HIV community viral load trends in South Carolina

2016 ◽  
Vol 28 (3) ◽  
pp. 265-276 ◽  
Author(s):  
Hrishikesh Chakraborty ◽  
Sharon Weissman ◽  
Wayne A Duffus ◽  
Akhtar Hossain ◽  
Ashok Varma Samantapudi ◽  
...  
Keyword(s):  
South Carolina ◽  
Viral Load ◽  
Hiv Risk ◽  
Rural Areas ◽  
Risk Group ◽  
The State ◽  
Transmission Risk ◽  
Hiv Viral Load ◽  
Single Tablet Regimen ◽  
Over Time

Community viral load is an aggregate measure of HIV viral load in a particular geographic location, community, or subgroup. Community viral load provides a measure of disease burden in a community and community transmission risk. This study aims to examine community viral load trend in South Carolina and identify differences in community viral load trends between selected population subgroups using a state-wide surveillance dataset that maintains electronic records of all HIV viral load measurements reported to the state health department. Community viral load trends were examined using random mixed effects models, adjusting for age, race, gender, residence, CD4 counts, HIV risk group, and initial antiretroviral regimen during the study period, and time. The community viral load gradually decreased from 2004 to 2013 ( p < 0.0001). The number of new infections also decreased ( p = 0.0001) over time. A faster rate of decrease was seen among men compared to women ( p < 0.0001), men who have sex with men ( p = 0.0001) compared to heterosexuals, patients diagnosed in urban areas compared to that in rural areas ( p = 0.0004), and patients prescribed single-tablet regimen compared to multiple-tablet regimen ( p < 0.0001). While the state-wide community viral load decreased over time, the decline was not uniform among residence at diagnosis, HIV risk group, and single-tablet regimen versus multiple-tablet regimen subgroups. Slower declines in community viral load among females, those in rural areas, and heterosexuals suggest possible disparities in care that require further exploration. The association between using single-tablet regimen and faster community viral load decline is noteworthy.

HIV Viral Load: A Concept Analysis and Critique

2014 ◽  
Vol 28 (3) ◽  
pp. 204-227 ◽  
Author(s):  
Marilou Gagnon ◽  
Adrian Guta
Keyword(s):  
Viral Load ◽  
Concept Analysis ◽  
Collection Management ◽  
Practice Research ◽  
Analysis Method ◽  
Critical Approach ◽  
Hiv Viral Load ◽  
Evolutionary View ◽  
Antecedents And Consequences ◽  
Over Time

In this article, we examine the concept of HIV viral load and how it has evolved over time (1995–2013) in the field of HIV/AIDS. Although the termviral loadis used extensively in this field, few efforts have been directed toward the conceptualization of HIV viral load, which is often left unquestioned, undertheorized, and portrayed as a neutral and objective laboratory value that has remained relatively stable over time—with the exception of progressive advancements in technology, techniques, and sensitivity. The purpose of this article is to apply the evolutionary concept analysis method developed by Rodgers (1989, 2000a) to the concept of HIV viral load. To set the stage, we establish the need for a concept analysis of HIV viral load and provide an overview of the evolutionary view. Then, drawing on the steps proposed by Rodgers (2000a), we outline the process of data collection, management, and analysis. We then offer an in-depth discussion of the findings (attributes, antecedents, and consequences) informed by Wuest’s (2000) critical approach to concept analysis. We conclude by highlighting the implications of this analysis for clinical practice, research, and theory.

