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Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. Discussion: A group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. Conclusions: HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) is a serious disease that threatens and affects capital stock, population composition, and economic growth. This research paper aims to study the mathematical modeling and disease dynamics of HIV/acquired immunodeficiency syndrome (AIDS) with memory effect. We propose two fractional models in the Caputo sense for HIV/AIDS with and without migration. First, we prove the existence and positivity of both models and calculate the basic reproduction number R0$$ {\mathcal{R}}_0 $$ using the next generation method. Then, we study the local and global stability of the obtained equilibria. In addition, numerical simulations are provided for different values of the fractional order ρ$$ \rho $$ using the Adams–Bashforth–Moulton fractional scheme, to verify the theoretical results. Moreover, a sensitivity analysis of the parameters for the model with migration is carried out. [ABSTRACT FROM AUTHOR]

In this paper, by using Itô's formula, we study the dynamic behaviors of a stochastic human immune deficiency virus (HIV) model, which describes Acquired Immune Deficiency Syndrome (AIDS) with the effect of treatment. First, we discuss the global positivity of the solution to such a model with positive initial value. Then, we consider the limiting behavior of the solution. Moreover, we obtain the sufficient condition to guarantee the extinction of AIDS. Meanwhile, by constructing an appropriate Lyapunov function, we prove that the solution has a unique ergodic stationary distribution under a certain assumptions. Finally, we illustrate the validity of our results by numerical simulations. [ABSTRACT FROM AUTHOR]

Many studies have documented nurses’ attitudes and concerns regarding AIDS/HIV, but little is known about Taiwanese nurses. We documented attitudes, concerns, gloving practices and practical AIDS/HIV knowledge of 1090 nurses from one metropolitan hospital in Changhua City, Taiwan. The response rate was 80.9%. Both HIV and hepatitis contraction in the workplace was nurses’ main concern. Two hundred and ten nurses (19.3%) were seriously considering leaving nursing because of fear of contracting AIDS/HIV. Virtually all nurses considered it their right to be informed of the presence of HIV-positive patients in their direct work area and many believed that HIV testing of patients should be mandatory. Practical AIDS/HIV knowledge was deficient. These Taiwanese nurses have concerns and fears that might be related to deficiencies in practical AIDS/HIV knowledge. Continuous educational programmes are recommended to alleviate these nurses’ attitudes and concerns regarding AIDS/HIV. [ABSTRACT FROM AUTHOR]

This paper explores the vertices of Jung's, Anzaldúa's and Benjamin's distinct ontologies and the way in which they connect in the shared recognition that what has been estranged in human history is enigmatically lodged in the world's fabric today. Cultural distress, in other words, is the outcome of what has become repudiated in the self and the collective across time. From this perspective, the paper argues that we have a collective responsibility to listen to the claims of the dead laid bare in moments of contemporary real‐world danger and it elaborates the psychical dimensions of being that are cultivated in times of danger. The author contends that these psychical presences are the dead of human history including our ancestral heritage that linger and possibly may penetrate our awareness. They haunt and hold a potential to animate our movement towards a sublimatory process that can be seen as a precursor to social responsiveness and action. The author explores this through her own experience with an example of the spawning of spiritual activism within the socio‐political maelstrom of AIDS. [ABSTRACT FROM AUTHOR]

Black women in the United States continue to be disproportionately affected by the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) epidemic. HIV/AIDS activism among Black women for Black women may be one solution to reduce the disparate rates of HIV/AIDS among Black women. However, little is known about what processes and experiences prompt Black women to participate in HIV/AIDS activism. In this paper, I aim to identify mechanisms of empowerment for Black women to engage in HIV/AIDS activism. I draw upon empowerment theory as a theoretical framework to guide analysis of the literature and to offer a strengths‐based perspective on Black women's efforts to reduce the spread of HIV/AIDS. An extensive literature search was conducted to identify studies of Black women's participation in HIV/AIDS activism. The search yielded 11 studies that were included for review. Synthesis of the literature indicated the following analytic themes as mechanisms of empowerment for Black women to participate in HIV/AIDS activism: relationships and interactions with others, critical awareness, self‐reflection, and spirituality. Article limitations, suggestions for future research, and implications for social change are also discussed. Overall, findings from this study suggest that there are unique mechanisms that facilitate psychological empowerment and prompt Black women's entry into HIV/AIDS activism. Highlights: A comprehensive review of 11 articles on Black women's participation in Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) activism. Explores how Black women become psychologically empowered to become HIV/AIDS activists. Many mechanisms of empowerment for Black women engaged in HIV/AIDS activism are communal. Emphasizes psychological empowerment as not only an intrapsychic process. [ABSTRACT FROM AUTHOR]

In this paper, we mainly present the dynamic properties of a stochastic SICA model with general incidence rate. Through rigorous analysis and reasoning of the stochastic model, we obtain that the solution of the model is global, positive, and unique. By constructing the threshold value R0s$$ {R}_0^s $$, which includes the influence of white noise, we obtain a sufficient condition for the ergodicity of this model. Furthermore, we show that the model has a unique ergodic stationary distribution while R0s>1$$ {R}_0^s>1 $$ by adopting a novel method. The extinction of the system is also established. Besides, the expression of probability density function of the stochastic model with bilinear incidence rate around the unique stable positive equilibrium of the deterministic model is derived. Finally, numerical simulations are presented to illustrate the theoretical results. [ABSTRACT FROM AUTHOR]

