Day 1 :
Keynote Forum
Loran J. Thompson
The Wellness Edge, USA
Keynote: The effects of alcohol and other drugs on HIV, AIDS STD's and STI's
Time : 09:00-09:30
Biography:
Loran J Thompson is a Corporate Trainer, National Speaker and Health Coach with a long history of working with the HIV/AIDS community since 1990. She worked with UCSD on a research project on the effects of drugs and alcohol and how it increases the risk for getting or transmitting HIV/AIDS. She also worked with the San Diego County of Health and Human Services HIV/AIDS branch and trained the facilitators of the GLI’s (Group Level Intervention) across San Diego County to insure quality groups for the participants. She also completed a final report of the findings for the county.
Abstract:
Substance abuse can lead to risky behaviors that increase the chances of getting or transmitting HIV infection. It can also weaken the immune system and damage the liver. A weaker immune system has a harder time fighting off infections, as well as HIV-related infections. Also many people with HIV take medicine every day. Substance abuse can make it hard to focus and stick to a daily medicine regimen. Skipping medicines allows HIV to multiply and damage the immune system. Drug interactions between HIV medicines and recreational drugs such as marijuana, cocaine, or heroin can also increase the risk of dangerous side effects. In this session, you’ll learn about: The effects of substance abuse on the body, how it increases the chances of getting or transmitting HIV, what you can do if you use drugs or alcohol and simple, practical tools and strategies to take care of yourself.
Keynote Forum
John A. Schetz
University of North Texas Health Science Center, USA
Keynote: Unraveling the complex psychopharmacology associated with the adverse neuropsychiatric side effects and recreational use of HIV-1 antiretroviral drugs
Time : 09:30-10:00
Biography:
Schetz is a Professor of Pharmacology, Neuroscience and Medical Education with a penchant for advancing knowledge and addressing societal needs of relevance to medicine. His translational research efforts focus on elucidating mechanisms of drug action, and discovery and development of innovative agents for preventing or treating neurological and psychiatric conditions. His research has been published in reputed journals and featured nationally and internationally in print, radio and televised media reports. His collaborative team pioneered a molecular mechanistic understanding of adverse neuropsychiatric events associated with efavirenz when taken as prescribed, and its attractiveness as a recreational drug when smoked.
Abstract:
Efavirenz has been a mainstay of HAART since its introduction in 1998. Though recently downgraded by DHHS from a first-line to an alternative treatment due to risk of neuropsychiatric adverse events (NPAE), both WHO and South African guidelines continue to recommend efavirenz as the preferred NNRTI for HAART in adults, and generic forms are becoming available. Yet, only recently has significant progress been made towards a molecular mechanistic appreciation of efavirenz-mediated NPAEs and its attractiveness as a recreational drug. Contributing factors are rapid brain accumulation and a narrow therapeutic window. Receptor pharmacology studies indicate that within a concentration range relevant to its brain exposure, efavirenz disrupts dopaminergic, serotoninergic, cholinergic, and GABAergic systems. Hence, the combined effects on these neurotransmitter systems is likely to be responsible for some of efavirenz’s NPAEs, such as sleep disturbances, depression, anxiety, hallucinations, dizziness, headaches and memory impairments. Specifically, a number of CNS off-target interactions for efavirenz have been identified, including with the 5-HT2A, 5-HT2C, 5-HT3, 5-HT6, M1, M3 and GABA-A receptors, DAT, SERT, and VMAT2 transporters, and MAO-A. In rats trained to discriminate LSD from saline, efavirenz partially substitutes for LSD and this substitution is blocked by pre-treatment with a 5-HT2A receptor selective antagonist. Efavirenz also apparently competes for the same binding site at the 5-HT2A receptor as LSD, and prolonged chronic treatment with efavirenz drastically reduces 5-HT2A receptor levels. Findings from our receptor pharmacology studies and those in animals and humans correlate primarily with behavioral effects related to depressive, anxiogenic, hallucinogenic, and sleep disturbances.
