Academic literature on the topic 'HIV infections – Botswana – Case studies'
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Journal articles on the topic "HIV infections – Botswana – Case studies"
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Neshumaev, D. A., E. N. Sukharev, and V. L. Stasenko. "Modeling the epidemic process of HIV infection in populations with different natural population growth." Journal Infectology 13, no. 2 (July 14, 2021): 115–25. http://dx.doi.org/10.22625/2072-6732-2021-13-2-115-125.
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Aim: to assess the incidence, prevalence of HIV infection and population dynamics in populations with negative, zero and positive natural increase.Materials and Methods: Computer probabilistic modeling by the Monte Carlo method of the epidemic process of HIV infection in populations with different natural population growths was carried out. The parameters that are minimally necessary for such a description are used – population, birth rate, mortality, HIV prevalence, probability of HIV transmission.Results and discussion: When modeling the epidemic process, two main scenarios of the spread of HIV infection in a population without diagnostic, therapeutic and preventive effects were established. With a negative or zero population growth and a random distribution of healthy and infected individuals in the simulated space, the population density gradually decreases. At some point, the probability of contact of the infected and healthy person becomes less than the probability of an infected person to live up to this event. Under such conditions, the complete elimination of the virus from the population is theoretically possible. With a positive natural increase, it is possible to form a stable state in which the periods of increase in population size, incidence and prevalence of HIV infection change in a cyclical decline. HIV prevalence in countries such as Swaziland, Botswana and Lesotho has been at the level of 25–30% for many years. In this case, the population steadily grows. Based on the conducted simulation studies, it can be assumed that in these territories an evolutionarily stable balance was formed between the share of healthy and HIV-infected people in which the prevalence does not occur above 30%.Conclusions. The development of the epidemic process of HIV infection is determined by the dynamics of natural population growth. With a negative or zero natural growth and a random distribution of individuals in the simulated space, a complete elimination of the virus from the population is theoretically possible. With a positive natural increase, it is possible to form an evolutionarily stable cyclic balance between the proportion of healthy and HIV-infected people.
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Grover, Surbhi, Nicola Zetola, Doreen Ramogola-Masire, Memory Bvochora-Nsingo, Allison F. Schnader, Rosemarie Mick, Lesego Gabaitiri, et al. "Building research capacity through programme development and research implementation in resource-limited settings - the Ipabalele study protocol: observational cohort studies determining the effect of HIV on the natural history of cervical cancer in Botswana." BMJ Open 9, no. 12 (December 2019): e031103. http://dx.doi.org/10.1136/bmjopen-2019-031103.
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IntroductionThe global burden of cancer continues to increase in low- and middle-income countries, particularly in sub-Saharan Africa (SSA). Botswana, a middle-income country in SSA, has the second highest prevalence of HIV worldwide and has seen an increase in human papillomavirus (HPV)-associated cervical cancer over the last decade in the setting of improved survival of HIV-infected women. There is an urgent need to understand more clearly the causes and consequences of HPV-associated cervical cancer in the setting of HIV infection. We initiated the Ipabalele (‘take care of yourself’ in Setswana) programme to address this need for new knowledge and to initiate long-term research programme capacity building in the region. In this manuscript, we describe the components of the programme, including three main research projects as well as a number of essential cores to support the activities of the programme.Methods and proceduresOur multidisciplinary approach aims to further current understanding of the problem by implementing three complementary studies aimed at identifying its molecular, behavioural and clinical determinants. Three participant cohorts were designed to represent the early, intermediate and late stages of the natural history of cervical cancer.The functional structure of the programme is coordinated through programmatic cores. These allow for integration of each of the studies within the cohorts while providing support for pilot studies led by local junior investigators. Each project of the Ipabalele programme includes a built-in capacity building component, promoting the establishment of long-lasting infrastructure for future research activities.Ethics and disseminationInstitutional review board approvals were granted by the University of Pennsylvania, University of Botswana and Ministry of Health and wellness of Botswana. Results will be disseminated via the participating institutions and with the help of the Community Advisory Committee, the project’s Botswana advisory group.
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Buthu'gwashe, Buthu'gwashe, Zhiyong Li, and Clement Kirui. "Optimizing Predictive Mining Techniques in HIV-Related Opportunistic Infections: Case for Botswana." International Journal of Computer Applications 76, no. 9 (August 23, 2013): 2–6. http://dx.doi.org/10.5120/13272-9943.
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Anderson, Motswedi, Wonderful Choga, Sikhulile Moyo, Trevor Bell, Tshepiso Mbangiwa, Bonolo Phinius, Lynnette Bhebhe, et al. "Molecular Characterization of Near Full-Length Genomes of Hepatitis B Virus Isolated from Predominantly HIV Infected Individuals in Botswana." Genes 9, no. 9 (September 7, 2018): 453. http://dx.doi.org/10.3390/genes9090453.
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The World Health Organization plans to eliminate hepatitis B and C Infections by 2030. Therefore, there is a need to study and understand hepatitis B virus (HBV) epidemiology and viral evolution further, including evaluating occult (HBsAg-negative) HBV infection (OBI), given that such infections are frequently undiagnosed and rarely treated. We aimed to molecularly characterize HBV genomes from 108 individuals co-infected with human immunodeficiency virus (HIV) and chronic hepatitis B (CHB) or OBI identified from previous HIV studies conducted in Botswana from 2009 to 2012. Full-length (3.2 kb) and nearly full-length (~3 kb) genomes were amplified by nested polymerase chain reaction (PCR). Sequences from OBI participants were compared to sequences from CHB participants and GenBank references to identify OBI-unique mutations. HBV genomes from 50 (25 CHB and 25 OBI) individuals were successfully genotyped. Among OBI participants, subgenotype A1 was identified in 12 (48%), D3 in 12 (48%), and E in 1 (4%). A similar genotype distribution was observed in CHB participants. Whole HBV genome sequences from Botswana, representing OBI and CHB, were compared for the first time. There were 43 OBI-unique mutations, of which 26 were novel. Future studies using larger sample sizes and functional analysis of OBI-unique mutations are warranted.
