JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
A Multi-Disciplinary Approach to Implementation Science: The NIH-PEPFAR PMTCT Implementation Science Alliance.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 10-14-2014
Show Abstract
Hide Abstract
: In resource-limited countries, interventions to prevent mother-to-child HIV transmission (PMTCT) have not yet realized their full potential health impact, illustrating the common gap between the scientific proof of an intervention's efficacy and effectiveness and its successful implementation at scale into routine health services. For PMTCT, this gap results, in part, from inadequate adaptation of PMTCT interventions to the realities of the implementation environment, including client and health care worker behaviors and preferences, health care policies and systems, and infrastructure and resource constraints. Elimination of mother-to-child HIV transmission can only be achieved through understanding of key implementation barriers and successful adaptation of scientifically proven interventions to the local environment. Central to such efforts is implementation science (IS), which aims to investigate and address major bottlenecks that impede effective implementation and to test new approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions. Advancing IS will require deliberate and strategic efforts to facilitate collaboration, communication, and relationship-building among researchers, implementers, and policy-makers. To speed the translation of effective PMTCT interventions into practice and advance IS more broadly, the US National Institutes of Health, in collaboration with the President's Emergency Plan for AIDS Relief launched the National Institutes of Health/President's Emergency Plan for AIDS Relief PMTCT IS Alliance, comprised of IS researchers, PMTCT program implementers, and policy-makers as an innovative platform for interaction and coordination.
Related JoVE Video
Cross-sectional study of genital, rectal, and pharyngeal Chlamydia and gonorrhea in women in rural South Africa.
Sex Transm Dis
PUBLISHED: 08-15-2014
Show Abstract
Hide Abstract
Epidemiological data of genital chlamydia and gonorrhea, required to inform design and implementation of control programs, are limited for rural Africa. There are no data on the prevalence of rectal or pharyngeal infections among African women.
Related JoVE Video
Ocular infections in sub-Saharan Africa in the context of high HIV prevalence.
Trop. Med. Int. Health
PUBLISHED: 07-07-2014
Show Abstract
Hide Abstract
Healthy eyes and good vision are important determinants of populations' health across the globe. Sub-Saharan Africa is affected by simultaneous epidemics of ocular infections and human immunodeficiency virus (HIV). Ocular infection and its complications, along with cataract and ocular trauma, are common conditions in this region with great impact on daily life. In this review, we discuss the epidemiology, clinical manifestations and microbial aetiology of the most important infectious ocular conditions in sub-Saharan Africa: conjunctivitis, keratitis and uveitis. We focus specifically on the potential association of these infections with HIV infection, including immune recovery uveitis. Finally, challenges and opportunities for clinical management are discussed, and recommendations made to improve care in this neglected but very important clinical field.
Related JoVE Video
Patient factors to target for elimination of mother-to-child transmission of HIV.
Global Health
PUBLISHED: 04-10-2014
Show Abstract
Hide Abstract
There is great impetus to achieve elimination of mother-to-child transmission of HIV (eMTCT) by 2015, and part of this is to identify factors to target to achieve the goal. This study thus identified key patient factors for MTCT in a high HIV prevalence setting in Johannesburg, South Africa. Between November 2010 and May 2012, we conducted a case-control study among HIV-infected women with HIV-infected (cases) and uninfected (controls) infants diagnosed around six weeks of age as part of routine, early infant diagnosis. Mothers and infants were identified through registers in six healthcare facilities that provide antenatal, postpartum and HIV care. Structured interviews were conducted with a focus on history of HIV infection, antenatal, intrapartum and immediate postpartum management of the mother-infant pair. Patient-related risk factors for MTCT were identified.
Related JoVE Video
Clinical assessment of peripheral neuropathy in HIV-infected children on antiretroviral therapy in rural South Africa.
Eur. J. Pediatr.
PUBLISHED: 03-24-2014
Show Abstract
Hide Abstract
Peripheral neuropathy is a well-known side effect of antiretroviral therapy (ART) in adult patients and is particularly related to the use of nucleoside reverse transcriptase inhibitors. This class of drugs is included in all first-line paediatric ART regimens in Africa, but data on the prevalence of neuropathy in children are scarce. In this cross-sectional study, 182 HIV-infected children on ART in rural South Africa were assessed for peripheral neuropathy using the neuropathy symptom score (NSS) and neuropathy disability score (NDS). Peripheral neuropathy was defined as NSS???5 or NDS???3. Neurological assessment was completed for 174 children (96 %). Symptoms of neuropathy were reported in NSS by 48 children (28 %; 95 % confidence interval (CI) 21-34 %), and signs were observed in NDS in 25 children (14 %; 95 % CI 12-16 %). A diagnosis of peripheral neuropathy was established in 42 children (24 %; 95 % CI 18-30 %). Independent risk factors for peripheral neuropathy were co-trimoxazole prophylaxis (adjusted odds ratio 0.45; 95 % CI 0.21-0.95, p?=?0.036) and didanosine use (adjusted odds ratio 12; 95 % CI 1.3-116, p?=?0.030).
Related JoVE Video
Low-frequency nevirapine (NVP)-resistant HIV-1 variants are not associated with failure of antiretroviral therapy in women without prior exposure to single-dose NVP.
J. Infect. Dis.
PUBLISHED: 01-16-2014
Show Abstract
Hide Abstract
Low-frequency nevirapine (NVP)-resistant variants have been associated with virologic failure (VF) of initial NVP-based combination antiretroviral therapy (cART) in women with prior exposure to single-dose NVP (sdNVP). We investigated whether a similar association exists in women without prior sdNVP exposure.
Related JoVE Video
Minority stress in the lives of men who have sex with men in Cape Town, South Africa.
J Homosex
PUBLISHED: 01-08-2014
Show Abstract
Hide Abstract
The mental health outcomes of men who have sex with men (MSM) living in sub-Saharan Africa are understudied, despite evidence that discrimination and stigma are widespread. This article examines the occurrence and mental health effects of minority stress in a sample of diverse South African MSM. Twenty-two MSM living in Cape Town took part in exploratory qualitative in-depth interviews and completed mental health questionnaires. Results indicate that the majority of participants experienced minority stress, which affected their sexual relationships and coping strategies. Concealment behaviors and perceived discrimination levels were high and were associated with race, religion, SES, and geographical location.
