Biography:

Dr. Robert W. Buckingham joins PHHS after having previously been appointed as the Jack W. Thompson, M.D. Distinguished Visiting Professor at the University of Michigan-Flint in 2013-14. A Yale graduate, Dr. Buckingham was appointed inaugural Executive Director/Dean of the School of Public Health with the University of Saskatchewan, in 2009. He has authored more than 12 books and many scientific referred papers, with the most recent being a textbook entitled, “A Primer on International Health” published by Allyn & Bacon, and five books on hospice care, including, “Care of the Dying Child” published by the Continuum Publishing Company, which was translated in seven languages. Research areas are Hospice care, Global public health and HIV/AIDS in South East Asia and Central America; He has wide range of publication and attended National or International Oral Presentations

Abstract:

This presentation will focus on the philosophy of care for the person with AIDS in the last 6 months of life. I will present palliative care for the special needs of the AIDS patient and their family. This presentation will focus on pain control, patient/family as the unit of care, palliative sedation, symptom control, continuity of care, respect of lifestyle, physician and nurse accessibility, control of loneliness, and fears of abandonment as well as grief management after the death of the loved one.

Biography:

Hiroshi Ohrui has received Ph.D. degree (1971) from The University of Tokyo. He joined RIKEN (1966), moved to Tohoku University (1881) and then to Yokohama University of Pharmacy (2006). His interest covers Organic Synthesis, Chemical Biology, and Chiral Discrimination.

Abstract:

ABSTRACT Since 4’-C-ethynyl-2-fluoro-2’-deoxyadenosine (EFdA) has attracted much attention due to its supremely excellent anti-HIV activity1-4), I would like to talk about the design1,2), synthesis3), and biological evaluation of EFdA1,2,4) including the clinical trials (phase1 and 1b) reported by Merck Sharp & Dohme4). INTRODUCTION Highly Active Anti-Retroviral Therapy (HAART) has made HIV-infection from fatal to clinically tractable lifelong infectious disease. However, the emergence of resistant HIV-mutants and the adverse effects of drugs are still critical problems to solve. EFdA which could solve these problems was developed by us1). I would like to discuss about (1) a general idea based on the mutation of viruses that it is possible to develop nucleosides which are active to viruses and not toxic to human beings2), (2) the working hypotheses for designing nucleoside which could solve the above problems1), (3) the efforts for the better syntheses of EFdA3), and (4) the biological evaluation of EFdA by Dr. H. Mitsuya and other groups1,2), and the clinical trials (phase 1 and 1b) reported by Merck Sharp & Dohme at CROI, 20164). RESULTS AND DISCUSSION On the basis of the general idea and the working hypotheses, 4’-C-substituted-2’-deoxynucleoside (4’SdN) was designed as the nucleoside which could prevent the emergence of resistant HIV-mutant and could be stable in plasma. The method to decrease the toxicity of nucleoside that the additional modification of a toxic nucleoside could decrease the toxicity of the nucleoside will be also discussed. Finally, EFdA was designed and synthesized by our constant efforts on the syntheses and biological evaluation of 4’SdN. The details of the general idea, the working hypotheses, the syntheses of EFdA, and the biological evaluation of EFdA will be discussed. CONCLUSION (Arial 12pt bold) The extensive Studies on 4’SdN have successfully developed EFdA. EFdA has prevented the emergence of resistant HIV mutants more than ten years, and is over 400 times more active than AZT and several orders of magnitude more active than the other clinical drugs and stable in plasma and lowly toxic. The clinical trials by Merck Sharp & Dohme have shown that EFdA is efficiently absorbed by both oral and parenteral administration and converted to 5’-O-triphosphate (EFdA-TP) promptly, EFdA-TP is very stable in human PMMCs and the half-life of EFdA-TP is over 100 hours, and further, once a week dosing of 10mg of EFdA is efficacious. Thus, EFdA is a very promising anti-HIV drug which could open a new paradigm in the anti-retroviral therapy.

Biography:

Edward M Kian is the Welch-Bridgewater Endowed Chair of Sports Media in the School of Media and Strategic Communications. His research focuses on sport media, specifically examining the framing of gender, sex and LGBTQ in content, social media and Web 2.0, attitudes and experiences of sport media members and sport marketing. He has authored more than 85 journal articles, books, book chapters and conference papers.