Keynote Forum
Shibo Jiang
Fudan University, China
Keynote: A chemically modified milk protein for preventing HIV sexual transmission and treating HPV infection
Time : 10:00-10:30
Biography:
Shibo Jiang's major research interest is to develop antiviral drugs, microbicides, and vaccines against HIV, HPV, influenza virus, SARS-CoV, MERS-CoV, Ebola virus and Zika virus. He has pioneered the studies on development of anti-HIV microbicides for prevention of sexual transmission of HIV. He discovered the first highly potent anti-HIV C-peptide and his patent were licensed to Trimeris for developing the first peptide anti-HIV drug, T-20 (Enfuvirtide, Fuzeon). In collaboration with Shanxi Jinbo Biomedicine Co., Ltd., he has successfully developed an anti-HPV bioproduct, JB-01, for controlling HPV infection and reducing morbidity of cervical cancer, which was approved for clinical use in more than 500 hospitals in China. He has published 374 peer-reviewed SCI papers with >11,000 citations. He has applied for 26 US patents (18 of them were issued), and 17 Chinese and PCT patents (5 of them were issued), and given more than 190 oral presentations at international conferences, academic institutions and pharmaceutical companies in more than 30 countries.
Abstract:
Most recently, more than 90% of the new HIV infection in China occurred through sexual transmission, particularly among the men who have sex with men (MSM). Therefore, it is urgently needed to develop effective and safe microbiocides to prevent sexual transmission of HIV. We previously have shown that a chemically modified bovine milk protein, β-lactoglobulin (3HP-β-LG, also known as JB01) is effective against infection by a broad-spectrum of HIV and SIV. It is highly stable, soluble, safe and abundant in milk. Therefore, we have been developing JB01 in a slow-release gel formulation as an effective, safe, and inexpensive microbicide for prevention of HIV sexual transmission in China and other countries. Later, we have demonstrated that JB01 is also highly effective against infection by HPV strains, including both the high- and low-risk types. Mechanism studies have demonstrated that JB01 protein that carries increased net-negative charges, because of the modification of the positively charged lysine and arginine residues, blocks HPV entry through its interaction with the positively charged proteins, such as L1 and L2 proteins on the surface of HPV. The results from a randomized open-label clinical trial of a JB01 biological dressing (JB01-BD) administered intravaginally have demonstrated that JB01-BD is safe, since no serious adverse events were recorded. The deteriorated vaginal micro-environment, due to the HPV infection, became normalized after the treatment. While only 13.5% of women in the non-treatment group becoming HPV-negative, about 60.5% of HPV-positive women in the treatment group became HPV-negative (P<0.001). These results suggest that JB01-BD is a safe and effective topical biological agent for the treatment of cervical HPV infection and reduction of morbidity of cervical cancer caused by the high-risk HPV infection. Since its approval by China Food and Drug Administration (CFDA) in 2013, JB01-BD has been used in more than 500 hospitals in China for treating women with cervical infection of HPV.
- Workshop
Location: Las Vegas
Session Introduction
Elizabeth Secord
Wayne State University, USA
Title: Adherence Barriers in Youth with Perinatally Acquired HIV
Time : 10:45-11:25
Biography:
Elizabeth Secord is the Medical Director of the Horizons HIV prevention and treatment center for youth in Detroit, Michigan. She is a Professor of Pediatrics at Wayne State University and is the Division Chief for Allergy and Immunology at WSU, Children’s hospital of Michigan.
Abstract:
Adherence to antiretroviral medication is fraught with emotional baggage for many of our perinatally infected youth. This course will cover the reasons for poor adherence that we have encountered, and the programs we have designed to work with youth around these issues. Objectives for learners are: 1) To understand the multiple reasons for non-adherence in perinatally infected youth, including aversion to medication, lack of consistent housing, anger and disorganization. 2) Knowledge of possible interventions including home based programs, electronic interventions and the tools of motivational interviewing and other brief targeted psychological interventions versus long term therapy and 3) Use of a multi-disiplinary team approach. Cases will be discussed to illustrate various aspects of this very complex issue.
Robert W Buckingham
University of Michigan-Flint, USA
Title: End stage care for the person with AIDS
Time : 11:25-12:05
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 care needed for the person with AIDS with a limited prognosis of less than 6 months to live. It will address issues of medical, nursing and psychological needs as well as spiritual. It will discuss palliative care versus curative care. Components of Hospice philosophy of care and treatment will be detailed.