demand for producer goods (that is, implements, fertilisers, etc.) was largely left unsatisfied, a fact which eroded the peasants' productive basis. The exchange with the peasantry became conditioned by the following three interlocking phenomena: (1) the reduction in relative and in absolute terms of official marketing of crops as result of the rapid expansion of parallel markets; (2) the galloping inflation of prices in the parallel markets; and (3) the consequent rapid depreciation of the currency and the increased reluctance to accept the metical in exchange for sale of goods. Although the surface appearances of these phenomena were generally recog-nised, the explanation of the underlying mechanisms was by no means clear. The dominant explanation of the problem came from the ministry of internal commerce which was in its day-to-day operation more directly con-fronted with the problem. According to this view the nature of the problem was the withdrawal from the market by the peasantry since money no longer bought goods. Hence, the payment of rural wages and the buying of cash crops channelled a volume of money into the economy far in excess of available pro-ducer and consumer goods directed to the peasantry. Cash balances therefore accumulated over time and the stimulus to further production was blunted. The fact that the supply of commodities destined to be traded with the peasantry was, in terms of value, far in excess of the official marketing of crops was the often quoted proof that peasants simply ran down cash balances to buy goods and did not produce more for exchange. This view often overlooked the impact of the demand springing from the wage bill and, hence, directly equated the difference between the supply of goods to the peasantry and the goods obtained in return with the running down of cash balances accumulated by the peasantry. The problem therefore was seen as one of an excessive volume of money being held in the rural areas: peasants had too much money relative to the available supply of goods. Therefore, they withdrew from the market and preferred to buy up any supplies forthcoming with the money in hand rather than through production. Implicit in this view was a conception of a single circuit of exchange between the state sector and the peasantry in which the state buys with money either cash crops or labour power, and subsequently the peasantry buys consumer and producer commodities from the state sector (with or without the intermediation of private trade). If both parts do not balance in value, idle balances of money will build up in the hands of the peasantry and over time blunt the incentive of production. The preoccupation was thus with the stock of money in the hands of the peasantry (as a measure of frustrated demand) and little attention was paid to its velocity since it was implicitly assumed that these balances remained idle (stuck in the peasants' pockets). Therefore, concerning economic policy, a solution was sought in the direction of neutralising the interference of accumulated balances by linking sale and purchase together. Hence, commodities would be sold to the peasantry only in exchange for the purchase of cash crops. Similarly, state farms would guarantee a certain part of the wage in kind to assure the flow of labour.

2013 ◽  
pp. 206-207
Keyword(s):  
Rural Areas ◽  
The State ◽  
Rapid Expansion ◽  
State Sector ◽  
Cash Crops ◽  
The Difference ◽  
Underlying Mechanisms ◽  
Rural Wages ◽  
The Impact ◽  
Over Time

scholarly journals Sexually transmitted infections in persons living with HIV infection and estimated HIV transmission risk: trends over time from the DC Cohort

2020 ◽  
Vol 96 (2) ◽  
pp. 89-95
Author(s):  
Alessandra Anna Secco ◽  
Hana Akselrod ◽  
Jonathan Czeresnia ◽  
Matthew Levy ◽  
Morgan Byrne ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Transmission ◽  
Limit Of Detection ◽  
Cohort Analysis ◽  
Incidence Rates ◽  
Transmission Risk ◽  
Washington Dc ◽  
Hiv Viral Load ◽  
Persons Living With Hiv ◽  
The Usa

ObjectiveA rise in incidence of STIs has been noted in the USA and in the District of Columbia (DC). We aim to describe changes in incident STIs among persons in care for HIV in Washington, DC as well as trends in HIV viral load among those with incident STIs.MethodsWe conducted a retrospective DC Cohort analysis (n=7810) measuring STI incidence (syphilis, gonorrhoea and chlamydia) as well as incare viral load (ICVL) and percentage with all viral loads less than the limit of detection (%<LLOD) by year (2012–2016) among those with incident STIs.ResultsFrom 2012 to 2016, the incidence of STIs increased: chlamydia from 2.1 to 3.4 cases/100 person-years (p=0.0006), gonorrhoea from 2.1 to 4.0 (p<0.0001), syphilis from 1.7 to 2.6 (p=0.0042) and any STI episode from 5.3 to 8.8 (p<0.0001). STI incidence rates increased for those aged 18–34 (from 13.2 to 23.2 cases/100 person-years, p<0.0001), cisgender men (from 6.5 to 11.5, p<0.0001), non-Hispanic whites (from 8.6 to 16.1, p=0.0003) and men who have sex with men (from 9.3 to 15.7, p<0.0001). During 2012–2016, the ICVL among those with incident STIs improved from 108 to 19 copies/mL and %<LLOD from 23.6% to 55.1%. However, even in 2016, younger participants, cisgender and transgender women, non-Hispanic blacks and Hispanics had higher ICVLs and lower %<LLOD.ConclusionsRates of incident STIs rose among persons in care for HIV in Washington, DC, with improved but not optimal measures of HIV viral suppression. These findings inform focused interventions towards preventing STI transmission and ending the HIV epidemic.