Related JoVE Video
The Mpumalanga Men's Study (MPMS): Results of a Baseline Biological and Behavioral HIV Surveillance Survey in Two MSM Communities in South Africa.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
The Mpumalanga Men's Study (MPMS) is the assessment of the Project Boithato HIV prevention intervention for South African MSM. Boithato aims to increase consistent condom use, regular testing for HIV-negative MSM, and linkage to care for HIV-positive MSM. The MPMS baseline examined HIV prevalence and associated risk behaviors, and testing, care, and treatment behaviors among MSM in Gert Sibande and Ehlanzeni districts in Mpumalanga province, South Africa in order to effectively target intervention activities. We recruited 307 MSM in Gert Sibande and 298 in Ehlanzeni through respondent-driven sampling (RDS) between September 2012-March 2013. RDS-adjusted HIV prevalence estimates are 28.3% (95% CI 21.1%-35.3%) in Gert Sibande, and 13.7% (95% CI 9.1%-19.6%) in Ehlanzeni. Prevalence is significantly higher among MSM over age 25 [57.8% (95% CI 43.1%-72.9%) vs. 17.9% (95% CI 10.6%-23.9%), P<0.001 in Gert Sibande; 34.5% (95%CI 20.5%-56.0%) vs. 9.1% (95% CI 4.6%-13.9%), P<0.001 in Ehlanzeni]. In Gert Sibande, prevalence is higher among self-identified gay and transgender MSM vs. other MSM [39.3% (95%CI, 28.3%-47.9%), P<0.01], inconsistent condom users [38.1% (18.1%-64.2%), P<0.05], those with a current regular male partner [35.0% (27.1%-46.4%), P<0.05], and those with lifetime experience of intimate partner violence with men [40.4%, (95%CI 28.9%-50.9%), P<0.05]. Prevalence of previous HIV testing was 65.8% (95%CI 58.8%-74.0%) in Gert Sibande, and 69.3% (95%CI 61.9%-76.8%) in Ehlanzeni. Regular HIV testing was uncommon [(34.6%, (95%CI 27.9%-41.4%) in Gert Sibande; 31.0% (95%CI 24.9%-37.8%) in Ehlanzeni]. Among HIV-positive participants, few knew their status (28.1% in Gert Sibande and 14.5% in Ehlanzeni), or were appropriately linked to care (18.2% and 11.3%, respectively), or taking antiretroviral therapy (13.6% and 9.6% respectively). MPMS results demonstrate the importance of implementing interventions for MSM to increase consistent condom use, regular HIV testing, and linkage and engagement in care for HIV-infected MSM.
Related JoVE Video
Disengagement of HIV-positive pregnant and postpartum women from antiretroviral therapy services: a cohort study.
J Int AIDS Soc
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Recent international guidelines call for expanded access to triple-drug antiretroviral therapy (ART) in HIV-positive women during pregnancy and postpartum. However, high levels of non-adherence and/or disengagement from care may attenuate the benefits of ART for HIV transmission and maternal health. We examined the frequency and predictors of disengagement from care among women initiating ART during pregnancy in Cape Town, South Africa.
Related JoVE Video
High seroprevalence of human herpesviruses in HIV-infected individuals attending primary healthcare facilities in rural South Africa.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Seroprevalence data of human herpesviruses (HHVs) are limited for sub-Saharan Africa. These are important to provide an indication of potential burden of HHV-related disease, in particular in human immunodeficiency virus (HIV)-infected individuals who are known to be at increased risk of these conditions in the Western world. In this cross-sectional study among 405 HIV-infected and antiretroviral therapy naïve individuals in rural South Africa the seroprevalence of HHVs was: herpes simplex virus type 1 (HSV-1) (98%), herpes simplex virus type 2 (HSV-2) (87%), varicella zoster virus (VZV) (89%), and 100% for both Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Independent factors associated with VZV seropositivity were low educational status and having children. Lack of in-house access to drinking water was independently associated with positive HSV-1 serostatus, whereas Shangaan ethnicity was associated with HSV-2 seropositivity. Increasing age was associated with higher IgG titres to both EBV and CMV, whereas CD4 cell count was negatively associated with EBV and CMV IgG titres. Moreover, IgG titres of HSV-1 and 2, VZV and CMV, and CMV and EBV were positively correlated. The high HHV seroprevalence emphasises the importance of awareness of these viral infections in HIV-infected individuals in South Africa.
Related JoVE Video
Homophobic stigma, depression, self-efficacy and unprotected anal intercourse for peri-urban township men who have sex with men in Cape Town, South Africa: a cross-sectional association model.
AIDS Care
PUBLISHED: 12-02-2013
Show Abstract
Hide Abstract
While research now highlights that men who have sex with men (MSM) in places such as South Africa are at particular risk of HIV infection, left relatively unexplored are potential relationships between one of the most pressing social issues affecting peri-urban MSM - namely homophobic stigma - and sexual risk-taking behaviour. Drawing on research from the Ukwazana baseline study of 316 township MSM in Cape Town we examine how homophobic stigma relates to psychosocial factors such as depression and self-efficacy and the risk activity of unprotected anal intercourse (UAI). By deploying cross-sectional association models, we examine a series of relationships between these variables and offer evidence to suggest that HIV prevention programmes aimed at sexual minority groups should be mindful of potentially complex relationships between social stigmas such as homophobia and sexual risk-taking behaviour.
Related JoVE Video
Early time-limited antiretroviral therapy versus deferred therapy in South African infants infected with HIV: results from the children with HIV early antiretroviral (CHER) randomised trial.
Lancet
PUBLISHED: 11-12-2013
Show Abstract
Hide Abstract
Interim results from the children with HIV early antiretroviral (CHER) trial showed that early antiretroviral therapy (ART) was life-saving for infants infected with HIV. In view of the few treatment options and the potential toxicity associated with lifelong ART, in the CHER trial we compared early time-limited ART with deferred ART.
Related JoVE Video
HIV risk and prevention among men who have sex with men (MSM) in peri-urban townships in Cape Town, South Africa.
AIDS Behav
PUBLISHED: 07-31-2013
Show Abstract
Hide Abstract
Current guidelines on HIV prevention for MSM emphasise the need for combination prevention based on context-specific understandings of HIV risk. MSM in South Africa are a population with a high risk of HIV infection, however there is little research available on the drivers of this risk. In the context of a focus on combination prevention, this paper argues that effective HIV prevention for MSM in South Africa requires an understanding of the factors at multiple distances from individuals that contribute to HIV risk. Based on qualitative research with MSM in Cape Town, South Africa, we situate HIV risk using a socio-ecological framework and identify factors at distal, proximal, and personal, levels that contribute to MSMs high risk of HIV infection. By understanding the interactions and linkages between risk environments and the risk situations in which HIV is transmitted, HIV prevention programmes will be more effectively able to address the multiple drivers of HIV risk in this population.
