Equity in HIV/AIDS services requires optimization of mainstreaming sectors in Ethiopia.

BACKGROUND: Mainstreaming HIV and AIDS across sectors is crucial to close the disparities in service provision and coverage. However, evidence has shown that certain social groups are left behind in receiving HIV/AIDS services. The objective of this study was twofold: to understand the reasons behind the existing inequities and to explore challenges of equity in HIV/AIDS services in the Amhara region of Ethiopia. METHODS: Twenty-two adults (aged 26-57 years) from eighteen sectors that are mainstreaming HIV and AIDS were purposefully selected until the point of saturation and participated in a semi-structured in-depth interview conducted between January 20 and February 17, 2023. Interviewees were asked to describe their mainstreaming experiences in equitable HIV/AIDS services, reflect on the challenges and barriers that impede equitable service provision, or explain the reasons behind the existence of inequity in HIV/AIDS services. The interviews were audio recorded, transcribed, translated, and iteratively analysed, with early analysis informing subsequent interviews. An inductive-reflexive thematic analysis was conducted, whereby themes and subthemes were identified, and the relationships between subthemes and patterns were critically reviewed. RESULTS: The challenges to equitable HIV/AIDS service provision were grouped into eight thematic areas: (1) changing contexts that shifts public and government attention to emerging diseases, war and political instability, and poverty; (2) leadership-related, such as the lack of supervision and monitoring, not politicising HIV/AIDS (not providing political attention to HIV/AIDS) and weak intersectoral collaboration; (3) financial constraints due to a random budgeting and contract interruption with non-governmental organisations (NGOs); (4) lack of resources due to scarcity and unfair distribution; (5) inadequate skilled personnel due to inadequate numbers and lack of continuous professional and career development; (6) lack of equity-related evidence-based tools and guidelines; (7) inadequate understanding of equity due to lack of training and misunderstanding, and lack of access to equity-oriented tools and guidelines; and (8) cultural norms, values, and perceptions. CONCLUSIONS: This study identified critical challenges faced in the equitable HIV/AIDS services provision. To achieve equity in HIV/AIDS services, mainstreaming sectors need to invest in mechanisms to sustain services in emergency situations; identify effective leaders to maintain collaboration, monitoring, and evaluation; institutionalise responsive budgeting and establish alternative funds to maintain non-governmental organisations initiatives; provide continuous up-to-date training and create a common evidence-sharing platform; implement proper recruitment, education, and professional development of HIV/AIDS focal persons; and promote and practice culturally safe care. It is, therefore, essential to optimise sectors that are mainstreaming HIV/AIDS and incorporate equity considerations in their strategic plans and working guidelines.

The Ryan White HIV/AIDS Program: Thirty Years of Addressing Health Disparities.

The Ryan White HIV/AIDS Program is a unique federal program to provide HIV care, treatment, and support services for people living with HIV in the United States. Through the distinctive structure of the program that allows for addressing both medical needs and some of the social determinants of health that can pose barriers to accessing care, the program has been instrumental in improving outcomes for people with HIV with documented improvement in HIV viral suppression and decreased disparities in that outcome over the past decade. To reach the goal of ending the HIV epidemic in the U.S., the program must expand services to people with HIV who are not regularly engaged in medical care.

["Revealing in the gerund": secrecy and stigma in practices of care for children and adolescents living with HIV/Aids]. / "Revelando", no gerúndio: segredo e estigma nas práticas de cuidado às crianças e adolescentes vivendo com HIV/Aids.

This article analyzes practices of care and the HIV diagnosis disclosure process to children and adolescents living with HIV/AIDS. A case study was conducted in an outpatient clinic located in a public hospital in Rio de Janeiro through participant observation, semi-structured interviews with health professionals, and the consultation of documents produced by the professionals. The analysis, based on the sociology of Simmel and Goffman, points to the revelation of the diagnosis as a hallmark that accompanies all the care established with users and sheds light on issues such as secrecy, stigma and the possible understandings about the health condition established. As a result, institutionalized relationships contribute to a progressive contact with the condition of bearing a stigma and enable phases of a patient's life protected by information to exist.