Abstract:

In 1991, U.S. sports media were shocked when Ervin “Magic” Johnson, a five-time champion for the Los Angeles Lakers and arguably then the world’s most famous basketball player, announced he had contracted the HIV-AIDS virus before immediately retiring as a player from the National Basketball Association. During that period AIDS was largely viewed as a death sentence that most Americans wrongly believed affected only gay men. Johnson’s historic announcement began to change that attitude. In a landmark study on media framing of homosexuality in sport, a textual analysis of national newspaper coverage of HIV-infected athletes Johnson, diver Greg Louganis and boxer Tommy Morrison found that most of the articles on Johnson and Morrison expressed shock that both athletes had contracted the HIV virus, while also noting multiple times that each athlete had proclaimed they were heterosexual. However, no article in any of the examined newspapers on the openly gay and more effeminate Louganis noted how he had contracted a virus that at that time was associated predominately with gay men. Johnson, however, has not only survived with HIV but returned to play and later coach in the NBA, co-captained the U.S. Olympic “Dream Team” in 1992, has constantly remained in great shape and is a highly successful businessmen and television commentator. He is one of the prime reasons public attitudes have changed toward far greater acceptance of those infected with HIV. This research used a textual analysis to examine media framing of Johnson and HIV this decade. A Lexus-Nexus academic search was used to locate all articles published in major U.S. newspapers from January 1, 2010 through August 15, 2016 that mentioned Johnson and HIV and/or AIDS in the same article. All articles were read and coded by two researchers to search for dominate themes, using the overarching frameworks of Connell’s (1995) Hegemonic Masculinity and Anderson’s (2009) Inclusive Masculinity to interpret results.

Biography:

Arnold Mervyn Levin has received his Diploma in Occupational Health from the University of the Witwatersrand in Johannesburg. He has joined Private medical practice including treatment of patients who were HIV positive and suffering from AIDS. Currently involved in Occupational health and a Medical Advisor to Private Medical Health services. He has experience in MEDICAL and NON-MEDICAL and has much Authorship and published many papers. He has interest in MODERN ART.

Abstract:

In order to appreciate the rationale behind the "Toxin Concept" in the aetiology, clinical manifestations and therapy of AIDS, it is necessary to appreciate the following information. Being HIV positive only implies the presence of the appropriate antibody's to the invasion of the human body by the H I Virus. This is not in itself a disease, but rather the body's immune response to the presence of this virus. An analogy would be the deliberate, well planned and coordinated inoculation of children to produce the appropriate protective antibody without manifestation of the disease in question, for example, Measles. These antibodies cannot and should not be destroyed in an endeavour to "get rid of the virus". Patients who are HIV positive but without any evidence of a compromised immune system, should not undergo any form of therapy which may be harmful to this process as designed by "nature". In contrast to the above, AIDS is the disease protocol in which the immune system has been destroyed, which would result in a progressive disease which may be fatal. Therefore, it is only AIDS patients who require the appropriate therapy to overcome this life threatening disease. Our treatment of AIDS is centred on restoring the body's depleted immune system, so as to overcome the invading H I Virus. This is achieved by removal of the toxin which is responsible for the body's immune system being compromised. A normal blood count after the required period of antitoxin treatment is evidence of the success of this modality or treatment. Usually within a period of 6-9 months, patients have shown significant improvement in their health and their ability to lead normal lives. Once the latter has been achieved, the treatment is discontinued. At no stage was ARV medication used in the treatment of the patients with AIDS. The above concept has been proposed and carried out by me as an independent medical syndrome investigator.

Biography:

Negi Bharat Singh is currently a PhD scholar of International Health specialization in Kobe University, Japan. He has 10 years of working or research experience in public health sector in developing countries. He has completed his Master’s degree from Graduate School of Medicine, the University of Tokyo Japan.

Abstract:

A 7.8 magnitude earthquake April 2015 in Nepal claimed >8600 lives, 21900 were injured and 88000 people were displaced. >1000 of health facilities got damaged; 402 were completely destroyed. In such situation, HIV/AIDS can invite risk of public health threat as >95% medical adherence is required to prevent drug resistance and to control HIV complications. Our study aimed to assess the impact of earthquake on people living with HIV (PLHIV) especially adherence to antiretroviral therapy, risk of drug resistance or treatment failure and to assess post-traumatic stress disorder, HIV stigma and risky sexual behavior among PLHIVs. 305 PLHIVs were interviewed to find the information regarding ART drug adherence (last 4-day pill count), post traumatic stress disorder (PTSD), earthquake damage and loss, access to medical services, social support, discrimination and stigma and risky sexual behavior. Finding revealed that around 13% of the PLHIV reported treatment failure while only 8% of participants were not >95%-adherent to ART. Around 44% of the participant had PTSD symptoms, 49.8% reported being stigmatized and 45% did not use condom during last 3 months. 5% of participants lost their family member during the earthquake. Interestingly, ART adherence is not found statistically associated with PTSD, stigma and social support; however it is associated with disclosure sero-positive status. In resource-limit countries improving access to ART drugs and eliminating social stigma can prevent ART drug resistance during natural crisis.