Related JoVE Video
Contextual correlates of per partner unprotected anal intercourse rates among MSM in Soweto, South Africa.
AIDS Behav
PUBLISHED: 07-31-2013
Show Abstract
Hide Abstract
Men who have sex with men (MSM) throughout the world are at high-risk of HIV acquisition and transmission. Although individual behavior remains a central feature of HIV prevention efforts in sub-Saharan Africa and beyond, contextual factors likely influence behavioral risk. We identify contextual factors at the individual, dyadic (within the partnership), and extra-dyadic (relationships external to the focal dyad) levels that are associated with increased rates of unprotected anal intercourse with a given male partner among MSM in Soweto, South Africa. Drawing on data from The Soweto Mens Study, multilevel models were applied to 758 partnerships nested within 377 MSM respondents. Independent of overall sexual engagement, dyadic (e.g. description of partner as regular), psychosocial (e.g. experiences of homonegativity), and sociocultural (e.g. income) contextual factors were significant predictors of differential 6-month rates of UAI with a given partner. By contrast, sexual partnerships outside of the focal sexual pair were not significantly related to UAI rates within the focal pair. Our findings support the need for continuing to understand and intervene on partner-level, psychosocial, and sociocultural dimensions of sexual behavior and sexual risk among MSM in Soweto.
Related JoVE Video
Attitudes toward couples-based HIV counseling and testing among MSM in Cape Town, South Africa.
AIDS Behav
PUBLISHED: 07-31-2013
Show Abstract
Hide Abstract
Couples-based voluntary HIV counseling and testing (CVCT) allows couples to receive their HIV test results together and has been demonstrated to be effective in reducing HIV transmission, increasing and sustaining condom use, and reducing sexual risk-taking among at-risk heterosexual couples. However, the acceptability of CVCT among MSM has yet to be evaluated in an African setting. The results from seven focus group discussions and 29 in-depth interviews conducted in Cape Town, South Africa exhibit overwhelmingly high acceptance of CVCT. Participants were attracted to the counseling components of the service, stating that these would allow for the couple to increase their commitment and to explore methods of how to effectively reduce their risk of acquiring or transmitting HIV in the presence of a trained counselor. These results suggest CVCT would be highly welcomed and could work to fill the significant lack of services available and accessible to MSM couples in Cape Town.
Related JoVE Video
Understanding the needs of township men who have sex with men (MSM) health outreach workers: exploring the interplay between volunteer training, social capital and critical consciousness.
AIDS Behav
PUBLISHED: 07-31-2013
Show Abstract
Hide Abstract
This article considers the complex ways volunteer outreach workers can frame their engagement with a community-based HIV prevention programme for South African township MSM. Drawing on research conducted during the Ukwazana programme in Cape Town it begins by exploring limitations towards MSM participation with programme facilitators (namely previous feelings of mistrust and community homophobia) and strategies developed to offset these concerns. It then considers how great care must also be taken to appreciate how volunteers from marginalised groups can frame training as a key condition for participation. To understand this it is therefore necessary for facilitators to acknowledge a number of additional concerns. These include community status, a lack of bonding social capital between volunteers and a highly developed from of critical consciousness by volunteers regarding HIV prevention possibilities. This article therefore suggests that effort to initially engage marginalised communities must also be met with effort to understand the complex ways volunteers relate to other MSM and to each other.
Related JoVE Video
Efavirenz-induced gynecomastia in a prepubertal girl with human immunodeficiency virus infection: a case report.
BMC Pediatr
PUBLISHED: 05-21-2013
Show Abstract
Hide Abstract
Prepubertal gynecomastia is a rare condition and most frequently classified as idiopathic. In HIV-infected adults gynecomastia is a recognised but infrequent side-effect of antiretroviral treatment (ART) and mostly attributed to efavirenz use. Gynecomastia should be distinguished from pseudogynecomastia as part of the lipodystrophy syndrome caused by Nucleoside Reverse Transcriptase Inhibitors (NRTIs) to avoid incorrect substitution of drugs. In the medical literature only five cases of prepubertal gynecomastia in children taking ART are described and underlying pathogenesis was unknown. The occurrence of adverse effects of ART may interfere with therapy adherence and long-term prognosis and for that reason requires attention. We report the first case of prepubertal gynecomastia in a young girl attributed to efavirenz use.
Related JoVE Video
Comparison of point-of-care versus laboratory-based CD4 cell enumeration in HIV-positive pregnant women.
J Int AIDS Soc
PUBLISHED: 04-18-2013
Show Abstract
Hide Abstract
Early initiation of antiretroviral therapy (ART) in eligible pregnant women is a key intervention for prevention of mother-to-child transmission (PMTCT) of HIV. However, in many settings in sub-Saharan Africa where ART-eligibility is determined by CD4 cell counts, limited access to laboratories presents a significant barrier to rapid ART initiation. Point-of-care (POC) CD4 cell count testing has been suggested as one approach to overcome this challenge, but there are few data on the agreement between POC CD4 cell enumeration and standard laboratory-based testing.
Related JoVE Video
A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa.
AIDS Behav
PUBLISHED: 03-28-2013
Show Abstract
Hide Abstract
Men who have sex with men (MSM) have a higher prevalence of common mental disorders (CMD), as compared with heterosexual men. HIV infection is independently associated with higher rates of CMD. Given this context, and the high background community prevalence of HIV in South Africa, MSM are at even greater risk of developing CMD. The aim of this research was to investigate neuropsychiatric symptoms and disorders in MSM who were referred for assessment and management of mental health problems, in an MSM Clinic in urban Cape Town, South Africa. Twenty-five men were screened using the MINI, AUDIT, DUDIT, and IPDE Screener. Depression, suicidality, as well as alcohol and drug use disorders were highly prevalent in this group (44, 56, 48, and 56 % respectively). The personality disorder screening was suggestive of a high prevalence of personality disorders. The high prevalence of neuropsychiatric disorders in this sample supports the idea that integrated mental health services are needed to address the complex needs of this population. Adequate input into the mental health needs of this population could reduce the potential for HIV acquisition and transmission, improve adherence to treatment and care, and ensure the provision a comprehensive health service for MSM.
Related JoVE Video
An exploration into the role of depression and self-efficacy on township men who have sex with mens ability to engage in safer sexual practices.
