Pandemics and Social Work

The onset of the Covid-19 pandemic in 2020 confronted health and also social services globally with unprecedented challenges. These amounted to a combination of increased demands for support to individuals and families whose physical and mental health and economic security were threatened by the rapid spread of the virus and the imposed limitations to direct contacts with service users. This constituted a situation for which there was no immediate historical parallel but from which important lessons for better preparedness for future global disasters and pandemics can be drawn. There existed no specific introductions to or textbooks on social work responses to pandemics and the nearest usable references concerned social work involvement in the HIV/AIDS epidemic and in the aftermath of natural disasters. Frontline social workers were at first forced to improvise ways of establishing and maintaining contacts with service users partly through electronic means and partly by taking personal risks. This is reflected in an initial delay in the production of comprehensive theoretical reflections on the practice implications of the new situation. Practitioners resorted to pragmatism, which became manifest in numerous episodic practice accounts and brief statements in social work journals which nevertheless contain important messages for new practice developments. Notably, the International Federation of Social Workers (IFSW) opened an online exchange and advice platform for social workers globally and also hosted a series of webinars. Nevertheless, books with collections of contributions from various practice fields and geographical areas soon began to appear. In view of the interdisciplinary nature of social work responses required in the pandemic the use of publications from a wider range of academic disciplines and related professions was indicated for this review.

Queer Epidemics

This chapter of my book Bodies Out of Rule (2014) considers John Greyson's Zero Patience – a 1993 musical satire on the early days of the AIDS epidemic – in the context of the epidemiological and immunity discourses inherent in neoliberal biopolitics. Greyson's film can be read as a queer critique of the broadly understood epidemiological operations of biopower, especially its authoritarian systematizations and taxonomizations that establish a certain "regime of truth" and are a necessary condition for the effective regulation of social practices and subjects. Through my reading of Greyson's film, I argue for a queer reclamation of the feared figure of the virus as a thoroughly transversal figure that transcends existing boundaries, identities, and cognitive categories.

Free terminal time optimal control of a fractional-order model for the HIV/AIDS epidemic

In this paper, we present a fractional model for the HIV/AIDS epidemic and incorporate into the model control parameters of pre-exposure prophylaxis (PrEP), behavioral change and antiretroviral therapy (ART) aimed at controlling the spread of diseases. We prove the local and global asymptotic stability of disease-free and endemic equilibria of the model. We present a general fractional optimal control problem (FOCP) with free terminal time and develop the Adapted Forward-Backward Sweep method for numerical solving of the FOCP. Necessary conditions for a state/control/terminal time triplet to be optimal are obtained. The results show that the use of all controls increases the life expectancy of HIV-treated patients with ART and remarkably increases the number of people undergoing PrEP and changing their sexual habits. Also, when the derivative order [Formula: see text] ([Formula: see text]) limits to 1, the value of optimal terminal time increases while the value of objective functional decreases.

Perfil epidemiológico das pessoas que vivem com HIV-AIDS: um desafio social

A síndrome da imunodeficiência adquirida (SIDA; AIDS - acquired immunodeficiency syndrome) é uma manifestação clínica avançada, decorrente de um quadro de imunodeficiência causado pelo vírus da imunodeficiência humana (VIH, HIV-human immunodeficiency virus), o qual é transmitido pelas vias sexual, parenteral ou vertical. (UNAIDS. AIDS epidemic update; 2007). O HIV altera o DNA da célula, cria um ciclo de infecção em que, continuamente se multiplica, o que a tornou uma patologia crônica e potencialmente letal (Brasil, 2020). Para conter o quadro epidêmico da doença, faz-se estritamente necessário o acompanhamento e tratamento dos pacientes infectados. Diante disso, foi realizado a partir deste artigo, um estudo transversal descritivo, com base em dados do SINAN (Sistema de Informação de Agravos de Notificação), disponíveis no DATASUS, entre os períodos de 2010 e 2020, em cujo objetivo foi verificar o perfil epidemiológico das pessoas que vivem com HIV-AIDS, no Município de Vitória da Conquista, e constatar os efeitos da estigmatização da doença, do preconceito e mais atualmente da pandemia causada pelo vírus Covid-19. Dos dados coletados, cerca de 59,81% dos pacientes eram do sexo masculino, e 56,12% do sexo feminino. A maioria dos casos diagnosticados eram jovens de 18 a 28 anos. Em relação às notificações, as mesmas se mantiveram instáveis até o ano de 2019, no total em cerca de 24.000 a 25.000 casos notificados. Já no ano de 2020, ocorreu uma queda, com 8.434 casos notificados. Quanto à questão das raças, na pesquisa apontam para um aumento no número de casos de aids entre os pretos e pardos para ambos os sexos; negros foram cerca de 3.000 em 2008, passando por 1.915 em 2019, decaindo para 541 casos. Já os pardos, em cerca de 9.000 mil, em 2008, decaindo para 2.474, em 2020, enquanto que entre os brancos apontam para uma redução proporcional. Portanto, o estudo conclui que, questões sociais e outros fatores externos refletem no perfil de pacientes infectados pelo vírus HIV, assim como provocam alterações nos índices da doença no município de Vitória da Conquista.