O artigo analisa as práticas de cuidado e o processo de revelação do diagnóstico a crianças e adolescentes vivendo com HIV/Aids. Foi realizado um estudo de caso em um ambulatório localizado em um hospital público do Rio de Janeiro (RJ), através de observação participante, entrevistas semiestruturadas com profissionais de saúde e consulta a documentos produzidos pelos profissionais. A análise, baseada na sociologia de Simmel e Goffman, aponta a revelação do diagnóstico como uma marca que acompanha todo o cuidado estabelecido com os usuários e dá luz a questões como o segredo, o estigma e as possíveis compreensões acerca da condição de saúde estabelecidas. Com isso, as relações institucionalizadas contribuem para um progressivo contato com a condição de portador de um estigma e fazem existir fases de uma carreira de doente protegido pela informação.

Determinants of HIV/AIDS treatment and care service quality in Woliso Town, Oromia, Ethiopia: in the case of HIV prevention and control project.

In Ethiopia, even though there is an effort to increase ART services, different challenges remain in the provision of HIV/AIDS treatment and care services, and little has been done to evaluate patient satisfaction levels. The purpose of this study is to assess the determinants of HIV/AIDS treatment and care service quality. A facility-based cross-sectional study was conducted during from October 2023 to November 2023 in Woliso Town. The total sample size was generated using a systematic random sampling method from the source population. The results of the study showed that client satisfaction with HIV/AIDS treatment and care service quality was 272 (81.4%) with 95% CI: 76.9-85.3%. Government employees were 67% less likely to be satisfied with HIV/AIDS treatment and care service quality (AOR = 0.33 95% CI: 0.11, 0.99) when compared to unemployed clients. The odds of client satisfaction were 6.72 times higher among study participants who do not have health insurance membership cards (AOR = 6.72 95% CI: 3.42, 13.91) compared to those who have health insurance membership cards. The odds of client satisfaction were 2.77 times higher among study participants who reported the availability of community referral for any social support (AOR = 2.77 95% CI: 1.12, 6.84) when compared to those who did not report. Those study participants for whom privacy was kept during the examination were 8.67 times higher to be satisfied (AOR = 8.67 95% CI: 2.53, 29.68) compared to those for whom privacy was not kept during the examination. In conclusion, the client satisfaction on HIV/AIDS treatment and care service quality was relatively high in the study area. Occupational status, health insurance membership cards, availability of community referral for any social support and keeping privacy during examination have significant associations with HIV/AIDS treatment and care service quality in terms of client satisfaction.

Palliative care considerations for the older adults with HIV/AIDS: a clinical practice review.

Human immunodeficiency virus (HIV) has historically been viewed as a terminal condition affecting younger populations, however, with advancements in antiretroviral therapy (ART) and better healthcare provisions, people with HIV are now living longer than ever before. This shift has highlighted the need to readdress the end-of-life care needs of patients aging with HIV. People aging with HIV face a double burden. Aging itself comes with an array of health challenges, including cognitive decline, frailty, and increased susceptibility to chronic illnesses. Despite effective management with ART, HIV is associated with ongoing inflammation, and may accelerate aging processes, increasing the risk of certain cancers and comorbidities, as well as an increased risk of cardiovascular disease. The stigma surrounding HIV, though diminished over the years, still lingers. People living with HIV have experienced decades of intersecting stigmatized identities in the context of social isolation, leading to potential psychological challenges like depression, anxiety, and loneliness, all of which may be amplified by aging. Addressing these emotional and social needs is as crucial as managing their physical health. The integration of primary palliative care into geriatric practice is crucial, as it improves the quality of life for older patients with chronic illnesses, life-limiting conditions. This is particularly relevant for aging individuals with HIV, who often face complex medical needs and multiple comorbidities. Primary palliative care is the basic, integrated palliative care support provided by non-specialists as part of routine care, while specialist palliative care involves more complex and specialized support from a team with specific training in palliative care. Incorporating palliative care principles enables geriatric healthcare providers to address these comprehensive needs more effectively. This approach encompasses not only physical symptom management but also the emotional well-being of patients. It aids in advanced care planning and decision-making that resonate with the patients' values and goals. Ultimately, this integrated approach leads to improved patient outcomes and a higher quality of care. This review delves into the unique considerations and challenges of providing palliative care to people aging with HIV, recognizing the interplay of age and HIV in the era of modern ART.

Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China.

Improving access to HIV/AIDS healthcare services is of great concern to government and policymakers striving to strengthen overall public health. How to reasonably allocate HIV/AIDS healthcare resources and maximize the equality of access to healthcare services across subdistrict areas has become an urgent problem to be solved. However, there is limited research on this topic in China. It is necessary to evaluate spatial accessibility to improve the accessibility and equity of HIV/AIDS healthcare services. In this study, the improved multi-modal two-step floating catchment area (2SFCA) and inverted 2SFCA (i2SFCA) methods are used to measure the spatial accessibility of HIV/AIDS healthcare services and the crowdedness of the healthcare sites in Shandong Province, China. Then, the theoretical supply and the optimal spatial distribution of resources are calculated and visualized by minimizing the accessibility gaps between demand locations. This study showed that the spatial accessibility of HIV/AIDS service resources in Shandong Province was concentrated and unevenly distributed, and the accessibility scores in the marginal areas of prefecture-level cities were significantly lower than those in other areas. Regions with a large number of doctors had significantly higher levels of spatial accessibility. The ART accessibility scores in the southwest of Shandong Province were higher than those in other regions. As the travel friction coefficient increased, the accessibility scores formed an approximately circular cluster distribution centered on the healthcare sites in geographical distribution. More ART drugs needed to be supplied in marginal areas and more doctors were needed to work on HIV/AIDS in urban areas to address the spatial distribution imbalance of HIV/AIDS healthcare services. This study profoundly analyzed the spatial accessibility of HIV/AIDS healthcare services and provided essential references for decision-makers. In addition, it gives a significant exploration for achieving the goal of equal access to HIV/AIDS healthcare services in the future.

The CRISPR-Cas9 induced CCR5 Δ32 mutation as a potent gene therapy methodology for resistance to HIV-1 variant: a review.

Human Immunodeficiency Virus (HIV) has continuously been the greatest epidemic for humanity over a period spanning almost five decades. With no specific cure or treatment available to date despite extensive research, the C-C Chemokine Receptor 5, Delta 32 (CCR5 Δ32) allele genetic point mutation plays an imperative role in the prevention of acquired immunodeficiency syndrome (AIDS). This comprehensive study aims to review the induction of the homozygous recessive deletion genotype using the Clustered Regularly Interspaced Short Palindromic Repeats, Cas 9 Enzyme (CRISPR-Cas9), and hematopoietic stem cell transplantation under positive selection pressure for active immunity in seropositive patients' populations as the phenotype. A methodology is proposed to trigger a significant increase in the expression of Delta 32 beneficial mutant alleles within controlled modern healthcare facilities utilizing totipotent stem cells through somatic gene therapy. It acts upon two dysfunctional CCR5 genes, translating mutant G protein-coupled co-receptors, whose primary function is similar to that of C-X-C Motif Chemokine receptor 4 (CXCR4), by blocking the entry of viral RNA into the CD4+ T helper lymphocytes, halting infection and seizing viral life cycle. This modification is endemic in Northern Europe, where it naturally pertains to the Caucasian descent population samples in the form of polymorphism, p (X=0.01), where X is the probability of frequency of complete immunity against HIV-1 in population samples. The epigenetics of the single nucleotide polymorphism (SNP) are analyzed as they play a significant role in immunity distribution. Furthermore, a comparative analysis within the ethical boundaries of CRISPR-Cas9 is conducted to discuss the practical aspects and challenges of the presented methodologies and treatment alternatives. Additionally, the study assembles all available data and summarizes preexisting research while providing a promising solution to this ethical dilemma. Finally, a methodology is devised to answer the question of whether the variant-specific epidemic of AIDS caused by HIV-1 can be cured via artificially inducing immunity by CRISPR-Cas9.

