The impacts of antiretroviral therapy (ART) on quality of life, mental health, labor productivity, and economic wellbeing for people living with HIV/AIDS in developing countries are only beginning to be measured. We conducted a systematic literature review to analyze the effect of ART on these economic and quality of life indicators in developing countries and assess the state of research on these topics. We searched Ovid/Medline, PubMed, Psych Info, Web of Science, Google Scholar, and the abstract database of the International AIDS Society Conference and the Conference on Retroviruses and Opportunistic Infections. Both qualitative and quantitative studies were included, as were peer-reviewed articles, gray literature, and conference abstracts and presentations. Findings are reported from 21 publications, including 14 full-length articles, six abstracts, and one presentation (representing 16 studies). Compared to HIV-positive patients not yet on treatment, patients on ART reported significant improvements in physical, emotional and mental health, and daily function. Work performance improved and absenteeism decreased, with the most dramatic changes occurring in the first three months of treatment and then leveling off. Little research has been done on the impact of ART on household wellbeing, with modest changes in child and family wellbeing within households where adults are receiving ART reportrd so far. Most studies from developing countries have not yet assessed economic and quality of life outcomes of therapy beyond the first year; therefore, longitudinal outcomes are still unknown. Findings were limited geographically, with an emphasis on sub-Saharan Africa and adult treatment. As ART roll out extends throughout high HIV prevalence, low-resource countries and is sustained over years and decades, research on pediatric and differential gender economic and quality of life outcomes will become increasingly urgent, as will systematic evaluation of ART programs.

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BackgroundInjection drug users and female sex workers are two of the populations most at risk for becoming infected with HIV in countries with concentrated epidemics. Many of the adults who fall into these categories are also parents, but little is known about the vulnerabilities faced by their children, their children's sources of resilience, or programmes providing services to these often fragile families. This review synthesizes evidence from disparate sources describing the vulnerabilities and resilience of the children of female sex workers and drug users, and documents some models of care that have been put in place to assist them.ReviewA large literature assessing the vulnerability and resilience of children of drug users and alcoholics in developed countries was found. Research on the situation of the children of sex workers is extremely limited. Children of drug users and sex workers can face unique risks, stigma and discrimination, but both child vulnerability and resilience are associated in the drug use literature with the physical and mental health of parents and family context. Family-centred interventions have been implemented in low- and middle-income contexts, but they tend to be small, piecemeal and struggling to meet demand; they are poorly documented, and most have not been formally evaluated. We present preliminary descriptive data from an organization working with pregnant and new mothers who are drug users in Ukraine and from an organization providing services to sex workers and their families in Zambia.ConclusionsBecause parents' drug use or sex work is often illegal and hidden, identifying their children can be difficult and may increase children's vulnerability and marginalization. Researchers and service providers, therefore, need to proceed with caution when attempting to reach these populations, but documentation and evaluation of current programmes should be prioritized.

In India most childhood nutrition recommendations and interventions are still not focused on infants under 6 months. Secondary data analyses of National Family Health Survey-3 data from India were analysed to compare the prevalence of wasting, stunting and underweight in infants less than 6 months and 6-59 months. Our results revealed that wasting was higher (31%) in infants less than 6 months (P < 0.05) as compared with children between 6 and 59 months. Thirteen per cent of infants less than 6 months had severe wasting, 30% were underweight and 20% were stunted. Most infants (69%) were exclusively breastfed (EB) for the first 2 months, but exclusive breastfeeding dropped to 50% at 2-3 months and to 27% at 4-5 months. There was no statistically significant difference in wasting and stunting in the EB and not exclusively breastfed (NEB) groups. Significantly fewer EB infants were underweight (28%) compared with NEB infants (31%) (P = 0.030). However, among EB children, 29% had wasting and 21% were stunted. Eleven per cent of EB infants were severely underweight, 13% were severely wasted and 9% were severely stunted. Diarrhoea was significantly lower among EB infants compared with NEB infants (P < 0.05). We conclude that infants less than 6 months of age are vulnerable to suffer from acute severe malnutrition irrespective of their breastfeeding status and need to be seriously considered for inclusion in national guidelines for early detection and management of undernutrition.

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Behavioral medicine scientists, practitioners, and educators can engage in evidence-based science communication strategies to amplify the science and combat misinformation. Such efforts are critical to protect public health during crises such as the COVID-19 pandemic and to promote overall well-being.