AIDS Care
PUBLISHED: 02-06-2013
Show Abstract
Hide Abstract
Men who have sex with men (MSM) in South Africa remain at particular risk of HIV infection. The Ukwazana baseline survey is the first to explore this risk in relation to psychological factors associated with unprotected anal intercourse (UAI). A cohort of 316 MSM from township peri-urban Cape Town took part in the survey. The survey found that 55.2% had engaged in UAI over the preceding 6 months. Depression was significantly associated with UAI. Respondents with self-efficacy scores less than two standard deviations above the mean were also more likely to have engaged in UAI. A Sobel test for mediation highlighted that the depression-UAI association was partially mediated by self-efficacy, indicating that most of the effect of depression on UAI was not covarying with self-efficacy. This study, therefore, highlights that both depression and self-efficacy should be considered factors to be addressed in HIV-prevention programmes aimed at peri-urban MSM.
Related JoVE Video
HIV prevention and treatment for South African men who have sex with men.
S. Afr. Med. J.
PUBLISHED: 12-18-2011
Show Abstract
Hide Abstract
Men who have sex with men (MSM) are at high risk for HIV acquisition and transmission owing to the high risks associated with unprotected anal sex and barriers to accessing appropriate health services. Globally HIV prevention is failing among MSM, as evidenced by high seroconversion rates. Prevention interventions for MSM are more limited than for heterosexual individuals. Prevention programmes should embrace early their programming. High transmission risk groups such as MSM will benefit from such interventions.
Related JoVE Video
Can devices for adult male circumcision help bridge the implementation gap for HIV prevention services?
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 10-04-2011
Show Abstract
Hide Abstract
Medical male circumcision could prevent more than 5 million new HIV infections in men in Africa over 20 years and should be a central part of any combination prevention public health strategy. Surgical methods, with systems designed for high volume services, have been used in circumcision scale-up programs in several African countries, but remain limited by the need for high-level health workers, skilled in the surgical techniques, and appropriate facilities. New male circumcision devices such as the Shang Ring and the PrePex device have shown promise in initial trials and may provide innovative ways to improve access to medical male circumcision in the future. The rapid introduction of new and promising biomedical strategies for HIV prevention, including antiretrovirals for HIV prevention, will require early consideration of delivery systems and service design.
Related JoVE Video
Reducing the low-dose lung radiation for central lung tumors by restricting the IMRT beams and arc arrangement.
Med Dosim
PUBLISHED: 07-15-2011
Show Abstract
Hide Abstract
To compare the extent to which 7 different radiotherapy planning techniques for mediastinal lung targets reduces the lung volume receiving low doses of radiation. Thirteen non-small cell lung cancer patients with targets, including the mediastinal nodes, were identified. Treatment plans were generated to both 60- and 74-Gy prescription doses using 7 different planning techniques: conformal, hybrid conformal/intensity-modulated radiation treatment (IMRT), 7 equidistant IMRT beams, 2 restricted beam IMRT plans, a full (360°) modulated arc, and a restricted modulated arc plan. All plans were optimized to reduce total lung V5, V10, and V20 volumes, while meeting normal tissue and target coverage constraints. The mean values for the 13 patients are calculated for V5, V10, V20, V(ave), V0-20, and mean lung dose (MLD) lung parameters. For the 74-Gy prescription dose, the mean lung V10 was 42.7, 43.6, 48.2, 56.6, 57, 55.8, and 54.1% for the restricted ±36° IMRT, restricted modulated arc, restricted ±45° IMRT, full modulated arc, hybrid conformal/IMRT, equidistant IMRT, and conformal plans, respectively. A similar lung sparing hierarchy was found for the 60-Gy prescription dose. For the treatment of central lung targets, the ±36° restricted IMRT and restricted modulated arc planning techniques are superior in lowering the lung volume treated to low dose, as well as in minimizing MLD, followed by the ±45° restricted IMRT plan. All planning techniques that allow the use of lateral or lateral/oblique beams result in spreading the low dose over a higher lung volume. The area under the lung dose-volume histogram curve below 20 Gy, V0-20, is proposed as an alternative to individual V(dose) parameters, both as a measure of lung sparing and as a parameter to be minimized during IMRT optimization.
Related JoVE Video
New regimens to prevent tuberculosis in adults with HIV infection.
N. Engl. J. Med.
PUBLISHED: 07-08-2011
Show Abstract
Hide Abstract
Treatment of latent tuberculosis in patients infected with the human immunodeficiency virus (HIV) is efficacious, but few patients around the world receive such treatment. We evaluated three new regimens for latent tuberculosis that may be more potent and durable than standard isoniazid treatment.
Related JoVE Video
Short-course Combivir after single-dose nevirapine reduces but does not eliminate the emergence of nevirapine resistance in women.
Antivir. Ther. (Lond.)
PUBLISHED: 06-03-2011
Show Abstract
Hide Abstract
In the Treatment Options Preservation Study (TOPS) trial, 4 or 7 days of Combivir (CBV; zidovudine/lamivudine) with maternal single-dose nevirapine (sdNVP) significantly reduced the emergence of NVP resistance as determined by virus population genotyping. To detect NVP resistance with greater sensitivity, we analysed TOPS samples by allele-specific real-time PCR (ASP).
Related JoVE Video
Low rates of nucleoside reverse transcriptase inhibitor resistance in a well-monitored cohort in South Africa on antiretroviral therapy.
Antivir. Ther. (Lond.)
PUBLISHED: 05-29-2011
Show Abstract
Hide Abstract
The emergence of complex HIV-1 drug resistance mutations has been linked to the duration of time patients are on a failing antiretroviral drug regimen. This study reports on resistance profiles in a closely monitored subtype C infected cohort.
Related JoVE Video
Inferior quantitative and qualitative immune responses to pneumococcal conjugate vaccine in infants with nasopharyngeal colonization by Streptococcus pneumoniae during the primary series of immunization.
Vaccine
PUBLISHED: 05-20-2011
Show Abstract
Hide Abstract
Heightened immunogenicity, measured one month after the primary series of pneumococcal conjugate vaccine (PCV), in African children was previously hypothesized to be due to increased rates of nasopharyngeal pneumococcal colonization during early infancy.
