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HIV Prevention - Science topic

Explore the latest questions and answers in HIV Prevention, and find HIV Prevention experts.
Questions related to HIV Prevention
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in HIV / AIDS research, Could fecal microbiota transplantation be considered as an alternative therapy to antiretrovirals?
What treatment (FMT and ART) for people with HIV do you think is the most appropriate?
If the FMT has been around for many years, why do you think it has not been implemented as yet another alternative against HIV?
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No.
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In many regions of the world, women have little or no authority or independence and are not in a position to demand safe sexual practices such as the use of barrier contraceptives. There is a great need, therefore, to identify methodologies that can be used discretely by women to prevent HIV transmission. An enhanced understanding of the factors that facilitate or retard male-to-female HIV transmission would enable the design and development of effective anti-HIV strategies. Many studies have shown A lactobacillus-dominant vaginal microbiota has been shown to decrease heterosexual HIV transmission. Others say that it doesn´t. Whats your opinion?
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Thanks for all the tips! This was extremely helpful
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Thanks for your help.
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It is possible to change target in scales that measure attitudes causing stigma e.g. towards HIV, Check our papers out:
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It is well known that low "current" CD4 count is correlated with decreased life expectancy among HIV infected people not on ART. It is also well known that CD4 counts vary hugely within the population of HIV negative people. The question is: is the life expectancy (~ natural disease progression) upon acquiring HIV infection the same for someone who had 1200 or 600 CD4 cells prior to infection?
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A disease that means it was caused by once genetic default by either onco- protein or viral- onco protein. .At first, the DNA/RNA confirmation is very important. The treatment arm should be consider on last symptom.
The last symptom that means a RNA virus /its viral protein or RNA cell-proteins in our cells are randomly (location based) virulent and would be affected to the DNA stranded "proteins". So, subsequently the last symptom will pave way the confirmation either RNA or DNA symptoms.
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Looking to follow up on 2003 article re: evaluation capacity in HIV prevention programs...
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Awesome. Thank you!
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Hi folks,
 There are many papers recommending that needle and syringe programs incorporate peer-workers, and there are many papers that examine the effectiveness of peer-based projects in drug treatment, mental health, sexual health, and other fields.
I am seeking any published literature that specifically examines the effectiveness of peer-based needle and syringe programs.
A quick search has turned up many articles, however these are the only ones I've found so far that specifically examine peer-based nsp/nsep;
A Case Study of the Transformative Effect of Peer Injection Drug Users in the Downtown Eastside of Vancouver, Canada
doi:10.3138/cjccj.2013.E30
.
An external evaluation of a peer-run outreach based
syringe exchange in Vancouver, Canada
DOI: 10.1016/j.drugpo.2010.03.002
.
Effectiveness of Peer Education Interventions for HIV Prevention in
Developing Countries: A Systematic Review and Meta-Analysis
doi: 10.1521/aeap.2009.21.3.181.
I'd greatly appreciate links to any other relevant  literature.
Thanks,
Paul.
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According to different studies and case reports, ranulas are considered as one of the salivary gland pathologies that are associated with HIV/AIDS. what role does HIV play in occurence of ranula? 
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 Dear Ms Noor and Dr Bouare
Thank you very much for the links and contribution.
The mechanism by which HIV promotes development of Lymphomas has been clearly put forward, as recent evidence indicates that HIV-encoded proteins endowed with peculiar biologic effects on B lymphocytes are secreted and accumulate in lymphoid tissues, mainly within lymph node germinal centers, where they may act as critical microenvironmental factors promoting lymphoma development.
And this makes me wonder whether there is clear explanation for mechanism by which HIV promotes deveelopment of ranula
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Hi,
I'm looking to obtain samples of people on Truvada who are HIV positive and people who are HIV negative. Does anybody know a good source for this material? Or does anybody know a way of obtaining Truvada in the EU for research purposes?
Thanks,
Alan
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 Thanks for the advice everyone. Very helpful. 
@David: Gilead stock Truvada so I have sent them a request. I am unsure they will be able to provide this to me however as I am not an MD. I've also found out that people who order Truvada online for PreP can go to GHMS clinic for help. I've contacted there offices to enquire if we could possibly obtain samples from their clinic.
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Stigma constitutes a major barrier to HIV prevention, treatment and care. It may be due to the community where HIV-positive individuals live, to family members, to sexual partners or to health care providers. Potential study participants may be HIV-positive individuals, HIV-negative people, health care providers, etc. The way stigma is perceived or expressed may give rise to misleading answers due to social desirability bias. That is why the choice of the scale of measurement is so important.
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The multi-items scaling scale is easier to use. It provides answers that may be readily quantified. It prevents social desirability bias. 
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I am planning to model the cost effectiveness of flu vaccine among elderly in India. I want to take more information of Dynamic transmission modeling that is used for infectious diseases.