Impact of exercise training and diet therapy on the physical fitness, quality of life, and immune response of people living with HIV/AIDS: a randomized controlled trial.

BACKGROUND: Exercise and dietary nutrition are considered crucial in human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) treatment protocols and people living with HIV/AIDS (PLWHA) rehabilitation care. However, there is no well-studied research evaluating the effects of combined interventions on the fitness and immune systems of PLWHA. Therefore, this study aimed to analyze the effects of exercise and dietary intervention on physical fitness, quality of life and immune response in PLWHA. METHODS: This was an experimental study, with a sample of 25 male PLWHA divided into two groups: the intervention group (IG: 12 participants) and the control group (CG: 13 participants). All participants have not had any exercise habits and nutritional supplements in the past six months. The participants in the IG completed 45 min of exercise (60-80% HRmax) 4 times per week for 4 weeks. The exercise was in the form of brisk walking or running. They were also given a nutritional dietary supplement 3 times a day for 4 weeks. The 13 individuals in the CG continued their normal daily life (physical activity and diet). The following parameters were evaluated before and after the intervention: body composition, physical fitness, immune response, quality of life (QoL), stress, dietary behavior, dietary habits, exercise motivation, and physical self-efficacy. RESULTS: The significant changes were observed in burnout of stress variables and physical efficiency index (PEI) of physical fitness in the IG (p =.023). Moreover, in the saliva samples, sal-T levels significantly increased only after the intervention in the IG (p =.012). Additionally, regarding the analysis of the interaction (group × time), there was a significant improvement in the reaction speed (p =.001) and grip strength (left: p =.002, right: p =.030) and a significant difference in physical satisfaction in QoL (p =.001), stress burnout (p =.043), self-confidence in physical efficacy (p =.045), external display (p =.008), and fulfillment (p =.047) in exercise motivation. Moreover, the significant effect of the intervention on emotional eating in dietary behavior was shown in the comparison of the IG before and after intervention (p =.001) and in the comparison of the IG group with the CG after the experiment (p =.013). However, there was no significant effect of time or interaction between the condition and time on body composition. CONCLUSIONS: In conclusion, exercise training and diet therapy caused changes in physical fitness and Sal-T levels, which had positive effects on the health promotion of PLWHA.

Mental Health and Treatment Engagement among Low-Income Women of Color Living with HIV.

Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified.

Prevalence and treatment of HIV/AIDS in Pakistani population: A retrospective study.

HIV/AIDS epidemic poses an emerging threat around the world. An estimated 0.1% of people aged 15 to 49 years have been infected with HIV/AIDS in Pakistan during the last few years. This research study aims to analyse the prevalence and treatment/management of HIV/AIDS among the Pakistani population aged 15 to 45 years from 1990 to 2020 and this research data was collected during the year 2021. The analysis was done by using E-views software. Descriptive statistical analysis, correlation coefficient, unit root analysis, and linear regression analysis were used. Results indicated that there is low awareness regarding AIDS in the population and there is a significant link between prevalence and population increase, i.e. with the increase in population the prevalence of AIDS also increases. Findings are discussed in terms of implications for prevention and education of HIV/AIDS in Pakistan's population.

Abandono de la terapia antirretroviral entre adolescentes y jóvenes con VIH/SIDA durante el COVID-19: un estudio de casos y controles / Antiretroviral therapy abandonment among adolescents and young people with HIV/AIDS during COVID-19: A case-control study / Abandono da terapia antirretroviral entre adolescentes e jovens com HIV/aids durante a COVID-19: estudo caso-controle