scholarly journals Opioid Misuse in Missouri: Analyzing Emergency Department Use in Urban/Rural Areas

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Evan Mobley ◽  
Andrew Hunter ◽  
Whitney Coffey
Keyword(s):  
Emergency Department ◽  
Rural Areas ◽  
Urban Areas ◽  
The State ◽  
Opioid Overdose ◽  
Metro Area ◽  
Urban Rural ◽  
Ed Visits ◽  
Changes Over Time ◽  
Over Time

ObjectiveCompare rate changes over time for Emergency Department (ED) visits due to opioid overdose in urban versus rural areas of the state of Missouri.IntroductionLike many other states in the U.S., Missouri has experienced large increases in opioid abuse resulting in hundreds dying each year and thousands of ED visits due to overdose. Missouri has two major urban areas, St. Louis and Kansas City and a few smaller cities, while the remainder of the state is more rural in nature. The opioid epidemic has impacted all areas in the state but the magnitude of that impact varies as well as the type of opioid used. Missouri Department of Health and Senior Services (MODHSS) maintains the Patient Abstract System (PAS) which contains data from hospitals and ambulatory surgical centers throughout the state. PAS includes data from ED visits including information on diagnoses, patient demographics, and other information about the visit. MODHSS also participates in the Enhanced State Surveillance of Opioid-involved Morbidity and Mortality project (ESOOS). One major aspect of this surveillance project is the collection of data on non-fatal opioid overdoses from ED visits. Through this collection of data, MODHSS analyzed opioid overdose visits throughout the state, how rates compare across urban and rural areas, and how those rates have changed over time.MethodsThe 115 counties in Missouri were organized into the six-level urban-rural classification scheme developed by the National Center for Health Statistics (NCHS). The attached table shows the breakout of counties into the six different categories. The data years analyzed were 2012 through 2016. ED visits due to opioid overdose were identified using case definitions supplied by ESOOS. Overdoses were analyzed in three different categories—all opioids, heroin, and non-heroin opioids. The all opioid category combines heroin and non-heroin opioids. Non-heroin opioids includes prescription drugs such as oxycodone, hydrocodone, fentanyl, and fentanyl analogues. Annual rates per 10,000 were calculated for each county classification using population estimates. Confidence intervals (at 95%) were then calculated using either inverse gamma when the number of ED visits was under 500, or Poisson when the number was 500 or more. Changes over time were calculated using both a year over year method and a 5 year change method.ResultsOverall opioid rates have increased in all geographic areas during the 5 year period analyzed. Large Central Metro and Large Fringe Metro counties had the highest rates of ED visits due to opioid overdose. These two classifications also saw the largest increases in rates. The Large Central Metro counties collectively increased over 125%, while the Large Fringe Metro area increased 130%. Both areas experienced statistically significant increases year-to-year between 2014 and 2016 in addition to the overall 5 year period of 2012-2016.Analysis was also conducted for heroin and non-heroin subsets of opioid abuse. There were important differences in these two groups. For heroin ED visits, the highest rates were found in the Large Central Metro and Large Fringe Metro regions. However, the largest increase in percentage terms were found in the Medium Metropolitan, Micropolitan and Noncore regions which all saw increases of over 300%. Notably, every region experienced increases of over 150%. The Medium Metro had two consecutive years (2013/2014 and 2014/2015) where the heroin ED rate more than doubled.In contrast, non-heroin ED visits did not experience such a large increase over time. Most areas saw small fluctuations year-to-year with moderate overall increases over the 5-year time period. The exception to this trend is the Large Fringe Metro area, which saw increases every year most notably between 2014 and 2015 and had by far the largest 5 year increase at 82%.ConclusionsThe urban areas in Missouri continue to have the highest rates of opioid overdose, however all areas within the state have experienced very large increases in heroin ED visits within the past five years. The increase in heroin ED visits in the rural areas suggests the abuse of heroin has now spread throughout the state, as rates were much lower in 2012. The steady increase in non-heroin opioids unique to the Large Fringe Metro may be due to the availability of fentanyl in urban areas especially the St. Louis area. This possible finding would correspond with the increased deaths due to fentanyl experienced in and around the St. Louis urban area that has been identified through analysis of death certificate data. 