Related JoVE Video
Role of low-frequency HIV-1 variants in failure of nevirapine-containing antiviral therapy in women previously exposed to single-dose nevirapine.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 05-16-2011
Show Abstract
Hide Abstract
In the OCTANE/A5208 study of initial antiretroviral therapy (ART) in women exposed to single-dose nevirapine (sdNVP) ? 6 mo earlier, the primary endpoint (virological failure or death) was significantly more frequent in the NVP-containing treatment arm than in the lopinavir/ritonavir-containing treatment arm. Detection of NVP resistance in plasma virus at study entry by standard population genotype was strongly associated with the primary endpoint in the NVP arm, but two-thirds of endpoints occurred in women without NVP resistance. We hypothesized that low-frequency NVP-resistant mutants, missed by population genotype, explained excess failure in the NVP treatment arm. Plasma samples from 232 participants were analyzed by allele-specific PCR at study entry to quantify NVP-resistant mutants down to 0.1% for 103N and 190A and to 0.3% for 181C. Of 201 women without NVP resistance by population genotype, 70 (35%) had NVP-resistant mutants detected by allele-specific PCR. Among these 70 women, primary endpoints occurred in 12 (32%) of 38 women in the NVP arm vs. 3 (9%) of 32 in the lopinavir/ritonavir-containing arm (hazard ratio = 3.84). The occurrence of a primary endpoint in the NVP arm was significantly associated with the presence of K103N or Y181C NVP-resistant mutations at frequencies >1%. The risk for a study endpoint associated with NVP-resistant mutant levels did not decrease with time. Therefore, among women with prior exposure to sdNVP, low-frequency NVP-resistant mutants were associated with increased risk for failure of NVP-containing ART. The implications for choosing initial ART for sdNVP-exposed women are discussed.
Related JoVE Video
Increased microbial translocation in ? 180 days old perinatally human immunodeficiency virus-positive infants as compared with human immunodeficiency virus-exposed uninfected infants of similar age.
Pediatr. Infect. Dis. J.
PUBLISHED: 05-10-2011
Show Abstract
Hide Abstract
The effect of early versus deferred antiretroviral treatment (ART) on plasma concentration of lipopolysaccharide (LPS) and host LPS-binding molecules in human immunodeficiency virus (HIV)-infected infants up to 1 year of age was investigated.
Related JoVE Video
Plasma and intracellular tenofovir pharmacokinetics in the neonate (ANRS 12109 trial, step 2).
Antimicrob. Agents Chemother.
PUBLISHED: 04-04-2011
Show Abstract
Hide Abstract
The objective of this study was to investigate for the first time tenofovir (TFV) pharmacokinetics in plasma and peripheral blood mononuclear cells (PBMCs) of the neonate. HIV-1-infected pregnant women received two tablets of tenofovir disoproxil fumarate (TDF; 300 mg) and emtricitabine (FTC; 200 mg) at onset of labor and then one tablet daily for 7 days postpartum. A single dose of 13 mg/kg of body weight of TDF was administered to 36 neonates within 12 h of life after the HIV-1-infected mothers had been administered two tablets of TDF-emtricitabine at delivery. A total of 626 samples collected within the 2 days after the drug administration were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and analyzed by a population approach. In the neonate, the median TFV plasma area under the curve and minimal and maximal concentrations, respectively, were 3.73 mg/liter · h and 0.076 and 0.29 mg/liter. In PBMCs, TFV concentrations were detectable in all fetuses, whereas tenofovir diphosphate (TFV-DP) was quantifiable in only two fetuses, suggesting a lag in appearance of TFV-DP. The median TFV-DP neonatal concentration was 146 fmol/10? cells (interquartile range [IQR], 53 to 430 fmol/10? cells); two neonates had very high TFV-DP concentrations (1,530 and 2963 fmol/10? cells). The 13-mg/kg TDF dose given to neonates produced plasma TFV and intracellular active TFV-DP concentrations similar to those in adults. This dose should be given immediately after birth to reduce the delay before the active compound TFV-DP appears in cells.
Related JoVE Video
Active tuberculosis case-finding among pregnant women presenting to antenatal clinics in Soweto, South Africa.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 03-26-2011
Show Abstract
Hide Abstract
Human immunodeficiency virus (HIV) and tuberculosis (TB) are among the leading causes of death among women of reproductive age worldwide. TB is a significant cause of maternal morbidity. Detection of TB during pregnancy could provide substantial benefits to women and their children.
Related JoVE Video
Men and antiretroviral therapy in Africa: our blind spot.
Trop. Med. Int. Health
PUBLISHED: 03-21-2011
Show Abstract
Hide Abstract
Most antiretroviral therapy (ART)-related policies remain blind to mens treatment needs. Global and national programmes need to address this blindness urgently, to ensure equitable access to ART in Africa.
Related JoVE Video
Optimal uses of antiretrovirals for prevention in HIV-1 serodiscordant heterosexual couples in South Africa: a modelling study.
PLoS Med.
PUBLISHED: 02-22-2011
Show Abstract
Hide Abstract
Antiretrovirals have substantial promise for HIV-1 prevention, either as antiretroviral treatment (ART) for HIV-1-infected persons to reduce infectiousness, or as pre-exposure prophylaxis (PrEP) for HIV-1-uninfected persons to reduce the possibility of infection with HIV-1. HIV-1 serodiscordant couples in long-term partnerships (one member is infected and the other is uninfected) are a priority for prevention interventions. Earlier ART and PrEP might both reduce HIV-1 transmission in this group, but the merits and synergies of these different approaches have not been analyzed.
Related JoVE Video
First-line antiretroviral therapy after single-dose nevirapine exposure in South Africa: a cost-effectiveness analysis of the OCTANE trial.
AIDS
PUBLISHED: 02-05-2011
Show Abstract
Hide Abstract
The OCTANE trial reports superior outcomes of lopinavir/ritonavir vs. nevirapine-based antiretroviral therapy (ART) among women previously exposed to single-dose nevirapine to prevent mother-to-child HIV transmission. However, lopinavir/ritonavir is 12 times costlier than nevirapine.
Related JoVE Video
Correcting mortality for loss to follow-up: a nomogram applied to antiretroviral treatment programmes in sub-Saharan Africa.
PLoS Med.
PUBLISHED: 01-18-2011
Show Abstract
Hide Abstract
The World Health Organization estimates that in sub-Saharan Africa about 4 million HIV-infected patients had started antiretroviral therapy (ART) by the end of 2008. Loss of patients to follow-up and care is an important problem for treatment programmes in this region. As mortality is high in these patients compared to patients remaining in care, ART programmes with high rates of loss to follow-up may substantially underestimate mortality of all patients starting ART.
Related JoVE Video
Condom avoidance and determinants of demand for male circumcision in Johannesburg, South Africa.