- Special Session
Location: Las Vegas
Session Introduction
Loran J. Thompson
The Wellness Edge, USA
Title: The impact of stress on those living wiith HIV/AIDS
Time : 12:05-12:45
Biography:
Loran J Thompson is a Corporate Trainer, National Speaker and Health Coach with a long history of working with the HIV/AIDS community since 1990. She worked with UCSD on a Research Project on the effects of drugs and alcohol and how it increases the risk for getting or transmitting HIV/AIDS. She also worked with the San Diego County of Health and Human Services HIV/AIDS branch and trained the facilitators of the GLI’s (group level intervention) across San Diego County to insure quality groups for the participants. She also completed a final report of the findings for the county.
Abstract:
Stress is a state of physical, mental and emotional tension resulting from challenging circumstances. Long term stress can contribute too many health problems, including digestive problems, heart problems, headaches, depression, anxiety and lack of sleep. It’s particularly important for people living with HIV and AIDS because stress is known to have a huge effect on the immune system. And stress reduces the production of T-cells in the body. In my years of experience, working with people living with HIV/AIDS, this group lives with additional life stressors and elevated levels of stress. A few of these stressors include: Shame and stigma, managing medication and medical appointments, unwanted disclosure of status. In this session, you’ll learn about: What stress is, how it effects on the body, what you can do if you are living with HIV/AIDS and simple, practical tools and strategies to deal with stress.
Lunch Break: 13:20-14:20
- AIDS stigma and discrimination
Viral, Bacterial, Fungal & Protozoan STDs
Awareness and knowled
Session Introduction
Laura Pittiglio
Oakland University, USA
Title: Does Learned Helplessness Facilitate Sexual Risk Taking behaviors among African American Young and Adolescent Females?
Time : 12:45-13:10
Biography:
Laura Pittiglio is an Associate Professor in the School of Nursing at Oakland University Rochester, MI. Her research interests include coping mechanisms of African American mothers who are living with HIV/AIDS and sexual risk taking behaviors that put young African American women in jeopardy of contracting HIV. Her most recent research is aimed at prevention strategies for sexual risk taking behaviors in adolescent and young African American females.
Abstract:
Research has demonstrated that adolescent and young African American females (AAF) face uncontrollable obstacles which interfere with the negotiation of safer sexual behaviors. If these obstacles are perceived as uncontrollable then these females may be at risk for the development of Learned Helplessness (LH). The LH model predicts that these uncontrollable obstacles may lead to deficits in motivational or cognitive decision making, deficits that could influence sexual risk taking behaviors. Therefore, it is important to gain a better understanding of the prevalence of LH in this population. Compared with other races and ethnicities, AAF still accounts for a greater proportion of new HIV diagnoses. If LH exists then the psychological impact of the uncontrollable obstacles prevalent in this group needs to be addressed in order to design cognitive interventions aimed at decreasing sexual risk taking behaviors. Since the concept of LH has not been tested in this particular population, a preliminary pilot study was conducted to initially trail a tool to examine the perceptions of LH in a populace of young, adolescent AAF. A convenience sample of 50 adolescents and young AAF between the ages of 16 and 21 were recruited from two clinics in Southeast Michigan. Results demonstrated a continuum of LH among the participants in the study. This pilot represents an initial attempt to examine if the obstacles that are experienced by adolescent and young AAF result in the perception of LH. Results are important because they validate the use of the Learned Helplessness Survey in this population. Moreover, findings can be used to refine the tool for use in studies aimed at examining the correlation between LH and sexual risk behaviors. Replication will provide empirical basis to be used in the design of culturally specific interventions for adolescent and young AA females.
