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BMJ Global Health Sep 2023Assess the relationship between income inequality and HIV incidence, AIDS mortality and COVID-19 mortality. (Observational Study)
Observational Study
OBJECTIVES
Assess the relationship between income inequality and HIV incidence, AIDS mortality and COVID-19 mortality.
DESIGN
Multicountry observational study.
SETTING
217 countries for HIV/AIDS analysis, 151 countries for COVID-19 analysis.
PARTICIPANTS
Used three samples of national-level data: a sample of all countries with available data (global sample), a subsample of African countries (African sample) and a subsample excluding African countries (excluding African sample).
MAIN OUTCOME MEASURES
HIV incidence rate per 1000 people, AIDS mortality rate per 100 000 people and COVID-19 excess mortality rate per 100 000 people. The Gini index of income inequality was the primary explanatory variable.
RESULTS
A positive and significant relationship exists between the Gini index of income inequality and HIV incidence across all three samples (p<0.01), with the effect of income inequality on HIV incidence being higher in the African sample than in the rest of the world. Also, a statistically positive association exists for all samples between income inequality and the AIDS mortality rate, as higher income inequality increases AIDS mortality (p<0.01). For COVID-19 excess mortality rate, a positive and statistically significant relationship exists with the Gini index for the entire sample and the excluding African sample (p<0.05), but the African sample alone did not deliver significant results (p<0.1).
CONCLUSION
COVID-19 excess deaths, HIV incidence and AIDS mortality are significantly associated with income inequality globally-more unequal countries have a higher HIV incidence, AIDS mortality and COVID-19 excess deaths than their more equal counterparts. Income inequality undercuts effective pandemic response. There is an urgent need for concerted efforts to tackle income inequality and to build pandemic preparedness and responses that are adapted and responsive to highly unequal societies, prioritising income inequality among other social determinants of health.
Topics: Humans; Acquired Immunodeficiency Syndrome; COVID-19; Pandemics; Africa; Income
PubMed: 37717952
DOI: 10.1136/bmjgh-2023-013703 -
Advanced Drug Delivery Reviews Aug 2023Candidiasis is an infection caused by fungi from a Candida species, most commonly Candida albicans. C. albicans is an opportunistic fungal pathogen typically residing on... (Review)
Review
Candidiasis is an infection caused by fungi from a Candida species, most commonly Candida albicans. C. albicans is an opportunistic fungal pathogen typically residing on human skin and mucous membranes of the mouth, intestines or vagina. It can cause a wide variety of mucocutaneous barrier and systemic infections; and becomes a severe health problem in HIV/AIDS patients and in individuals who are immunocompromised following chemotherapy, treatment with immunosuppressive agents or after antibiotic-induced dysbiosis. However, the immune mechanism of host resistance to C. albicans infection is not fully understood, there are a limited number of therapeutic antifungal drugs for candidiasis, and these have disadvantages that limit their clinical application. Therefore, it is urgent to uncover the immune mechanisms of the host protecting against candidiasis and to develop new antifungal strategies. This review synthesizes current knowledge of host immune defense mechanisms from cutaneous candidiasis to invasive C. albicans infection and documents promising insights for treating candidiasis through inhibitors of potential antifungal target proteins.
Topics: Female; Humans; Antifungal Agents; Candidiasis; Candida albicans; Candida; Acquired Immunodeficiency Syndrome
PubMed: 37307922
DOI: 10.1016/j.addr.2023.114960 -
Clinics in Dermatology 2024The global burden of HIV remains a formidable challenge, affecting millions. Despite significant progress in understanding, treatment, and prevention , HIV/AIDS...
The global burden of HIV remains a formidable challenge, affecting millions. Despite significant progress in understanding, treatment, and prevention , HIV/AIDS continues to exert a substantial impact on personal and public health, particularly in sub-Saharan Africa, where the prevalence is highest. HIV not only poses a direct threat to the well-being of individuals but also contributes to social and economic disparities. Approximately 38 million people worldwide are living with HIV, with millions unaware of their status. Stigma and discrimination still hinder testing, starting and staying on treatment. Access to antiretroviral therapy has improved, yet disparities persist, with marginalized communities often facing barriers to essential health care services. Efforts to reduce new HIV infections and transmission include comprehensive prevention strategies, education, and increased access to testing and treatment. Addressing social determinants, reducing stigma, and ensuring equitable access to health care remain crucial to reach the ambitious goal of ending AIDS by 2030.