Health Policy Plan
PUBLISHED: 10-20-2010
Show Abstract
Hide Abstract
BACKGROUND Circumcision is efficacious in reducing HIV acquisition in heterosexual males. The South Africa government has been reluctant to adopt a national circumcision programme, possibly due to concerns that circumcision may result in decreased condom use. OBJECTIVE To identify the determinants of demand for male circumcision, to examine variations by ethnicity, and to determine whether it is demanded to avoid condom use. METHODS 403 parents and 237 sons in Johannesburg, South Africa, were recruited through a randomized household survey, with oversampling to balance between blacks (n ?= ?220), coloured (mixed ethnicity) (n ?=? 202) and whites (n ?=? 218). The demand for male circumcision was estimated using a conjoint analysis, with each respondent randomly receiving four tasks comparing seven possible benefits-six identified through key informant interviews and one for condom avoidance. Respondents choices were analysed using logistic regression, including stratified analyses to test for homogeneity. RESULTS Overall, circumcisions beneficial effects on HIV transmission (P ?< ?0.001), sexually transmitted infection (STI) transmission (P?< ?0.001), hygiene (P ?< ?0.05) and sex (P? < ?0.05) were identified as determinants of demand, but the condom avoidance hypothesis was rejected as it was repulsive to respondents (P? < ?0.001). Consistent results were found for blacks (P ?< ?0.001) and coloured (P?
Related JoVE Video
Population pharmacokinetics of nevirapine in HIV-1-infected pregnant women and their neonates.
Antimicrob. Agents Chemother.
PUBLISHED: 10-18-2010
Show Abstract
Hide Abstract
The aim of the present study was to describe the nevirapine (NVP) pharmacokinetics (PK) in pregnant women and their neonates and to evaluate the transplacental drug transfer and administration scheme for the prevention of mother-to-child transmission. Thirty-eight HIV-1-infected pregnant women were administered one tablet of NVP (200 mg) and two tablets of tenofovir-emtricitabine (Truvada) at the initiation of labor. Children were given NVP syrup (2 mg/kg of body weight) as a single dose (sdNVP) on the first day of life. By pair, NVP concentrations were measured in 11 maternal, 1 cord blood, and 2 neonatal plasma samples and analyzed by a population approach. A one-compartment model was used for mothers and neonates; the absorption rate constants for mothers and neonates were 0.95 h(-1) (intersubject variability, 111%) and 0.39 h(-1), respectively; the apparent elimination clearances were 1.42 liter·h(-1) (intersubject variability, 22%) and 0.035 liter·h(-1), respectively; and apparent volumes of distribution were 87.3 liters (intersubject variability, 25%) and 5.65 liters, respectively. An effect compartment was linked to maternal circulation by mother-to-cord and cord-to-mother rate constants of 1.10 h(-1) and 1.43 h(-1), respectively. Placental transfer, expressed as the fetal-to-maternal area under the curve ratio, was 75%. Neonates had a very long half-lives (110 h) compared to adults. In the 38 mothers, the simulated median individual predicted time during which the NVP concentration remained above the half-maximal inhibitory concentration (IC(50)) was 13.2 days (range, 12 to 19.2 days). Thus, the administration of tenofovir-emtricitabine for at least 3 weeks after delivery should be considered to prevent the emergence of resistant viruses. The neonate must receive sdNVP immediately after birth when the infant is born less than 30 min after maternal drug intake to keep NVP concentrations above the IC(50).
Related JoVE Video
Maternal and nenonatal tenofovir and emtricitabine to prevent vertical transmission of HIV-1: tolerance and resistance.
AIDS
PUBLISHED: 09-10-2010
Show Abstract
Hide Abstract
Viral resistance occurs with a high frequency after single-dose nevirapine. We aimed to evaluate the tolerance and resistance profiles of a combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) given to HIV-1-infected delivering women and their newborns.
Related JoVE Video
Initiating patients on antiretroviral therapy at CD4 cell counts above 200 cells/microl is associated with improved treatment outcomes in South Africa.
AIDS
PUBLISHED: 07-09-2010
Show Abstract
Hide Abstract
To compare treatment outcomes by starting CD4 cell counts using data from the Comprehensive International Program of Research on AIDS-South Africa trial.
Related JoVE Video
Effect of HIV infection status and anti-retroviral treatment on quantitative and qualitative antibody responses to pneumococcal conjugate vaccine in infants.
J. Infect. Dis.
PUBLISHED: 06-30-2010
Show Abstract
Hide Abstract
Serotype-specific antibody concentration and opsonophagocytic activity (OPA) were evaluated after 3 doses of pneumococcal conjugate vaccine. Groups included human immunodeficiency virus (HIV)-positive infants with CD4(+) cell percentages > or =25% who initiated immediate antiretroviral treatment (the HIV+/ART+ group) or whose antiretroviral treatment was deferred until clinically or immunologically indicated (the HIV+/ART- group). Immune responses were also evaluated in HIV-noninfected infants born to HIV-seronegative (M-/I-) or HIV-positive mothers (M+/I-). Antibody concentrations were similar between HIV+/ART+ and HIV+/ART- infants. However, antibody concentrations were lower in M-/I- infants than in M+/I- infants. Nevertheless, M-/I- infants had superior OPA responses, compared with those in HIV+/ART+ infants, who in turn had better OPA responses, compared with those in HIV+/ART- infants.
Related JoVE Video
Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial.
Lancet
PUBLISHED: 06-19-2010
Show Abstract
Hide Abstract
Expanded access to combination antiretroviral therapy (ART) in resource-poor settings is dependent on task shifting from doctors to other health-care providers. We compared outcomes of nurse versus doctor management of ART care for HIV-infected patients.
Related JoVE Video
Antiretroviral program associated with reduction in untreated prevalent tuberculosis in a South African township.
Am. J. Respir. Crit. Care Med.
PUBLISHED: 06-17-2010
Show Abstract
Hide Abstract
In 2005, we reported high prevalence of untreated pulmonary tuberculosis (TB) in a South African community. Prevalent untreated TB is the main source of transmission. In settings with large burdens of human immunodeficiency virus (HIV) and TB, highly active antiretroviral therapy (HAART) may contribute to TB control.
Related JoVE Video
Body mass index and risk of tuberculosis and death.
AIDS
PUBLISHED: 05-28-2010
Show Abstract
Hide Abstract
High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa.
Related JoVE Video
Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis.
Lancet
PUBLISHED: 05-26-2010
Show Abstract
Hide Abstract
High plasma HIV-1 RNA concentrations are associated with increased risk of HIV-1 transmission. Initiation of antiretroviral therapy (ART) reduces plasma HIV-1 concentrations. We aimed to assess the effect of ART use by patients infected with HIV-1 on risk of transmission to their uninfected partners.
