Shifting the HIV Paradigm from Care to Cure: Proceedings from the Caribbean Expert Summit in Barbados, August 2017

Landis, R. Clive; Abayomi, E. A.; Bain, B; Greene, Edward; Jánossy, G.; Joseph, Patrice; Kerrigan, Deanna; McCoy, J. Philip; Núñez, César; O’Gorman, Maurice R.G.; Pastoors, Alexander; Parekh, Bharat; Quimby, Kim R; Quinn, Thomas C.; Robertson, Kevin; Thomas, Réjean; Gorp, Eric C. M. Van; Vermund, Sten H.; Wilson, Valerie

doi:10.1089/aid.2017.0310

Cited by 7 publications

(3 citation statements)

References 58 publications

(54 reference statements)

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“…Furthermore, with 39% of HCP stating the Hospital/VCT Center is ill-equipped to handle HIV patients, it stands to reason why some HCP remain fearful of working with PLWH, as shown by our study. These findings are consistent with other studies in revealing that the majority of HCP most often describe their place of work as unequipped to manage HIV patients [31,32]. In light of these findings, the government and community must commit to upgrading their healthcare facilities to ensure an ideal work environment for staff that makes possible the delivery of quality health care for all patients, regardless of their health status.…”

Section: Juniper Online Journal Of Public Healthsupporting

confidence: 88%

Baseline HIV Stigma Index Survey for St. Kitts and Nevis

Fakoya

Lugo

Otohinoyi

et al. 2022

jojph

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The stigma associated with AIDS is a setback for HIV/AIDS prevention, care, and treatment. Persons living with HIV/AIDS (PLWH), and those that fear they might be HIV-infected, fear judgment and discrimination from within their community, and more especially from their health care services. Thus, this study seeks to establish a baseline index of the stigma level for HIV in Saint Kitts and Nevis (SKN), as well as estimate this level among local health care providers (HCP). A total of 88 participants volunteered for the study, consisting of 43 PLWH and 45 HCP. Data from the PLWH was collected by trained physicians, while the HCP collected their data via a self-administered questionnaire. The results of the study reveal that the majority of PLWH had experienced stigmatization due to their health condition, either externally or internally, or both. The study revealed deficiencies in HIV-patient counseling and possible breaches of confidentiality regarding HIV status disclosure. However, the results of the study statistically showed an occupational bias concerning potential confidentiality breaches, as none of the skilled participants had their status revealed without their permission. This differed for the semi-skilled and unskilled participants. Amongst the HCP, the study revealed both passive and active displays of HIV stigma, attributed mainly to insufficient training. The study also revealed that HCP’s perception of their work environment in terms of safety negatively impacted their interaction with the PLWH. The results of this study underline the need for active participation from the SKN Community and Government, to ensure the quality of life for PLWH, as this could have a boomeranging effect on the health of the society as a whole.

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Section: Juniper Online Journal Of Public Healthsupporting

confidence: 88%

Baseline HIV Stigma Index Survey for St. Kitts and Nevis

Fakoya

Lugo

Otohinoyi

et al. 2022

jojph

View full text Add to dashboard Cite

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“…The studies rarely provided a priori power analysis to estimate a sufficient size of study sample to be able to detect changes in psychological outcomes. Despite medical advances in the prevention and care of HIV [37, 38], there are emotional and social problems, such as stigma, that may make the burden of disease challenging not only for the infected individual but also for the family [38–40]. Since study findings indicated changes in psychosocial outcomes for individuals with preexisting stress or anxiety [14, 23, 25] but are not statistically significant in other populations, future intergenerational interventions should be expanded in scope to focus more on PLH with preexisting psychological stress.…”

Section: Discussionmentioning

confidence: 99%

Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review

et al. 2018

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A variety of interventions have been tested targeting people living with HIV (PLH) and their relationships with their children. The purpose of this study was to synthesize evidence on the goals, types, scope, and outcomes of such intergenerational interventions for PLH. Randomized trials targeting PLH alone or together with their children, published in English, with an intergenerational intervention component were included in this review. Thirteen studies met eligibility criteria. The types and goals of interventions varied greatly but often involved educational sessions with groups of PLH, skill-building sessions, or parental disclosure of HIV status among mothers living with HIV; six studies targeted problem behaviors, resilience, and self-esteem among their children. Two studies addressed general family coping with HIV. Seven studies reported positive outcomes as a result of an intergenerational intervention, with the greatest improvements being observed in those participants with the most stress. Most studies failed to report specific intervention methodology. Due to gaps in the literature noted, future intergenerational interventions targeting PLH should include more diverse groups of PLH. Studies should also explore the impact of intergenerational-based interventions on the mental health of PLH and their families.

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“…Moreover, the elimination of persistent HIV within infected patients will require effective treatments that eradicate cells harboring latent provirus genomes. To date, noteworthy HIV eradication programs such as UN/AIDS 90-90-90, which utilize global epidemiological strategies and mathematical models, have been implemented by the World Health Organization (WHO) with the goal of controlling HIV disease among the global population, focusing on developing nations [3, 4]. Within infected individuals, despite the remarkable successes in reducing morbidity and mortality of people living with HIV, eradication of the virus is limited by persistent latently HIV-infected cellular reservoirs.…”

Section: Introductionmentioning

confidence: 99%

Strategies to eradicate HIV from infected patients: elimination of latent provirus reservoirs

Sadowski

Hashemi

2019

Cell. Mol. Life Sci.

121

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35 years since identification of HIV as the causative agent of AIDS, and 35 million deaths associated with this disease, significant effort is now directed towards the development of potential cures. Current anti-retroviral (ART) therapies for HIV/AIDS can suppress virus replication to undetectable levels, and infected individuals can live symptom free so long as treatment is maintained. However, removal of therapy allows rapid re-emergence of virus from a highly stable reservoir of latently infected cells that exist as a barrier to elimination of the infection with current ART. Prospects of a cure for HIV infection are significantly encouraged by two serendipitous cases where individuals have entered remission following stem cell transplantation from compatible HIV-resistant donors. However, development of a routine cure that could become available to millions of infected individuals will require a means of specifically purging cells harboring latent HIV, preventing replication of latent provirus, or destruction of provirus genomes by gene editing. Elimination of latently infected cells will require a means of exposing this population, which may involve identification of a natural specific biomarker or therapeutic intervention to force their exposure by reactivation of virus expression. Accordingly, the proposed "Shock and Kill" strategy involves treatment with latency-reversing agents (LRA) to induce HIV provirus expression thus exposing these cells to killing by cellular immunity or apoptosis. Current efforts to enable this strategy are directed at developing improved combinations of LRA to produce broad and robust induction of HIV provirus and enhancing the elimination of cells where replication has been reactivated by targeted immune modulation. Alternative strategies may involve preventing re-emergence virus from latently infected cells by "Lock and Block" intervention, where transcription of provirus is inhibited to prevent virus spread or disruption of the HIV provirus genome by genome editing.

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Shifting the HIV Paradigm from Care to Cure: Proceedings from the Caribbean Expert Summit in Barbados, August 2017

Cited by 7 publications

References 58 publications

Baseline HIV Stigma Index Survey for St. Kitts and Nevis

Baseline HIV Stigma Index Survey for St. Kitts and Nevis

Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review

Strategies to eradicate HIV from infected patients: elimination of latent provirus reservoirs

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