AIDS

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Stimulant Use and Depression Predict Erratic Use of HIV Drugs

HIV-positive people with a high degree of depressive symptoms, or who use stimulants on a weekly basis, are highly likely to go on and off antiretroviral (ARV) therapy or to stop treatment altogether, according to a study published November 24 in the Journal of Acquired Immune Deficiency Syndromes. The study’s authors suggest this behavior may help explain why people with psychological and substance use problems have worse health outcomes and faster HIV disease progression.

Researchers have noted the harmful effects of depression and substance abuse on the course of a person’s HIV disease since the earliest days of the epidemic. Taken together, the dozens of studies on these issues have demonstrated that people living with HIV and either depression or substance abuse have lower CD4 counts, higher viral loads, faster disease progression and higher mortality.

A number of factors can help explain poorer health outcomes in people with these conditions. People with psychological and substance abuse problems tend to be poorer, to have worse access to medical care, to be infected with diseases other than HIV, and to have poor treatment adherence when they do go on ARV drugs.

One potential contributing factor to poorer health that has not been well investigated is erratic use of ARVs. This is different than adherence, where the concern is how many doses over a period of time a person took correctly. Rather, ARV utilization explores whether a person purposefully stops taking medication and either remains off treatment or opts to use treatment only intermittently.

To explore this matter, Adam Carrico, PhD, from the University of California in San Francisco, and his colleagues analyzed data from a study that was initially designed to test an intervention to help HIV-positive people reduce behaviors that could pass on the virus to others.

Over 600 people participated in the study, which involved surveys and blood tests conducted every six months for 25 months. Roughly 18 percent of the participants reported at least weekly stimulant use, and 12 percent reported injecting drugs at least once in the previous year.

Ninety-four percent were on ARVs, and 33 percent had an undetectable viral load at the start of the study. Though an ideal adherence level is 95 percent of doses taken correctly, adherence averaged 88 percent across in the cohort.

Carrico and his colleagues defined ARV discontinuation as a person being on treatment and then going off for the remainder of the study. Intermittent ARV use was defined as going off treatment purposefully and then restarting treatment again—at least once. 

The team found that depression and stimulant use both predicted erratic ARV use. People with high depressive scores at the outset of the study were 39 percent more likely to discontinue treatment altogether, while weekly stimulant users were more than two and a half times more likely to report intermittent discontinuations.

People who discontinued ARVs or who had intermittent utilization had much higher viral loads—and therefore a higher risk of HIV disease progression and CD4 cell loss—than people who remained on ARVs throughout the course of the study.

When accounting for poorer adherence and other factors, ARV discontinuation and intermittent utilization were both strongly predictive of a high viral load.

These study results suggest that “adjuvant mental health and substance abuse treatment will be needed to promote sustained ART utilization [and] achieve viral suppression,” the authors stated.

“In the context of HIV medical care, this will require implementation of rapid screening tools for depression and substance abuse and efficient methods for linkage to mental health and/or substance abuse treatment,” they concluded.

Helpful notes:

CD 4 stands for cluster of differentiation. Lymphocytes, a type of immune blood cell in the body, that are infected by HIV and decline. Robust CD4 activity is necessary for antibody production in response to infection or vaccination.

Viral load is a measure of the severity of a viral infection, and can be calculated by estimating the amount of virus in an involved body fluid.

HIV: Acronym for the Human Immunodeficiency Virus, the cause of AIDS .

ARV:anti retroviral therapy

Cohort:, population based or selected on the basis of a previous disease.

Read the text and answer the following questions:

1.Who has less possibilities of being successful with the antiretroviral therapy?

2.In which way do psychological and  substance abuse problems may affect people with HIV?

3.What was the initial purpose of the study carried out by Adam Carrico?

4. How long did the study last?

5. What is intermittent ARV?

What happened to the people that discontinued ARVs?

Find synonyms in the text for:

Result; worry;beginning;supplementary;association 

Alicia Keys' Last Tweet and Testament

TEXT ALICIA TO 90999.
@aliciakeys is dead. Alicia sacrificed her digital life to help Keep a Child Alive save millions of real lives affected by HIV/AIDS in Africa and India. This is her Last Tweet and Testament, the last message she will send out until $1,000,000 is raised to buy her digital life back. Visit http://bit.ly/a1wqi6 to buy her life back now, and then join the fight against this horrible disease by sacrificing your own digital life.

Listen to Alicia´s Key video and answer the questions below:

a)What has been Alicia´s Key decision?

b)What is her heart devoted to?

c)Complete the following text :

So until enough money is ___________to buy back my _______life, no more tweets and no more ______   ______

d) What is the money for?  To _______the medicine, the ________and the food that is so needed to fight this _____________     _______________

Bono Gathers Celebs for AIDS Campaign

In advance of a documentary called 'The Lazarus Effect' that airs on HBO on May 24th, Bono's Product Red campaign created this public service announcement to spread the word about how easy it is to save the lives of people with HIV. (May 3)

             1.  Name at least 6 objects from the video.  
             2. What are the 40 cents for? What is this campaign for?
The Aids Song / Jony Jerusalem 
The aids stigma song, a song that talk about the aids stigma and call everyone to smash the aids stigma and give big huge to hiv personals. Jony Jerusalem hiv positive for 7 years wrote this song and hope that it will help us do it
      No one is to blame because I’m just the same

As the people you meet when you walk down the street

We all have a purpose, a life to fulfill

Though some may be healthy and some may be ill

The trouble that hides in me couldn’t be worse

The illness inside me is more like a curse

For I have a virus and AIDS is its name

But don’t turn away from me, I’m not to blame

There are viruses, illnesses, cancers, disease

That can wrestle the strongest of men to his knees

But of all the diseases that cut short one’s life

Only AIDS has a stigma that cuts like a knife

   No, don’t turn away from him, don’t try to hide

   From the person who suffers this sickness inside

   No, don’t turn away for the sake of a name

   For you know, deep inside, we are all just the same

And always remember that though this is true

It doesn’t make me less a person than you

So try to be loving and don’t criticise

Though the stigma may burn in society’s eyes

Yes, the virus may be in the blood in my veins

But I’m just like you, we’re all just the same

I’m still the same person I was yesterday

So next time you see me, please don’t turn away

Remember there’s no one this virus ignores

Though you’ve locked up your houses and bolted the doors

Remember the powerful key that you hold

That opens the heart and brings hope to the soul

   No, don’t turn away, be a friend, understand

   No matter what happens a man’s still a man

   And I call from the heart that beats deep in my breast

   Be loving and patient and look for the best 
       
Write in very brief lines what is the song about. 
Listen to the song clicking on this weblink:
THE AIDS SONG


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