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Dear Giridara Gopal Parameswaran
Pls. find the attached files
Alexander Krämer, Mirjam Kretzschmar, Klaus Krickeberg. 2010. Modern Infectious Disease Epidemiology: Concepts, Methods, Mathematical Models, and Public Health Springer Science & Business Media,Pp.443. ISBN0387938354, 9780387938356
Hoping this will be helpful
Regards
Prof. Houda Kawas
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please i want an article that proved that the immune strength of HIV+ mother determines if the infant becomes HIV infected or not
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Dear Sir,
See this file may be useful for you.
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I am co-authoring a book chapter on the use of drama that combines the ideas of participation and empowerment in HIV prevention research, which partners with young people.
I would like to know which scholars first made the connection between drama and HIV prevention work, as I am struggling to find any articles making reference to these historical roots.
Any ideas/suggestions will be greatly appreciated. 
Warm regards
Carol Maibvisira
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if you send me your email I can forward a paper we wrote on this in Zimbabwe - sunanda28@hotmail.com 
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HIV tropism
discodancy
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Dear sir/Madam
See these links may be useful for you.
1) Association of CCR5-delta32 mutation with reduced risk of ...
Traduire cette page de V Berce - ‎2008 - ‎Cité 12 fois - ‎Autres articles
Association of CCR5-delta32 mutation with reduced risk of nonatopic asthma in Slovenian children. Berce V(1), Repnik K, Potocnik U. Author information:
2) A130: Is the CCR5-delta32 Mutation Protective Against ...
Traduire cette page de V Chasnyk - ‎2014
The purposes of the study was to compare the prevalence of the CCR5-delta32 mutation in children with and without soJIA, to assess the association of this ...
3) Chemokine receptor CCR2 and CCR5 ... - NCBI
Traduire cette page de C Szalai - ‎1999 - ‎Cité 64 fois - ‎Autres articles
Chemokine receptor CCR2 and CCR5 polymorphisms in children with ... A common 32-bp deletion mutation in the CCR5 gene (CCR5delta32) and a G-to-A ...
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Many peoples in our district East Godavari and in Agency area having no awareness on Aids and HIV. So that we are planning to aware the children and people from their School level. Itself so we are selecting some Z.P School and A.P.S.W. R Schools and we go for awareness programs and camps to educate the children. And we are also planning to make an HIV Anti- group. We select some children and conduct some competitions, seminars and workshops and aware them against HIV and Aids.
We are requesting you for the fund needed for our plan and requesting for the addresses of any other organizations who are supporting us.
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Bill & Melinda Gates Foundation
Commonwealth Foundation
Elton John AIDS Foundation
European Union
Global Fund to Fight AIDS, Tuberculosis and Malaria
Hewlett Foundation
International HIV/AIDS Alliance
Government of the Netherlands
The Abbott Fund
US President’s Emergency Plan for AIDS Relief (PEPFAR)
UK Department for International Development (DFID)
UNAIDS
United States Agency for International Development (USAID)
United Nations Development Programme
World Health Organization
NACO, 9th Floor, Chanderlok Bldg., 36 Janpath,
New Delhi-110001 Tel: 23325337
Rajiv Gandhi Foundation
Rajendra Prasad Road
New Delhi - 110 001, India
Tel.: +91 11 2375 5117
Fax: +91 11 2375 5119
The Foundation supports HIV training programs for health professionals working with NGOs to treat the underprivileged throughout India. It also supports education, prevention and direct services programs for PLWHA as well as capacity-building grants for CBOs working in this area.
Vasavya Mahila Mandali
Benz Circle, Vijayawada - 520 010
Andhra Pradesh, India
Tel.: +91 86 6247 0966
Fax: +91 86 6247 3056
Vasavya is an intermediary for international and national
funders and governments. It supports home and community-based HIV/AIDS care and prevention programs.
MAMTA MAMTA
Health
Institute for Mother and Child
B-5, Greater Kailash Enclave-II
New Delhi, India 110048
Tel.: +91 11 2922 0210
Fax: +91 11 2922 0575
MAMTA is an intermediary for international and national funders and governments. It supports HIV/AIDS programs focusing on direct care, advocacy, and training throughout the country.
Palmyrah Workers Development Society (PWDS PWDS PWDS )
Crystal Street, Marthandam – 629165
Kanyakumari District
Tamil Nadu, India
Tel.: +91 46 5127 0241
Fax: +91 46 5127 0138
PWDS is an intermediary for international and national funders and governments. It supports CBOs and NGOs working with AIDS orphans as well as organizations providing community-based care and support programs for PLWHA.
LEPRA
Society
Post Box No. 1518
West Marredpally, Secunderabad
Andhra Pradesh, India
Tel.: +91 040 2780 2139
Fax: +91 040 2780 1391
LEPRA is an intermediary for international and national funders and governments. It supports a wide range of HIV/AIDS projects from direct care to advocacy to education and vocational programs throughout the country.