Lunch Break: 13:10-14:00
Eugenia Curet
University of Texas Rio Grande Valley, USA
Title: HIV prevention among Hispanic youth and young adults in South Texas
Time : 14:00-14:25
Biography:
Dr. Eugenia Curet. The University of Texas Rio Grande Valley Department of Social Work
EMPLOYMENT Academic - Post-Secondary Part-time lecturer, UTRGV College of Health Sciences (January 2016) Part-time Lecturer, UTRGV School of Medicine (June 2015) Instructor in Public Health, Weill Cornell Medical College (June 1, 1992 - March 30, 2008) Professional Assistant Dean, Student Support Counseling and Wellness, University of Texas Rio Grande Valley School of Medicine (June 2015) Assistant Dean, Student Health Services and Counseling and Psychological Services Center, UTPA (September 1, 2013 - May 30, 2015) Clinical Associate Professor and Assitant Dean for Student Health and Menal Health Services, The University of Texas at Brownsville and Texas Southmost College (April 1, 2008 - August 31, 2013) AWARDS AND HONORS 2013 Leadership on University Campuses and in the Community Award by the Texas Suicide Prevention Council, Texas Suyicide Prevention Council (April 1, 2013) TEACHING Courses Taught Adv SOCW Pract Individuals SOCW Practice w/ Latinos
Abstract:
The residents of South Texas continue to be heavily impacted by HIV, accounting for high rates of new infections, AIDS diagnoses and people living with HIV. The Texas-Mexico Border region is a major port of drug-trafficking as well as string market for “holding houses” for drug redistribution. A significant consequence of the drug trafficking in the area is the increase of HIV largely due to intravenous drug use and risky sexual behaviors. The Substance Abuse and HIV Prevention Project resulted in the establishment of an evidence-based approach to prevent substance abuse and the spread of HIV/AIDS among college students and community members and to facilitate the referral process of those who are at risk. By implementing the peer educator and community-health worker model, the project provided enhanced comprehensive substance abuse and HIV prevention education to more than 600 participants during 2013-2014. Level of awareness of important knowledge related to HIV/AIDS and Substance Use is measured through the administration of a pretest and posttest. Through the statistical analysis it was learned that the information sessions were successful at changing perceptions concerning risky sexual behaviors and drug use. This project outlines the sociocultural, structural, and individual issues that both facilitate and limit the access to health care and prevention services. The evidence for the effectiveness of minority serving institutions in collaboration with community-based organizations strategy is strong; that is why the project continues to increase system capacity to address substance use and HIV infection prevention.
Jeff Cheung
Interfaith Medical Center, USA
Title: Implementing a routine testing model to improve diagnosis and linkage to care of newly HIV positive patients
Time : 14:25-14:50
Biography:
Jeff K.H. Cheung, MD, FACEP, FASAM, is a graduate of Mount Sinai School of Medicine. He trained in emergency medicine at Lincoln Medical and Mental Health Center in the Bronx, New York. Jeff K.H. Cheung, MD, FACEP, FASAM, is a graduate of Mount Sinai School of Medicine. He trained in emergency medicine at Lincoln Medical and Mental Health Center in the Bronx, New York. Cheung recently accepted the position of Interfaith Medical Center’s Chairman of Emergency Medicine
Abstract:
Statement of the problem: Interfaith Medical Center’s (IMC) Emergency Room lacked a systematic process to ensure that newly diagnosed HIV+ patients were linked to care. The lack of defined policies and procedures to test and treat HIV+ patients was compounded by the high rate of socio-economic factors affecting the patient population. Through a FOCUS grant, in January 2015 IMC implemented an improved system for conducting HIV testing in the ED and linking newly diagnosed patients to follow up care. Findings: Interfaith Medical Center’s FOCUS program has conducted a retrospective study of patients initiating emergency department care where routine HIV testing was conducted from January 2015 to March 2017. The purpose of this study was to evaluate the increase in newly HIV diagnosed patients resulting from the routine HIV testing in the emergency department and the efforts of the HIV clinical linkage to care team. Prior to routine HIV testing, IMC’s emergency department only tested on average 100 patients during January 2014 to December 2014 .During the study period; IMC has performed 10,520 4th generation HIV tests. Additionally, IMC was able to scale up HIV screening from year one to year two of the study. From January 2015 to Dec 2015 a total of 3,546 HIV tests were conducted. HIV testing almost doubled in year two increasing numbers to 6,974 tests. From January 2015 to December 2015, IMC diagnosed 19 new HIV positives and linked 14 to care (68%) From January 2016 to March 2017, IMC diagnosed 22 new HIV positives and linked 19 to care (72%). Conclusion & Significance: While the use of this model successfully identified patients with undiagnosed HIV infection in the ED, and enabled scale up of routine HIV screening in an emergency department setting. . Innovative testing approaches, such as routine, non-targeted screening, are necessary to effectively diagnose new HIV cases and link those patients to regular HIV medical care. Recommendations: In summary, Routine HIV testing at Interfaith Medical Center emergency department has increased the number of new HIV cases identified. The steps that we undertook-i.e. EMR updates, updating polices, administrative support, training, lab procedures for notification, lab testing updates all aided in the increase of HIV Testing and linkage to care.