The inclusion of Men who have Sex with Men (MSM) in global health policies has resulted in significant resource prioritisations in order to treat and prevent the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). MSM policy inclusions and health prioritisations, however, are primarily motivated by an epidemiological understanding of male same‐sex sexual behaviours, based on biological risks associated with HIV infection. Owing to South Africa's high HIV rates and MSM policy prioritisations, we aimed to examine experiences of engagement in urban MSM‐targeted HIV interventions. Qualitative interviews were conducted with participants (n = 20) who previously engaged in MSM‐HIV interventions, across a variety of historically marginalised "township" spaces in Cape Town, South Africa. Interviews were audio‐recorded with the consent of all participants, transcribed verbatim, and verified, and anonymised using alpha‐numeric codes. Data were analysed for core themes and in this paper we describe interactions between biological and social risks that shape city life for MSM in diverse township spaces. When positioned against the background of the Neuropolis, a recent sociological intervention by Des Fitzgerald, Nikolas Rose and Ilina Singh, our results portray urban life among MSM as a form of biological citizenship: (1) constructed by experiences that are constitutive of biosocial stressors, based on (2) health‐seeking attitudes and behaviours, and (3) reinforced through socio‐spatial engagements in peer‐led and community‐based HIV interventions. We conclude by offering critical insight into recent calls for the development of comprehensive and localised peer‐led health programmes as a current void in the geographies of health and sexualities in the global south. In this paper we describe Men who have Sex with Men and their urban experiences associated with HIV/AIDS interventions, and socio‐economic and spatial health inequalities in "townships" across Cape Town, South Africa. MSM's engagement in HIV interventions was examined as a form of urban citizenship that is: (1) constructed by biological and social interactions, (2) based on health‐seeking attitudes and behaviours, and (3) reinforced through peer‐led socio‐spatial relations. We offer critical insights into recent calls for comprehensive urban interventions in Africa as a current void in the geographies of health and sexualities in the global south. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the dynamics of a high‐dimensional human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) model with treatment and standard incidence, which is perturbed by telegraph noise. The switching is formulated by a continuous time Markov chain. Firstly, we show the existence and uniqueness of the global positive solution. Then, conditions for extinction of the disease are established. Moreover, through constructing suitable Lyapunov functions, we derive sufficient conditions for the existence of positive recurrence of the solutions. Positive recurrence implies all the individuals can coexist and persist in the long term. Finally, numerical experiments are performed for supporting the theoretical results. [ABSTRACT FROM AUTHOR]

In this paper, to investigate the synthetic effect of PrEP (pre‐exposure prophylaxis) and ART (antiretrovial therapy) on HIV transmission among MSM (men who have sex with men) in heterogenous environment, a realistic HIV epidemic model with spatial diffusion is established. Here, HIV infectious people are divided into three immunity based compartments, that is, CD4+ T cell count less than 350, between 350 and 500, and more than 500, respectively. The basic reproduction number R0 is established and proved as a threshold parameter: The global asymptotic stability of the disease‐free steady state holds for R0<1, and the disease will be present if R0>1. Considering the substantial advantages of PrEP and ART in controlling HIV transmissions among MSM, the optimal control problem is presented for the case of positive constant diffusion coefficients, which minimize the total population of susceptible individual and HIV infected individual, the cost of PrEP and ART therapy. As an illustration of our theoretical results, we conduct numerical simulations. We also conduct an optimal control case study where model parameters are estimated from the demographic and epidemiological data from China. This work suggests the following: (1) Spatial factors cannot be ignored during the HIV intervention; (2)taking the PrEP intervention measure for HIV transmissions among MSM as early as possible will help to improve the control efficiency and reduces its cost; (3) reducing the PrEP drug costs will promote the efficiency of PrEP treatment in preventing the spread of HIV among MSM. [ABSTRACT FROM AUTHOR]

Acquired immune deficiency syndrome (AIDS) caused by human immunodeficiency virus continues to scavenge lives of millions around the world. Reverse transcriptase (RT) also known as the RNA‐directed DNA polymerase enzyme is responsible for converting RNA into viral DNA through process known as reverse transcription. Investigations on the pathogenic aspects of the RT enzyme, its associated elements such as gag (group‐specific antigen gene), pol (polymerase gene), and env (environmental gene) (envelope gene) reveals its contribution towards emergence of resistance to all various anti‐HIV drugs. Therefore, research into the control and blockage of the RT pathway has been a prominent focus in the quest for novel targets for HIV treatment. A slew of heterocyclics has been claimed to play a significant part in the fight against doomy HIV, saving the lives of millions of people throughout the world and providing hope for HIV treatment. Due to their improved potency and selectivity, as well as the fact that they have fewer off‐target effects against the several targets implicated in RT inhibition, heterocyclics are becoming more and more useful. The RT inhibition pathway, the function of numerous heterocyclic scaffolds, and their ability to inhibit the RT enzyme pathway have all been the main topics of this paper. Recent advances in RT inhibitors in the last eight years (2014–2022) including mechanisms of action, preclinical and clinical investigations, structural activity relationships, and docking studies, to investigate mechanistic studies that would eventually aid in the design and development of powerful RT inhibitors have also discussed. [ABSTRACT FROM AUTHOR]

Objectives The aim of the study was to evaluate the use of dried plasma spots to determine HIV-1 RNA viral loads. Methods The viral loads of 30 liquid plasma samples were compared with those of corresponding dried plasma spots on filter paper (DPS-FP) and in tubes (DPS-T), both of which were left for 7 days at 22°C. Also, 10 liquid plasma samples with detectable viral load were stored at 4, 22 or 37°C for 7 days and five further liquid plasma samples were air-dried for up to 54 h to assess the effects of temperature and the drying step on HIV-1 viral load. Results The viral loads of the 30 liquid plasma samples correlated significantly with those of the paired dried spots DPS-FP and DPS-T, but with median losses of 0.64 and 0.69 log10 HIV-1 RNA copies/mL, respectively, and a limit of detection of 3 log10 copies/mL. The 10 liquid plasma samples stored for 1 week at 37°C showed a weaker correlation and had a significantly reduced median viral load (–0.92 log10; P=0.005) when compared with the viral load of the matched plasma stored at −80°C. Most of the loss happened during the drying step. Conclusions Reliable measurement of HIV-1 RNA viral load requires good plasma storage conditions. HIV RNA stability was affected by desiccation and 1 week of storage at 37°C. However, our findings suggest that liquid plasma can be kept at 4 or 22°C for a week with no effect on viral load. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV)‐positive women can breastfeed with minimal risk of mother‐to‐child transmission if taking antiretrovirals. Guidelines surrounding infant feeding for HIV‐positive women have evolved several times over the last two decades. Our review aimed to explore perspectives of breastfeeding with antiretrovirals from HIV‐positive women since the World Health Organization (2010) infant feeding and antiretroviral guidelines. HIV‐positive pregnant and postnatal women from all countries/settings were eligible. HIV‐positive women were either on an antiretroviral regimen at the time of the study, previously on an antiretroviral regimen, not initiated on a regimen yet, or enrolled in prevention of mother‐to‐child transmission (PMTCT) care. Quality assessment of all included studies were conducted. Four databases (CINAHL, EMBASE, MEDLINE and PsycINFO) were searched for studies conducted from January 2010 to October 2020. Nine papers were included in the review, of which two presented findings from the same study. Five analytical themes were developed via thematic synthesis: (1) awareness of breastfeeding with antiretrovirals, (2) turmoil of emotions, (3) coping mechanisms, (4) the intertwining of secret, stigma and support and (5) support needed. Support from family and health care professionals and coping approaches were important to overcome stigma and the emotional challenges of breastfeeding with antiretrovirals. Health care professionals should be familiar with the most updated national and local guidance surrounding infant feeding and antiretrovirals. Further research into interventions to encourage HIV‐positive women to adhere and commit to lifelong antiretroviral treatment (Option B+) for breastfeeding is required. [ABSTRACT FROM AUTHOR]

