Vaginal gels may act as physical barriers to HIV during sexual transmission. However, the extent and significance of this effect are not well understood. During male-to-female sexual transmission of HIV, semen containing infectious HIV is present within the lower female reproductive tract. In cases where a topical gel has previously been applied to the vaginal epithelium, virions must move through gel layers before reaching vulnerable tissue. This additional barrier could affect the functioning of anti-HIV microbicide gels and placebos. To better understand HIV transport in gels, we: (1) quantified diffusion coefficients of HIV virions within semi-solid delivery vehicles; and (2) tested the barrier functioning of thin gel layers in a Transwell system. Two gels used as placebos in microbicides clinical trials, hydroxyethyl cellulose (HEC) and methylcellulose (MC), were found to hinder HIV transport in vitro. The diffusion coefficients for HIV virions in undiluted HEC and MC were 4±2 x 10⁻¹² and 7±1 x 10⁻¹² cm²/s, respectively. These are almost 10,000 times lower than the diffusion coefficient for HIV in water. Substantial gel dilution (80%:diluent/gel, v/v) was required before diffusion coefficients rose to even two orders of magnitude lower than those in water. In the Transwell system, gel layers of approximately 150-μm thickness reduced HIV transport. There was a log reduction in the amount of HIV that had breached the Transwell membrane after 0-, 4-, and 8-h incubations. The ability of a gel to function as a physical barrier to HIV transport from semen to tissue will also depend on its distribution over the epithelium and effects of dilution by vaginal fluids or semen. Results here can serve as a baseline for future design of products that act as barriers to HIV transmission. The potential barrier function of placebo gels should be considered in the design and interpretation of microbicides clinical trials.
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http://dx.doi.org/10.1016/j.antiviral.2010.08.006 | DOI Listing |
AIDS Care
February 2025
Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
Despite the successful rollout of antiretroviral therapy (ART) and positive ART outcomes in the Kingdom of Eswatini, adolescents still present poor ART outcomes including low viral load suppression and suboptimal ART adherence. The aim of the study was to explore the perceptions of adolescents living with HIV (ALHIV) on the barriers and facilitators to ART adherence in Eswatini. We conducted a qualitative study using in-depth interviews among 29 ALHIV and on ART in Eswatini in December 2023.
View Article and Find Full Text PDFInt J Ment Health Syst
January 2025
University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France.
Introduction: Group Interpersonal Therapy (IPT), an evidence-based treatment of depression recommended by the WHO mhGAP Intervention Guide, was implemented through a task-shifting approach in Senegal, as a treatment for depressed people living with HIV (PLWH). Since a description of the resources used and the implementation costs incurred is necessary to inform policymakers better, this study aimed to estimate the costs associated with its implementation.
Methods: Intervention costs were analyzed using an "ingredients-based costing approach" from the provider's perspective.
Health SA
December 2024
Department of Sociology, Faculty of Human Sciences, University of South Africa, Pretoria, South Africa.
Background: South Africa accounts for 14% of all new HIV infections representing the highest annual rate of new HIV infections globally. In addition, South Africa is home to 21% of the worldwide HIV burden, with 7.97 million people living with HIV.
View Article and Find Full Text PDFPLoS One
January 2025
Monitoring and Evaluation Technical Support, Makerere University School of Public Health, Kampala, Uganda.
Introduction: Effective prevention of mother to child transmission (PMTCT) programmes require women and their infants to have access to a cascade of HIV care and treatment interventions. Retention in care reduces the risk of vertical transmission and opportunistic infections among mothers living with HIV. Uganda has made great strides in ensuring the success of the prevention of mother to child transmission program.
View Article and Find Full Text PDFJ R Stat Soc Ser A Stat Soc
January 2025
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Studies intended to estimate the effect of a treatment, like randomized trials, may not be sampled from the desired target population. To correct for this discrepancy, estimates can be transported to the target population. Methods for transporting between populations are often premised on a positivity assumption, such that all relevant covariate patterns in one population are also present in the other.
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