Shibani Datta
All India Institute Of Hygiene And Public Health, India
Title: A study on “Association between different socio-demographic factors and Tuberculosis infection in HIV patients and the health seeking behavior of them attending a tertiary care hospital in Kolkata, West Bengal
Time : 14:50-15:15
Biography:
Shibani Datta is a Professor of Public Health in All India Institute of Hygiene and Public Health. She was a Professor of Calcutta Medical College in West Bengal, India. She was the Team Leader of Central Surveillance team of India. Many of her research works have been published and presented in national and international journals and conferences.
Abstract:
Background: HIV is considered to be the most potent risk factor for progression to active TB among those infected both with TB and HIV and as a result TB is the most life threatening opportunistic infection associated with HIV and biggest cause of death among patients with AIDS. In areas hard hit by HIV like India TB is increasing leading to greater case load thereby overstretching the already fragile health infrastructure. To achieve an effective, accessible, acceptable and affordable control program it is very much essential to address the health seeking behavior of the HIV positive patients.
Objectives & Methodology: An Institution based observational and cross-sectional study was done to see the association between different socio-demographic factors and tuberculosis infection in HIV patients and to study the health seeking behavior of patients having HIV with TB and HIV without TB.
Findings: In this study 104 cases of tuberculosis were diagnosed out of 500 HIV patients. It has been observed that the maximum concentration of HIV-TB co-infection patients are in the age group of 31-45 years (total 23%) and among the HIV-TB co-infection patients 79% are male and 21% are female. The other significant factors are literacy, occupation, economic status, housing and addiction etc.
Recommendation: Extensive awareness program regarding HIV/AIDS and TB is needed.
Mariam Davtyan
University of California, USA
Title: A Grounded Theory Study of HIV-related Stigma in US-based Health Care Settings
Time : 15:15-15:40
Biography:
Mariam Davtyan is doctoral candidate in Public Health at University of California Irvine. In 2005, she has also served as a pediatric and adult HIV/AIDS Researcher at the LAC+USC Maternal, Child and Adolescent Center for Infectious Diseases and Virology (MCA Center). Her work with women of color living with HIV/AIDS has inspired her to study stigma, a significant stressor that leads to poor outcomes. Her research focuses on stigma and discrimination in healthcare settings and within provider-patient interactions. Her current projects use photovoice, a community-based participatory research (CBPR) methodology involving documentary photography, to define and describe the extent of stigma among African American and Latina women living with HIV/AIDS in Los Angeles, and to educate healthcare workers about the impact of stigma on patients. She has presented her research at the International Conference on HIV-Stigma at Howard University and the International AIDS Conferences in Melbourne, Australia, and Durban, South Africa.
Abstract:
Despite biomedical advances in the treatment and care of people living with HIV/AIDS (PLHIV), stigma has remained a persistent global challenge. Health care settings and workers have been identified as important sources of stigma directed towards PLHIV. Studies have addressed the construct of stigma in US health care settings, but mainly from the perspectives of PLHIV. We used grounded theory to understand how health care professionals conceptualize HIV stigma in health care settings and how it may impact HIV patients to describe the pertinent concepts involved in the operationalization of stigma in health care settings and to develop a substantive model that projects a purposive view of HIV stigma in the health context. Our model indicates that stigma may be rooted in historically derogatory representations of HIV and intensified by patient-provider power inequalities. Stigma may be triggered by fear of contracting an incurable disease, inadequate clinical education and training on HIV and stigma, unintentional behaviors, and limited contact with HIV patients. Stigma was perceived as injurious to both patient and provider outcomes. Patient outcomes included engagement in care and psychological functioning, and provider outcomes included anxiety and nervousness when delivering care to HIV patients. Additional research on provider perceptions of stigma and programs that encourage empowerment, communication, and training may be needed for stigma reduction.
Rui Gu
New York City Department of Health and Mental Hygiene, USA
Title: Application of Antiretroviral Drug Resistance Testing in the New York City Public Health Laboratory
Time : 15:40-16:05
Biography:
Rui Gu completed her PhD from University of Connecticut and Postdoctoral studies from Wadsworth Center. She is a Research Scientist and the group leader in the NYC PHL HIV Phylogenetic Unit. She is the first author of 6 papers in reputed journals.