Objetivo: identificar los factores asociados al abandono de la terapia antirretroviral entre adolescentes y jóvenes que vivían con VIH/sida durante la pandemia de COVID-19. Método: estudio de casos y controles realizado entre 2020 y 2021 en Maringá, Paraná. Los casos fueron: adolescentes y jóvenes (10 a 24 años) diagnosticados con VIH/sida y que abandonaron el tratamiento, mientras que el grupo de controles fue compuesto por personas con características sociodemográficas semejantes, diagnosticadas con VIH/sida, sin historia de abandono del tratamiento. El emparejamiento de casos y controles se hizo por conveniencia, con cuatro controles por cada caso. El instrumento de investigación presentó variables sociodemográficas y clínicas, entre otras y la asociación con el abandono del tratamiento se analizó por regresión logística. Resultados: se incluyeron 27 casos y 109 controles en el estudio (proporción 1/4). La variable asociada con mayor probabilidad de abandono fue la edad próxima a 22,8 años (ORaj:1,47; IC 95%:1,07-2,13; p=0,024). El uso esporádico del preservativo (ORaj:0,22; IC 95%:0,07-0,59; p=0,003) y padecer una infección oportunista (OR:0,31; IC 95%:0,10-0,90; p=0,030) fueron factores protectores. Conclusión: la edad próxima a los 23 años en la última visita se asoció al abandono de la terapia antirretroviral. La presencia de infección oportunista y el uso de preservativos son factores determinantes para la continuidad del tratamiento durante el COVID-19.

Objective: to identify the factors associated with antiretroviral therapy abandonment among adolescents and young people living with HIV/AIDS during the COVID-19 pandemic. Method: a case-control study carried out between 2020 and 2021 in Maringá, Paraná. The cases corresponded to the following: adolescents and young people (aged from 10 to 24 years old) diagnosed with HIV/AIDS and who abandoned treatment, while the Control Group consisted of people with similar sociodemographic characteristics, diagnosed with HIV/AIDS and with no history of treatment abandonment. Pairing of the cases and controls was by convenience, with four controls for each case. The research instrument presented sociodemographic variables, clinical characteristics and others, whose association with treatment abandonment was analyzed by means of logistic regression. Results: a total of 27 cases and 109 controls were included in the study (1/4 ratio). The variable associated with an increased chance of abandonment was age close to 22.8 years old (ORadj: 1.47; 95% CI: 1.07-2.13; p=0.024). Sporadic condom use (ORadj: 0.22; 95% CI: 0.07-0.59; p=0.003) and having an opportunistic infection (OR: 0.31; 95% CI: 0.10-0.90; p=0.030) were protective factors. Conclusion: age close to 23 years old at the last consultation was associated with antiretroviral therapy abandonment. The presence of opportunistic infections and condom use are determining factors for treatment continuity during COVID-19.

Objetivo: identificar os fatores associados ao abandono da terapia antirretroviral entre adolescentes e jovens vivendo com HIV/aids durante a pandemia de COVID-19. Método: estudo caso-controle realizado entre 2020 e 2021 em Maringá, Paraná. Os casos foram: adolescentes e jovens (10 a 24 anos) diagnosticados com HIV/aids e que abandonaram o tratamento, enquanto o grupo dos controles foi composto por pessoas com características sociodemográficas semelhantes, diagnosticadas com HIV/aids, sem histórico de abandono de tratamento. O pareamento dos casos e controles foi por meio de conveniência, sendo quatro controles para cada caso. O instrumento de pesquisa apresentou variáveis sociodemográficas, características clínicas e outras, cuja associação com o abandono do tratamento foi analisada por meio de regressão logística. Resultados: 27 casos e 109 controles foram incluídos no estudo (proporção 1/4). A variável associada à maior chance de abandono foi idade próxima de 22,8 anos (ORaj.:1,47; IC95%:1,07-2,13; p=0,024). O uso esporádico de preservativo (ORaj:0,22; IC95%:0,07-0,59; p=0,003) e ter infecção oportunista (OR:0,31; IC95%:0,10-0,90; p=0,030) foram fatores de proteção. Conclusão: idade próxima a 23 anos na última consulta foi associada ao abandono da terapia antirretroviral. A presença de infecção oportunista e o uso de preservativo são fatores determinantes para continuidade do tratamento durante a COVID-19.

Inclusion of nutritional counseling and mental health services in HIV/AIDS management: A paradigm shift.