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Ligthelm, Robert J., Alexander G. C. Bauer, and Pieter J. Wismans. "Case Studies of Acute HIV-1 Infections Acquired While Visiting Subsaharan Africa." Journal of Travel Medicine 2, no. 3 (September 1, 1995): 196–98. http://dx.doi.org/10.1111/j.1708-8305.1995.tb00654.x.
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Mulale, Unami Koolebogile, Thanolo Kashamba, Jonathan Strysko, and Lynnette Tumwine Kyokunda. "Fatal SARS-CoV-2 and Mycobacterium tuberculosis coinfection in an infant: insights from Botswana." BMJ Case Reports 14, no. 4 (April 2021): e239701. http://dx.doi.org/10.1136/bcr-2020-239701.
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We report a fatal case of SARS-CoV-2 and Mycobacterium tuberculosis coinfection in an infant, Botswana’s first paediatric COVID-19-associated fatality. The patient, a 3-month-old HIV-unexposed boy, presented with fever and respiratory distress in the setting of failure to thrive. Both the patient and his mother tested positive for rifampin-sensitive M. tuberculosis (Xpert MTB/Rif) and SARS-CoV-2 (real time-PCR). Initially stable on supplemental oxygen and antitubercular therapy, the patient experienced precipitous clinical decline 5 days after presentation and subsequently died. Autopsy identified evidence of disseminated tuberculosis (TB) as well as histopathological findings similar to those described in recent reports of SARS-CoV-2 infections, including diffuse microthrombosis. TB remains a serious public health threat in hyperendemic regions like sub-Saharan Africa, and is often diagnosed late in infants. In addition to raising the question of additive/synergistic pathophysiology and/or immune reconstitution, this case of coinfection also highlights the importance of leveraging the COVID-19 pandemic response to strengthen efforts for TB prevention, screening and detection.
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Dintle Mogobe, Keitshokile, Sunanda Ray, Farai Madzimbamuto, Mpho Motana, Doreen Ramogola-Masire, Goabaone Rankgoane, Raina Phillips, Habte Dereje, and Mosidi Mokotedi. "Non-citizens and maternal mortality in Botswana: a rights perspective." International Journal of Migration, Health and Social Care 10, no. 4 (December 9, 2014): 220–30. http://dx.doi.org/10.1108/ijmhsc-08-2013-0029.
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Purpose – The purpose of this paper is to identify organisational, technical and individual factors leading to maternal deaths in non-citizen women in Botswana. Design/methodology/approach – A sub-analysis was conducted comparing non-citizen women to citizens in a case record review of maternal deaths in 2010. Feedback on the results to health professionals was provided and their comments were noted. Findings – In total, 19.6 per cent of 56 case notes reviewed to establish contributory factors to maternal deaths were in non-citizens. This is lower than health professionals perceptions that most maternal deaths are in non-citizens. Non-citizens were significantly less likely to have been tested for HIV and less likely to have received antenatal care, so did not receive interventions to prevent transmission of HIV to their infants or anti-retroviral therapy. They were more likely than citizens to have miscarried or delivered before 28 weeks gestational age at death. Delays in seeking health care were a major contributory factor to death. Research limitations/implications – Incomplete record keeping and missing details, with 30 per cent of the notes of maternal deaths missing, a common problem with retrospective case-note studies. Practical implications – Botswana is unlikely to meet Millennium Development Goal five target to reduce the maternal mortality ratio by 75 per cent. To make progress non-citizens must be given the same rights to access maternal health services as citizens. Rationing healthcare for non-citizens is a false economy since treatment of subsequent obstetric emergencies in this group is expensive. Originality/value – Discrimination against non-citizen women in Botswana, by denying them free access to maternal health services, extends into loss of life because of delays in seeking healthcare especially for obstetric emergencies.
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Mocumbi, Ana Olga. "Cardiac Disease and HIV in Africa: A Case for Physical Exercise." Open AIDS Journal 9, no. 1 (October 20, 2015): 62–65. http://dx.doi.org/10.2174/1874613601509010062.
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AIDS-related deaths and new HIV infections have declined globally, but continue to be a major problem in Africa. Prior to the advent of antiretroviral treatment (ART) HIV patients died of immunodeficiency and associated opportunistic infections; Highly Active Antiretroviral Therapy (HAART) has resulted in increased survival of these patients and has transformed this illness into a chronic condition. Cardiovascular, respiratory, neurological and muscular problems interfere with exercise in HIV-infected patients. Particularly cardiovascular disease may be associated with direct damage by the virus, by antiretroviral therapy and by malnutrition and chronic lung disease, resulting in physical and psychological impairment. Recent studies have shown the benefits of exercise training to improvement of physiologic and functional parameters, with the gains being specific to the type of exercise performed. Exercise should be recommended to all HIV patients as an effective prevention and treatment for metabolic and cardiovascular syndromes associated with HIV and HAART exposure in sub-Saharan Africa.
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Abbas, Hafsa, Harish Patel, Ahmed Baiomi, Masooma Niazi, Trupti Vakde, and Sridhar Chilimuri. "A Rare Case of Splenic Pneumocystis jirovecii in a HIV-Positive Patient." Case Reports in Gastrointestinal Medicine 2020 (June 10, 2020): 1–5. http://dx.doi.org/10.1155/2020/8509591.