TEST Foundation
4, Sathalvar Street
Mugappair West
Chennai, India 600037
Tel.: +91 044 2624 4100
Fax: +91 044-2625 0315
TEST is both an operating foundation, running its own programs including home-based care and a hospice for AIDS patients, and a grantmaking
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Can I have an updated list of anti HIV medications (+manufacturers) recommended by the WHO for pregnant women, adults and children in resource-limited settings?
Thank you.
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Please see these links may be useful for you.
1)WHO | WHO to update guidelines on antiretrovirals in 2015
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WHO to update guidelines on antiretrovirals in 2015. ... HIV topic: use of antiretrovirals for treatment and prevention of HIV infection · 2013 Consolidated ...
2)WHO | Guidelines: HIV
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Supplement to the 2014 Consolidated guidelines for HIV prevention, diagnosis, treatment and care for key populations 1 July 2015; Consolidated strategic ...
‎Consolidated guidelines - ‎Consolidated strategic ... - ‎March 2014 supplement
3)WHO | Guideline on when to start antiretroviral therapy and ...
Traduire cette page
Overview. This early-release guideline makes available two key recommendations that were developed during the revision process in 2015. First, antiretroviral ...
4)[PDF]Guidelines for the use of antiretroviral agents in ... - AIDSinfo
de A Council
Downloaded from http://aidsinfo.nih.gov/guidelines on 11/20/2015. Guidelines for ... It is emphasized that concepts relevant to HIV management evolve rapidly.
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Experimental evidences suggests that HIV infection is not transmitted via arthropods including mosquitoes. However, one paper investigated possible transmission of HIV-1 by African soft tick, ornithodoros moubata. This vector has the potentiality for mechanical transmission of HIV viruses (which otherwise do not survive in arthropods) under field conditions. But this is an old research and any new insights on this topic?
Is this a cause for alarm? As far as we know, HIV is not transmitted by bites of ticks, mites or mosquitoes and there are no evidences to suggest that retroviruses are transmitted by arthropods. 
Evaluation of mechanical transmission of HIV by the African soft tick, Ornithodoros moubata.
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There is no indication they biologically transmit the virus.  No molecular or immunological studies found any virus binding sites in the midgut for example of mosquitoes.
Insects are really not very good vectors of almost any virus (with a few exceptions).  The shear number of viruses out there is astronomical and insects are not shown or even implicated in most.  The only exception are the arboviruses and to be truthful if you look at the biology of these viruses you will find that even susceptible vectors are really not that good at transmitting most of them.  The viruses end up getting blocked by midgut or salivary gland barriers or there just are not enough in a blood meal to even infect a vector.
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 Krentz HB, MacDonald J, Gill MJ.  High mortality among human immunodeficiency virus (HIV)-infected individuals before accessing or linking to HIV care: a missing outcome in the cascade of care?  Open Forum Infectious Diseases.  2014 1 (1)
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Not sure if we can do this in England - will ask valerie Delpech at PHE. Excellent paper John!
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We try to isolate CD56neg NK cells from HIV patients, but the presence of this NK cell subset seems to be correlated with the viral load so I wondered from which viral load you can assure the presence of CD56neg NK cells
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Please review the following:
Persistence of pathological distribution of NK cells in HIV-infected patients with prolonged use of HAART and a sustained immune response. PLoS One. 2015 Mar 26;10(3):e0121019.
 Frias M(1), Rivero-Juarez A(1), Gordon A(1), Camacho A(1), Cantisan S(1),
Cuenca-Lopez F(1), Torre-Cisneros J(1), Peña J(2), Rivero A(1).
OBJECTIVE: A prospective analysis of the distribution of NK subsets and natural cytotoxicity receptors (NKp30/NKp46) in HIV patients with long-term HAART use and sustained virological and immunological response.
METHODS: The main inclusion criteria were: at least 3 years' receipt of HAART; current CD4+ count ≥ 500 cells/mm3; undetectable viral load for at least 24 months; no hepatotropic virus co-infection. Percentages of CD56dim, CD56bright NK cells and CD56neg CD16+ cells were obtained. Expression of the NCRs, NKp30 and NKp46 was analysed in CD56+ cells. Thirty-nine infected patients and sixteen healthy donors were included in the study.
RESULTS: The percentages of total CD56+ and CD56dim NK cells were significantly lower in HIV-infected patients than in healthy donors (70.4 vs. 50.3 and 80.9 vs. 66.1 respectively). The percentage of total CD56+ NK cells expressing NCR receptors was lower in HIV patients than in healthy donors (NKp30: 25.20 vs. 58.63; NKp46: 24.8 vs. 50.59). This was also observed for CD56dim and CD56bright NK cells. Length of time with undetectable HIV viral load was identified as an independent factor associated with higher expression of NKp30 and NKp46. 
