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Open Access
Article
Publication date: 17 December 2019

Hamid Emadi-Koochak, Zeinab Siami, Jayran zebardast, SeyedAhmad SeyedAlinaghi and Ali Asadollahi-Amin

During the ART era, persistent immune activation remains a significant challenge in people living with HIV (PLWH). Microbial translocation play an essential role in this setting…

1534

Abstract

Purpose

During the ART era, persistent immune activation remains a significant challenge in people living with HIV (PLWH). Microbial translocation play an essential role in this setting. Probiotics have several immunological benefits which can reverse this process. The purpose of this paper is to investigate the safety and efficacy of probiotics on CD4 counts among Iranian PLWH.

Design/methodology/approach

In total, 50 PLWH with CD4 counts above 350 cells/mm3 did not receive ART participated in a randomized, double-blind trial and underwent 24 weeks of treatment with either LactoCare® or placebo twice daily. CD4 counts of the patients were measured at baseline, 12 weeks and 24 later in the two groups. Side effects were measured monthly using a specific checklist.

Findings

The mean CD4 count of the patients showed a significant difference between the two groups after six months. Through six months follow up, the mean CD4 count of the patients showed a significant reduction as compared to the baseline in the placebo group; however, it did not show a significant difference in the probiotic group. Repeated Measures Anova test showed a significant effect for time × treatment interaction on the CD4 count during the trial course. No significant difference between the two groups concerning adverse events was reported.

Originality/value

It seems the use of probiotics in PLWH with a CD4 count above 350 cells/mm3 who are not receiving antiretroviral drugs is safe and can reduce the devastating process of CD4+ T cells in these patients.

Details

Journal of Health Research, vol. 34 no. 2
Type: Research Article
ISSN: 2586-940X

Keywords

Article
Publication date: 3 August 2015

Maria Nnyepi, Maurice R. Bennink, Jose Jackson-Malete, Sumathi Venkatesh, Leapetswe Malete, Lucky Mokgatlhe, Philemon Lyoka, Gabriel M. Anabwani, Jerry Makhanda and Lorraine J. Weatherspoon

Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the…

Abstract

Purpose

Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the benefits of integrating nutrition (assessment and culturally acceptable food supplement intervention) in the treatment strategy for this target group.

Design/methodology/approach

The authors conducted a randomized, double blind pre-/post-intervention trial with 201 HIV-positive children (six to 15 years) in Botswana. Eligibility included CD4 cell counts < 700/mm3 (a marker for the severity of HIV infection), documented treatment with antiretroviral (ARV) drugs, and no reported evidence of taking supplemental food products with one or more added nutrients in the six-month period prior to the study. The intervention (12 months) consisted of two food supplements for ethical reason, one with a higher protein content, bean (bean-sorghum based) group (n=97) and a cereal (sorghum) group (n=104) both of which contained added energy- and micro- nutrients. Anthropometric and biochemical nutritional status indicators (stunting, wasting, underweight, skinfolds for fat and muscle protein reserves, and hemoglobin levels) were compared within and between the bean and the cereal groups pre- and post-intervention separately for children six to nine years and ten to 15 years.

Findings

Older children (ten to 15 years) fared worse overall compared to those who were younger (six to nine years) children in anthropometric and protein status indicators both at baseline and post-intervention. Among children six to nine years, the mid arm circumference and blood hemoglobin levels improved significantly in both the bean and cereal groups (p < 0.01 and p < 0.05, respectively). Although the BMI for age z-score and the triceps skinfold decreased significantly in the bean group, the post-intervention subscapular skinfold (fat stores) was significantly higher for the bean group compared to the cereal group (p < 0.05). Among children ten to 15 years, both the bean and the cereal groups also showed improvement in mid arm circumference (p < 0.001), but only those in the bean group showed improvement in hemoglobin (p < 0.01) post-intervention.

Originality/value

Similar significant nutritional status findings and trends were found for both food interventions and age within group pre- vs post-comparisons, except hemoglobin in the older children. Post-intervention hemoglobin levels for the type food supplement was higher for the “bean” vs the “cereal” food in the younger age group. The fact that all children, but especially those who were older were in poor nutritional status supports the need for nutrition intervention in conjunction with ARV treatment in children with HIV/AIDS, perhaps using a scaled up future approach to enhance desired outcomes.

Details

Health Education, vol. 115 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 19 December 2016

Joseph Bick, Gabriel Culbert, Haider A. Al-Darraji, Clayton Koh, Veena Pillai, Adeeba Kamarulzaman and Frederick Altice

Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related…

Abstract

Purpose

Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related mortality is high. Few studies have comprehensively assessed the complex health needs of this population. The paper aims to discuss these issues.

Design/methodology/approach

From October 2012 through March 2013, 221 sequentially selected HIV-infected male prisoners underwent a comprehensive health assessment that included a structured history, physical examination, and clinically indicated diagnostic studies.