Human immunodeficiency virus (HIV) infection is a public health challenge that can degenerate into acquired immunodeficiency syndrome (AIDS) if not properly managed. HIV infection shortens life expectancy to about 5 to 10 years compared to noninfected individuals. People living with HIV/AIDS (PLWHA) are prone to several health challenges as a result of a deranged immune system culminating in high morbidity and mortality. Depression is a common feature of PLWHA. Depression heightens the emergence of opportunistic infections in HIV-infected individuals, accelerates the progression to AIDS, and increased suicidal tendencies, morbidity, and mortality. Food insecurity with its resultant undernutrition contributes to HIV/AIDS-related deaths. Undernourished PLWHA are more prone to opportunistic infections due to poor immunity. Interestingly, proper diet intake can boost immunity, slow the progression of AIDS and opportunistic infections, enhance body weight, and retard depression tendencies. Undernutrition can also be ameliorated by incorporating nutritional counseling and oral nutrient supplementation in routine HIV/AIDS checkups. Therefore, to increase HIV/AIDS management outcomes, the integration of nutrition counseling, dietary supplements, and mental health services should be embraced. Thus, HIV/AIDS care centers should amplify these services. In this article, we isolated relevant studies from various databases, illuminated the interwoven relationship between HIV/AIDS, depression, and undernutrition, and also reemphasized the need for adequate nutritional intervention in the battle against HIV/AIDS. Thus, this study provides a reawakening call to focus on incorporating nutritional guides and mental health care in HIV/AIDS management protocols.

How Do People Living With HIV (PLHIV) and AIDS Feel About the Quality of Care They Received Amid the COVID-19 Pandemic in Lagos, Nigeria?

Background: This study aimed to assess the perception of quality of care among people living with HIV (PLHIV) in Lagos, Nigeria, and identify factors influencing their perceptions. Methodology: The study was a descriptive cross-sectional survey conducted between December 2020 and March 2021 among 578 PLHIVs drawn from various healthcare facilities in Lagos where HIV care and treatment services were provided. Data were collected through pretested questionnaires and analyzed using Stata SE 12. Results: About 83% of the respondents had a good attitude toward their HIV medication, and 95.5% had a good perception of the quality of care they received. PLHIVs with higher education, skilled or professional occupations and higher monthly income had a significantly higher perception of quality of care compared to others (P < .05). Conclusion: The PLHIV in Lagos had a positive attitude toward their medication and a good perception of the quality of care they received during the COVID-19 pandemic. All stakeholders' efforts should be sustained for continuous quality improvement in HIV care in Lagos.

PEPFAR at 20-Looking Back and Looking Ahead.

This Viewpoint looks at PEPFAR (the United States President's Emergency Plan for AIDS Relief) from its inception to today, including successes and goals for the future to help care for people worldwide living with HIV.

The impact of the COVID-19 pandemic on the provision of HIV/AIDS-related services in Iran: a qualitative study.

BACKGROUND: Providing services to people living with HIV (PLWH) faced many challenges during the COVID-19 pandemic. This study aimed to examine the impact of the COVID-19 pandemic on providing HIV/AIDS-related services in Iran. METHODS: In this qualitative study, the participants were included by purposive sampling between November 2021 and February 2022. Virtually focused group discussion (FGD) meetings were conducted with the first group including policymakers, service providers, and researchers (n = 17), and the interviews were conducted telephonic and face-to-face using a semi-structured guide with the second group including people who received services (n = 38). Data were analyzed by content analysis using the inductive method in MAXQDA 10 software. RESULTS: Six categories were obtained, including mostly affected services, ways of the effect of COVID-19, healthcare systems reaction, effects on social inequality, opportunities created by the pandemic, and suggestions for the future. In addition, people who received services believed the COVID-19 pandemic has affected their life in several ways, including getting COVID-19, mental and emotional problems during the pandemic, financial problems, changes in the care plan, and changes in high-risk behaviors. CONCLUSION: Considering the level of community involvement with the issue of COVID-19 and the shock caused by the pandemic, as mentioned by the world health organization, it is necessary to improve health systems' resilience for better preparedness for similar conditions.

Disciplined appetites: Reimagining food and nutrition programs for people living with HIV and AIDS.