Biography:

Tahani Al-Rahbeni has completed her PhD from the University of Aberdeen, United Kingdom in Molecular Toxicology and Genetics. Currently she is Postdoctoral Member at the Immunocompromised host department at KFSH&RC. Additionally she is the Vice Dean at Riyadh Colleges of Dentistry and Pharmacy and the Clinical and Administrative Coordinator of the Pharmacy Postgraduate Department.

Abstract:

A major complication of antiretroviral therapy is the development of resistance mutations that limit drug effectiveness. Very limited data are currently available on emerging HIV-1 drug resistance mutations in Saudi Arabia. Here, we present HIV-1 resistance data from clinical isolates of patients referred to and treated at KFSH&RC, Riyadh, Saudi Arabia. A retrospective analysis was done on the drug resistance mutation (DRM) profiles of 450 patients at KFSH&RC, who are undergoing HAART protocols and experienced virological failure with DRM detected by sequencing. These tests were done at our reference laboratory in Mayo clinic. The evaluation for DRM was at the earliest available testing done and diagnosed within 1 year of their estimated date of infection at KFSH&RC. All necessary comparisons of mutations and statistics were made. The highest frequency for DRM was observed in RTI’s (68%) followed by (47%) for both NNRTI’s and PRI’s. Our study showed that the DRM reported was similar to the annual international report, interestingly; the profile of mutations with each drug within the antiviral group was different from the international report. Additionally, a new set of novel mutations was also seen, that were neither reported nor seen in any international ARV drug resistance report. Resistance to ARV represents an increasing problem to patients at KFSH&RC. While some are infected with viruses harboring pre-existing mutations, most resistance mutations seem to develop during treatment and may be related to wrong treatment or patient non-compliance. Dissemination of drug resistant HIV-1 adds burden to the HIV-1 epidemic in the Middle East. Annual reporting of these DRM will aid in the development of ARV protocols.

Biography:

Vaishali Gautam has completed her MBBS from Lady Hardinge Medical College, India and currently pursuing Post-graduation in the field of Community Medicine from University College of Medical Sciences, India.

Abstract:

This study was conducted to better understand HIV/AIDS vulnerability and risk of a novel study population; migrant female college students using mixed method approach i.e quantitative and qualitative explanatory method. For quantitative aspect, a randomly selected group of 100 students were recruited and administered semi-closed questionnaire assessing their HIV/AIDS related knowledge and behaviour. Further, respondents with self-reported high risk sexual behavior were screened for in-depth interviews (qualitative aspect) with the purpose to identify the factors that increased their vulnerability and risk. 21% of the respondents had inadequate HIV/AIDS related knowledge, mean age of sexual initiation was 18.7 years and 10% of the respondents showed high risk sexual behavior as none used condom consistently. Statistically significant association was observed between respondent’s high risk behavior and having friends who were sexually exposed (fischer’s exact test, p value 0.005) and also with respondent’s partner’s current place of residence [LR, p value<.001].  On conducting in depth interviews; broadly four categories emerged; Gap in knowledge and behaviour, Push, Pull and behavioural factors. Push factors like greater opportunities, peer pressure and pull factor like coerced sexual intercourse led to adoption of high risk sexual behaviour. In addition, behavioural factors like inability to negotiate condom use, embarrassment in purchasing condom and poor self-perceived risk further increased the respondent’s vulnerability to acquire HIV infection. Keeping in mind that in India, migrant female students comprises a sizeable number hence we conclude that migrant female college students are vulnerable therefore requires focus to further measure their HIV vulnerability and risk.

Biography:

Sylvia Heloisa Arantes Cruz has completed her PhD from Santa Casa de São Paulo, Brazil. She is an Assistant Professor at Santa Casa de São Paulo, Brazil and at CRT/AIDS São Paulo, Brazil. Her research is on screening anal cancer in HIV-positive patients.

Abstract:

HPV infection is responsible for warts and carcinoma in genital area. Almost 80% of the sexual active population is infected with at least one serotype. The cervix Pap smear is collected for the prevention of the cervix cancer performing a similar technique we are able to prevent anal cancer collecting anal Pap-smear. The rates of anal cancer are increasing since the start of HIV epidemic. The anal intercourse seems to be extremely related to HPV infection. Anal dysplasia is described as a precursor of anal squamous carcinoma, so anal cancer has been screened with anal Pap-smear protocol, high-resolution anoscopy and high-risk HPV DNA test. The aim of this study is to compare the findings of the screening with anal Pap-smear in 38 HIV-positive and negative patients from January 2014 to December 2015 at CRT/AIDS, São Paulo who previously had anal intercourse. The first anal Pap-smear sample was collected in 2014 and the second in 2015. The anal lesions were treated with 90% trichloroacetic acid (TCA) and 5% imiquimod for 12 weeks. The statistical analysis was performed using chi-square test and the significance level was set at less than 5%. 38 patients were evaluated, 28 were infected with high risk HPV; 10 of them presented improvement in anal Pap-smear after one year. We concluded that anal dysplasia was more common in HIV-positive patients and that high-risk HPV infection was related to anal dysplasia.