CONCLUSION: Despite the prolonged and effective use of HAART, HIV-infected patients do not fully reconstitute the distribution of NK cells. Length of time with an undetectable viral load was related to greater recovery of Kp30/NKp46 receptors.
Human NK cell response to pathogens. Semin Immunol. 2014 Apr;26(2):152-60.
 Della Chiesa M(1), Marcenaro E(1), Sivori S(1), Carlomagno S(1), Pesce S(1),
Moretta A(2).
 NK cells represent important effectors of the innate immunity in the protection
of an individual from microbes. During an NK-mediated anti-microbial response,
the final fate (survival or death) of a potential infected target cell depends
primarily on the type and the number of receptor/ligand interactions occurring at
the effector/target immune synapse. The identification of an array of receptors
involved in NK cell triggering has been crucial for a better understanding of the
NK cell biology. In this context, NCR play a predominant role in NK cell
activation during the process of natural cytotoxicity. Regarding the NK-mediated
pathogen recognition and NK cell activation, an emerging concept is represented
by the involvement of TLRs and activating KIRs. NK cells express certain TLRs in
common with other innate cell types. This would mean that specific TLR ligands
are able to promote the simultaneous and synergistic stimulation of these innate
cells, providing a coordinated mechanism for regulating the initiation and
amplification of immune responses. Evidences have been accumulated indicating
that viral infections may have a significant impact on NK cell maturation,
promoting the expansion of phenotypically and functionally aberrant NK cell
subpopulations. For example, during chronic HIV-infection, an abnormal expansion
of a dysfunctional CD56neg NK cell subset has been detected that may explain, at
least in part, the defective NK cell-mediated antiviral activity. An analogous
imbalance of NK cell subsets has been detected in patients receiving HSCT to cure
high risk leukemias and experiencing HCMV infection/reactivation. Remarkably, NK
cells developing after CMV reactivation may contain "memory-like" or "long-lived"
NK cells that could exert a potent anti-leukemia effect.
Healthy Neonates Possess a CD56-Negative NK Cell Population with Reduced
Anti-Viral Activity. PLoS One. 2013 Jun 21;8(6):e67700.
 Jacobson A(1), Bell F, Lejarcegui N, Mitchell C, Frenkel L, Horton H.
 BACKGROUND: Neonatal Natural Killer (NK) cells show functional impairment and expansion of a CD56 negative population of uncertain significance.
METHODS: NK cells were isolated from cord blood and from adult donors. NK subpopulations were identified as positive or negative for the expression of CD56 and characterized for expression of granzyme B and surface markers by multi-parameter flow cytometry. Cell function was assessed by viral suppression and cytokine production using autologous lymphocytes infected with HIV. Activating (NKp30, NKp46) and inhibitory (Siglec-7) markers in healthy infants and adults were compared with viremic HIV-infected adults.
RESULTS: Cord blood contained increased frequencies of CD56 negative (CD56neg) NK cells with reduced expression of granzyme B and reduced production of IFNγ and the CC-class chemokines RANTES, MIP1α and MIP1β upon stimulation. Both CD56pos and CD56neg NK subpopulations showed impaired viral suppression in cord blood, with impairment most marked in the CD56neg subset. CD56neg NK cells from cord blood and HIV-infected adults shared decreased inhibitory and activating receptor expression when compared with CD56pos cells.
CONCLUSIONS: CD56neg NK cells are increased in number in normal infants and these effectors show reduced anti-viral activity. Like the expanded CD56neg population described in HIV-infected adults, these NK cells demonstrate functional impairments which may reflect inadequate development or activation.
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Is viread effective if used to prevent HIV infection?
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Dr. Bello,
In at least one of the trials mentioned tenofovir alone (Viread) was less effective as an HIV pre-exposure prophylaxis than the combination tenofovir/emtricitabine (brand name Truvada). Thus, for high risk individuals Truvada would be the medication of choice. In some of the clinical trials mentioned, the Partners PrEP study for example, analysis of those who were adherent to the once-daily oral regimen of Truvada attained over 90% protection against HIV infection, placing Truvada on par with condoms for efficacy if used daily. However, keep in mind that Truvada does not protect against other STDs or unwanted pregnancy. A clinical trial conducted in Thailand showed that oral pre-exposure prophylaxis (tenofovir) was partially effective at preventing HIV transmission among injection drug uses. A recent review article on PrEP for sexually acquired HIV risk management can be found at the following link: Wilton et al 2015, HIV/AIDS Research and Palliative Care.   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422285/pdf/hiv-7-125.pdf   New York State has developed comprehensive clinical guidelines for provision of Truvada for PrEP. See here: http://www.hivguidelines.org/clinical-guidelines/pre-exposure-prophylaxis/guidance-for-the-use-of-pre-exposure-prophylaxis-prep-to-prevent-hiv-transmission/
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Doing a study on " the role of sexual pleasure in donor sponsored HIV prevention in East Africa". I plan to interview adults 18+ in the community and HIV donor policy workers, I am therefore looking for some indicative questions. First, because sex is a senstive issue in African communities, what are some of the indicative questions I could ask community participants and key informants, obviously with prompts?; secondly, I need to know how to phrase the questions related to 'sexual pleasure' in the context of HIV prevention? What is the best way to get into the 'sexual pleasure' related questions without coming across as insensitive to community participants? 