AIMS: Medical nutrition therapy is recommended for people living with HIV/AIDS to improve health and wellness; however, there is a lack of food and nutrition programs for people living with HIV/AIDS in Nova Scotia, Canada. The aim of this study was to explore the beliefs, values, and experiences of people living with HIV/AIDS in relation to food and nutrition programs. METHODS: A critical social theory lens with two disciplinary contexts: critical health geography and critical dietetics guided this research. Semi-structured interviews were conducted with 12 people living with HIV/AIDS and analysed for themes. RESULTS: The three main themes were identified: (1) intersections of social determinants of health, wellness, and food security; (2) discursive shaping of food and nutrition in relation to HIV; and (3) the dynamic nature of HIV care. CONCLUSIONS: Participants offered recommendations on how food and nutrition programs might be reimagined to be more accessible, inclusive, and effective for people living with HIV/AIDS.

Modelling Botswana's HIV/AIDS response and treatment policy changes: Insights from a cascade of mathematical models.

The management of HIV/AIDS has evolved ever since advent of the disease in the past three decades. Many countries have had to revise their policies as new information on the virus, and its transmission dynamics emerged. In this paper, we track the changes in Botswana's HIV/AIDS response and treatment policies using a piece-wise system of differential equations. The policy changes are easily tracked in three epochs. Models for each era are formulated from a "grand model" that can be linked to all the epochs. The grand model's steady states are determined and analysed in terms of the model reproduction number, $ R_{0}. $ The model exhibits a backward bifurcation, where a stable disease-free equilibrium coexists with a stable endemic equilibrium when $ R_{0} < 1. $ The stability of the models for the other epochs can be derived from that of the grand model by setting some parameters to zero. The models are fitted to HIV/AIDS prevalence data from Botswana for the past three decades. The changes in the populations in each compartment are tracked as the response to the disease and treatment policy changed over time. Finally, projections are made to determine the possible trajectory of HIV/AIDS in Botswana. The implications of the policy changes are easily seen, and a discussion on how these changes impacted the epidemic are articulated. The results presented have crucial impact on how policy changes affected and continue to influence the trajectory of the HIV/AIDS epidemic in Botswana.

A CRISPR-Cas Cure for HIV/AIDS.

Human immunodeficiency virus (HIV) infections and HIV-induced acquired immunodeficiency syndrome (AIDS) continue to represent a global health burden. There is currently no effective vaccine, nor any cure, for HIV infections; existing antiretroviral therapy can suppress viral replication, but only as long as antiviral drugs are taken. HIV infects cells of the host immune system, and it can establish a long-lived viral reservoir, which can be targeted and edited through gene therapy. Gene editing platforms based on the clustered regularly interspaced palindromic repeat-Cas system (CRISPR-Cas) have been recognized as promising tools in the development of gene therapies for HIV infections. In this review, we evaluate the current landscape of CRISPR-Cas-based therapies against HIV, with an emphasis on the infection biology of the virus as well as the activity of host restriction factors. We discuss the potential of a combined CRISPR-Cas approach that targets host and viral genes to activate antiviral host factors and inhibit viral replication simultaneously. Lastly, we focus on the challenges and potential solutions of CRISPR-Cas gene editing approaches in achieving an HIV cure.

Advancements in Cell-Based Therapies for HIV Cure.

The treatment of human immunodeficiency virus (HIV-1) has evolved since the establishment of combination antiretroviral therapy (ART) in the 1990s, providing HIV-infected individuals with approaches that suppress viral replication, prevent acquired immunodeficiency syndrome (AIDS) throughout their lifetime with continuous therapy, and halt HIV transmission. However, despite the success of these regimens, the global HIV epidemic persists, prompting a comprehensive exploration of potential strategies for an HIV cure. Here, we offer a consolidated overview of cell-based therapies for HIV-1, focusing on CAR-T cell approaches, gene editing, and immune modulation. Persistent challenges, including CAR-T cell susceptibility to HIV infection, stability, and viral reservoir control, underscore the need for continued research. This review synthesizes current knowledge, highlighting the potential of cellular therapies to address persistent challenges in the pursuit of an HIV cure.