Journal of acquired immune deficiency syndromes : JAIDS
-
J. Acquir. Immune Defic. Syndr. · Nov 2009
ReviewImpact of HIV treatment scale-up on women's reproductive health care and reproductive rights in Southern Africa.
The HIV epidemic has changed the face of women's reproductive health across southern Africa. In some circles, there have been calls for restrictions on women's reproductive rights, focusing particularly on the spread of HIV between sexual partners and from mother to child. However, during the past decade, public health attention and resources for the clinical care of HIV-infected individuals living in Africa have led to advances in women's reproductive health services. ⋯ In much of the region, this programmatic focus has helped increase attention on the ground to women's reproductive rights. However, in many settings, policies explicitly supporting the reproductive rights of HIV-infected women have lagged. Important gaps remain both in policy development and in the design, evaluation, and implementation of interventions promoting women's reproductive health and rights at the service delivery level.
-
J. Acquir. Immune Defic. Syndr. · Nov 2009
The role of nonphysician clinicians in the rapid expansion of HIV care in Mozambique.
The shortage of health workers impedes universal coverage of quality HIV services, especially in those countries hardest hit by the epidemic. The dramatic increase in international aid to scale-up HIV services, including antiretroviral therapy (ART), has highlighted workforce deficiencies and provided an opportunity to strengthen health systems capacity. ⋯ As a result of responsible task shifting, the number of facilities providing ART tripled during a 6-month period, and patients from disadvantaged areas have access to quality ART services. Because the NPC-driven ART approach is integrated into primary health care, the addition of new clinical staff also promises to improve general health services.
-
J. Acquir. Immune Defic. Syndr. · Sep 2009
Comparative StudyA comparison of patient acceptance of fingerstick whole blood and oral fluid rapid HIV screening in an emergency department.
Although whole blood rapid HIV testing has a greater sensitivity and specificity compared with oral fluid (OF) testing, patients prefer HIV testing using OF specimen collection. Whether patient preference for noninvasive collection methods affects acceptance of HIV screening in clinical practice, however, is unknown. ⋯ Among emergency department patients, the preference for 1 rapid test collection modality over another has a minimal effect on actual screening rates.
-
J. Acquir. Immune Defic. Syndr. · Aug 2009
Multicenter StudyBacterial meningitis in HIV-1-infected patients in the era of highly active antiretroviral therapy.
The burden that spontaneous bacterial meningitis (SBM) currently represents among HIV-1-infected patients is poorly known. ⋯ Even in the highly active antiretroviral therapy era, the risk of developing SBM is 19 times higher among HIV-1-infected patients than among uninfected ones. It tends to present in severely immunosuppressed patients not previously vaccinated and off antiretroviral therapy, with a concomitant extrameningeal infection, bacteremia, and focal neurologic signs, and is caused by S. pneumoniae. SBM in HIV-1-infected patients carries a worse prognosis than in uninfected ones both in terms of lethality and sequelae.