Findings

Participants were mostly PWID (83.7 percent) and diagnosed with HIV while incarcerated (66.9 percent). Prevalence of hepatitis C virus (90.4 percent), untreated syphilis (8.1 percent), active (13.1 percent), and latent (81.2 percent) tuberculosis infection was several fold higher than non-prisoner Malaysian adults, as was tobacco use (71.9 percent) and heavy drinking (30.8 percent). Most (89.5 percent) were aware of their HIV status before the current incarceration, yet few had been engaged previously in HIV care, including pre-incarceration CD4 monitoring (24.7 percent) or prescribed antiretroviral therapy (ART) (16.7 percent). Despite most (73.7 percent) meeting Malaysia’s criteria for ART (CD4 <350 cells/μL), less than half (48.4 percent) ultimately received it. Nearly one-quarter (22.8 percent) of those with AIDS (<200 cells/μL) did not receive ART.

Originality/value

Drug addiction and communicable disease comorbidity, which interact negatively and synergistically with HIV and pose serious public health threats, are highly prevalent in HIV-infected prisoners. Interventions to address the critical shortage of healthcare providers and large gaps in treatment for HIV and other co-morbid conditions are urgently needed to meet the health needs of HIV-infected Malaysian prisoners, most of whom will soon transition to the community.

Details

International Journal of Prisoner Health, vol. 12 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

Book part
Publication date: 8 August 2016

Sara LeGrand, Teresa L. Scheid and Kathryn Whetten

This chapter examines the associations between gender, social support, and health outcomes for individuals living with HIV disease. We include social integration and social…

Abstract

Purpose

This chapter examines the associations between gender, social support, and health outcomes for individuals living with HIV disease. We include social integration and social isolation as structural measures of social support as well as perceived social support and social conflict as functional measures of social support. We include both mental health and physical health outcomes, which are too often studied in isolation of each other.

Methodology/approach

Data are from the Coping with HIV/AIDS in the Southeast (CHASE) study; this study reports on baseline data from 611 participants collected from 2001 to 2002. We first examined differences by gender and race, and then used blocked linear regression to determine the additive effects of the social support variables on both mental and physical health outcomes while controlling for potential confounders.

Findings

There were notable differences in the significance and strength of social support variables in health outcome models for men and women. Unlike men, social conflict was the strongest predictor of greater psychological distress and poorer physical health-related quality of life among women.

Research limitations/implications

While the results from this study contribute to a greater understanding of gender differences in the relationships between social support and health outcomes, the data used for this study are limited to those living with HIV/AIDS in the Southeast.

Originality/value

Our findings suggest that social conflict may be more detrimental for the health of women than men.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

Keywords

Article
Publication date: 4 March 2021

Sofie Stulens, Kim De Boeck and Nico Vandaele

Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and…

Abstract

Purpose

Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and middle-income countries. The effective and efficient operation of HIV supply chains is critical to tackle this problem. The purpose of this paper is to give an introduction to HIV supply chains in low- and middle-income countries and identify research opportunities for the operations research/operations management (OR/OM) community.

Design/methodology/approach

First, the authors review a combination of the scientific and grey literature, including both qualitative and quantitative papers, to give an overview of HIV supply chain operations in low- and middle-income countries and the challenges that are faced by organizing such supply chains. The authors then classify and discuss the relevant OR/OM literature based on seven classification criteria: decision level, methodology, type of HIV service modeled, challenges, performance measures, real-life applicability and countries covered. Because research on HIV supply chains in low- and middle-income countries is limited in the OR/OM field, this part also includes papers focusing on HIV supply chain modeling in high-income countries.

Findings

The authors conclude this study by identifying several tendencies and gaps and by proposing future research directions for OR/OM research.

Originality/value

To the best of the authors’ knowledge, this paper is the first literature review addressing this specific topic from an OR/OM perspective.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 11 no. 3
Type: Research Article
ISSN: 2042-6747

Keywords

Book part
Publication date: 28 September 2020

Rajeev Kumar, Damodar Suar, Sanjay Kumar Singh and Sangeeta Das Bhattacharya

Purpose – This study investigates the sociodemographics, late entry to antiretroviral therapy (ART), and clinical markers associated with AIDS-related mortality…

Abstract

Purpose – This study investigates the sociodemographics, late entry to antiretroviral therapy (ART), and clinical markers associated with AIDS-related mortality.

Methodology/Approach – Applying retrospective cohort design, 960 medical records of people who died of AIDS, from October 2006 to December 2014, were accessed from the ART center at tertiary health care center of Ranchi (India).

Findings – With useable data from 889 medical records revealed that the majority of people who died of AIDS consisted of married males in the age group of 19–40 years who were truck drivers, migrant laborers, and of rural origins. The median survival period was below 3 months following the ART. Males and people on the pre-ART group had a shorter survival period than their counterparts. Early mortality was associated with lower CD4+ T cell counts, the third or fourth clinical stage, ambulatory or bed-ridden functional status, and poor medication adherence.