Biography:

Ezeama Martina is currently working at the Imo State University, Nigeria. Her research interest is HIV/AIDS, Public health etc.

Abstract:

Introduction: Strategies to prevent Human Immuno-deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS among adolescents remain the greatest challenge in human development especially in developing countries like Nigeria. It is necessary to provide in school adolescents with appropriate HIV and AIDS preventive educational interventions. However, effective interventions for HIV prevention for adolescents are limited in Nigeria. This study investigated the effects of using Class-room Instruction (CI) and Drama (DR) for HIV and AIDS prevention among in school adolescents in Orlu Senatorial Zone.

Materials & Method: A quasi-experimental design using 165 students from three randomly selected co-educational secondary schools was adopted. There were two experimental groups (CI and DR) and control. Baseline data using a semi-structured questionnaire with 29-point knowledge and 9-point attitudinal scales were collected. To analyze knowledge, scores of <15 and ≥15 were classified as poor and good respectively; while for attitude, scores of <5 and ≥5 were categorized as negative and positive. The results for baseline studies were used to design interventions that were implemented for 8 weeks. Also mid-term and follow-up evaluations were conducted during the study. Data were analyzed using descriptive statistics, t-test and ANOVA at p=0.05.

Results: The mean ages of the respondents in CI, DR and control groups were 13.4±1.2, 13.9±1.5 and 13.8±1.2 years respectively. Knowledge scores on HIV/AIDS at baseline were 20.5±2.7, 20.4±2.6 and 21.1±2.7 for CI, DR and Control groups respectively. These scores increased to 22.7±2.7, 22.6±1.8 and 21.2±0.3 at mid-term for CI, DR and control, respectively. At follow-up, scores for CI and DR increased to 23.9±1.8 and 24.5±1.4 respectively while the score for the control dropped to 20.0±2.8. Scores for attitude among CI, DR and control groups during baseline study were 5.3±1.4, 4.9±1.5 and 5.3±1.0 respectively. For mid-term, attitude scores were 5.1±1.2, 5.0±0.9 and 4.7±1.5 for CI, DR and control respectively while scores for follow-up were 5.3±1.2, 5.6±0.7 and 4.5±1.2, indicating greater increase among the intervention groups than that of control.

Conclusion: Intervention using drama yielded more positive outcomes in both knowledge gained and in attitudinal change than others. Drama is therefore recommended as the most appropriate HIV intervention strategy to use for HIV and AIDS prevention among in school adolescents in Orlu Senatorial Zone, Imo State, Nigeria.

Biography:

Enwereji Ezinna Ezinne is a Professor and Lecturer in Dept. of Community Medicine, College of Medicine, Abia State University, Nigeria

Abstract:

Introduction: Partner notification is encouraged for safer sex practices and minimized HIV infection, but PLWHA report violence after disclosure. Most surveys focusing on violence HIV and AIDS have been used to assist women who experience violence but such surveys have some disadvantages. They concentrate on identifying women with violence but do not encourage the participation of such women in planning feasible interventions to reduce violence. The aim of study is to use participatory reservation approach (PRA) to involve PLWHA to identify interventions necessary to reduce domestic violence against them. Using PRA will show cost effective and efficient methods of reducing violence as well as ensuring sustainability of program.

Method: PRA was used to identify PLWHA who have experienced domestic violence. Data were collected through 12 focus group discussions and interview guides. A total sample of 96 PLWHA in network participated in the study. The perceptions of PLWHA on likely strategies for reducing violence were sought based on their local experiences. Data were analyzed quantitatively and qualitatively using simple percentages.

Results: Domestic violence was experienced by both sexes and perceived from different experiences including mutual exclusion or restriction from participating in family or community functions after disclosure. Out of 45 (46.9%) PLWHA that disclosed their status, 36 (40%) experienced violence. Interventions suggested were theater programs in public places, training male peer groups, encouraging gender equity and allowing women express their problems openly and stakeholders organizing workshops on gender inequity.

Conclusions: Result suggests that PRA is an efficient and cost effective method for sustaining interventions for reducing violence according to PLWHA perceptions. Training programs on risks of violence on HIV infection for PLWHA is need since both sexes experienced violence.