HIV/AIDS late presentation and its associated factors in China from 2010 to 2020: a systematic review and meta-analysis

Background Late presentation to HIV/AIDS care presents serious health concerns, like increased transmission and high healthcare costs, increased mortality, early development of opportunistic infection, increased risk of antiretroviral therapy drug resistance. Despite the effort to contain the HIV/AIDS epidemic, LP has remained an impediment to individual immune reconstitution and public health. Objective This review aimed to estimate the prevalence and determine the factors associated with late presentation to HIV/AIDS care. Methods We searched PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Wanfang, and Weipu database for articles published from 2010 to 2020. We utilized I2 statistics and Q-test to estimate heterogeneity between studies. Random-effects meta-analysis models were used to calculate the aggregate odds ratio of late presentation to HIV/AIDS care. Results Of 9563 titles and abstracts retrieved, 189 were identified as potentially eligible and 39 fulfilled the inclusion criteria. The pooled prevalence of late presentation to HIV/AIDS care was 43.26%. The major risk factors were patients ≥ 50 years old (OR = 2.19, 95% CI: 1.85–2.58; I2 = 97.44%), married (OR = 1.50, 95% CI: 1.35–1.68; I2 = 96.58%), with heterosexual contact as risk factor for infection (OR = 1.91, 95% CI: 1.73–2.11; I2 = 90.74%) and diagnosed in medical institutions (OR = 2.35,95% CI: 2.11–2.62; I2 = 96.05%). In middle or low HIV prevalence areas, patients ≥ 50 years old (P = 0.01), married (P < 0.01) and diagnosed in medical institutions (P = 0.01) were more likely to be presented late than in high prevalence areas. From 2016–2020, the OR of patients who were married and diagnosed in medical facilities were significantly lower than before (P < 0.01). Conclusion Patients ≥ 50 years old, married, with heterosexual contact as risk factor for infection, and diagnosed in medical institutions were risk factors of LP. Gender had no significant relationship with LP. In middle or low prevalence areas, patients who were ≥ 50 years old, married, and diagnosed in medical institutions were more likely to be presented late than in other areas. Married patients and those diagnosed in medical institutions after 2015 have a lower risk of LP than before.

When does an epidemic become a ‘crisis’? Analogies between Covid-19 and HIV/AIDS in American public memory

This article critically interrogates historical analogies made between the Covid-19 pandemic and HIV/AIDS epidemic in American public discourse, highlighting the role of cultural memory and normative frameworks of ‘crisis’ and its temporalities in shaping collective responses. It situates the Covid-19 pandemic in a multidirectional mnemonic frame by analysing borrowings from other usable pasts, particularly the HIV/AIDS epidemic in the United States, which in turn drew upon memory of the Holocaust. A reading of Susan Sontag’s ‘The Way We Live Now’ affirms the value of multidirectional cultural borrowing while also revealing its limits. Notably, the ever-growing AIDS Memorial Quilt may serve as a model for memorializing victims of Covid-19. While analogies between pandemics may be comforting or mobilizing, their meaning must remain open to contestation and also preserve particularities and differences. The history of HIV/AIDS centres the question, ‘crisis for whom?’ and cautions against prematurely declaring the ‘end’ of the Covid-19 pandemic.