In her 2016 article Sherry Ortner discusses what she calls the rise of 'dark anthropology': that is, ethnographic work that analyses situations of domination, dispossession, and violence. She, like Joel Robbins (), posits as a counterpoint the emergence of 'anthropologies of the good,' which emphasise care and ethics. In this paper I put these two anthropological projects into generative tension through an analysis of HIV‐positive women's lives in Papua New Guinea. In the first part of the paper I demonstrate the ways in which resource extraction has created vulnerabilities to HIV—in part through the coerced marriages of women to powerful landowners. In the second, I discuss ways in which the antiretroviral era has made possible unexpected forms of kindness towards HIV‐positive women. I end the paper with a discussion of what HIV‐positive women mean when they claim that they are happier now than in their pre‐diagnosis lives. [ABSTRACT FROM AUTHOR]

This paper explores ethical considerations for active studies of circumcision, i.e., the amputation of the foreskin, in the form of a case study of three major trials performed in African countries in the early 2000s. The paper outlines the function of the foreskin and method and history of its amputation as well as its current use in attempting to combat the global AIDS crisis. These trials are then interrogated in accordance with the Declaration of Helsinki. In particular, the irreversible nature of amputation is given great consideration. The case studies are found to have serious failures in terms of the modern iteration of the Declaration of Helsinki. This paper calls for extreme scrutiny in accordance with international norms relating to the ethical treatment of human subjects in a research context of studies of circumcision if and when they are proposed again. [ABSTRACT FROM AUTHOR]

HIV/AIDS and child malnutrition are pervasive in eastern and southern Africa. This paper employs cross‐country panel data on 20 countries from 1991 to 2017 to explore the macro‐level relationship between HIV/AIDS and child malnutrition. Using instrumental variables (IV) regression, we find that HIV/AIDS is a robust predictor of long‐term and chronic malnutrition. Conditional on various controls, the results demonstrate a positive empirical association between HIV/AIDS and stunting. Moreover, increased access to improved water, female education, and food availability are critical for reducing stunting. These findings underscore the need for an integrated national policy on nutrition and HIV/AIDS and intersectoral collaboration between government agencies responsible for managing nutrition and HIV/AIDS programs. [ABSTRACT FROM AUTHOR]

Introduction: In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Our objective in this article is to help the global HIV policy makers and implementers of HIV programmes better understand the benefits and limitations of the tFDA by providing an in-depth review of the relevant legal and regulatory processes. Discussion: USFDA's dedicated tFDA process for ARVs used by the PEPFAR programme has a wide impact globally; however, the implementation and the regulatory processes governing the programme have not been thoroughly described in the medical literature. This paper seeks to help stakeholders better understand the legal and regulatory aspects associated with review of ARVs under the tFDA by describing the following: (1) the tFDA and its importance to global ARV procurement; (2) the regulatory pathways for applications under tFDA for the PEPFAR programme, including modifications to applications, review timelines and costs; (3) the role of US patents, US marketing exclusivity rights, and the Medicines Patents Pool in tFDA; and (4) an overview of how applications for PEPFAR programme are processed through the USFDA. We also provide a case study of a new ARV, tenofovir alafenamide fumarate (TAF), not yet reviewed by USFDA for PEPFAR use. Conclusions: In this paper, we describe the importance and implementation of USFDA's tentative approval process to review ARVs for resource-constrained settings. We also highlight the impact of patents and exclusivities on review of HIV drugs under tFDA and illustrate the concepts using a new HIV drug as an example. [ABSTRACT FROM AUTHOR]

Introduction: While there is a global consensus on monitoring Human Immunodeficiency Virus (HIV) treatment progress, there has been less attention to the degree of consistency of the measurement of HIV prevention programmes—and the global prevention response is not on‐track to achieve 2020 goals. In this paper, we assess the degree of variability in primary prevention indicators selected by national strategic plans (NSPs) and global stakeholder monitoring and evaluation (M&E) strategies. Methods: We obtained the most recent NSPs from low and middle income Joint United Nations Programme on HIV/AIDS (UNAIDS) Fast‐Track countries, and M&E documents from The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), President's Emergency Plan for AIDS Relief (PEPFAR), UNAIDS, the Global HIV Prevention Coalition and the World Health Organization (WHO). We extracted HIV primary prevention indicators from each document, standardized and aggregated them by age/ sex, categorized indicators by topic, and evaluated the frequency of matched indicators between countries and stakeholders. Data were collected between February and April of 2019. Results: Twenty‐one NSPs and five global stakeholder documents were assessed; 736 primary prevention indicators were identified; 284 remained following standardization and aggregation. NSPs contained from 3 to 48 primary prevention indicators, with an average of 23; categories included: HIV education and outreach (17.6%), testing (17.3%) and condom use (16.2%). Of unique national indicators, only 34% was shared between two or more countries. Sixty‐nine per cent was applied in a single country only. 56% of NSP indicators did not appear in any global stakeholder document. Conversely, 42% of global indicators did not appear in any surveyed NSPs. Within global indicators, 63% was only measured by one global body, and no single indicator was measured by all five. Conclusions: These analyses reveal a lack of consensus both between and within countries' and global stakeholders' measurement of HIV prevention. Though some variability is expected, these findings point to a need to refocus attention on achieving greater consensus on a global measurement framework for HIV prevention. [ABSTRACT FROM AUTHOR]

Background: Fungal infections have increased during the last years due to the AIDS epidemic and immunosuppressive therapies. The available diagnostic methods, such as culture, histopathology and serology, have several drawbacks regarding sensitivity, specificity and time‐consuming, while molecular methods are still expensive and dependent on many devices. In order to overcome these challenges, isothermal nucleic acid amplification techniques (INAT) arose as promising diagnostic methods for infectious diseases. Objective: This review aimed to present and discuss the main contributions of the isothermal nucleic acid amplification techniques applied in medical mycology. Methods: Papers containing terms for each INAT (NASBA, RCA, LAMP, CPA, SDA, HAD or PSR) and the terms 'mycoses' or 'disease, fungal' were obtained from National Center for Biotechnology Information database until August 2019. Results: NASBA, RCA, LAMP and PSR are the INAT reported in the literature for detection and identification of pathogenic fungi. Despite the need of a previous conventional PCR, the RCA technique might also be used for genotyping or cryptic species differentiation, which may be important for the treatment of certain mycoses; nevertheless, LAMP is the most used INAT for pathogen detection. Conclusion: Among all INATs herein reviewed, LAMP seems to be the most appropriate method for fungal detection, since it is affordable, sensitive, specific, user‐friendly, rapid, robust, equipment‐free and deliverable to end‐users, fulfilling all ASSURED criteria of the World Health Organization for an ideal diagnostic method. [ABSTRACT FROM AUTHOR]