Topics: Humans; HIV Infections; Acquired Immunodeficiency Syndrome; Africa South of the Sahara; Prevalence
PubMed: 38387533
DOI: 10.1016/j.clindermatol.2024.02.001 -
AIDS Research and Therapy Aug 2023The goal of the AIDS and Cancer Specimen Resource (ACSR) is to play a major role in the advancement of HIV/AIDS cancer-related research/treatment by providing richly... (Review)
Review
The goal of the AIDS and Cancer Specimen Resource (ACSR) is to play a major role in the advancement of HIV/AIDS cancer-related research/treatment by providing richly annotated biospecimens and data to researchers at no cost. The ACSR acquires, stores, and equitably distributes these samples and associated clinical data to investigators conducting HIV/AIDS-related research, at no costs. Currently, it is the only biorepository of human biospecimens from people with HIV and cancer available to eligible researchers globally who are studying HIV associated malignancies.This review describes the history and organizational structure of the ACSR, its types of specimens in its inventory, and the process of requesting specimens. In addition, the review provides an overview of research that was performed over the last 5 years with its support and gives a summary of important new findings acquired by this research into the development of cancers in people with HIV, including both Aids-related and non-Aids-related malignancies.
Topics: Humans; HIV Infections; Neoplasms; Acquired Immunodeficiency Syndrome
PubMed: 37641153
DOI: 10.1186/s12981-023-00558-4 -
African Journal of AIDS Research : AJAR Dec 2023According to Transparency International, of the US$7.5 trillion spent globally on health each year, US$500 billion is lost to corruption.1 This article deals with the...
According to Transparency International, of the US$7.5 trillion spent globally on health each year, US$500 billion is lost to corruption.1 This article deals with the topic of corruption in the health sector in sub-Saharan Africa with a focus on how it affects persons living with HIV and their families. It begins with a definition of corruption and outlines the types of activities, people and institutions that fall within that definition in the context of HIV/AIDS. Examples are provided of what happens in practice and the types of persons (in terms of their societal roles) who yield to corruption, and how and why they commit it. The effects of corruption in health and in the fight against HIV/AIDS are then considered, drawing on published research on the costs to institutions and society. For example, HIV prevalence among women is higher than men, yet their reliance on health services plagued by corruption makes them vulnerable to abuse, blocking access to vital contraceptive, HIV testing, and reproductive and child health services. Attention is then focused on the factors that encourage the adoption of corrupt practices and what approaches have been taken to try to counter them. This includes a review and analysis of the steps that have been taken to strengthen compliance, governance and accountability and why attempts to deal with corruption have met with little success. This article suggests a new approach - harnessing digitalisation - to combat corruption more quickly and effectively, pointing out that corruption is both a major factor contributing to inefficiency and is harming peoples' health. This article aims to raise interest and renew efforts in fighting corruption in health.
Topics: Male; Humans; Female; Child; Acquired Immunodeficiency Syndrome; HIV Infections; Social Responsibility; Costs and Cost Analysis; Africa South of the Sahara
PubMed: 38117744
DOI: 10.2989/16085906.2023.2270483 -
Viruses Aug 2023Antiretroviral therapies (ARTs) have revolutionized the management of human immunodeficiency virus (HIV) infection, significantly improved patient outcomes, and reduced... (Review)
Review
Antiretroviral therapies (ARTs) have revolutionized the management of human immunodeficiency virus (HIV) infection, significantly improved patient outcomes, and reduced the mortality rate and incidence of acquired immunodeficiency syndrome (AIDS). However, despite the remarkable efficacy of ART, virologic failure remains a challenge in the long-term management of HIV-infected individuals. Virologic failure refers to the persistent detectable viral load in patients receiving ART, indicating an incomplete suppression of HIV replication. It can occur due to various factors, including poor medication adherence, drug resistance, suboptimal drug concentrations, drug interactions, and viral factors such as the emergence of drug-resistant strains. In recent years, extensive efforts have been made to understand and address virologic failure in order to optimize treatment outcomes. Strategies to prevent and manage virologic failure include improving treatment adherence through patient education, counselling, and supportive interventions. In addition, the regular monitoring of viral load and resistance testing enables the early detection of treatment failure and facilitates timely adjustments in ART regimens. Thus, the development of novel antiretroviral agents with improved potency, tolerability, and resistance profiles offers new options for patients experiencing virologic failure. However, new treatment options would also face virologic failure if not managed appropriately. A solution to virologic failure requires a comprehensive approach that combines individualized patient care, robust monitoring, and access to a range of antiretroviral drugs.