Maasai Girls’ Experiences of Ukimwi ni Homa (AIDS Is a Fever): Idioms of Vulnerability and HIV Risk in East Africa

There have been enormous strides in response to the AIDS epidemic in the past decades; however, adolescent girls and young women (AGYW) remain at high risk for new HIV infection throughout sub-Saharan Africa. Recognizing this continued discrepancy, I call for more attention to girls’ perceptions of vulnerabilities by revisiting an ethnographic study of HIV risk carried out in 2004 in a rural community in Kenya. My analysis situates Maasai AGYW perceptions and understandings of HIV risk as a culturally constructed idiom of distress: “Ukimwi ni Homa” (AIDS is a fever). I examine the emic perspectives of HIV vulnerability and the association of sexual relationships within the context of economic precarity. Findings demonstrate how references to fevers expressed feelings of helplessness, which increased indifference to HIV risk. This indifference led AGYW to prioritize imminent economic needs over long-term effects of a viral infection that they perceived as inevitable. Critically reflecting on AGYW understandings of their own risk perceptions can influence effective HIV intervention design. My conclusions support the need for tailoring combination prevention approaches to address perceived vulnerabilities within populations. Such perspectives add valuable insights to studies rooted in cultural constructions of illness perspective.

AIDS Related Kaposi’s Sarcoma: A 20-Year Experience in a Clinic from the South-East of Romania

Kaposi’s sarcoma (KS) was peculiarly described in the first notified cases of the acquired immunodeficiency syndrome as an opportunistic condition. However, the medical progress and the development of active antiretroviral therapy allowed the control of the HIV/AIDS epidemic, although the features of KS have changed throughout the past decades. The purpose of our study is to assess the epidemiological and clinical features of AIDS related KS in Romanian patients. A retrospective follow-up study was achieved in a single infectious diseases’ clinic from Galati—Romania, between 2001 and 2021. Referring to 290 new HIV diagnosed cases from our clinic retained in care, the prevalence of KS was 3.4%. The main characteristics of patients with KS are a median age of 33, a predominance of males, prevalent severe systemic forms of diseases, frequent association of past or concomitant tuberculosis, and context of immune reconstruction syndrome. The mortality rate was 70%. KS has occurred in patients with delayed HIV diagnoses and inadequate adherence to therapy. Early recognition of both infections, the close monitoring of latent or symptomatic tuberculosis, improving the antiretroviral adherence and raising the access to oncologic procedures in Romanian HIV patients could improve their prognosis related to KS.

Rapid Response to SARS-CoV-2 in Aotearoa New Zealand: Implementation of a Diagnostic Test and Characterization of the First COVID-19 Cases in the South Island

It has been 20 months since we first heard of SARS-CoV-2, the novel coronavirus detected in the Hubei province, China, in December 2019, responsible for the ongoing COVID-19 pandemic. Since then, a myriad of studies aimed at understanding and controlling SARS-CoV-2 have been published at a pace that has outshined the original effort to combat HIV during the beginning of the AIDS epidemic. This massive response started by developing strategies to not only diagnose individual SARS-CoV-2 infections but to monitor the transmission, evolution, and global spread of this new virus. We currently have hundreds of commercial diagnostic tests; however, that was not the case in early 2020, when just a handful of protocols were available, and few whole-genome SARS-CoV-2 sequences had been described. It was mid-January 2020 when several District Health Boards across New Zealand started planning the implementation of diagnostic testing for this emerging virus. Here, we describe our experience implementing a molecular test to detect SARS-CoV-2 infection, adapting the RT-qPCR assay to be used in a random-access platform (Hologic Panther Fusion® System) in a clinical laboratory, and characterizing the first whole-genome SARS-CoV-2 sequences obtained in the South Island, right at the beginning of the SARS-CoV-2 outbreak in New Zealand. We expect that this work will help us and others prepare for the unequivocal risk of similar viral outbreaks in the future.