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1. For HIV donor, the "same blood same sexual partners" should be an concept at the back of the mind. That is whether the donor groups attitude about having sexual pleasure with the non-infective partner can be revealed.
2. Regarding sexual pleasure in the context of HIV: This can be divided among unisex and bisexual partners
secondly: their mode of having sex which helps them complete their orgasm with the partner
thirdly: Their state of mind about the status evaluation of the partner before commencing sex for the first time with that partner
next: whether would they prefer having sex with known, relative, friend or with the unknown ones
next: If unknown, whether its economically possible to get the unkown sexual partner
next: influence of drugs and sexual activity
next: pre marital,marital and extra marital groups and their belief about having sex
whether due to high burden of HIV, the sexual pleasure is more with the same partner or  not ? can be evaluated
These are few of the things. If you are happy with any, let me know we would work on framing the questions. Bye. Take care
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What innovative ways can one use to promote consistent uptake of HIV testing among Marps without the fear of stigmatization from the community or other healthcare providers in Sub-Saharan Africa?
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Train members of the  MARPS' community to promote HIV/STI Testing. There are very interesting interventions proven to be effective DEBIs (deffusion of evidence based interventions), Best of lucks ! Mariana 
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I saw last week a pregnant girl, 17 week of gestation. She is 38 years old and she is a new HIV diagnosis. Her CD4 were 576, HIVRNA <1000 cp/ml. I've started immediately ARV therapy with a combination on tenofovir/emtricitabine and lopinavir/ritonavir. Two days later she told me she started vomiting many times during the days and I decided to stop lopinavir/r. What do you think could be the best option in substitution the PI: another PI like Atazanavir/r 300/100 (with half dose of ritonavir in confront of lopinavir) or, changing completely class and avoiding ritonavir, Raltegravir bid?
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The best options at this stage would be to either continue with a PI (such as darunavir) or switch to efavirenz. The British HIV Association still advocates one of these two options even in early pregnancy. I suspect Raltegravir or even Dolutegravir would be good options but there is not much information at the moment to promote their use in pregnancy.
I would personally try boosted darunavir and see how she goes.
I am attaching link to the British guidance on HIV treatment in pregnancy (2014 update):
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I am doing a study on monitoring and evaluation system and am trying how the system is designed using a a case study in Kenya. Are there any publications and journals in this area. Kindly share any useful information.
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The assessment tool will depend on your objective but the 12 components framework will good to use considering the system thinking approach principle associated with it.  In addition, the stakeholders engagement which usually lack in most situation is a plus regarding the buy-in of end users.
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The target audience is virally unsuppressed HIV-positive gay-identified men in the U.S. who have had condomless anal sex with HIV-negative or unknown status male partners.
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We can create one by using PPT or keynote. 
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Especially in understanding negotiation of condom use.
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See also Rosenthal and Levy (2010) "Understanding women's risk for HIV..." Published in Psychology of Women.
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Doing a systematic literature review on risk associated with MSMs and PEP.
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Look at this site belonging to Sigma Research - London School of Tropical Medicine
http://www.sigmaresearch.org.uk/gay or just search PEP on their site.
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To be used at 0, 3 and 6 monthly intervals.
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It depends on the population you are studying (e.g. adults vs adolescents etc). I would suggest checking out the CAPS website (University of California, San Francisco) - they have a lot of survey instruments for HIV researchers, prevention planners etc - as long as you cite CAPS as your source. 
Hope this helps!
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I am conducting a systematic review on resilience in high-risk, HIV-negative sexual minority men. If you're willing, would you mind sending any peer-reviewed articles you may have authored, or know of, that are possibly a good fit? Articles need to meet the following criteria:
  • biologically-born men (i.e., not transgender men)
  • sexual minority (e.g., gay, bisexual), OR men who have sex with men (MSM)
  • HIV-negative sample or subsample
  • at least 50% or entire sample reported 1+ of the following:
  • elevated mean score on mental health measure (e.g., >16 on CES-D)
  • substance use, including polydrug use
  • childhood sexual abuse
  • partner abuse of intimate partner violence
  • suicidal thoughts or attempts
  • psychiatric diagnoses
  • negative affect
  • evidence of resilience: psychological strength (e.g., coping), protective factor (e.g. neighborhood cohesion), positive developmental milestone (e.g., graduated college), positive adaptation to adversity (e.g., meaning making)
If you are unsure, I'd appreciate a citation or PDF anyway, and then I can screen the article. Please backchannel articles to enwoodward@suffolk.edu. Thanks so much for any help!