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Introduction. Human immunodeficiency virus (HIV) positive individuals with the CD4 count less than 200 cells/mm3 are at risk for opportunistic infections. Pneumocystis jirovecii, a fungal pathogen, is a common cause of opportunistic infections with predominantly pulmonary involvement. Disseminated P. jiroveciii infection presenting with hepatosplenic lesion is extremely rare. Case Summary. A 31-year-old male with HIV with and acquired immunodeficiency syndrome (AIDS) presented with diarrhea for 3 weeks. He had splenomegaly and inguinal lymphadenopathy on physical examination. Laboratory parameters revealed anemia and hypoalbuminemia, while stool studies for infectious etiology and fecal leucocyte were negative. Computed tomography (CT) of the chest and abdomen depicted consolidation of the lungs and a large splenic mass. He underwent fiberoptic bronchoscopy with transbronchial biopsy which was consistent with P. jirovecii pneumonia. He also had a ultrasound-guided core biopsy of the splenic mass which revealed necrotizing granulomas with Pneumocystis jirovecii infection on Grocott-Gomori's methenamine silver (GMS) stain and was initiated on treatment for P. jirovecii with sulfamethoxazole with trimethoprim. Conclusion. Malignancy and atypical infection are key differentials in patients presenting with hepatosplenic lesions. HIV positive patients are at increased risk of AIDS-related lymphoma. Tissue diagnosis is often required for further evaluation. Disseminated P. jirovecii presenting with splenic mass and liver lesion is extremely rare.
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Bautista, C. T., D. E. Singer, R. J. O'Connell, N. Crum-Cianflone, B. K. Agan, J. A. Malia, J. L. Sanchez, S. A. Peel, N. L. Michael, and P. T. Scott. "Herpes simplex virus type 2 and HIV infection among US military personnel: implications for health prevention programmes." International Journal of STD & AIDS 20, no. 9 (September 2009): 634–37. http://dx.doi.org/10.1258/ijsa.2008.008413.
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US military personnel are routinely screened for HIV infection. Herpes simplex virus type 2 (HSV-2) is a risk factor for HIV acquisition. To determine the association between HSV-2 and HIV, a matched case-control study was conducted among US Army and Air Force servicemembers with incident HIV infections (cases) randomly matched with two HIV-uninfected servicemembers (controls) between 2000 and 2004. HSV-2 prevalence was significantly higher among cases (30.3%, 138/456) than among controls (9.7%, 88/912, P < 0.001). HSV-2 was strongly associated with HIV in univariate (odds ratio [OR] = 4.2, 95% confidence interval [CI] = 3.1–5.8) and multiple analyses (adjusted [OR] = 3.9, 95% CI = 2.8–5.6). The population attributable risk percentage of HIV infection due to HSV-2 was 23%. Identifying HSV-2 infections may afford the opportunity to provide targeted behavioural interventions that could decrease the incidence of HIV infections in the US military population; further studies are needed.
Dissertations / Theses on the topic "HIV infections – Botswana – Case studies"
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Carcamo, Cesar Paul. "Etiology, manifestations, and oral supplementation with zinc in adults with persistent diarrhea and HIV-1 infection /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/10891.
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Alexander-Terry, Jennifer. "Organizational legitimacy of nonprofit service organizations engaged in HIV prevention among women." Diss., Virginia Tech, 1993. http://hdl.handle.net/10919/37896.
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All organizations are concerned with survival and effectiveness, but for third sector and public organizations these issues are acute; they hinge on the organization’s ability to establish and sustain its legitimacy. Legitimacy has been defined as a manifestation of value congruence between an organization’s activities and the social system within which it functions (Dowling and Pfeffer, 1975). This study oxamines the multi-dimensionality of organizational legitirnicy in a comparative case study of nonprofit service organizitions (NSO’s) which provide HIV education and support services for women. Processes of seeking organizational legitirnacy are identified and organizational relationships analyzed within the environmental networks of clientele and the interorganizational network. The study also seeks to identity tte focus and progression of legitimating efforts over tho course of the organization’s existence.
Tw. Community based organizations are included; one in the United States and one in the Spanish-speaking Caribbean. The organizations studied are directed to women in a variety of circumstances: sex workers, drug users, and women who self-identify as being at risk. The majority of clients were Hispanic, although a few were Caucasian and African-American.
The study is intended to generate theory as to how organizations address legitimacy in a multidimensional environment, and how this challenge has been confronted in the case of NSO’s serving women at risk for HIV. The study identifies strategies for preserving the organization’s internally defined objectives and processes and its active relationship with the client community.Ph. D.
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Castelletto, Simona. "Processes that influence the experiences of children living with mothers that have HIV: two case studies." Thesis, Rhodes University, 2004. http://hdl.handle.net/10962/d1007728.
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Maternal HIV-infection is considered to be a threat to the psychosocial development of AIDS-affected children. In South Africa, AIDS-affected children may be particularly vulnerable due to the unprecedented effects of the HIV/AIDS epidemic on the breakdown of family and community resources in already disadvantaged communities. The aim of this study was to explore the contextualised experiences of two children living with mothers who have HIV by conducting two case studies. Mother-child dyads were recruited from local HIV/AIDS centres and informed consent was obtained. The mothers were in the minor symptomatic phase of HIV-infection and the children were uninfected and aged between 10 and 12 years. Through semi-structured interviewing, the mothers provided background and contextual information about the children. Play techniques were used in the child interviews to encourage the introduction and exploration of issues salient to the children. Play facilitated engagement around sensitive and potentially anxiety-provoking material. A key issue for the children was their concerns about the anticipated deaths of their mothers. The children held misconceptions about the transmission of HIV/ AIDS. They feared HIV/AIDS and expected that others would have negative perceptions of them. Family processes such as secrecy and avoidance around HIV/AIDS-related issues were understood to perpetuate the children's fears and false beliefs in a broader community context that stigmatised HIV/AIDS. It was argued that the mothers' shame over HIV-infection and their need to protect their relationship with their children compromised their ability to communicate openly with their children and to offer them meaningful emotional support. Limited parental involvement was identified as the key contextual process that engendered vulnerability in the children, as they were isolated within and beyond the family. Recommendations to address the processes that engendered vulnerability in the children are discussed.
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Phooko, Puleng M. (Puleng Mpopi). "Nutritional factors associated with oral lesions in HIV disease and TB infection." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53528.
