Human Immunodeficiency Virus/acquired Immunodeficiency Syndrome (human + immunodeficiency_virus_immunodeficiency_syndrome)

Distribution by Scientific Domains

Selected Abstracts

The well-being of gays, lesbians and bisexuals in Botswana

V.J. Ehlers BA BSSc MA DLitt RGN RM
The well-being of gays, lesbians and bisexuals in Botswana Aims.,To investigate the level of well-being of gays, lesbians and bisexuals (GLBs) in Botswana, how this level of well-being could be promoted and whether their health care needs were met by health care professionals. Rationale.,It is illegal to engage in same-sex activities in Botswana, punishable by imprisonment. Although Botswana's citizens have one of Africa's best health care systems, little is known about the health status, health care needs and general well-being of Botswana's GLBs. This survey attempted to uncover some of these potential health care needs, impacting on the GLBs' well-being. Design/methods.,The research framework adopted was the health and human rights approach, placing dignity before rights. A survey design, with structured questionnaires, was used. Snow-ball sampling techniques were used. Results.,Results indicated that varying degrees of distress were experienced by 64% of the GLBs in this study. The GLBs identified a need for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and had concerns about their general health, discrimination against them and vulnerability to violence including sexual assaults. Conclusions.,The well-being of the GLBs in Botswana was influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Health care professionals played insignificant roles in the promotion of GLBs' well-being, and could make greater inputs into health education efforts, and more significant contributions towards enhancing the GLBs' levels of well-being. Enhanced collaboration between health professionals and human rights activists are recommended to reduce violations of Botswana's GLBs' dignity and to improve their quality of life, including enhanced access to and utilization of health care services. [source]

Implementing a community intervention to reduce young people's risks for getting HIV: Unraveling the complexities

Maretha J. Visser
The ineffectiveness of community-based interventions can often be traced to problems that occur during implementation. In this study, we outline the implementation of a human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) prevention program in an educational setting in South Africa. An action research approach was used in the implementation of the intervention and a process and outcome evaluation, integrating qualitative and quantitative research methods, was made. The research illustrated the various levels of interaction in the community and the complexity of the processes involved in the implementation of interventions to facilitate community change. Social ecological theory, systems theory, and the social constructional approach are used to clarify the complexities of the implementation of community interventions. 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 145,165, 2004. [source]

Patents and Access to Antiretroviral Medicines in Vietnam after World Trade Organization Accession

Jakkrit Kuanpoth
Antiretroviral (ARV) drugs, where they are accessible, have been shown to prolong the lives and increase the health and well-being of people living with human immunodeficiency virus/acquired immunodeficiency syndrome. In general terms, whether a country is able to provide affordable ARVs to people in need is determined by the pricing structure of the drugs, which is in turn based on the patent environment that regulates them. Increasing access in many developing countries, including Vietnam, requires a thorough understanding of the patent environment and of the legal options that will allow the production and/or importation of affordable treatments. This article provides an analysis of current patent law in Vietnam with regard to the production and importation of pharmaceuticals. It then reviews the current situation of supply of ARVs with regard to pharmaceutical patents and Vietnam's obligations and practices against international agreements. The study concludes by suggesting options for utilizing current law to improve access to ARVs and makes recommendations for the implementation of Vietnamese patent law. [source]

Onychomycosis in clinical practice: factors contributing to recurrence

R.K. Scher
Summary The treatment of onychomycosis has improved in recent years and many patients can now expect a complete and lasting cure. However, for up to 25% of patients, persistent disease remains a problem, thus presenting a particular challenge to the clinician. For these patients, it is obviously important to ensure that a correct diagnosis of onychomycosis has been made, as misdiagnosis will inevitably jeopardize the perception of therapeutic effectiveness. Although onychomycosis accounts for about 50% of all nail diseases seen by physicians, nonfungal causes of similar symptoms include repeated trauma, psoriasis, lichen planus, local tumours vascular disorders and inflammatory diseases. Predisposing factors that contribute to a poor response to topical and/or oral therapy include the presence of a very thick nail, extensive involvement of the entire nail unit, lateral nail disease and yellow spikes. However, poor penetration of systemic agents to the centre of infection, or the inability of topical agents to diffuse between the surface of the nail plate and the active disease below, probably contributes to this. Other factors contributing to recurrence may be related to the patient's family history, occupation, lifestyle or underlying physiology. In addition, patients with concomitant disease (e.g. peripheral vascular disease, diabetes) or patients who are immunosuppressed (e.g. those with human immunodeficiency virus/acquired immunodeficiency syndrome) are more susceptible to onychomycosis. In the elderly, the prevalence of onychomycosis may be as high as 60%, and increases with age; in this population, physical trauma plays a major role in precipitating recurrence, especially in patients with faulty biomechanics due to underlying arthritis and bone abnormalities. It is also possible that recurrence in some cases is due to early termination of treatment or use of an inappropriate dose, and these possibilities should be eliminated before further investigations are undertaken. ,There is good evidence to suggest that a combination of oral and topical therapies, when given at the same time, yield excellent clinical outcomes, although there remains a need for more effective topical agents with greater nail penetration and more effective oral antifungal agents. [source]