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Hi Eva,
Thank you so much! It's actually very close to what I was looking for, as adherence to HAART is a great part of my research, kind of an outcome. Please, if you have any papers dealing with stigma, coping strategies, resilience in PLHIV I'd be happy to get them.
Have a great day!
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Early infant diagnosis.
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Exclusive breastfeeding doesn't protect infants from acquiring HIV from their HIV-infected mothers. However, the benefits of breastfeeding in infants under 6 months (such as good nutrition and passive immunity against certain infectious diseases) outweigh the risks in developing countries. The WHO recommends breastfeeding where replacement feeding cannot be provided for children born to HIV-infected mothers. 
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My focus is not particularly on those infected or affected by HIV/AIDS, but on international donors who focus mainly on conservative, conditionality based abstinence only type funding where the recipient countries have to sign contracts disallowing them from using such funds for sex workers, 'loose' men and women in society. One of the principle ways for the HIV infection is via sex. I want to find out why the world's two largest HIV donors do not fund anything on sexual pleasure, sexuality etc. even though researches have found that this can encourage use of condom, minimize HIV risks and save innocent lives. If we want to combat the scourge of HIV shouldn't we be doing everything rather than limiting ourselves to moralistic methods which are unhelpful and may have led to many deaths among young people who are no longer as moralistic as these donors? I therefore plan to interview key policy officers in the US and UN's Africa head offices in Nairobi, to determine their reasons and their new models of funding in Africa in light of discovery, that a sexual pleasure can help limit invention? What might be the best research methodology for this type of research? Semi-structured interviews only? Literature review? I do not think focus group will work as these guys are seniors officers who might not have time to meet together. Your suggestions? What might be the best research methodology for a research focused on policy-type people?
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Would these folks talk to you? In a group or one-on-one? I'd propose a mixed methods study with an online survey coupled with focus groups (if you can get that) and one-on-one interviews with key stakeholders. Just a thought 
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As researchers design new HIV prevention interventions or as communities consider new intervention strategies they should be mindful of how cost effective alternatives might be in reducing the spread of the virus in a given population under different model assumptions. Some researchers have published articles on the cost effectiveness of their interventions under different assumptions, but I don't know of an easy common tool or tools that could do this to make assessments and comparisons across interventions easier. Does anyone know of such an easy to use tool that might be available on the web one could plug values into to get such an rough assessment (e.g., target population (ideally the tool would store updated values for prevalence in that population), effect size of intervention or similar parameter, cost of intervention, numbers of individuals reached, etc.).
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I do not know right now anyone but, personally, based on the cost of HAART and other treatments associated with HIV infection, it is difficult to not find a study suggesting that preventin is to less expensive than treamente. Almost in HIV intection. Compare a condom prize vs. only 1 antiretroviral...
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We know condom use to be effective in preventing HIV transmission but can we confidently say it works in all societies irrespective of prevailing social conditions?
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The first consideration in providing a response is what is meant by "all societies" and the second is what is "behavior change." Condom use has been the most frequent recommendation to prevent transmission of HIV - and after "abstinence," the most effective. Variations in behavior might include (a) carrying condoms, rather than suppose that one's casual and/or regular partner might have them; (b) learning negotiation skills and using these to limit types of sex in which someone is willing to engage [some sexual actions are statistically more risky]; (c) medical adherence to ART, if one is HIV positive, and following physician advice for Pre-Exposure Prophylaxis, if one is HIV-negative. Consistent use of condoms in each instance is recommended for all three. These in one form or another are essential to some prevention-education interventions. One source of interventions that have been tested, piloted and "approved" is > www.effectiveinterventions.org
Another consideration is the possibility / necessity of "adapting an intervention" to better fit the population, community or group where it will be implemented without diminishing the core elements that make the intervention effective.
Finally, other modes of HIV transmission would require protective behaviors other than condom use -- these too have effective interventions.
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It is commonly accepted to inactivate HIV by heat (56°C 30min), but I was wondering what is the rationality and if any study have been published about it?
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Here is a nice paper about HIV inactivation and stability. The rationality is the same as with FBS decomplementation. Heating at 56 for 30min degrades the enzymatic activity. In the case of HIV-1, the enzymes (reverse transcriptase and integrase mostly) are required for infectivity but heat can also affect envelope protein integrity. We use PFA 2% for 20 minutes, Ethanol 70% for 20 minutes and we have also used 2-aldrithiol to inactivate the virus without affecting the conformation of envelope proteins. They all work very well.
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Presently HIV drug therapy is widely available in India. now there is need for the research to do among the drug therapy users.