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Thesis (Mnutr)--University of Stellenbosch, 2003.ENGLISH ABSTRACT: Problem Definition: In the context of HIV/AIDS malnutrition is almost universal among children, and of the adverse effects of Protein Energy Malnutrition, the most frequent seems to be the occurrence of opportunistic infections with micro-organisms such as oral Candida. Objective: The aim of this study was to determine the nutritional status of children with oral complications in relation to HIV/AIDS as well as the effects of the oral lesions on nutritional status. Subjects/setting: The subjects of study were 24 children co-infected with TB and HIV who were admitted consecutively to the paediatric ward of Brooklyn Chest Hospital in Cape Town, South Africa. The nutritional status of the children was assessed over a maximum period of six months by nutrient intake, anthropometric status, and by biochemical parameters and clinical and oral examination on admission and at discharge from hospital. Results: Children with HIVand TB infection presenting with or without oral lesions were similarly malnourished throughout the period of hospitalization. There was no improvement in the nutritional status as indicated by height and weight measurements. Throughout the time of hospitalization, 7% of the children had a combination of stunting, underweight and wasting. Average nutrient intake was not found to be higher than the Recommended Dietary Allowance (RDA) in any of the children. At the time of admission to hospital and at discharge, carbohydrate intake provided most of the daily energy (36% and 42%, the difference not being statistically significant). There was a significant increase in the intake of energy (p=O.04) and a decrease in total fat intake (p=O.03) at discharge. Although not significant, mean protein intake at admission was higher than at time of discharge. Selected sub-optimal biochemical values were prevalent among the children studied, with 45% and 41% showing low serum albumin values «2.9g/dL) at the time of admission and at discharge respectively. Both on admission and at discharge, 38% of the children had Haemoglobin levels below normal values. Serum ferritin levels below normal values were present in almost all the children and the trend was similar for the prevalence of low zinc values. Sub-normal plasma retinol was present in 79% of the children at time of admission, while only 21% had deficient values at time of discharge (p=O.03). On admission, 29% of the children had vitamin evalues below the normal range whereas at time of discharge 17% of the children had values below normal (p=O.04). A total of 29% children presented with oral complications on admission. These included oral herpes, oral thrush, reflux, bleeding gums and stomatitis/angular cheilosis. Two children were asymptomatically colonized with Candida of the oral cavity. Mean total protein intake was higher (p=O.057) among the children who were not diagnosed with oral complications. Conclusions: This study confirmed that malnutrition is not only a common and serious problem associated with HIVand AIDS, but also that nutritional problems cannot be dealt with in isolation where Opportunistic Infections are present. The severity of malnutrition depends on various factors including oral complications. Additionally, appropriate management and treatment of tuberculosis did not appear to affect the nutritional status significantly. Recommendations: On the basis of these findings, and because of the increased risk of growth failure and developmental delays, children should be referred for full nutritional evaluation as soon as possible after diagnosis of HIV -infection. In addition, there is a need for intervention programmes to identify the immediate underlying causes of malnutrition and the ways in which such causes interact, in order to ensure that such interventions increase the resistance of HIV infected infants and children to the disease.
AFRIKAANSE OPSOMMING: Probleemdefiniëring: Binne die konteks van MIVNIGS is wanvoeding bykans universeelonder kinders en van die nadelige effekte van proteïen energie wanvoeding is die voorkoms van opportunistiese infeksies (Ol) met mikro-organismes soos orale candida die algemeenste. Doelwit: Die doel van dié studie was om die voedingstatus van kinders met orale komplikasies in verhouding tot MIVNIGS en die effek van orale letsels op voedingstatus, te bepaal. Proefpersone/omgewing: 'n Groep van 24 kinders, met beide tuberkulose en MIVNIGSinfeksie, wat agtereenvolgend in die kindersaal van Brooklyn Bors-Hospitaal in Kaapstad, Suid- Afrika opgeneem is, is bestudeer. Vir 'n periode van ses maande is die kinders se voedingstatus geassesseer deur middel van voedingstofinname, antropometriese status en biochemiese parameters met opname in en ontslag uit die hospitaal. Kliniese en orale ondersoeke was op elke kind uitgevoer met opname sowel as ontslag. Resultate: Kindres met HIV en tuberkulose, met of sonder orale letsels, het soortgelyke wanvoeding tydens hospitalisering ervaar het. Volgens antropometriese metings was daar geen verbetering in die voedingstatus nie. 'n Kombinasie van belemmerde groei, ondergewig en uittering het in 7% van die kinders tydens hospitalisering voorgekom. Nie een van die gemiddeldes van die voedingstowwe was hoër as die Aanbevole daaglikse toelatings (ADT) in enige van die kinders wat bestudeer is nie. Met opname sowel as ontslag, was koolhidraatinname die grootste energieverskaffer met onderskeidelik 36% en 42% (alhoewel die verskil nie statisties beduidend was nie). Daar was 'n beduidende toename in energie-inname (p=O.04) en 'n afname in totale vetinname (p=O.03) met ontslag. Alhoewel nie beduidend nie, was die gemiddelde proteïeninname hoër met ontslag. Die voorkoms van geselekteerde sub-optimale biochemiese waardes met toelating en ontslag wys dat onderskeidelik 45% en 41% van die kinders lae serum albumienwaardes «2.9g/dL) getoon het. Subnormale plasma retinol het in 79% van die kinders met toelating voorgekom, terwyl slegs 21% gebrekkige waardes (p=O.03) met ontslag getoon het. Tydens opname, sowel as met ontslag, was 38% van die kinders se hemoglobienvlakke laer as die normale. Serum ferritienvlakke was amper by al die kinders laer as die normale vlakke te bespeur, met sinkvlakke wat op soortgelyke lae vlakke voorkom. Met toelating was 29% van die kinders se Vitamien C-waardes laer as normaal en met ontslag was sowat 17% se waardes steeds laer as die normaal (p=O.04). Met toelating het 29% van die kinders orale komplikasies getoon. Ingeslote hierby was orale herpes, orale sproei, refluks, bloeiende tandvleise en stomatis/ angulêre cheilose. Slegs twee kinders was asimptomaties met orale Candida van die mondholte gediagnoseer. Die gemiddelde proteïeninname was hoër (p=O.057) onder die kindres wat nie orale komplikasies getoon het nie. Gevolgtrekking: Hierdie studie bevestig dat wanvoeding me net 'n algemene en ernstige probleem is wat met MIV en VIGS geassosieer word nie, maar ook in die teenwoordigheid van opportunistiese infeksies, die voedingsprobleem nie in isolasie gehanteer kan word nie. Die graad van wanvoeding hang af van ander faktore, insluitende orale komplikasies. Voldoende behandeling van TB het ook nie 'n beduidende effek op voedingstatus gehad nie. Aanbevelings: Op hierdie bevindings gebaseer, en as gevolg van die verhoogde risiko VIr belemmerde groei en vertraagde ontwikkeling wat al die liggaamstelsels van MIV -positiewe kinders affekteer, moet kinders so gou as moontlik nadat die MIV-infeksie gediagnoseer is, vir volle voedingsevaluasies verwys word. Daarmee gepaardgaande is daar 'n behoefte aan programme wat die onmiddellike onderliggende oorsake van wanvoeding identifiseer, asook om interaksie van hierdie oorsake met HIV vas te stel, ten einde intervensies wat weerstand van HIVkinders en-babas verbeter, positieftoe te pas.