HIV is no longer a death sentence with early diagnosis and effective treatment contributing to a good prognosis. Surveillance data, however, suggest that one in four people globally living with HIV are unaware of their HIV infection and remains at risk of transmitting their infection if having unprotected sex. A wider array of testing opportunities and settings are thus needed to address this issue of public health significance. Evidence suggests there is a role for the dental team, particularly dentists, in offering chairside point‐of‐care HIV screening to patients during their dental appointments. Dentists, dental hygienists, and other members of the dental team may still have a role in helping to identify new cases of HIV with the goal of improving health outcomes, addressing health inequalities and improving the quality and quantity of life. This paper reviews the global epidemiology of HIV/AIDS, summarizes the point‐of‐care HIV testing process, highlights key findings of international studies (from high‐, middle‐, and low‐income countries) on the role of dental professionals in point‐of‐care HIV testing, and offers suggestions for what additional evidence is needed to make point‐of‐care HIV testing a routine part of dental care. [ABSTRACT FROM AUTHOR]

Objectives: Despite recent pharmacological progress, memory impairment is still frequently reported in people living with HIV. We aimed to conduct a systematic literature review investigating the presence of impairment of (sub)components of memory function in patients prescribed highly active antiretroviral therapy (ART). Methods: We adopted a cognitive neuropsychological model of memory function as the theoretical framework, distinguishing between a short‐term working memory component and a long‐term component of memory, along with their specific (sub)components. We systematically searched for the presence of impairment of each (sub)component in the selected papers. Careful consideration was given to study design and methods and control of covariates. Results: Only the central executive component of working memory has been consistently reported to be impaired in HIV infection. The other two (sub)components, namely the phonological loop and the visuospatial sketchpad, were unimpaired. Discordant results have been obtained as to verbal and visual episodic memory, as some authors reported an association with HIV infection, whereas others did not. There is little evidence for semantic memory deficit in HIV infection, while there are suggestions that the neural substrate of implicit memory may be damaged by the effects of HIV infection and inflammation. Most studies in this area have been conducted in small samples and with poor control for covariates. Thus, conclusions regarding the association of memory dysfunction with HIV infection are hampered by methodological issues such as selection bias and unmeasured confounding. Conclusions: The task remains for future research to ascertain the impact of HIV infection on memory function. [ABSTRACT FROM AUTHOR]

Context Until the last decade of the 20th century, France had no equivalent to the US Food and Drug Administration. In this paper we describe and interpret the complex series of events that led to the passage by the French Parliament in December 1992 of a law incorporating such an agency, the Agence du Médicament (literally, 'medicines agency'). The broad aim of this project was to learn how public health policy change comes about by detailed analysis of a specific instance. More specifically, we aimed to better understand the circumstances under which public health crisis leads to significant public health policy reform. Methods This paper is based on detailed analysis of primary documents (eg, archived French health ministry papers, recorded parliamentary debates, government reports, newspaper articles) and oral history interviews covering a period from 1988 to 1993. Thematic analysis of these materials was initially grounded in theories of organizational change, moving to constructs that emerged from the data themselves. Findings Policy entrepreneurs positioned to frame adverse events and seize opportunities are key to public health policy reform. However, whether these entrepreneurs will have the requisite institutional power is contingent both on political structure and on the power of competing institutional actors. Health crises may catalyze institutional reform, but our analysis suggests that whether reform occurs, or even whether adverse episodes are labeled as crises, is highly contingent on circumstances of history, political structure, and political ideology and is extremely difficult to predict or control. Conclusions Actors positioned to shape public health policy need to have a detailed understanding of the circumstances that facilitate or impede policy reform. Health crises are now more often global than not. Comparative, theoretically grounded, cross-national research that looks in detail at how different countries respond to similar health crises would be extremely valuable in informing both policymakers and researchers. [ABSTRACT FROM AUTHOR]

The Research Agenda generated by the 7th World Workshop on Oral Health and Disease in AIDS (WW7) is delivered in this paper. Panels of international experts presided over nine workshops that constituted the conference held in November 2014 in Hyderabad, India. The main goal of the Workshop was to bring together clinician and scientists interested in the subject to debate with world-wide perspectives current issues related to the oral manifestations in HIV/AIDS. The workshops were structured around three themes; basic science, clinical/translational science and social science and were attended by 135 participants from 31 countries. The research questions debated at the workshops are presented in nine consensus papers published in this issue and are summarised in this paper along with an outline of the identified research needs in the field. [ABSTRACT FROM AUTHOR]

Although the world has experienced remarkable progress in health care since the last half of the 20th century, global health inequalities still persist. In some poor countries life expectancy is between 37-40 years lower than in rich countries; furthermore, maternal and infant mortality is high and there is lack of access to basic preventive and life-saving medicines, as well a high prevalence of neglected diseases, HIV/AIDS, tuberculosis, and malaria. Moreover, globalization has made the world more connected than before such that health challenges today are no longer limited within national or regional boundaries, making all persons equally vulnerable. Because of this, diseases in the most affluent countries are closely connected with diseases in the poorest countries. In this paper, we argue that, because of global health inequalities, in a situation of equal vulnerability, there is need for global solidarity not only as a means of reducing health inequalities, but also as a way of putting up a united force against global health challenges. We argue for an African approach to solidarity in which the humanity of a person is not determined by his/her being human or rational capacity, but by his/her capacity to live a virtuous life. According to this view of solidarity, because no one is self-sufficient, no individual can survive alone. If we are to collectively flourish in a world where no individual, nation or region has all the health resources or protection needed for survival, we must engage in solidarity where we remain compassionate and available to one another at all times. [ABSTRACT FROM AUTHOR]

When modeling longitudinal data, the true values of time-varying covariates may be unknown because of detection-limit censoring or measurement error. A common approach in the literature is to empirically model the covariate process based on observed data and then predict the censored values or mismeasured values based on this empirical model. Such an empirical model can be misleading, especially for censored values since the (unobserved) censored values may behave very differently than observed values due to the underlying data-generation mechanisms or disease status. In this paper, we propose a mechanistic nonlinear covariate model based on the underlying data-generation mechanisms to address censored values and mismeasured values. Such a mechanistic model is based on solid scientific or biological arguments, so the predicted censored or mismeasured values are more reasonable. We use a Monte Carlo EM algorithm for likelihood inference and apply the methods to an AIDS dataset, where viral load is censored by a lower detection limit. Simulation results confirm that the proposed models and methods offer substantial advantages over existing empirical covariate models for censored and mismeasured covariates. [ABSTRACT FROM AUTHOR]