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you can study 1.the determinants of mortality in patients with HIV on treatment, two different interactions of HIV treatment and anti tuberculosis, 3 studying the determinants of immune reconstitution syndrome of anti HIV and anti tuberculosis .... .
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I am engaged with a study team that is trying to evaluate models for delivery of Pre exposure prophylaxis (PrEP) to HIV serodiscordant groups. The study is designed to evaluate how well either of three models would ensure PrEP (a) gets to the people who needs it and (b) people who start on PrEP continue to use it. The question that keeps coming up is how would you be able to report that your model of service deliver for PrEP is effective. I think this would require developing a composite score. Any possible help with this?
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Thanks Justyna for bringing in the collaboration and merging data sets, as indeed the occurrence of end point will always be low. And with this the need for standardization of processes and procedures is critical to derive reliable and valid findings
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Bangladesh is a resource limited country and most of the HIV infected people are poor. Which research can reduce management cost?
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I agree that among the important things is the therapeutic adherence intervention. another strategy in virologically suppressed stable patients with protease inhibitor is the de-intesification
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This may be an unmatured question but I have had this doubt from my college days.
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HIV is an enveloped virus. For the capsid protein to be presented for antibody production, the virus has to first be ingested by the antigen presenting cells. Where CD4+ T-cells and macrophages become involved in the adaptive immunity process, they end up getting infected. The best way to stop the virus is by targeting its Envelope proteins with neutralizing antibodies. These are exposed to the human immune system right from the time it enters the body and if there are sufficiently good antibodies, they can prevent an infection event altogether. For this reason, capsid is not targeted much in terms of vaccination.
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Since dendritic cells deliver HIV by cell synapses.
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In fact, the point is that infection through sexual contact takes the DC cells pathway, with no need for coreceptors to enter LT CD4
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I don't have answer, bud I would like ask you for one question. Have you got any informations about new Chinesse vaccine against HIV infection?
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Most at risk people for HIV/AIDS are hidden in the population because of stigma, illegality of their acts like injecting drug use etc., and therefore we can not count them by using direct ways like census. What are the most suitable ways then?
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Dear Ali,
Please have a look at the material available in this webiste. You may find relevant courses there also. http://hivhub.ir/en/publications/reviews/mapping. You can also search for papers on network scale up techniques.There are good published papers.
Good luck,
Mehdi
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This is to investigate the prevention of mother to child HIV transmission using an alternative therapy to ARVs.
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Yes i realized that there's no kits available on the market. We will try the The VERSANT HIV-1 RNA Assay (bDNA) for now. Thanks Dmitry.
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I am really surprised when I see absence of any discussion on the sexual behaviour influenced by alcohol consumption.
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This is an interesting topic indeed. Intuitively one would think surely there should be a link between alcohol consumption/ psychoactive drug use and HIV. However, to the best of my knowledge, this has remained a 'grey' area due to the lack of epidemiological evidence linking alcohol/ non-injection drug use directly to the acquisition of HIV. There is a lot of evidence linking alcohol to risky sexual behaviour (or the intention to have unprotected sex e.g. this systematic review DOI: 10.1111/j.1360-0443.2011.03621.x), but not to HIV acquisition for example; and lots of evidence also on injection drug use to hiv acquisition. Linking alcohol/ non-injection psychoactive drug use to HIV acquisition has remained an under developed area. Inturn, as most HIV prevention policies and practices are evidence driven/ evidence informed, this lack of scientific evidence results in lack of policies and practices addressing this.
However, the language has now changed and alcohol and other psychoactive substances are more and more being recognised as structural drivers of HIV. This has led to increased attention and interest in research in this area. STRIVE for example, an organization under the london school of hygiene and tropical medicine (http://strive.lshtm.ac.uk/drivers) has a research strand looking at this. Also there are now research fellowships to encourage researchers to look at this (e.g. the HIV and Drug Use Research Fellowship under the International AIDS Society). So as more and more evidence is accumulated in this area, we will hopefully begin to see prevention policies and practices addressing this issue.
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Great progress has been made in the global response to the AIDS epidemic. However, HIV management and HAART spurred substantial increases in funding of health care. Because of enormous challenge of sustaining political, programmatic, and technical commitment, along with national and international funding, these achievements are fragile.
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Thank you very much for your answer. I really appreciate it. Thank you also for the paper.
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Low literate community members ask this question; there is need to find less technical ways to clarify.
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Thanks Saryatun and Janak. These are good contributions about HIV immunology. And I am looking for published works to support my message development.
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Since the virus incorporates its genome into the host cell, I think inhibiting all or some of host cell transcription factors could be a potential target for HIV proliferation.
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The secret lies in inhibiting Nuclear factor kappa b, which activates the HIV transcription in the CD4 T-Cells
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The HIV-infected mothers may have multiple physical, emotional, and social concerns, including coming to terms with the reality of their own infection while facing uncertainty about the HIV status of their infant. If the child is seropositive the mother usually has difficulty to inform him about his illness.