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Chamuka, Paidashe. "Understanding the sexual practices of medically circumcised males in the context of HIV and AIDS : a study in Harare Zimbabwe." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1011745.
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Zimbabwe is one of the priority countries nominated by the World Health Organisation and the Joint United Nations Programme on HIV and AIDS to adopt and implement voluntary medical male circumcision (VMMC) because of its high rate of HIV prevalence and its low level of male circumcision. VMMC, which was introduced in Zimbabwe in 2009, is a new HIV prevention method which reportedly offers partial protection of about 60 percent for circumcised males with respect to contracting HIV through sexual relations. The other key prevention method, namely the use of condoms consistently and correctly, has a protection rate of up to 95 percent. As a result, because of only partial protection, medically-circumcised men are encouraged to use condoms to decrease the chances of HIV infection. Concerns though have been raised about the possibility of risk compensation by circumcised males by way of increases in unsafe or risky sexual practices subsequent to circumcision and arising from perceptions of reduced risk through VMMC. This compensation may take the form of condom use aversion including when involved with concurrent sexual partners. If risk compensation does take place, this would lead to increases in HIV transmissions affecting not only the circumcised men but their sexual partners as well. The supposed effectiveness of VMMC as a HIV prevention method has been subjected to significant criticism and, as yet, no significant study has been undertaken in Zimbabwe on the relationship between VMMC, condom use, concurrent sexual partners and risk compensation. Based on a study of twenty-five medically-circumcised males in Harare, the capital of Zimbabwe, this thesis seeks to understand and explain the relationship between voluntary medical male circumcision and risky sexual practices with particular reference to condom use amongst men engaged in concurrent sexual partnerships. While the thesis finds evidence of risky sexual practices subsequent to circumcision, risk compensation does not seem to be particularly prevalent.
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Sousa, Carina Isabel Correia de. "Diversidade genética e resistência natural ao Maraviroc em estirpes do vírus da imunodeficiência humana Tipo 1 (HIV-1) em circulação em utilizadores de drogas por via endovenosa na Grande Lisboa." Master's thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2012. http://hdl.handle.net/10362/8170.
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RESUMO: O maraviroc (MVC) é o único anti-retroviral antagonista do co-receptor CCR5 licenciado e interage com as ansas transmembranares de CCR5, induzindo uma
alteração da sua conformação e impedindo a interacção com gp120. O MVC é activo
apenas contra estirpes R5 de HIV-1, sendo utilizado em terapia de recurso.
Neste trabalho, foi estudada a diversidade genética da região C2V3C3 do gene env de estirpes de HIV-1 de oxicodependentes por via endovenosa da Grande Lisboa, pesquisando-se também a presença de polimorfismos genéticos naturais. Foram
utilizadas 52 amostras de plasma e para 35 destas foi amplificado por RT-nested PCR
um produto de 565 pb. A análise filogenética revelou a seguinte distribuição de genótipos: 23 B (incluindo, provavelmente, 2 CRF14_BG), 8 A, 3 G e 1 F1. Após tradução, e por comparação com a sequência consenso B, verificou-se uma elevada frequência de polimorfismos genéticos, sendo encontradas algumas “assinaturas de aminoácidos” relativas aos subtipos não-B. Realizou-se ainda uma pesquisa de locais de N-glicosilação e a previsão da utilização de co-receptores (abordagem genotípica), com
recurso às regras 11/25 e da carga líquida da ansa V3 e aos programas PSSM e
geno2pheno[coreceptor]. Observou-se uma conservação genérica do número de locais de
N-glicosilação e foram identificadas 5 sequências com tropismo X4 ou duplo. Por fim,
com base na literatura, realizou-se uma pesquisa de polimorfismos genéticos associados a resistência ao MVC presentes na ansa V3. Foi observado um número elevado destas mutações. A presença dos padrões 11S+26V e 20F+25D+26V, num total de 3
sequências, é relevante, visto estes estarem inequivocamente associados à resistência in
vivo ao MVC.
Apesar de não estar ainda definido um perfil de resistência para o MVC, a presença das mutações encontradas, em indivíduos sem contacto prévio com o fármaco, trará implicações relevantes na sua gestão clínica, considerando a introdução do MVC
na terapia de recurso.---------- ABSTRACT: Maraviroc (MVC) is the only CCR5 inhibitor licensed today. This drug interacts
with the transmembrane helices of CCR5 co-receptor, inducing a conformation change
of its extracellular loops and preventing the interaction with gp120. MVC is only active against R5 strains of HIV-1 and is currently used in salvage therapy.