Topics: Humans; Acquired Immunodeficiency Syndrome; HIV Infections; Anti-Retroviral Agents; Medication Adherence; Treatment Failure
PubMed: 37632074
DOI: 10.3390/v15081732 -
Annals of Clinical Microbiology and... Jul 2023Acquired immunodeficiency syndrome (AIDS) is associated with a high rate of pulmonary infections (bacteria, fungi, and viruses). To overcome the low sensitivity and long...
BACKGROUND
Acquired immunodeficiency syndrome (AIDS) is associated with a high rate of pulmonary infections (bacteria, fungi, and viruses). To overcome the low sensitivity and long turnaround time of traditional laboratory-based diagnostic strategies, we adopted metagenomic next-generation sequencing (mNGS) technology to identify and classify pathogens.
RESULTS
This study enrolled 75 patients with AIDS and suspected pulmonary infections who were admitted to Nanning Fourth People's Hospital. Specimens were collected for traditional microbiological testing and mNGS-based diagnosis. The diagnostic yields of the two methods were compared to evaluate the diagnostic value (detection rate and turn around time) of mNGS for infections with unknown causative agent. Accordingly, 22 cases (29.3%) had a positive culture and 70 (93.3%) had positive valve mNGS results (P value < 0.0001, Chi-square test). Meanwhile, 15 patients with AIDS showed concordant results between the culture and mNGS, whereas only one 1 patient showed concordant results between Giemsa-stained smear screening and mNGS. In addition, mNGS identified multiple microbial infections (at least three pathogens) in almost 60.0% of patients with AIDS. More importantly, mNGS was able to detect a large variety of pathogens from patient tissue displaying potential infection and colonization, while culture results remained negative. There were 18 members of pathogens which were consistently detected in patients with and without AIDS.
CONCLUSIONS
In conclusion, mNGS analysis provides fast and precise pathogen detection and identification, contributing substantially to the accurate diagnosis, real-time monitoring, and treatment appropriateness of pulmonary infection in patients with AIDS.
Topics: Humans; Acquired Immunodeficiency Syndrome; High-Throughput Nucleotide Sequencing; Azure Stains; Hospitalization; Hospitals; Pneumonia
PubMed: 37430367
DOI: 10.1186/s12941-023-00608-9 -
BMJ (Clinical Research Ed.) Aug 2023
Topics: Humans; Acquired Immunodeficiency Syndrome
PubMed: 37643770
DOI: 10.1136/bmj.p1929 -
Bioethics Feb 2024While the WHO, public health experts, and political leaders have referenced solidarity as an important part of our responses to COVID-19, I consider how we build...
While the WHO, public health experts, and political leaders have referenced solidarity as an important part of our responses to COVID-19, I consider how we build solidarity during pandemics in order to improve the effectiveness of our responses. I use Prainsack and Buyx's definition of solidarity, which highlights three different tiers: (1) interpersonal solidarity, (2) group solidarity, and (3) institutional solidarity. Each tier of solidarity importantly depends on the actions and norms established at the lower tiers. Although empathy and solidarity are distinct moral concepts, I argue that the affective component of solidarity is important for motivating solidaristic action, and empathetic accounts of solidarity help us understand how we actually build solidarity from tier to tier. During pandemics, public health responses draw on different tiers of solidarity depending on the nature, scope, and timeline of the pandemic. Therefore, I analyze both COVID-19 and HIV/AIDS using this framework to learn lessons about how solidarity can more effectively contribute to our ongoing public health responses during pandemics. Whereas we used institutional solidarity during COVID-19 in a top-down approach to building solidarity that often overlooked interpersonal and group solidarity, we used those lower tiers during HIV/AIDS in a bottom-up approach because governments and public health institutions were initially unresponsive to the crisis. Thus, we need to ensure that we have a strong foundation of respect, trust, and so forth, on which to build solidarity from tier to tier and promote whichever tiers of solidarity are lacking during a given pandemic to improve our responses.
Topics: Humans; Acquired Immunodeficiency Syndrome; COVID-19; Public Health; Government; Morals
PubMed: 38058238
DOI: 10.1111/bioe.13247 -
African Journal of AIDS Research : AJAR Dec 2023
Topics: Humans; HIV Infections; Pandemics; Acquired Immunodeficiency Syndrome; Publishing
PubMed: 38117738
DOI: 10.2989/16085906.2023.2293613