This paper explores beliefs revealed in classroom discussions at a majority black university in the United States that HIV/AIDS is a form of genocide. The perspective of the sociology of knowledge, a critique of the realist interpretation of science, argues that these beliefs are rational given the students' social relationship to the scientific establishment. Paolo Friere's philosophy of popular education and the anthropological method teach us to take these beliefs seriously. The white instructor's own gaps in knowledge counsel humility in teaching about the origins of HIV to students of colour. Finally, the paper describes how the students and the instructor were able to find a common ground in the interpretation of AIDS as a man-made epidemic. [ABSTRACT FROM AUTHOR]

In recent years, anxieties have been expressed that the impacts of southern Africa's AIDS pandemic on young people today will damage their future livelihood prospects. Geographers have been remarkably reluctant to explore young people's future livelihoods, inspired by a concern to view young people as human beings, worthy of study in their own right rather than mere human becomings, of interest only as 'adults in the making'. Yet there is growing acknowledgement that young people, like older people, are always both 'being and becoming'. The connections between current and future lives merit much greater attention, both because experiences and actions in childhood and youth undoubtedly shape the futures of individuals and wider society, but also because young people's thoughts and actions are so often geared to the future, and this future orientation shapes their present worlds. This paper reports on research that set out to explore links between the impacts of AIDS and young people's livelihood prospects. Intensive case study research was undertaken, combining participatory methods and life history interviews with young people aged 10-24 in two villages, one in southern Malawi and the other in the mountains of Lesotho. By theorising a temporal dimension to de Haan and Zoomers' concept of livelihood trajectories, the paper focuses on the ways in which young people respond to both the immediate sustenance requirements of themselves and their households and their need to accrue assets for future livelihoods. Some young people's trajectories appear to be disturbed by the influence of AIDS, but with no systematic patterns. Beyond addressing empirical questions concerning the impacts of AIDS, the paper contributes to our understanding of how livelihoods are produced and to the conceptualisation of youth transitions as produced through the iteration of present and future. [ABSTRACT FROM AUTHOR]

HIV-positive individuals often face community-wide discrimination or public shame and humiliation as a result of their HIV-status. In Sub-Saharan Africa, high HIV incidence coupled with unique cultural contexts make HIV-positive individuals particularly likely to experience this kind of HIV/AIDS-related (HAR) stigma. To date, there is a relatively small amount of high-quality empirical literature specific to HAR stigma in this context, supporting the notion that a better understanding of this phenomenon is needed to inform potential interventions. This paper provides a thorough review of the literature specific to HAR stigma in Sub-Saharan Africa, finding (a) qualitative support for the existence of important relationships between HAR stigma and health service utilization and barriers; (b) a need for more quantitative study of stigma and its relationships both to health service utilization and to HIV outcomes directly; and (c) a disconnect between methodological techniques used in this context-specific literature and well-known theories about stigma as a general phenomenon. This paper then draws from its empirical literature review, as well as from well-known theoretical frameworks from multiple disciplines, to propose a theoretical framework for the ecological and multilevel relationships among HAR stigma, health service utilization, and HIV outcomes in this context. [ABSTRACT FROM AUTHOR]

Introduction: The transition from paediatric to adult care poses risks to the health of young adults living with HIV if unsuccessful, including interruptions in care and poor health outcomes. Evolving best practices in HIV healthcare transition should ideally be informed by real-world qualitative and quantitative clinical healthcare transition outcomes. There has been a recent proliferation of HIV healthcare transition outcome research, largely from Europe and North America. Methods: A literature search was undertaken using the online databases PubMed, Web of Science, and Google Scholar. Medical subject and text word searches were combined for terms relating to HIV, paediatric transition outcomes, and internal and external factors were used to identify peer-reviewed articles. Results: In this paper, we review data on HIV healthcare transition outcomes in North America and Europe. Internal and external factors which may impact the success of HIV healthcare transition are examined. We describe ongoing research efforts to capture transition outcomes in the North America and Europe. Clinical, operational, and implementation science research gaps that exist to date are highlighted. Efforts to improve HIV healthcare transition research through country-level surveillance networks and large multicentre cohorts, including data integration and linkage between paediatric and adult cohorts are discussed. Conclusions: We identified the need for a comprehensive approach to implementing empirically supported protocols to support healthcare transition for ALHIV. While there is limited prospective longitudinal cohort data available at this time, cohorts linking the paediatric and adolescent with ongoing surveillance into adulthood are being developed. Through a review of existing qualitative and quantitative healthcare transition outcomes studies, we identify emerging areas of consensus surrounding healthcare transition research implementation. Successful healthcare transition programmes in Europe and North America often share several characteristics, including implementation of a youth friendly multidisciplinary approach, consistent communication and integration between paediatric and adult care teams, and an individualized approach which is attuned the adolescent's transition readiness. Moving forward, the voices of youth and young adults living with HIV should be included in the development and evaluation of healthcare transition protocols to ensure that the definition of successful transition reflects all of the stakeholders in the transition process. [ABSTRACT FROM AUTHOR]

Introduction: The transition from paediatric to adult care poses risks to the health of young adults living with HIV if unsuccessful, including interruptions in care and poor health outcomes. Evolving best practices in HIV healthcare transition should ideally be informed by real-world qualitative and quantitative clinical healthcare transition outcomes. There has been a recent proliferation of HIV healthcare transition outcome research, largely from Europe and North America. Methods: A literature search was undertaken using the online databases PubMed, Web of Science, and Google Scholar. Medical subject and text word searches were combined for terms relating to HIV, paediatric transition outcomes, and internal and external factors were used to identify peer-reviewed articles. Results: In this paper, we review data on HIV healthcare transition outcomes in North America and Europe. Internal and external factors which may impact the success of HIV healthcare transition are examined. We describe ongoing research efforts to capture transition outcomes in the North America and Europe. Clinical, operational, and implementation science research gaps that exist to date are highlighted. Efforts to improve HIV healthcare transition research through country-level surveillance networks and large multicentre cohorts, including data integration and linkage between paediatric and adult cohorts are discussed. Conclusions: We identified the need for a comprehensive approach to implementing empirically supported protocols to support healthcare transition for ALHIV. While there is limited prospective longitudinal cohort data available at this time, cohorts linking the paediatric and adolescent with ongoing surveillance into adulthood are being developed. Through a review of existing qualitative and quantitative healthcare transition outcomes studies, we identify emerging areas of consensus surrounding healthcare transition research implementation. Successful healthcare transition programmes in Europe and North America often share several characteristics, including implementation of a youth friendly multidisciplinary approach, consistent communication and integration between paediatric and adult care teams, and an individualized approach which is attuned the adolescent's transition readiness. Moving forward, the voices of youth and young adults living with HIV should be included in the development and evaluation of healthcare transition protocols to ensure that the definition of successful transition reflects all of the stakeholders in the transition process. [ABSTRACT FROM AUTHOR]