scholarly journals Fauna of Culicidae in rural areas of Porto Velho and the first record of Mansonia (Mansonia) flaveola (Coquillet, 1906), for the state of Rondônia, Brazil

2012 ◽  
Vol 45 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Renata Antonaci Gama ◽  
Ivoneide Maria da Silva ◽  
Hamilton Antônio de Oliveira Monteiro ◽  
Álvaro Eduardo Eiras
Keyword(s):  
Rural Areas ◽  
Brazilian Amazon ◽  
First Record ◽  
The State ◽  
Current Understanding ◽  
Rural Regions ◽  
Bg Sentinel ◽  
First Time ◽  
Porto Velho ◽  
Over Time

INTRODUCTION: Knowledge concerning the fauna of Culicidae in the Brazilian Amazon States contributes to current understanding of the bionomics of the insects collected and makes it possible to observe changes in the fauna over time. METHODS: The Culicidae were captured with a BG-Sentinel® trap in extra-domiciliary area of two rural regions of Porto Velho in June and July of 2007 and 2008. RESULTS: A total of 10,695 Culicidae was collected, belonging to nine genera: Coquillettidia, Culex, Mansonia, Psorophora, Aedes, Aedeomyia, Anopheles, Uranotaenia and Wyeomyia. CONCLUSIONS: The presence of Mansonia (Mansonia) flaveola was recorded in the State of Rondônia for the first time.

scholarly journals Characterizing the Human Immunodeficiency Virus Care Continuum Among Transgender Women and Cisgender Women and Men in Clinical Care: A Retrospective Time-series Analysis

2019 ◽  
Vol 70 (6) ◽  
pp. 1131-1138 ◽  
Author(s):  
Tonia Poteat ◽  
David B Hanna ◽  
Peter F Rebeiro ◽  
Marina Klein ◽  
Michael J Silverberg ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Risk ◽  
Viral Suppression ◽  
Risk Group ◽  
Retention In Care ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Immunodeficiency Virus ◽  
Over Time

Abstract Background Prior studies suggest that transgender women (TW) with human immunodeficiency virus (HIV) are less likely to be virally suppressed than cisgender women (CW) and cisgender men (CM). However, prior data are limited by small sample sizes and cross-sectional designs. We sought to characterize the HIV care continuum comparing TW to CW and CM in the United States and Canada. Methods We analyzed annual HIV care continuum outcomes by gender status from January 2001 through December 2015 among adults (aged ≥18 years) in 15 clinical cohorts. Outcomes were retention in care and viral suppression. Results The study population included TW (n = 396), CW (n = 14 094), and CM (n = 101 667). TW had lower proportions retained in care than CW and CM (P &lt; .01). Estimates of retention in care were consistently lower in TW, with little change over time within each group. TW and CW had similar proportions virally suppressed over time (TW, 36% in 2001 and 80% in 2015; CW, 35% in 2001 and 83% in 2015) and were lower than CM (41% in 2001 and 87% in 2015). These differences did not reach statistical significance after adjusting for age, race, HIV risk group, and cohort. Conclusions TW experience challenges with retention in HIV care. However, TW who are engaged in care achieve viral suppression that is comparable to that of CW and CM of similar age, race, and HIV risk group. Further research is needed to understand care engagement disparities.

scholarly journals Diagnosis of latent tuberculosis infection is associated with reduced HIV viral load and lower risk for opportunistic infections in people living with HIV

