“HIV Stops with Me”

2017 ◽  
Author(s):  
Trevor Hoppe
Keyword(s):  
Public Health ◽  
Hiv Prevention ◽  
Condom Use ◽  
Communicable Disease ◽  
People Living With Hiv ◽  
Public Health Officials ◽  
Living With Hiv ◽  
Policy Shifts ◽  
New Strategies ◽  
Health Experts

When the CDC announced its new priorities for HIV prevention in 2003, many public health advocates were alarmed—where were the condoms? This announcement came on the heels of a growing sentiment among public health experts that declining rates of condom use required new strategies for keeping the epidemic in check. This chapter tells the story of how a series of CDC policy shifts over the next decade worked to “repolarize” the very notion of HIV prevention away from targeting HIV-negative people and toward targeting people living with HIV. By framing people living with HIV as individually responsibility for preventing new infections, public health officials contributed to the notion that people with a communicable disease are responsible for their illness and, as such, blameworthy for its continued spread.

scholarly journals HIV Care Prioritization using Phylogenetic Branch Length

2019 ◽  
Author(s):  
Niema Moshiri ◽  
Davey M. Smith ◽  
Siavash Mirarab
Keyword(s):  
Public Health ◽  
Public Health Intervention ◽  
Branch Length ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Terminal Branch ◽  
Simple Strategy ◽  
Subtype B ◽  
Public Health Officials ◽  
Living With Hiv

AbstractIn HIV epidemics, the structure of the transmission network can be dictated by just a few individuals. Public health intervention, such as ensuring people living with HIV adhere to antiretroviral therapy (ART) and are continually virally-suppressed, can help control the spread of the virus. However, such intervention requires utilizing the limited public health resource allocations. As a result, the ability to determine which individuals are most at-risk of transmitting HIV could allow public health officials to focus their limited resources on these individuals. Molecular epidemiology suggests an approach: prioritizing people living with HIV based on patterns of transmission inferred from their sampled viral sequences. In this paper, we introduce ProACT (Prioritization using AnCesTral edge lengths), a phylogenetic approach for prioritizing individuals living with HIV. ProACT uses a simple idea: ordering individuals by their terminal branch length in the phylogeny of their virus. In simulations and also on a dataset of HIV-1 subtype B pol sequences obtained in San Diego, we show that this simple strategy improves the effectiveness of prioritization compared to state-of-the-art methods that rely on monitoring the growth of transmission clusters defined based on genetic distance.

scholarly journals SEPIA: Simulation-based Evaluation of Prioritization Algorithms

2021 ◽  
Author(s):  
Kimberly Almaraz ◽  
Tyler Jang ◽  
McKenna Lewis ◽  
Titan Ngo ◽  
Miranda Song ◽  
...  
Keyword(s):  
Public Health ◽  
Molecular Data ◽  
People Living With Hiv ◽  
Cluster Growth ◽  
Contact Networks ◽  
Simulation Based ◽  
Public Health Officials ◽  
Living With Hiv ◽  
Growth Approach ◽  
Better Than

Abstract Background: The ability to prioritize people living with HIV by risk of future transmissions could aid public health officials in optimizing epidemiological intervention. While methods exist to perform such prioritization based on molecular data, their effectiveness and accuracy are poorly understood, and it is unclear how one can directly compare the accuracy of different methods. We introduce SEPIA (Simulation-based Evaluation of PrIoritization Algorithms), a novel simulation-based framework for determining the effectiveness of prioritization algorithms. Under several metrics of effectiveness that we propose, we utilize various properties of the simulated contact networks and transmission histories to compare existing prioritization approaches: one phylogenetic (ProACT) and one distance-based (growth of HIV-TRACE transmission clusters). Results: Using all metrics of effectiveness that we propose, ProACT consistently slightly outperformed the transmission cluster growth approach. However, both methods consistently performed just marginally better than random, suggesting that there is significant room for improvement in prioritization tools. Conclusion: We hope that, by providing ways to quantify the effectiveness of prioritization methods in simulation, SEPIA will aid researchers in developing novel tools for prioritizing people living with HIV by risk offuture transmissions.

scholarly journals SEPIA: Simulation-based Evaluation of Prioritization Algorithms

2020 ◽  
Author(s):  
Kimberly Almaraz ◽  
Tyler Jang ◽  
McKenna Lewis ◽  
Titan Ngo ◽  
Miranda Song ◽  
...  
Keyword(s):  
Public Health ◽  
Molecular Data ◽  
People Living With Hiv ◽  
Cluster Growth ◽  
Contact Networks ◽  
Simulation Based ◽  
Public Health Officials ◽  
Living With Hiv ◽  
Growth Approach ◽  
Better Than

AbstractBackgroundThe ability to prioritize people living with HIV by risk of future transmissions could aid public health officials in optimizing epidemiological intervention. While methods exist to perform such prioritization based on molecular data, their effectiveness and accuracy are poorly understood, and it is unclear how one can directly compare the accuracy of different methods. We introduce SEPIA (Simulation-based Evaluation of PrIoritization Algorithms), a novel simulation-based framework for determining the effectiveness of prioritization algorithms. Under several metrics of effectiveness that we propose, we utilize various properties of the simulated contact networks and transmission histories to compare existing prioritization approaches: one phylogenetic (ProACT) and one distance-based (growth of HIV-TRACE transmission clusters).ResultsUsing all metrics of effectiveness that we propose, ProACT consistently slightly outperformed the transmission cluster growth approach. However, both methods consistently performed just marginally better than random, suggesting that there is significant room for improvement in prioritization tools.ConclusionWe hope that, by providing ways to quantify the effectiveness of prioritization methods in simulation, SEPIA will aid researchers in developing novel tools for prioritizing people living with HIV by risk of future transmissions.