Background and aims Pre-exposure prophylaxis for HIV, or 'PrEP', is the use of antiretroviral medicines by people who are HIV-negative to protect themselves against acquiring HIV. PrEP has shown efficacy for preventing HIV acquisition. Despite the potential, many concerns have been voiced by people who inject drugs (PWID) and their organizations. There is a need to engage with these views and ensure their integration in to policy and strategy. This paper presents PWID views on PrEP to foster the uptake of these opinions into scientific and policy debate around PrEP Methods Critical analysis of a report of a community consultation led by the International Network of People who Use Drugs (INPUD). Results The INPUD report highlights enthusiasm from PWID for PrEP, but also three main concerns: the feasibility and ethics of PrEP, its potential use as a substitute for other harm reduction strategies and how a focus on PrEP heralds a re-medicalization of HIV. Each concern relates to evidenced gaps in essential services or opposition to harm reduction and PWID human rights. Conclusions People who use drugs have fundamental concerns about the potential impacts of pre-exposure prophylaxis for HIV which reflect a 'fault line' in HIV prevention: a predominance of biomedical approaches over community perspectives. Greater community engagement in HIV prevention strategy is needed, or we risk continuing to ignore the need for action on the underlying structural drivers and social context of the HIV epidemic. [ABSTRACT FROM AUTHOR]

This paper presents a new Bayesian methodology for identifying a transition period for the development of drug resistance to antiretroviral drug or therapy in HIV/AIDS studies or other related fields. Estimation of such a transition period requires an availability of longitudinal data where growth trajectories of a response variable tend to exhibit a gradual change from a declining trend to an increasing trend rather than an abrupt change. We assess this clinically important feature of the longitudinal HIV/AIDS data using the bent-cable framework within a growth mixture Tobit model. To account for heterogeneity of drug resistance among subjects, the parameters of the bent-cable growth mixture Tobit model are also allowed to differ by subgroups (subpopulations) of patients classified into latent classes on the basis of trajectories of observed viral load data with skewness and left-censoring. The proposed methods are illustrated using real data from an AIDS clinical study. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Little research has been conducted on women living with HIV with a focus on caregiving. This paper explores data that emerged in a study examining caregiving networks among people living with HIV in the Prairies in Canada. Photovoice provided a methodology for data collection. The narratives presented suggest that while these women's lives are riddled with risk and violence, there are clear features to which they turn to in order to gain support and strength. Recommendations for future social support conclude the paper. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The social, economic, political and environmental structural factors that increase susceptibility to HIV infection and undermine prevention and treatment efforts continue to pose a challenge. The papers in this series highlight the importance of sustaining those efforts to address the structural drivers of the HIV epidemic, and that initiatives to achieve HIV elimination will only come about through a comprehensive HIV response, that includes meaningful responses to the social, political, economic and environmental factors that affect HIV risk and vulnerability. In the context of declining resources for HIV/AIDS, the papers speak to the need to integrate responses to the structural drivers of HIV/AIDS into future HIV investments, with both initiatives to integrate HIV into broader gender and development initiatives, as well as adaptations of current service models, to ensure that they are sensitive to and able to respond to the broader economic and social responsibilities that their clients face. [ABSTRACT FROM AUTHOR]

In 1998, the US Supreme Court first held that asymptomatic HIV infection constituted a disability when it ruled on the case of Bragdon v. Abbott. The use of yet another label (disabled) to identify women living with HIV has been rarely (if ever) questioned. While we do value the use of this label as an anti-discriminatory strategy, we believe that there is a need to examine how language and more specifically, the use of words such as disability, limitation, and impairment may create new forms of identities for women living with HIV. Using this legal case as a starting point, the goal of this paper is to critically examine the 'fabrication' of asymptomatic HIV infection as a disability. Grounded in a feminist poststructuralist perspective, this paper exposes the relationship between language, social institutions, subjectivity, and power in the construction of difference. By doing so, it addresses the identification of women living with HIV/AIDS as disabled and the self-differentiation process that they must go through in order to live as normally as possible. [ABSTRACT FROM AUTHOR]

Drawing on a case study from eastern Uganda, this paper describes how social and environmental factors combine to affect the sustainability of both sorghum landraces and the farmers who depend on it for food and income security. It delineates how changing regional patterns of agricultural production and consumption, institutional neglect, economic hardship, natural resource degradation and a labour supply crisis precipitated by the HIV/AIDS pandemic, may be conspiring to place sorghum landraces at risk of extinction and, thus, undermine already precarious livelihoods. The paper therefore challenges the common assumption that marginalized rural women – by virtue of having diverse varieties and species under their care – can be expected to conserve that diversity. [ABSTRACT FROM AUTHOR]

The findings presented in this paper are part of an independent evaluation study of the Communication Aids Project (CAP). The study was carried out between July 2003 and April 2004 and looked at the impact of CAP on children receiving communication aids and evaluated the CAP strategy of assessment and delivery. In this paper the views of education staff and speech and language therapists who were working with communication aid users in school are presented. The professionals who were interviewed provided positive feedback on the existence of CAP, on the assessment for the communication aid, particularly where the use of the aid in the classroom was considered, and on the children's increased participation in classroom and learning activities since receiving the aid. They also highlighted the issue of managing parents' expectations regarding the use of aids and the value of and need for continued training for professionals working with communication aids in the classroom. The authors of this article, Jannet Wright, senior lecturer, Chris Donlan, senior lecturer, Caroline Newton, lecturer, and Michael Clarke, lecturer, from University College London; Claire Lister, from the Institute of Child Health, London; and Jasmina Cherguit, assistant psychologist, draw upon their findings to develop recommendations for future policy, practice and professional development. [ABSTRACT FROM AUTHOR]