Related JoVE Video
Use of antiretrovirals during pregnancy and breastfeeding in low-income and middle-income countries.
Curr Opin HIV AIDS
PUBLISHED: 01-05-2010
Show Abstract
Hide Abstract
The purpose of the study was to review recent evidence on the use of antiretrovirals during pregnancy and breastfeeding in low-income and middle-income settings.
Related JoVE Video
Isoniazid preventive therapy, HAART and tuberculosis risk in HIV-infected adults in South Africa: a prospective cohort.
AIDS
PUBLISHED: 06-16-2009
Show Abstract
Hide Abstract
The World Health Organization recommends isoniazid preventive therapy (IPT) for preventing tuberculosis in HIV-infected adults, although few countries have instituted this policy. Both IPT and highly active antiretroviral therapy (HAART) used separately result in reductions in tuberculosis risk. There is less information on the combined effect of IPT and HAART. We assessed the effect of IPT, HAART or both IPT and HAART on tuberculosis incidence in HIV-infected adults in South Africa.
Related JoVE Video
Optimization of allele-specific PCR using patient-specific HIV consensus sequences for primer design.
J. Virol. Methods
PUBLISHED: 06-02-2009
Show Abstract
Hide Abstract
Allele-specific PCR based on subtype consensus sequences is a powerful technique for detecting low frequency drug resistant mutants in HIV-1 infected patients. However, this approach can be limited by genetic variation in the region complementary to the primers, leading to variability in allele detection. The goals of this study were to quantify this effect and then to improve assay performance.
Related JoVE Video
Preferences for characteristics of antiretroviral therapy provision in Johannesburg, South Africa: results of a conjoint analysis.
AIDS Behav
PUBLISHED: 05-25-2009
Show Abstract
Hide Abstract
A survey was administered to HIV-infected patients and a sample in Soweto and the Johannesburg inner city to measure preferences for antiretroviral therapy (ART) provision. The 25 to 49-year-old male and female respondents viewed 20 sets of three hypothetical ART clinic choices after reading information on ART. Each set had a permutation of four levels of: monthly ART price, clinic waiting times, HIV clinic branding and clinic staff attitudes. For each set, respondents selected the preferred mix of characteristics and indicated if they would pay for it. For every ZAR 100 (USD PPP 25) increase in price, the average probability of selecting a clinic decreased by 2.8 and 3.0% in the HIV patient and household samples, respectively. Cost as well as staff attitude, wait time, and clinic branding may constitute important barriers to ART uptake and adherence in resource-poor settings.
Related JoVE Video
Population pharmacokinetics of emtricitabine in human immunodeficiency virus type 1-infected pregnant women and their neonates.
Antimicrob. Agents Chemother.
PUBLISHED: 05-20-2009
Show Abstract
Hide Abstract
The objectives of this study were to evaluate emtricitabine (FTC) pharmacokinetics in pregnant women and their neonates and to determine the optimal prophylactic dose for neonates after birth to prevent mother-to-child transmission of human immunodeficiency virus (HIV). A total of 38 HIV-infected pregnant women were administered tenofovir disoproxyl fumarate (300 mg)-FTC (200 mg) tablets-two tablets at the initiation of labor and one daily for 7 days postpartum. By pair, 11 maternal, one cord blood, and two neonatal FTC concentrations were measured using a high-performance liquid chromatography-tandem mass spectrometry validated method and analyzed by a population approach. Model and mean estimates (interpatient variability) were a two-compartment model for mothers, with an absorption rate constant of 0.54 h(-1) (61%), apparent elimination and intercompartmental clearances of 23.2 (17%) and 6.04 liters x h(-1), and apparent central and peripheral volumes of 127 and 237 liters, respectively; an effect compartment linked to maternal circulation for cord blood and a neonatal compartment disconnected, after delivery, with a 10.6-h half-life (30%). After the 400-mg FTC administration, the median population area under the concentration-time curve and the minimal and maximal plasma FTC concentrations in pregnant women were 14.3 mg x liter(-1) x h and 1.68 and 0.076 mg/liter, respectively. At delivery, median (range) predicted maternal and cord blood FTC concentrations were, respectively, 1.16 (0.14 to 1.99) and 0.72 (0.05 to 1.19) mg x liter(-1). We concluded that the 400-mg FTC administration in pregnant women produces higher exposition than does the 200-mg administration in other adults, at steady state. FTC was shown to have good placental transfer (80%). Administering 1 mg FTC/kg as soon as possible after birth or 2 mg/kg 12 h after birth should produce neonatal concentrations comparable to the concentrations observed in adults.
Related JoVE Video
High HIV prevalence among men who have sex with men in Soweto, South Africa: results from the Soweto Mens Study.
AIDS Behav
PUBLISHED: 04-01-2009
Show Abstract
Hide Abstract
The Soweto Mens Study assessed HIV prevalence and associated risk factors among MSM in Soweto, South Africa. Using respondent driven sampling (RDS) recruitment methods, we recruited 378 MSM (including 15 seeds) over 30 weeks in 2008. All results were adjusted for RDS sampling design. Overall HIV prevalence was estimated at 13.2% (95% confidence interval 12.4-13.9%), with 33.9% among gay-identified men, 6.4% among bisexual-identified men, and 10.1% among straight-identified MSM. In multivariable analysis, HIV infection was associated with being older than 25 (adjusted odds ratio (AOR) 3.8, 95% CI 3.2-4.6), gay self-identification (AOR 2.3, 95% CI 1.8-3.0), monthly income less than ZAR500 (AOR 1.4, 95% CI 1.2-1.7), purchasing alcohol or drugs in exchange for sex with another man (AOR 3.9, 95% CI 3.2-4.7), reporting any URAI (AOR 4.4, 95% CI 3.5-5.7), reporting between six and nine partners in the prior 6 months (AOR 5.7, 95% CI 4.0-8.2), circumcision, (AOR 0.2, 95% CI 0.1-0.2), a regular female partner (AOR 0.2, 95% CI 0.2-0.3), smoking marijuana in the last 6 months (AOR 0.6, 95% CI 0.5-0.8), unprotected vaginal intercourse in the last 6 months (AOR 0.5, 95% CI 0.4-0.6), and STI symptoms in the last year (AOR 0.7, 95% CI 0.5-0.8). The results of the Soweto Mens Study confirm that MSM are at high risk for HIV infection, with gay men at highest risk. HIV prevention and treatment for MSM are urgently needed.