Abstract:
Background: As part of the overall effort in the Ending the AIDS Epidemic (ETE) program in New York State, the Public Health Laboratory (PHL) at NYC Department of Health and Mental Hygiene (DOHMH) launched HIV-1 Genotyping testing in June 2016 for DOHMH Sexual Health clinic patients with a new diagnosis of HIV. Availability of the testing will roll out to include all newly diagnosed patients city-wide throughout the next year. The significance of this implementation is to provide real-time viral sequence data and clinical anti-viral drug resistance data to public health epidemiologists and clinicians respectively. Phylogenetic analyses will be used to prioritize field response and provide guidance in disease management.
Method: Tests were performed according to the ViroSeq HIV-1 Genotyping System 2.0 (CELERA/Abbott Molecular) kit instruction. Viral sequences were analyzed using ViroSeq HIV-1 Genotyping Software v3.0 (CELERA/Abbott Molecular) to detect HIV-1 antiretroviral drug resistance-associated mutations. Wherever applicable, subtypes of HIV-1 viral sequences were identified using HIVseq program hosted by Stanford University's HIV Drug Resistance Database.
Results: From June 2016 to February 2017, NYC PHL performed ViroSeq HIV-1 genotyping test on 172 confirmed HIV-1 positive specimens. 151 specimens (87.8%) were sequenced and reported successfully. The subtype distribution of these specimens is: A (n=1), B (n=135), C (n=3), B+C (n=1), CRF01_AE (n=2), CRF02_AG (n=6), CRF07_BC (n=1), CRF12_BF (n=1) and 28_BF (n=1). In successfully sequenced and reported specimens, 27 specimens (15.7%) contained HIV-1 antiviral drug resistance mutations in protease and/or reverse transcriptase region that conferred antiviral drug resistance.
Conclusion: In support of the ETE program in NYC, NYC PHL began offering HIV-1 antiretroviral drug resistance testing in June, 2016. The test provides essential phylogenetic and clinical data to public health epidemiologists and clinicians in NYC respectively, enabling the NYC PHL to play an important role in the NYS ending the AIDS epidemic campaign.
Sharwani Vijayshree Lal
Dr. Ram Manohar Lohia Hospital, India
Title: A rare case of Zidovudine induced lactic acidosis with pancreatitis with myopathy
Time : 16:20-16:45
Biography:
Sharwani Vijayshree Lal is currently working as a Medical Officer at a Central Government Hospital in the capital of India. She has developed sharp acumen and insight in effective diagnostical skills. Her passion for meticulous and comprehensive evaluation of a case, has matured during her rewarding exposure to healthcare in hospitals and educational institutions over the years. This case explains the importance of exhaustive history taking and heedful physical examination to reach a diagnosis.
Abstract:
Statement of the problem: 40 years old male with fever and constitutional symptoms for ≥2 months who concealed his diagnosis of HIV/AIDS and developed Zidovudine induced lactic acidosis with pancreatitis with myopathy. Methodology: Patient presented with c/o weakness, body ache, weight loss (8kg), pain abdomen since ≥2 months, and intractable vomiting and breathlessness since last 1 week. He was prescribed antibiotics, PPIs, prokinetics earlier by previous doctors but to no relief. Findings: General physical examination was unremarkable expect for toxic looks, dehydration and extensive oral thrush. HIV testing was advised but he refused to consent. On repeated counseling and questioning his wife accepted the patient being a case of HIV/AIDS on ART (Zidovudine, Lamivudine and Nevirapine) for past 1 year. This fact was willingly concealed by patient to all previous doctors. CECT head and abdomen, and routine laboratory reports were normal except S. Amylase which was 350U/L (Normal: 30-125U/L), S. Lipase was 210U/L (Normal: 10-150U/L) S. Lactate was 7mmol/L (Normal: 0.5-1.0mmol/L), CPK was 320U/L (Normal: 25-200U/L), CD4 cell counts were 224/µL. ABG was suggestive of high anion gap metabolic acidosis. A provisional diagnosis of AIDS with Zidovudine induced lactic acidosis with pancreatitis with myopathy was made. ART was immediately stopped and appropriate treatment was started. He was discharged after 10 days in satisfactory condition on Tenofovir, Lamivudine and Efavirenz. Conclusion & Significance: This case explains the importance of detailed history taking (including concomitant medicine exposure) and vigilant physical examination (oral candidiasis in our case) especially in India to reach a diagnosis where HIV/AIDS is a social stigma and its status is not willingly disclosed by the patient. Other fact being that Zidovudine can also cause lactic acidosis and pancreatitis (which is more commonly associated with Stavudine) and that too with no bone marrow toxicity (more often a hallmark of Zidovudine).