Appropriate analysis of observational data is our best chance to obtain answers to many questions that involve dynamic treatment regimes. This paper describes a simple method to compare dynamic treatment regimes by artificially censoring subjects and then using inverse probability weighting (IPW) to adjust for any selection bias introduced by the artificial censoring. The basic strategy can be summarized in four steps: 1) define two regimes of interest, 2) artificially censor individuals when they stop following one of the regimes of interest, 3) estimate inverse probability weights to adjust for the potential selection bias introduced by censoring in the previous step, 4) compare the survival of the uncensored individuals under each regime of interest by fitting an inverse probability weighted Cox proportional hazards model with the dichotomous regime indicator and the baseline confounders as covariates. In the absence of model misspecification, the method is valid provided data are available on all time-varying and baseline joint predictors of survival and regime discontinuation. We present an application of the method to compare the AIDS-free survival under two dynamic treatment regimes in a large prospective study of HIV-infected patients. The paper concludes by discussing the relative advantages and disadvantages of censoring/IPW versus g-estimation of nested structural models to compare dynamic regimes. [ABSTRACT FROM AUTHOR]

The paper shows how policies aimed at confronting HIV/AIDS in sub-Saharan Africa have shifted over the past 10 years. Initially, the focus was on prevention. Anti-retroviral treatments (ARVs), which could prolong the lives of people living with HIV and AIDS, were considered too expensive for the African poor. In 2000, following global campaigns to lower the prices of ARVs, and concern about the political instability caused by AIDS in Africa, policies started focusing on access to treatment. Cost-effectiveness arguments played a key role in the formulation and implementation of the prevention policies, while human rights and equity considerations drive the current treatment programmes. Though different in policy content, the prevention and treatment policies have in common that they pay little attention to the socio-cultural realities in sub-Saharan Africa that ultimately determine their success. Based on illustrative case material from Uganda, the paper calls for more research on and understanding of the successes and failures of prevention and treatment programmes. Such understanding can help adapt global policies to local realities. [ABSTRACT FROM AUTHOR]

Tropes of borderlessness are pervasive both in discourses concerning the spread of HIV/AIDS and the Growth Triangle, a transnational economic zone that ideally binds together the Indonesian island of Batam, the Malaysian province of Johor and Singapore. This paper considers how the emergence of HIV as a problem in the Growth Triangle, and on Batam in particular, has been framed as a problem to be addressed in context of the nation-state rather than as a transnational problem that demands cooperation across borders. In conjunction with this, it focuses on further attempts to create boundaries around HIV, through the identification of risk groups, the localisation of prostitutes and the distribution of condoms. The paper focuses particular attention on the relationship between Batam and Singapore, and how non-governmental organisations and governments have dealt with HIV/AIDS issues in both places. Furthermore, it problematises these activities by paying ethnographic attention to other forms of cultural and economic logics that often are odds with prevention models. This raises important questions concerning, most specifically, the problems of HIV prevention and cross-border cooperation, and, more generally, the regulation and formation of new kinds of borders in a‘borderless world’. [ABSTRACT FROM AUTHOR]

This paper examines the social geography of sexually transmitted diseases (STDs) in China, focusing on the spread of HIV/AIDS, and the extent to which migration and urbanisation might be contributing to both the spread and the increasing prevalence of these diseases. The paper begins with a discussion of the early years of the epidemic (beginning in the mid-1980s), when the consensus view was that STDs and HIV were geographically marginal phenomena, occurring either on China's periphery, or in isolated parts of its rural interior. This characterisation seemed to be less appropriate in the latter part of the 1990s, when it became clear that temporary and circular migration had the potential to spread the diseases from one part of the country to another. The second part of the paper examines the connection between migration and the prevalence of STDs and HIV, reporting on some of the empirical evidence to support such a hypothesis, and speculating on the theoretical underpinnings of the migration/STD relationship. The third part of the paper considers what might lie in store for China in terms of its HIV epidemic. One distinct possibility is the spread of HIV to China's booming cities, and to explore this possibility in theoretical terms, a number of interrelated aspects of urbanisation that might be associated with higher rates of HIV-related risky behaviours are considered. It is suggested that these overlapping sets of forces could be related to the emergence of new behaviours and lifestyles that may be putting a growing number of Chinese people at risk in the new millennium. [ABSTRACT FROM AUTHOR]

Although alliances between community-based organizations (CBOs) and university-based evaluators provide opportunities to enhance community-based interventions, such partnerships may be fraught with challenges and obstacles. This paper focuses on the "story" behind a collaborative partnership between a Latino-focused CBO and a team of university-based evaluators that was formed to evaluate HIV prevention interventions for Mexican American female adolescents and gay/bisexual/questioning (GBQ) Latino male adolescents. A developmental trajectory of the partnership is detailed, with a focus on the creation and enhancement of a reciprocal and mutually beneficial relationship. In tracing this history, the paper explores challenges that were faced and presents ways in which the partnership attempted to over- come obstacles. Recommendations are offered to assist in the formation and maintenance of collaborative partnerships between CBOs and university-based evaluators/researchers. [ABSTRACT FROM AUTHOR]

BACKGROUND: The increase in human immunodeficiency virus infection among women of childbearing age increases the potential risk for vertical transmission of infection to their newborns. AIM: This paper discusses literature reviewed on human immunodeficiency virus infection of women in Africa with reference to Ghana, West Africa. The paper provides an epidemiological overview of human immunodeficiency virus infection of women in Ghana and Africa and the potential risk for vertical transmission and associated contributing factors. Literature reviewed was retrieved from the Cumulative Index of Nursing and Allied Health Literature and United States National Library of Medicine databases. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Findings from the review of literature suggest that human immunodeficiency virus infection of African women is a major public health problem which must be addressed and considered a priority in the next decade. Leadership in African countries including nurses and policy-makers will have to do more to make a difference to the epidemic. Measures to reduce transmission of human immunodeficiency virus are discussed. [ABSTRACT FROM AUTHOR]

This paper seeks to understand better the media practices of people who are directly affected by an illness or health problem. Internet sites that have been created by people with HIV/AIDS are examined as a strategy for self-representation. This analysis identifies four prominent 'organising themes' in Internet sites: autobiography; expertise; self promotion; and dissent. It is argued that there is a connection between media activism within the contemporary AIDS movement and Internet use among people with HIV/AIDS. This paper discusses the potential of the Internet, as a form of media activism, to raise the private troubles of people with health problems as public issues through a revitalisation of the public sphere in contemporary post-industrial societies. [ABSTRACT FROM AUTHOR]

The HIV/AIDS epidemic is the greatest threat to development in much of Africa. It is already the main cause of death in many countries, especially those in Southern Africa. However there is an absence of solid data on the scale and scope of the disease and how it is evolving. In this article we discuss the data on the epidemic--where it comes from and how it is presented. We note the limitations of the use of antenatal clinic surveys--which provide the bulk of our information. We then turn to the evidence of impact. The paper shows that the long incubation period between infection and illness means that it takes time for HIV infections to turn into AIDS cases, and AIDS cases to translate into deaths with all the consequences of orphaning, poverty and changing population structures. Furthermore it means that once the HIV prevalence has peaked, AIDS impact will take years to work through--this epidemic is a 'long-wave' event. The paper is premised on the view that HIV causes AIDS and AIDS causes death. It notes that insufficient and/or unreliable data have allowed leaderships to deny the scope and scale of the problem and that this is unacceptable. However it is incumbent on all to accept the moral responsibility for and the moral consequences of their work, and this includes those who gather, interpret and use the data. [ABSTRACT FROM AUTHOR]