scholarly journals SEPIA: simulation-based evaluation of prioritization algorithms

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kimberly Almaraz ◽  
Tyler Jang ◽  
McKenna Lewis ◽  
Titan Ngo ◽  
Miranda Song ◽  
...  
Keyword(s):  
Public Health ◽  
Molecular Data ◽  
People Living With Hiv ◽  
Cluster Growth ◽  
Risk Prioritization ◽  
Simulation Based ◽  
Public Health Officials ◽  
Living With Hiv ◽  
Growth Approach ◽  
Better Than

Abstract Background The ability to prioritize people living with HIV (PLWH) by risk of future transmissions could aid public health officials in optimizing epidemiological intervention. While methods exist to perform such prioritization based on molecular data, their effectiveness and accuracy are poorly understood, and it is unclear how one can directly compare the accuracy of different methods. We introduce SEPIA (Simulation-based Evaluation of PrIoritization Algorithms), a novel simulation-based framework for determining the effectiveness of prioritization algorithms. SEPIA expands upon prior related work by defining novel metrics of effectiveness with which to compare prioritization techniques, as well as by creating a simulation-based tool with which to perform such effectiveness comparisons. Under several metrics of effectiveness that we propose, we compare two existing prioritization approaches: one phylogenetic (ProACT) and one distance-based (growth of HIV-TRACE transmission clusters). Results Using all proposed metrics, ProACT consistently slightly outperformed the transmission cluster growth approach. However, both methods consistently performed just marginally better than random, suggesting that there is significant room for improvement in prioritization tools. Conclusion We hope that, by providing ways to quantify the effectiveness of prioritization methods in simulation, SEPIA will aid researchers in developing novel risk prioritization tools for PLWH.

HIV and other STIs in the United Kingdom: further increases

2003 ◽  
Vol 7 (48) ◽  
Author(s):  
◽  
Keyword(s):  
United Kingdom ◽  
Disease Surveillance ◽  
Communicable Disease ◽  
People Living With Hiv ◽  
Health Protection Agency ◽  
Protection Agency ◽  
England And Wales ◽  
The United Kingdom ◽  
The Uk ◽  
Living With Hiv

The Health Protection Agency Communicable Disease Surveillance Centre for England and Wales and others have reported that the number of people living with HIV in the UK has increased

scholarly journals Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Care ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Persons Who Inject Drugs ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

scholarly journals Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 111 ◽  
Author(s):  
Graham Brown ◽  
William Leonard ◽  
Anthony Lyons ◽  
Jennifer Power ◽  
Dirk Sander ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Gay Men ◽  
Sexual Minorities ◽  
Research Policy ◽  
Scale Up ◽  
People Living With Hiv ◽  
Structural Level ◽  
Biomedical Technologies ◽  
Living With Hiv ◽  
The Impact

Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM’s access to and use of these technologies. At the personal level, stigma can affect individual gay men’s sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM’s incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.

scholarly journals Prevalence and risk factors of pulmonary hypertension among adult patients with HIV infection in Ethiopia

2020 ◽  
Vol 10 (4) ◽  
pp. 204589402097151
Author(s):  
Dawit Kebede Huluka ◽  
Desalew Mekonnen ◽  
Sintayehu Abebe ◽  
Amha Meshesha ◽  
Dufera Mekonnen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Communicable Disease ◽  
Previous History ◽  
Systolic Pressure ◽  
Chronic Obstructive ◽  
Heart Catheterization ◽  
People Living With Hiv ◽  
Significant Difference ◽  
Living With Hiv

Globally, non-communicable diseases are increasing in people living with HIV. Pulmonary hypertension is a rare non-communicable disease in people living with HIV with a reported prevalence of <1%. However, data on pulmonary hypertension in people living with HIV from Africa are scarce and are non-existent from Ethiopia. This study aimed to examine the prevalence and severity of echocardiographic pulmonary hypertension and risk factors associated with pulmonary hypertension in people living with HIV in Ethiopia. A total of 315 consecutive adult people living with HIV followed at the Tikur Anbessa Specialized Hospital HIV Referral Clinic were enrolled from June 2018 to February 2019. Those with established pulmonary hypertension of known causes were excluded. A structured questionnaire was used to collect data on demographics, respiratory symptoms, physical findings, physician-diagnosed lung disease, and possible risk factors. Pulmonary hypertension was defined by a tricuspid regurgitant velocity of ≥2.9 m/sec on transthoracic echocardiography. A tricuspid regurgitant velocity ≥3.5, which translates into a pulmonary arterial pressure/right ventricular systolic pressure of ≥50 mmHg, was considered moderate-to-severe pulmonary hypertension. The mean age of the participants was 44.5 ± 9.8 years and 229 (72.7%) were females. Pulmonary hypertension was diagnosed in 44 (14.0%) of participants, of whom 9 (20.5%) had moderate-to-severe disease. In those with pulmonary hypertension, 17 (38.6%) were symptomatic: exertional dyspnea, cough, and leg swelling were seen in 12 (27.3%), 9 (20.5%), and 4 (9.1%), respectively. There was no significant difference in those with pulmonary hypertension compared to those without the disease by gender, cigarette smoking, previous history of pulmonary tuberculosis treatment, physician-diagnosed chronic obstructive pulmonary disease or bronchial asthma, duration of anti-retroviral therapy therapy or anti-retroviral regimen type. Pulmonary hypertension looks to be a frequent complication in people living with HIV in Ethiopia and is often associated with significant cardiopulmonary symptoms. Further studies using right heart catheterization are needed to better determine the etiology and prevalence of pulmonary hypertension in people living with HIV in Ethiopia compared to other countries.

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