Search results

The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.

The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.

Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.

Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

The cardiomegaly can be determined by the cardiothoracic ratio (CTR) which can be measured in a chest x-ray image. It is calculated based on a relationship between a size of heart and a transverse dimension of chest. The cardiomegaly is identified when the ratio is larger than a cut-off threshold. This paper aims to propose a solution to calculate the ratio for classifying the cardiomegaly in chest x-ray images.

The proposed method begins with constructing lung and heart segmentation models based on U-Net architecture using the publicly available datasets with the groundtruth of heart and lung masks. The ratio is then calculated using the sizes of segmented lung and heart areas. In addition, Progressive Growing of GANs (PGAN) is adopted here for constructing the new dataset containing chest x-ray images of three classes including male normal, female normal and cardiomegaly classes. This dataset is then used for evaluating the proposed solution. Also, the proposed solution is used to evaluate the quality of chest x-ray images generated from PGAN.

In the experiments, the trained models are applied to segment regions of heart and lung in chest x-ray images on the self-collected dataset. The calculated CTR values are compared with the values that are manually measured by human experts. The average error is 3.08%. Then, the models are also applied to segment regions of heart and lung for the CTR calculation, on the dataset computed by PGAN. Then, the cardiomegaly is determined using various attempts of different cut-off threshold values. With the standard cut-off at 0.50, the proposed method achieves 94.61% accuracy, 88.31% sensitivity and 94.20% specificity.

The proposed solution is demonstrated to be robust across unseen datasets for the segmentation, CTR calculation and cardiomegaly classification, including the dataset generated from PGAN. The cut-off value can be adjusted to be lower than 0.50 for increasing the sensitivity. For example, the sensitivity of 97.04% can be achieved at the cut-off of 0.45. However, the specificity is decreased from 94.20% to 79.78%.