The genetic diversity of the env C2V3C3 region of HIV-1 strains from injecting
drug users in the Greater Lisbon was studied, along with the presence of natural genetic polymorphisms. 52 plasma samples were used and the amplification by RT-nested PCR of a 565 bp-product was possible in 35 of them. The phylogenetic analysis revealed 23 sequences classified as subtype B (probably including 2 CRF14_BG), 8 A, 3 G and 1 F1. After translation, the presence of natural genetic polymorphisms was studied by
comparison to a subtype B consensus. A high frequency of genetic polymorphisms was
observed and significant “amino acid signatures” were found in association with non-B subtypes. A full characterization of the N-glycosylation sites was also performed and a coreceptor prediction (genotypic approach) was accomplished using the 11/25 and the V3 net charge rules and the programs PSSM and geno2pheno[coreceptor]. The number of N-glycosylation sites was generically preserved. Five sequences were defined as X4 or dual-tropic. Based on published data, a search for genetic polymorphisms, present in V3loop, associated to MVC resistance was finally undertaken. Several of such mutations
were observed, being particularly interesting the presence of the patterns 11S+26V and 20F+25D+26V, in a total of 3 sequences, since these patterns have unequivocally been associated with MVC resistance in vivo.
Although a resistance profile for MVC is not yet defined, the presence of these mutations in MVC-naïve populations may have significant impact in their clinical
management in the future, especially considering the introduction of this drug in salvage therapy.
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Khumalo, Princess Sengeziwe. "The effectiveness of social support mechanisms provided to HIV and AIDS opharns: the case of Tembisa child and family welfare society, Gauteng." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1005633.
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The study was aimed at investigating the effectiveness of social support mechanisms provided to HIV and AIDS orphans in Tembisa, Gauteng Province. An interview guide was designed and it guided the in-depth interviews with HIV and AIDS affected and infected orphans. In addition, a focus group was run with the social workers and the children‟s caregivers. Empirical findings gathered were based on the qualitative information from the participants. The findings indicated that social support systems were effective although there were various challenges facing their smooth running. Firstly social support provided to orphans is mainly provided by caregivers, social workers, schools and the government. Secondly for some, the support is not entirely enough to help them cope with life. The minority of the orphans indicated that they were not even aware that they were orphaned. The study therefore recommends that social workers and caregivers be trained on how to be effective social support systems for HIV and AIDS orphans. Furthermore psycho-social support groups need to be more informational and inclusive of HIV and AIDS orphans.
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Yeager, Valerie (Valerie Ann). "Beyond the barriers : HIV prevention and treatment in South African public sector - a Western Cape Science Communication Study." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/17254.
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Thesis (MPhil)--Stellenbosch University, 2005.ENGLISH ABSTRACT: This work provides a comprehensive overview of the South African HIV/AIDS epidemic. It examines the historical and social background of the HIV/AIDS situation and looks at the importance of the media and science communication in combating the effects of the epidemic on society. This research explores the different forms of health communication and the varied benefits of each. Overall, it highlights positive media efforts that have helped redirect the HIV/AIDS epidemic within the social and political context of the HIV epidemic in South Africa. The second half of this work covers the challenges experienced in gaining publicsector antiretroviral treatment and the roles the media have played in informing and mobilizing society for these efforts. Through a community clinic ethnographic case study this work explores the current state of treatment clinics, social challenges experienced in the Usapho Lwethu Clinic of Gugulethu and the future of the HIV/AIDS epidemic in South Africa.
AFRIKAANSE OPSOMMING: Hierdie werk verskaf ‘n omvattende oorsig van die Suid-Afrikaanse HIV/VIGS epidemie. Dit ondersoek die historiese en sosiale agtergrond van die HIV/VIGS toestand en belig die belangrikheid van media en wetenskaplike kommunikasie in die bestryding van die effek van hierdie epidemie op die samelewing. Hierdie navorsing verken die verskillende vorms van gesondheidskommunikasie en die onderskeie voordele van elk. In sy geheel beklemtoon dit die positiewe pogings van die media wat gehelp het met die herkanalisering van die HIV/VIGS epidemie binne die sosiale en politieke konteks in Suid-Afrika. Die tweede helfte van die werk gee 'n oorsig van die rol wat die media speel in die beskikbaarstelling van inligting en die mobilisasie van die publiek en die stryd rondom die verkryging van antiretrovirale behandeling vir die algemene publiek. ‘n Etnies-grafiese gevallestudie van ‘n plaaslike gemeenskapskliniek word gebruik om die huidige toestand in behandelingsklinieke toe te lig asook die sosiale uitdagings in die Usapho Lwethu Kliniek in Gugulethu en die toekoms rondom die HIV/VIGS epidemie in Suid-Afrika.
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Fadul, Nada, Jacob Couturier, Xiaoying Yu, Claudia A. Kozinetz, Roberto Arduino, and Dorothy E. Lewis. "Treatment-Naïve HIV-Infected Patients Have Fewer Gut-Homing β7 Memory CD4 T Cells than Healthy Controls." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1497.
Full textAbstract:
OBJECTIVES: The integrin α4β7 is the gut-homing receptor for lymphocytes. It also is an important co-receptor for human immunodeficiency virus (HIV) via glycoprotein (gp)120 binding. Depletion of gut cluster of differentiation (CD)4 T cells is linked to chronic inflammation in patients with HIV; however, measuring CD4 cells in the gut is invasive and not routine. As such, establishing a peripheral marker for CD4 depletion of the gut is needed. We hypothesized that α4β7 CD4 T cells are depleted in the peripheral blood of treatment-naïve patients with HIV compared with healthy controls.