Eveline Ndii Kalomo
Wichita State University, USA
Title: To Tell or Not Tell: Dimensions of Disclosure to Children with HIV in the Zambezi Region of Northern Namibia
Time : 16:45-17:10
Biography:
Eveline Ndii Kalomo is an Assistant Professor at Wichita State, School of Social Work. She teaches various courses in social work for students both in the undergraduate and graduate programs. Her research interests are the intersections of HIV/AIDS and, kinship caregiving, population aging, gerontology, mental health, intimate partner violence, substance abuse, children’s mental health and educational outcomes. She has expertise and passion in improving the health and well-being of individuals and families affected by HIV and AIDS in Africa. Her research area stemmed from her extensive experience working with families and children affected by AIDS in Namibia.
Abstract:
Statement of the Problem: Prenatally HIV-infected children are surviving due to improvements in antiretroviral treatment (ART). With the advent of ART, the quality of life and the survival rates of children living with HIV have significantly improved allowing these children to live into adolescence and well into adulthood. Despite the significant decrease in the morbidity and mortality of children, a disclosure issue is increasingly becoming a concern for policymakers, health professionals, and family members. Studies report that HIV disclosure is associated with increased self-esteem, lower depressive symptoms, and improved adherence to treatment. However, despite known benefits of disclosure, researchers suggest that HIV-infected children, do not know they are HIV-infected. Scholars, suggest that this practice may be attributed to parental fears, social stigma and discrimination, and lack of caregivers’ knowledge with respect to when and how to approach disclosure questions. However, limited research has examined this phenomenon in Namibia, one of the top five countries in the world with the highest AIDS prevalence rates.
Methodology & Conceptual Framework: Applying the ecological systems theory, this cross-sectional exploratory study conducted face-to-face interviews with 83 caregiver-child dyads of HIV-affected children aged 6-18.
Findings: The mean age of caregivers was 37.1 [range 15-93, SD=11.9]. Majority were female (87.5%). Over half HIV-infected children (55.7%) were between the ages 6 to 10 years old. More than two-thirds of children (67.1%) had their HIV diagnosis disclosed to them. Care givers (42.2%) believed it was very important to disclose the HIV status to children.
Conclusions & Recommendations: Health professionals and social workers should offer ongoing support to caregivers in the disclosure process so that children are sensitively and effectively informed of their HIV status. Greater practitioner-caregiver involvement is needed to ensure that caregivers have the adequate supports and communication skills to initiate and sustain the disclose process among adolescents.
Simon Kang ethe
University of Fort Hare, South Africa
Title: Exploring Underpinnings Weighing Down the Phenomenon of Adherence to Anti-Retroviral Drugs (ARVs) among the People Living With HIV/AIDS (PLWHA) in South Africa and Botswana: A Literature Review
Time : 17:10-17:35
Biography:
Simon Kang ethe is currently working as a professor at University of Fort Hare, South Africa.
Abstract:
It is critical that People Living with HIV/AIDS (PLWHA) in African countries hard- hit by the HIV/
AIDS pandemic such as Botswana and South Africa be the cornerstone of a successful HIV/AIDS campaign by taking responsibility and accountability of taking the ARVs according to the drug regimen. Anti-retrovirals (ARVs) are very expensive and drains national coffers immensely that translates to a heavy burden on the tax payers. The aim of this paper is, through a review of literature methodology, to debate and discuss a few underpinnings behind the PLWHA defaulting their drug regimen. The following environment promotes defaulting: poverty and its ramifications
such as lack of food; excessive intake of alcohol; capacity of the ARVs to deform body structure; use of both biomedical concoctions and those of traditional healers in tandem; sexual libido emanating to the use of ARVs; and stigma associated with taking ARVs. The paper recommends: strong awareness to strengthen PLWHA ownership of the campaign; immense community support of the PLWHA and the campaign generally; and further research on how to reduce food appetite and sexual libido.