Related JoVE Video
Tolerance and viral resistance after single-dose nevirapine with tenofovir and emtricitabine to prevent vertical transmission of HIV-1.
AIDS
PUBLISHED: 03-25-2009
Show Abstract
Hide Abstract
Viral resistance occurs with high frequency after single-dose nevirapine. We aimed to evaluate the safety and resistance profiles of a combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) in HIV-1-infected pregnant women and their newborns.
Related JoVE Video
Women exposed to single-dose nevirapine in successive pregnancies: effectiveness and nonnucleoside reverse transcriptase inhibitor resistance.
AIDS
PUBLISHED: 03-17-2009
Show Abstract
Hide Abstract
To assess the impact of prior exposure to single-dose nevirapine (sdNVP) on mother-to-child transmission and genotypic resistance in HIV-infected women.
Related JoVE Video
Costs of providing care for HIV-infected adults in an urban HIV clinic in Soweto, South Africa.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 02-06-2009
Show Abstract
Hide Abstract
As access to antiretroviral therapy (ART) in sub-Saharan Africa expands, estimates of the costs of initiating and maintaining patients on ART are important to program planning, budgeting, and cost-effectiveness analyses.
Related JoVE Video
Efficacy of short-course AZT plus 3TC to reduce nevirapine resistance in the prevention of mother-to-child HIV transmission: a randomized clinical trial.
PLoS Med.
PUBLISHED: 01-23-2009
Show Abstract
Hide Abstract
Single-dose nevirapine (sdNVP)-which prevents mother-to-child transmission of HIV-selects non-nucleoside reverse-transcriptase inhibitor (NNRTI) resistance mutations in the majority of women and HIV-infected infants receiving it. This open-label, randomised trial examined the efficacy of short-course zidovudine (AZT) and lamivudine (3TC) with sdNVP in reducing NNRTI resistance in mothers, and as a secondary objective, in infants, in a setting where sdNVP was standard-of-care.
Related JoVE Video
Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study.
PLoS ONE
PUBLISHED: 01-13-2009
Show Abstract
Hide Abstract
The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort.
Related JoVE Video
Test and tell: correlates and consequences of testing and disclosure of HIV status in South Africa (HPTN 043 Project Accept).
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 01-10-2009
Show Abstract
Hide Abstract
As the numbers of HIV-positive diagnoses rise in South Africa, it is important to understand the determinants and consequences of HIV disclosure.
Related JoVE Video
PEPFARs evolving HIV prevention approaches for key populations--people who inject drugs, men who have sex with men, and sex workers: progress, challenges, and opportunities.
J. Acquir. Immune Defic. Syndr.
Show Abstract
Hide Abstract
In most countries, the burden of HIV among people who inject drugs, men who have sex with men, and sex workers is disproportionately high compared with that in the general population. Meanwhile, coverage rates of effective interventions among those key populations (KPs) are extremely low, despite a strong evidence base about the effectiveness of currently available interventions. In its first decade, Presidents Emergency Plan for AIDS Relief (PEPFAR) is making progress in responding to HIV/AIDS, its risk factors, and the needs of KPs. Recent surveillance, surveys, and size estimation activities are helping PEPFAR country programs better estimate the HIV disease burden, understand risk behavior trends, and determine coverage and resources required for appropriate scale-up of services for KPs. To expand country planning of programs to further reduce HIV burden and increase coverage among KPs, PEPFAR has developed a strategy consisting of technical documents on the prevention of HIV among people who inject drugs (July 2010) and prevention of HIV among men who have sex with men (May 2011), linked with regional meetings and assistance visits to guide the adoption and scale-up of comprehensive packages of evidence-based prevention services for KPs. The implementation and scaling up of available and targeted interventions adapted for KPs are important steps in gaining better control over the spread and impact of HIV/AIDS among these populations.
Related JoVE Video
Cervical intra-epithelial neoplasia in HIV-positive women after excision of transformation zone - does the grade change?
S. Afr. Med. J.
Show Abstract
Hide Abstract
After previously reporting the presence of disease by cytology findings after treatment for cervical intra-epithelial neoplasia (CIN) in 64.6% of HIV-infected women and in 13.0% of HIV-negative women, we aimed to determine the severity of cytological disease after treatment in HIV-infected women.
Related JoVE Video
Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings.
BMC Infect. Dis.
Show Abstract
Hide Abstract
Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART.
Related JoVE Video
Nevirapine- versus lopinavir/ritonavir-based initial therapy for HIV-1 infection among women in Africa: a randomized trial.
PLoS Med.
Show Abstract
Hide Abstract
Nevirapine (NVP) is widely used in antiretroviral treatment (ART) of HIV-1 globally. The primary objective of the AA5208/OCTANE trial was to compare the efficacy of NVP-based versus lopinavir/ritonavir (LPV/r)-based initial ART.
Related JoVE Video
Frequent emergence of N348I in HIV-1 subtype C reverse transcriptase with failure of initial therapy reduces susceptibility to reverse-transcriptase inhibitors.
Clin. Infect. Dis.
Show Abstract
Hide Abstract
It is not known how often mutations in the connection and ribonuclease H domains of reverse transcriptase (RT) emerge with failure of first-line antiretroviral therapy (ART) in subtype C human immunodeficiency virus type 1 (HIV-1) infection and how these mutations affect susceptibility to other antiretrovirals.
Related JoVE Video
The reliability of point-of-care CD4 testing in identifying HIV-infected pregnant women eligible for antiretroviral therapy.
J. Acquir. Immune Defic. Syndr.
Show Abstract
Hide Abstract
Point-of-care (POC) CD4 testing may play an important role in identifying individuals who require antiretroviral therapy (ART), particularly during pregnancy. However, there have been no evaluations of POC CD4 testing in pregnant women. We compared the performance of the PIMA POC analyzer with laboratory-based testing in identifying pregnant women eligible for ART.
Related JoVE Video
Blood Lactate in HIV-Infected Children on Antiretroviral Therapy in Rural South Africa.
Pediatr. Infect. Dis. J.
Show Abstract
Hide Abstract
We studied blood lactate levels in 253 South African children on antiretroviral therapy (ART). The prevalence of hyperlactatemia was 68% and severity was mild in most cases (69%). There was no association of symptoms and/or signs with hyperlactatemia. Independent predictors were lipodystrophy, time on ART and baseline CD4 count. Increased awareness of hyperlactatemia in African children on ART is warranted.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.