METHODS: The study groups were treatment-naïve patients with HIV and uninfected controls. Subjects were included if they were 18 years or older with no history of opportunistic infections, active tuberculosis, or cancer. We collected peripheral blood and examined on whole blood using flow cytometry for the following cell surface markers: CD4, CD45RO, chemokine receptor type 5, C-X-C chemokine receptor type 4 (CXCR4), and the integrin β7. We collected demographic information, including age, sex, and ethnicity, as well as viral load (VL) and CD4 count. Two-samplettests and Fisher exact tests were used to compare the differences between the two groups. Spearman correlation coefficients were calculated between CD4 count and log10-VL and percentage of CD4+/CD45RO+/β7+and log10-VL in patients.
RESULTS: Twenty-two subjects were enrolled in the study (12 patients with HIV and 10 controls). There were no differences in age or sex between the two groups. There were more Hispanics and fewer Asians in the group comprising patients with HIV compared with the control group (7 vs 2 and 0 vs 4,P= 0.05, respectively). Patients infected with HIV had significantly lower frequencies of CD4+/CD45RO+/β7+cells (median 12%, range 5-18 compared with uninfected controls: median 20%, range 11-26,P= 0.0007). There was a statistically significant difference in the percentage of CD4+/CD45RO+/C-X-C chemokine receptor type 4+cells between patients (72%, range 60%-91%) compared with controls (79%, range 72%-94%,P= 0.04). The percentage of CD4+/CD45RO+/chemokine receptor type 5+did not differ between the group of patients with HIV and the control groups (22%, range 11%-57% vs 27%, range 14%-31%;P= 0.8, respectively). There was no correlation between percentage of CD4+/CD45RO+/β+cells and log10-VL as measured by the Spearman correlation coefficient (r= 0.05,P= 0.88) in patients infected with HIV.
CONCLUSIONS: Memory CD4 β7+cells are reduced significantly in the peripheral blood of untreated patients infected with HIV, which could be used as a noninvasive indicator of intestinal CD4 T cell loss and recovery. Further studies are needed to examine whether depletion of these CD4+/CD45RO+/β7+cells in the peripheral blood parallels depletion in the gut of treatment-naïve patients with HIV and whether levels return to control levels after treatment.
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Baratedi, William Mooketsi. "Lived experiences of HIV sero-discordant couples in Botswana." Thesis, 2014. http://hdl.handle.net/10500/14386.
Full textAbstract:
The phenomenon of HIV discordance has been in existence for a long time along with HIV. However, very limited attention has been given to HIV discordance. This phenomenological study aimed at gaining a deeper understanding on the lived experiences of sero-discordant couples in Botswana. Reports show that discordance in Botswana is around 17%. The main objectives of this study were to identify HIV discordant couples living in Botswana and explore their knowledge and understanding of the situation, explore the psychological, social and sexual experiences of the HIV discordant couples and determine its impact in their lives, and examine the meaning they attach to such experiences and challenges they face as well as their coping strategies. A qualitative phenomenological approach using face to face in-depth interviews was used to explore and describe meanings and experience as lived by the HIV discordant couples. The study sample consisted of forty-six (N=46) (twenty-nine (n=29) females and seventeen (n=17) males) participants selected using purposive sampling from three cities in Botswana. The Inclusion criteria were that participants should be aged 21 years and above; with no known diagnosis of mental illness; having been in a discordant relationship for at least six months at the time of data collection; living in Botswana and willing to participate in the study. The findings were that there are three forms of discordance, which are: discordant unaware which are couples who went into the relation unaware of their HIV status. Discordant aware; those who got into the relationship already knowing each other’s HIV status and discordantly discordant which are those with differing HIV status and differing motives of going into the relationship. These are the couples that conceal their status from one another. The results revealed intense emotional/psychological, sexual and social stresses as experienced by couples. HIV discordant goes through three phases of initial shock, conflict and resolution. The researcher recommends the OPEN DESK MODEL to be integrated in the health facilities to encompass the concept of a family or couple and as a unit.Health Studies
D. Litt. et Phil. (Health Studies)
Books on the topic "HIV infections – Botswana – Case studies"
1
Walque, Damien de. Who gets AIDS and how ? the determinants of HIV infection and sexual behaviors in Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania. Washington, D.C: World Bank, 2006.
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2
(Organization), ACHAP, ed. The front line in the war against HIV/AIDS in Botswana: Case studies from the African Comprehensive HIV/AIDS Partnerships (ACHAP). [Gaborone]: African Comprehensive HIV/AIDS Partnerships, 2004.
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Sucahya, Purwa Kurnia. Memahami kebutuhan aktor dan pengguna narkotika suntik. [Yogyakarta]: Kerja sama Pusat Studi Kependudukan dan Kebijakan, Universitas Gadjah Mada dengan Ford Foundation, 2002.
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4
ebrary, Inc. Global reach: How trade unions are responding to AIDS : case studies of union action. Copenhagen: UNAIDS, 2006.
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5
Walque, Damien de. Discordant couples: HIV infection among couples in Burkina Faso, Cameroon, Ghana,Kenya, and Tanzania. Washington, D.C: World Bank, 2006.
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6
Bangladesh", Project on "Prevention of HIV/AIDS Among Young People in. Understanding the operational dynamics and possible HIV interventions for residence-based female sex workers in two divisional cities in Bangladesh. Dhaka: National AIDS/STD Programme, 2009.
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Secrets of a woman's soul: Based on a true story. Harare, Zimbabwe: L. Shaba, 2005.
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8
Renaud, Michelle. Profiles of activities to reduce perinatal transmission of HIV: Assessing the response. Washington, D.C: U.S. Conference of Mayors, 1997.
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9
Shaheen, Lim, and Asian Muslim Action Network, eds. Muslim responses to HIV/AIDS: Case studies, key issues & ways forward : report of the Muslim Pre-International AIDS Conference organised by AMAN/ARF. Bangkok, Thailand: Asian Muslim Action Network, 2004.