Key Words: Stigma. Sexual Libido. Traditional Concoctions. Bio Medics. Traditional Healers.
Xingdong Ye
Guangzhou Institute Of Dermatology, China
Title: The upate of syphilis prevention in Guangzhou China: epidemiology and case reporting
Time : 17:35-18:00
Biography:
Xingdong Ye has his passion in improving the health and wellbeing, graduated from Jiangxi Gannan School of Medicine, China in 1988, and got his master's degree in Sun Yatsum Medical University, Guangzhou in 1995, engaged in the prevention and treatment of syphilis. He loves life, rigorous scholarship, more than 100 professional academic papers had been published in the past decades, He has put forward to the prevention and control of syphilis in Guangzhou with his proposal entiled “1234” basic strategies after finishing the Guangzhou municipal major project on syphilis control, and reported application of nested quantitative PCR in detecting TP DNA in the diagnosis of syphilis from various biological samples for the first time.
Abstract:
Syphilis is a sexually transmitted infection (STI) that causes cutaneous manifestations such as genital ulcers, and a variety of complications including neurologic, renal, gastrointestinal, and hepatic diseases. After being virtually eradicated in the 1960s, syphilis has made a re-emergence in China since the initiation of economic and social reforms, and Chinese government has implemented a battle for syphilis control named syphilis control plan 2010~2020, set the goal of The average annual growth rate of early syphilis is less than 5%,By the end of 2015, the number of congenital syphilis was controlled at 30/100,000 live births, and at the end of 2020, the number of live births was controlled at 15/10. Guangzhou is one of the cities most affected by syphilis within Guangdong province. During the period of 2000 to 2011, syphilis burden in this area was tripled that of the national average. Given its specific position as the capital city of Guangdong Province and the de facto economic center of South China, as well as the large population involved (over 14 million in 2016), syphilis epidemics in Guangzhou are of great concern. We had downloaded the data of syphilis case from China national infectious reporting system and analysed. It showed that number of syphilis cases reported in Guangzhou has increased from 2691 individuals in 2005 to 8546 individuals in 2016, and incidence of syphilis during this time was increase from 47.33/100,000 population in 2005 to 55.28/100,000 population in 2016. And of those syphilis case reported, the incidence of early syphilis including primary syphilis and secondary syphilis had been decreased from 21.84/100,000 population to 7.84/100,000 populations, The composition ratio of different types of syphilis changes, highlighting the realization of early syphilis, congenital syphilis decline otherwise the proportion of latent syphilis has been rising, cases of latent syphilis account for 48% in 2015 increased to 82% in 2016, the incidence of congenital syphilis get to around 30/ 100,000 live births. But, whether the syphilis cases in the national infectious reporting system mentioned above were all really syphilis cases of initiated diagnose and need to be reported? Answer was not. We reviewed more than 2000 syphilis cases data and conclude that the accuracy of syphilis case report ranged from 30.21% to 73.14% in China, it implicated that Syphilis case reported in the infectious disease system was partly incorrect because of over-reporting (rate of over Reporting ranged from 27% to 70% varied different types of syphilis). As for syphilis incidence of high risk population such as MSM, FSWs and Drug user population, cross-sectional survey by our colleague during recently year showed that The rate of TPPA positive was 10.1% among MSM; and the prevalence of syphilis was 5.5%; HIV 7.6% and co-infection was 2.7%. For population of FSWs, The positive rate of TPPA was 8.2%, the reactive syphilis prevalence was 1.4%. The positive rate of TPPA in middle and low places was 9.4%, and the rate of the population with both RPR and TPPA positive was 1.6%. We also conducted a syphilis incidence investigation among Drug users in 2014, Guangzhou, It showed that The positive rate of TPPA was 8.9%, the syphilis prevalence was 4%. In short, China has implemented the second battle for control syphilis spreading for seven years, over reporting of syphilis cases were common and ranged from 27% to 70% varied different types of syphilis. Currently, more than 80% reported syphilis cases were latent syphilis. Both early syphilis and congenital syphilis had been controlled through series intervention precaution. Men who has sex with men has the highest incidence of syphilis among the target four populations, However, in Guangzhou, the current epidemiological features of syphilis among MSM has not yet showed that syphilis promoted HIV infection and spread that observed in other country and region.