reality, Victor De Gruttola, William Ira Bennett

New England Journal of Public Policy

Mathematical modeling of the AIDS epidemic can be useful for policymakers even though precise projections are not possible at this time. Models are useful in establishing ranges for current and future prevalence of HIV infection and incidence of AIDS, as well as in predicting the effect of a given intervention strategy. Most decision makers are using models implicitly when they use epidemiological information as a basis for policy; formulating a model explicitly permits examination of the underlying assumptions. By creating and testing a variety of models, an investigator can determine whether the models reflect more the underlying assumptions or the …


Understanding The Psychological Impact Of Aids: The Other Epidemic, Marshall Forstein Jan 1988

Understanding The Psychological Impact Of Aids: The Other Epidemic, Marshall Forstein

New England Journal of Public Policy

HIV has created two epidemics, one of disease, the other the consequence of the psychological response to that disease. Thus far, behavioral change is the only effective means of interrupting the transmission of HIV. The underlying psychological dimensions of the societal and individual responses to AIDS are discussed, with suggestions for how both rational thinking and irrational fears and anxiety contribute to the development of public policy. Examples are given of how short-term solutions to reduce anxiety may actually create long-term problems, potentially increasing the risk of transmission of HIV. Specific psychological mechanisms that contribute to the epidemic of fear …


U.S. Women And Hiv Infection, P. Clay Stephens Jan 1988

U.S. Women And Hiv Infection, P. Clay Stephens

New England Journal of Public Policy

Women are inadequately provided with HIV services and education and are differentially denied access to these. Divisions of race, ethnicity, economic class, and religion, among others, are compounded by sexual discrimination within each of these categories.

Review of current data on women with AIDS reveals that the reporting methods used convey a false impression that women are not at significant risk. Moreover, the persons indirectly affected by AIDS are predominantly women — mothers, sisters, partners, family members, teachers, and human service workers. Thus, AIDS is more of a women's issue than the statistics imply.

Women, as a gender-defined class, face …