This paper is based on the last public lecture given by Dr Solomon at the 7th World Workshop on Oral Health & Disease in HIV/AIDS, held in Hyderabad, India, in November 2014. It examines the social impact of HIV in India and the founding of the Y.R. Gaitonde Center for AIDS Research and Education (YRG CARE) clinic in Chennai, India, by Dr Suniti Solomon and her colleagues. This is a story of prejudice and ignorance throughout the various social levels in India. Reports of India's first AIDS case surfaced in 1986, when female sex workers were found to be HIV positive. The first voluntary counseling and testing center, part of a sexually transmitted diseases (STD) clinic, was set up to increase awareness about the epidemic. To address the rapid spread of HIV infection in Tamil Nadu and the existing stigma in society and hospitals, Dr Solomon established YRG CARE in 1993. She recognized that fear and panic about HIV led to widespread social prejudice against HIV-positive patients, even within hospitals. By the end of 2014, over 34 000 patients had accessed these services and 20 000 HIV+ patients had been registered, nearly 40% of whom were females. The team embarked on a statewide awareness program on HIV and sexuality, covering over two hundred schools and colleges educating them about prevention strategies and combating the social stigma attached. The grass-root work of YRG CARE in the management of HIV infections revealed a widespread prejudice, due largely to the lack of awareness about the subject. It is estimated that even in 2015, as little as 40% of HIV-infected people are formally diagnosed and have access to care. In a country as socially and culturally diverse as India, there is much more to be carried out to build on the pioneering work of Dr Solomon. [ABSTRACT FROM AUTHOR]

The interplay between HIV-1 and epithelial cells represents a critical aspect in mucosal HIV-1 transmission. Epithelial cells lining the oral cavity cover subepithelial tissues, which contain virus-susceptible host cells including CD4+ T lymphocytes, monocytes/macrophages, and dendritic cells. Oral epithelia are among the sites of first exposure to both cell-free and cell-associated virus HIV-1 through breast-feeding and oral-genital contact. However, oral mucosa is considered to be naturally resistant to HIV-1 transmission. Oral epithelial cells have been shown to play a crucial role in innate host defense. Nevertheless, it is not clear to what degree these local innate immune factors contribute to HIV-1 resistance of the oral mucosa. This review paper addressed the following issues that were discussed at the 7th World Workshop on Oral Health and Disease in AIDS held in Hyderabad, India, during November 6-9, 2014: (i) What is the fate of HIV-1 after interactions with oral epithelial cells?; (ii) What are the keratinocyte and other anti- HIV effector oral factors, and how do they contribute to mucosal protection?; (iii) How can HIV-1 interactions with oral epithelium affect activation and populations of local immune cells?; (iv) How can HIV-1 interactions alter functions of oral epithelial cells? [ABSTRACT FROM AUTHOR]

The paper studies the role of population mobility in the transformation of the Mae Sa village community in Mae Rim District of Chiang Mai Province, northern Thailand. Data for the analysis derive from an in-depth investigation in 1976–1977 and successive studies over the following 22 years including a substantial reinvestigation in 1995–1996. In these two decades, the village has been transformed from a traditional agricultural community to a ‘modern’ rural community with considerable employment outside the village and other links to the outside world. The paper discusses the complexity of the in- and out- migration process and the significance of the roles played by permanent and non-permanent migration in the transformation of the village resource base and social institutions. Special attention is given to social relations at the individual, family and community levels with implications on the definition of movement for the people of Mae Sa. [ABSTRACT FROM AUTHOR]

This paper analyses the relationship of history to two current and inter-related policy issues, AIDS and drugs. AIDS, in particular in its early years, was a disease surrounded by history; and historians and others actively brought the 'lesson of history' into the public debates. Cholera and the Black Death provided historical examples of reactions to past epidemic disease; and the record of voluntarism in Britain in the area of sexually transmitted diseases was used to justify a non-punitive response to AIDS. As the perception of AIDS has changed from epidemic to chronic disease, as reactions to the disease have become 'normalized; so the type of historical input has also altered. The 'lesson of history' approach has appeared less relevant, or has changed focus to encompass chronic--TB, multiple sclerosis--rather than epidemic disease. The concept of AIDS itself as an historic event, of the 'contemporary history' of AIDS has also come to the fore. The paper contrasts the relationship of AIDS and history with the ahistorical reaction to the particular impact of AIDS on drug policy. The policy reaction to illicit drugs has been historically conscious, in particular in the 1960's. But little of this historical perspective filtered into the reaction to AIDS on drug policy. Drugs, unlike AIDS, was not an open policy arena. The paper argues that overall drug policy objectives were already clear and it suited no policy interest to call on the historical record. The achievement of established policy objectives was better achieved by an emphasis on the newness of development, a response to potentially epidemic and unusual circumstances. [ABSTRACT FROM AUTHOR]

'Risk' and 'risk behaviour' have become keywords in discourses about AIDS. Notions of risk behaviour in the field of HIV prevention and the addictions largely derive from epidemiological categorisations which have had a key role in constructing lay and scientific understandings of the 'problems' of AIDS and injecting drug use. This has encouraged a restricted vision which inadequately captures risk as it is understood and experienced by drug users themselves. Drawing on case examples from qualitative research with illicit drug users, this paper explores the utility of current theories of risk behaviour in understanding how risk behaviour is socially organised. Two key developments in risk behaviour theory are examined. These are situated rationality and social action theories. Findings illustrate that situated rationality theories tend to be conceptually limited to an analysis of individual rationality which fails to capture the distribution and influence of power in negotiated actions and the habituated nature of risk behaviour. In contrast, social action theories aim to understand the interplay of social factors which give rise to individuals' situated risk perceptions and actions. Findings highlight the important role that qualitative research plays in questioning, as well as complementing, dominant scientific constructions of risk. Future theories of risk behaviour in the field of HIV prevention, as well as other health domains, need to consider risk as a socially organised rather than individual phenomenon. The paper concludes by asserting that understanding what risk actually means to participants themselves provides the necessary data for public health interventions to create the conditions where risk reduction becomes possible. [ABSTRACT FROM AUTHOR]