PLoS Biology ◽  
2020 ◽  
Vol 18 (12) ◽  
pp. e3000963
Author(s):  
Katharina Kusejko ◽  
Huldrych F. Günthard ◽  
Gregory S. Olson ◽  
Kyra Zens ◽  
Katharine Darling ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Transmission ◽  
Opportunistic Infections ◽  
Latent Tuberculosis ◽  
Geographic Region ◽  
Transmission Risk ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Set Point

Approximately 28% of the human population have been exposed to Mycobacterium tuberculosis (MTB), with the overwhelming majority of infected individuals not developing disease (latent TB infection (LTBI)). While it is known that uncontrolled HIV infection is a major risk factor for the development of TB, the effect of underlying LTBI on HIV disease progression is less well characterized, in part because longitudinal data are lacking. We sorted all participants of the Swiss HIV Cohort Study (SHCS) with at least 1 documented MTB test into one of the 3 groups: MTB uninfected, LTBI, or active TB. To detect differences in the HIV set point viral load (SPVL), linear regression was used; the frequency of the most common opportunistic infections (OIs) in the SHCS between MTB uninfected patients, patients with LTBI, and patients with active TB were compared using logistic regression and time-to-event analyses. In adjusted models, we corrected for baseline demographic characteristics, i.e., HIV transmission risk group and gender, geographic region, year of HIV diagnosis, and CD4 nadir. A total of 13,943 SHCS patients had at least 1 MTB test documented, of whom 840 (6.0%) had LTBI and 770 (5.5%) developed active TB. Compared to MTB uninfected patients, LTBI was associated with a 0.24 decreased log HIV SPVL in the adjusted model (p < 0.0001). Patients with LTBI had lower odds of having candida stomatitis (adjusted odds ratio (OR) = 0.68, p = 0.0035) and oral hairy leukoplakia (adjusted OR = 0.67, p = 0.033) when compared to MTB uninfected patients. The association of LTBI with a reduced HIV set point virus load and fewer unrelated infections in HIV/TB coinfected patients suggests a more complex interaction between LTBI and HIV than previously assumed.

Opponent Center-Surround Contrast: Colour to Grey Conversion

2020 ◽  
Vol 2020 (1) ◽  
pp. 105-108
Author(s):  
Ali Alsam
Keyword(s):  
Evolutionary Algorithms ◽  
Three Dimensional ◽  
The State ◽  
Colour Space ◽  
Vision Science ◽  
State Of Art ◽  
Over Time

Vision is the science that informs us about the biological and evolutionary algorithms that our eyes, opticnerves and brains have chosen over time to see. This article is an attempt to solve the problem of colour to grey conversion, by borrowing ideas from vision science. We introduce an algorithm that measures contrast along the opponent colour directions and use the results to combine a three dimensional colour space into a grey. The results indicate that the proposed algorithm competes with the state of art algorithms.

A PROPOSED EVALUATION PLAN TO ASSESS THE IMPACT OF A YOUTH DEVELOPMENT PROGRAMME FACILITATED BY THE STATE INFORMATION TECHNOLOGY AGENCY (SITA) IN RURAL SOUTH AFRICA

2017 ◽  
Vol 14 (1) ◽  
pp. 174-181
Author(s):  
Maura Mbunyuza-deHeer Menlah
Keyword(s):  
Information Technology ◽  
Youth Development ◽  
Rural Areas ◽  
Secondary Data ◽  
The State ◽  
State Information ◽  
Evaluation Plan ◽  
Lessons Learnt ◽  
Slow Development ◽  
The Impact

This article reports on a proposed evaluation plan that has been developed to assess the work done by the State Information Technology Agency (SITA). The SITA programme was implemented in response to the South African government’s call to improve the lives of the populations in some rural areas through technology. The programme was meant to address slow development in  rural  areas  that  lack  technological  innovations  and  advances.  In  the proposed evaluation plan a review is made of secondary data, deciding how strategic priorities are to be determined, as well as analysis of the rural context environment. The researcher gives an account of how the evaluation strategies are to be piloted and rolled out thereafter. Lessons learnt are recorded and reported upon. A proposed evaluation plan will be developed, based on the lessons learnt in line with the objectives of the project.

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