Find full textBook chapters on the topic "HIV infections – Botswana – Case studies"
1
Navarrete Gil, Cynthia, Manjula Ramaiah, Andrea Mantsios, Clare Barrington, and Deanna Kerrigan. "Best Practices and Challenges to Sex Worker Community Empowerment and Mobilisation Strategies to Promote Health and Human Rights." In Sex Work, Health, and Human Rights, 189–206. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-64171-9_11.
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AbstractSex workers face a number of health and human rights challenges including heightened risk for HIV infection and suboptimal care and treatment outcomes, institutional and interpersonal violence, labour rights violations, and financial insecurity. In response, sex worker-led groups have been formed and sustained across geographic settings to address these challenges and other needs. Over the last several decades, a growing body of literature has shown that community empowerment approaches among sex workers are associated with significant reductions in HIV and other sexually transmitted infections. Yet legal and policy environments, as well as funding constraints, have often limited the reach, along with the impact and sustainability, of such approaches.In this chapter, we first review the literature on community empowerment and mobilisation strategies as a means to collectively address HIV, violence, and other health and human rights issues among sex workers. We then utilise two case studies, developed by the sex worker-led groups APROASE in Mexico and Ashodaya Samithi in India, to illustrate and contextualise community empowerment processes and challenges, including barriers to scale-up. By integrating the global literature with context-specific case studies, we distil lessons learned and recommendations related to community empowerment approaches among sex workers.
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Goldenberg, Shira M., Ruth Morgan Thomas, Anna Forbes, and Stefan Baral. "Overview and Evidence-Based Recommendations to Address Health and Human Rights Inequities Faced by Sex Workers." In Sex Work, Health, and Human Rights, 1–11. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-64171-9_1.
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AbstractThis volume uses community case studies and data from around the world to highlight the sustained health and social inequities that sex workers in all of their diversity experience in 2020. Guided by a balanced community–academic partnership, this volume aims to ensure that sex workers’ voices are amplified in describing both challenges and the ways forward. Collectively, the chapters describe an elevated burden of HIV, sexually transmitted infections, drug-related harms, violence and other human rights violations, and significant unmet sexual and reproductive health needs. They also demonstrate that sex workers are not passive recipients of such inequity, but rather actively resist and continue to mobilise to advocate for improved health, safety, and human rights conditions and policy changes. Evidence-based recommendations include sex work decriminalisation, ensuring accessible and sex worker-friendly services, removal of punitive policing and surveillance, community empowerment, and strengthening capacity for community engagement in research, policy, and programmes.
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Lux, Joseph Z., and Harold W. Goforth. "HIV, AIDS, and Medical Multimorbid Illnesses." In Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.003.0014.
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Since the introduction of combination antiretroviral therapy, clinicians have seen a sharp decrease in the incidence of many HIV-associated comorbidities, and patients with access and adherence to combination antiretroviral therapy are living longer and healthier lives. However, the frequency of endocrine, metabolic, cardiovascular, renal, dermatological, neoplastic, hepatic, renal, pulmonary, and gastrointestinal multimorbid medical conditions remains very significant and in some cases is increasing. Although the incidence of particular HIV-associated comorbidities such as cytomegalovirus (CMV) retinitis has declined considerably, it remains a significant source of distress and suffering for persons with AIDS. This chapter is not intended to provide a lengthy discourse on each topic addressed, but rather be a general overview that will give the reader a basic working knowledge of multimorbid medical conditions and enhance the understanding of associated psychiatric complications and psychological distress. For a summary of these conditions and their respective features and treatment, see Table 10.1. HIV and AIDS have been associated with a wide spectrum of endocrine abnormalities that underscore the complex relationships between immunological, endocrinological, and psychological systems. Endocrinopathies are great mimickers of psychiatric disorders, manifesting in some cases as disturbances of mood, sleep, appetite, thought process, energy level, or general sense of well-being. Endocrinopathies may present insidiously or abruptly, in either case with potentially tragic consequences when misdiagnosed as psychopathology. Prompt recognition of reversible alterations in endocrine function is essential to prevent unnecessary morbidity and mortality. An understanding of the complex interactions between endocrine and psychological systems may improve recognition and treatment of endocrinopathies, diminish suffering, and enhance quality of life and longevity in persons with HIV and AIDS. Many studies have demonstrated alterations in adrenal function in patients with HIV and AIDS. Associated infections and tumors, as well as direct invasion of the adrenal glands by the virus, partly explain these changes. Patients are also commonly prescribed drugs that alter steroid synthesis or metabolism; for example, ketoconazole decreases steroid synthesis, megesterol acetate suppresses pituitary secretion of corticotropin, and rifampin increases p450 activity, leading to increased metabolism of cortisol.
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Newton, Charles R. "Epidemiology of bacterial and parasitic infections of the central nervous system." In Oxford Textbook of Neurologic and Neuropsychiatric Epidemiology, edited by Carol Brayne, Valery L. Feigin, Lenore J. Launer, and Giancarlo Logroscino, 379–86. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198749493.003.0036.
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This chapter looks at the epidemiology of bacterial and parasitic infections of the central nervous system (CNS). Bacteria and parasites are important infections of the CNS, but the epidemiology has changed significantly over the last few decades with the introduction of vaccines; appearance of organisms resistant to antimicrobial and anti-parasitic drugs; increase in number of immunocompromised people from human immunodeficiency virus (HIV) and oncological conditions; and increased movement of people throughout the world. The CNS infections present with a multitude of symptoms and signs, which often overlap, making case definitions for epidemiological studies difficult. The main syndromes of CNS infections are meningitis, encephalitis, epilepsy, and paralysis. Most bacteria gain access to the CNS via blood, although scalp, ear, and oropharyngeal infections are possible routes of infection. The chapter then discusses acute bacterial meningitis, brain abscesses, ventriculitis, tuberculosis meningitis, malaria, cysticercosis, onchocerciasis, sparganosis, and paragonimiasis.