Research limitations/implications – This study was limited to the analysis of AIDS deceased people only; it did not compare the survival duration with living people on ART. The lower CD4+ T cell counts and medication adherence, being strong predictors of mortality, can be addressed to attain higher survival rates of people who have AIDS.

Originality/Value of Paper – This is the first study conducted in the tribal-populated region, covering a large sample of 889 cases. Unique findings of this study update the existing data on AIDS-related mortality.

Details

Race, Ethnicity, Gender and Other Social Characteristics as Factors in Health and Health Care Disparities
Type: Book
ISBN: 978-1-83982-798-3

Keywords

Article
Publication date: 3 June 2020

Hakan Özkaya, Nehir Balcı, Hülya Özkan Özdemir, Tuna Demirdal, Selma Tosun, Şükran Köse and Nur Yapar

The purpose of this study is to estimate the average cost of treatment and investigate the related parameters of HIV/AIDS among patients based on their annual treatment regime…

Abstract

Purpose

The purpose of this study is to estimate the average cost of treatment and investigate the related parameters of HIV/AIDS among patients based on their annual treatment regime during the 2017 in Izmir.

Design/methodology/approach

The average annual direct cost of an HIV patient's treatment was estimated for 2017 at four university hospitals in a retrospective study in Izmir, Turkey. Inclusion criteria included confirmed HIV infection, age = 18 years, visited one of the hospitals at least three times a year and with at least one CD4+ T cell count. The average annual treatment cost per patient was calculated using accounting data for 527 patients from the hospitals' electronic databases.

Findings

The mean treatment cost per patient was US$4,381.93. Costs for treatment and care were statistically significantly higher (US$5,970.55) for patients with CD4+ T cell counts of fewer than 200 cells/mm3 than for other patients with CD4+ T cell counts above 200 cells/mm3. The mean treatment cost for patients who were 50 years old or older (US$4,904.24) was statistically significantly higher than for those younger than 50 years (US$4,216.10). The mean treatment cost for female patients (US$4,624.92) was higher than that of male patients ($US4,339.72), although the difference was not statistically significant. The main cost driver was antiretroviral treatment (US$3,852.38 per patient), accounting for almost 88% of all costs. However, the high burden of antiretroviral treatment cost is counterbalanced by relatively low care and hospitalization costs in Turkey.

Originality/value

The paper contributes to the literature by providing average annual treatment cost of an HIV-infected patient in Turkey by using a comprehensive bottom up approach. Moreover, cost drivers of HIV treatment are investigated.

Details

International Journal of Health Governance, vol. 25 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 1 March 2006

Adila Hassin

South Africa has been hailed as possessing one of the most progressive and visionary Constitutions in the world. It recognizes the right of everyone to have access to health care…

Abstract

South Africa has been hailed as possessing one of the most progressive and visionary Constitutions in the world. It recognizes the right of everyone to have access to health care services. It also recognizes, in detail, various rights of accused, arrested and detained people, including the right to adequate medical treatment. However, despite the constitutionally entrenched rights, we (as civil society) are painfully aware that this does not magically transform the social conditions of the poor and marginalized amongst us. In fact, we have learnt that it is not only food, shelter and healthcare that cost money, but rights also. For without access to legal services in order to enforce one’s rights, they often remain not much more than paper ideals. This is recently demonstrated in the case of EN and Others v Government of the Republic of South Africa and Others , more commonly called the Westville Correctional Centre case (WCC case). This article will examine this case, and the implications of the right to adequate medical treatment for prisoners in South Africa, by addressing the factual background to the litigation, the legal and policy framework, the key issues that arose and the legal remedy.

Details

International Journal of Prisoner Health, vol. 2 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 12 September 2016

Yazhini Subramanian, Muhammad Naeem Khan, Sara Berger, Michelle Foisy, Ameeta Singh, Dan Woods, Diane Pyne and Rabia Ahmed

The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in…

Abstract

Purpose

The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in community care post-release.

Design/methodology/approach

A retrospective chart review of patients who attended the human immunodeficiency virus (HIV) Outreach Clinic at a Canadian remand center between September 2007 and December 2011 was carried out. Data extraction included CD4 lymphocyte count, HIV viral load, ART prescription refills, and community engagement and retention during and one-year pre- and post-incarceration.

Findings

Outpatient engagement increased by 23 percent (p=0.01), as did ART adherence (55.2-70.7 percent, p=0.01), following incarceration. Retention into community care did not significantly improve following incarceration (22.4 percent pre-incarceration to 25.9 percent post-release, p=0.8). There was a trend toward improved virologic suppression (less than 40 copies/ml; 50-77.8 percent (p=0.08)) during incarceration and 70. 4 percent sustained this one-year post-incarceration (p=0.70).

Originality/value

The impact of short-term incarceration in a Canadian context of universal health coverage has not been previously reported and could have significant implications in optimizing HIV patient outcomes given the large number of HIV-positive patients cycling through short-term remand centers.

Details

International Journal of Prisoner Health, vol. 12 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Content available
Article
Publication date: 6 February 2009

92

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of 90