Who should tell the child's status? (doctor, mother or psychologist)
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It will be difficult to have a cut of age for when to give information to HIV infected children about their illness.Key will be to ascertain if they have the capacity to understand and process this information. Information can be given tailored to their age and understanding.
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I'm writing a college research paper on this subject. Is there any document that opposes adopting option B+? Scholarly would be preferable but anything will help. I found lancet article and commentary on Is option B+ best? however, could not find any more.
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Option A is AZT prophylaxis in monotherapy for women with CD4 above 350, and this is not considered HAART.
Malawi has adopted B+ and I believe Botswana as well. In Mozambique it is going to be started prety soon.
See the paper attached for the intrauterus exposition to HAART.
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In Nigeria, rapid antibody testing is used by most blood banks with only a few centers using 4th generation ELISA. Many of us are worried over the window period challenge with antibody testing.
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Thanks a lot, Valencia.
The idea of comparing the cost of total care of an HIV infected person with cost of molecular testing on donor blood is a big strategy for advocacy. This also helps me with my research on minipool.
Blessings.
Sunday
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I was doubtful while writing a postmortem finding about a HIV positive patient in a mortuary. Can the HIV virus be transferred from the HIV/AIDS affected person's blood after his or her death? If so, then how many days can the virus live in the dead body?
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Satyaprasad, are you an HIV specialist? I would like to see an official report or paper where dried HIV virus was activated by moisture. Would you be so kind to show the reference? HIV does not survive out of the body. Virus become noninfectious in dried blood samples. The fact that HIV DNA and/or RNA can be recovered or amplified from dry blood doesn't mean that people can be infected by dried blood sample. You need to provide a special pH and temperature (controlled environment) in order to keep HIV virus infectious in dried blood samples. This conditions are not available naturally. Moreover, you need an extremely high viral titre in that dried sample and extensive contact to open wound or bloodstream in order to transmit virus to a victim. Chances to get HIV from the dried blood are close to zero. Please check this:
"While HIV may live for a short while outside of the body, HIV transmission has not been reported as a result of contact with spillages or small traces of blood, semen or other bodily fluids. This is partly because HIV dies quite quickly once exposed to the air, and also because spilled fluids would have to get into a person's bloodstream to infect them.
Scientists agree that HIV does not survive well in the environment, making the chance of environmental transmission remote. To obtain data on the survival of HIV, laboratory studies usually use artificially high concentrations of laboratory-grown virus. Although these concentrations of HIV can be kept alive for days or even weeks under controlled conditions, studies have shown that drying of these high concentrations of HIV reduces the amount of infectious virus by 90 to 99 percent within a few hours.
Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, the real risk of HIV infection from dried bodily fluids is probably close to zero. Incorrect interpretation of conclusions drawn from laboratory studies have unnecessarily alarmed some people. AVERT.org has additional facts about HIV and AIDS.
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This study is to be conducted in a low resource setting.
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Probably the theoretical perspective you use to ask the question. I would strongly advise against asking empirical question and adding 'theoretical perspectives' after the research has been done.
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Nowadays, due to the recently success of pre-exposure antiretrovial therapies, the investigation on the use of anti HIV gels and the employment of male circumcision, there are possible future options to prevent HIV infection. Also the research in the vaccines field has reported relevant advances. Which will be the balance between the two trends in the upcoming years?
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Future cost effectiveness studies should consider pre-exposure prophylaxis implementation issues, budget impact, and the role of pre-exposure prophylaxis as part of combination HIV-prevention strategies including expanded testing and treatment access.
Medical male circumcision resulted in a 50% to 60% reduction in HIV acquisition among men (nevertheless, HIV diagnosis rates are highest in women).
However, men reporting unprotected receptive anal sex, regardless of partner serostatus, account for an high number of new HIV infection.
The identification of broadly neutralizing monoclonal antibodies (such as VRC01, a human monoclonal antibody capable of neutralizing over 90% of natural HIV-1 isolates) has revealed new opportunities for vaccine design: thus, it is possible for a vaccine to reduce the risk of HIV-1 infection.
Finally, the CDC's new strategy, “High Impact Prevention,” involves prioritizing and implementing the optimal combination of cost-effective, scalable interventions based on current science. The pre-exposure prophylaxis in a recent randomized trials demostrated up to a 73% reduction of HIV acquisition throught ART, a 96% reduction in transmission from infected patients taking ART, and a 39% reduction in HIV acquisition among women using vagina microbicide. For me, this is a realistic iter to have successes (combined to a 100% of use of male and female condoms).
Buchbinder SP. Top Antivir Med. 2012
Schackman BR, Eggman AA. Curr Opin HIV AIDS. 2012
Kwong PD, Mascola JR, Nabel GJ. J Int AIDS Soc. 2012
Mermin J, Fenton KA. JAMA. 2012