Objectives: The scaling up of antiretroviral treatment (ART) for HIV-infected adults requires a sizeable investment of resources in the South African public health care system. It is important that these resources are used productively and in ways that reach those in need, irrespective of social status or personal characteristics. In this study we evaluate whether the distribution of ART services in the public system reflects the distribution of need among adults in the urban population.
Methods: Data from a 2008 national survey were used to estimate the distribution of socioeconomic status (SES) and sex in HIV-positive adults in urban areas. These findings were compared to SES and sex distributions in 635 ART users within 6 urban public ART facilities.
Results: Close to 40% of those with HIV are in the lowest SES quintile, while 67% are women. The distributions in users of ART are similar to these distributions in HIV-positive people.
Conclusions: Patterns of ART use in study settings correspond to patterns of HIV in the urban population at the national level. This suggests that the South African ART programme is on track to ensure equitable delivery of treatment services in urban settings.
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http://dx.doi.org/10.1016/j.healthpol.2010.10.016 | DOI Listing |
Cureus
December 2024
Department of Internal Medicine, Osmania Medical College, Hyderabad, IND.
Intramedullary spinal tuberculomas constitute a small percentage of spinal tuberculosis. These, in combination with brain tuberculomas, are an uncommon manifestation of central nervous system (CNS) tuberculosis. This report details a unique case of a 32-year-old retroviral disease-positive male who presented with a two-month history of symmetrical quadriparesis and recent seizures.
View Article and Find Full Text PDFVirus Evol
November 2024
Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.
Hypermutated proviruses, which arise in a single Human Immunodeficiency Virus (HIV) replication cycle when host antiviral APOBEC3 proteins introduce extensive guanine to adenine mutations throughout the viral genome, persist in all people living with HIV receiving antiretroviral therapy (ART). However, hypermutated sequences are routinely excluded from phylogenetic trees because their extensive mutations complicate phylogenetic inference, and as a result, we know relatively little about their within-host evolutionary origins and dynamics. Using >1400 longitudinal single-genome-amplified HIV sequences isolated from six women over a median of 18 years of follow-up-including plasma HIV RNA sequences collected over a median of 9 years between seroconversion and ART initiation, and >500 proviruses isolated over a median of 9 years on ART-we evaluated three approaches for masking hypermutation in nucleotide alignments.
View Article and Find Full Text PDFJ Drug Deliv Sci Technol
February 2025
Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY, 40202.
Whether it be due to genetic variances, lack of patient adherence, or sub-optimal drug metabolism, the risk of antibiotic resistance from medications administered systemically continues to pose significant challenges to fighting infectious diseases. Ideally, infections would be treated locally for maximal efficacy while minimizing off-target effects. The electrospinning of biomaterials has recently facilitated the creation of electrospun nanofibers as an alternative delivery vehicle for local treatment.
View Article and Find Full Text PDFFront Immunol
January 2025
Department of Preventive Medicine, Medical School of Shihezi University, Shihezi, China.
With the increasing number of people with HIV (PWH) and the use of antiretroviral treatment (ART) for PWH, HIV has gradually become a chronic infectious disease. However, some infected individuals develop issues with immunologic non-responses (INRs) after receiving ART, which can lead to secondary infections and seriously affect the life expectancy and quality of life of PWH. Disruption of the gut microbiota is an important factor in immune activation and inflammation in HIV/AIDS, thus stabilizing the gut microbiota to reduce immune activation and inflammation and promoting immune reconstitution may become a direction for the treatment of HIV/AIDS.
View Article and Find Full Text PDFIJTLD Open
January 2025
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Background: TB preventive treatment (TPT) prevents the development of TB disease in individuals at risk of progression from infection to disease. However, implementation of TPT for children is poor in most high-burden settings. The long duration and pill burden of the 6-month once-daily isoniazid regimen (6H) pose significant barriers to completion.
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