Aging with HIV

Aging isn’t easy for any of us. Our bodies aren’t quite as fast as they used to be, recovery time is longer and we have a few more aches than when we were younger.

So is it actually harder for people living with HIV to age well? 

Research shows that it is. 


Specifically, they experience:

• Increased likelihood of living with more than one adverse health condition at once (multimorbidity), including hepatitis C, hypertension, cognitive dysfunction and frailty.

• Stigma both from HIV infection and from aging. Negative stereotypes of aging, including viewing older people as needy, senile and less useful than younger people, persist and can be added to the negative stereotypes and overt discrimination of HIV infection. Stigmas can lead to increased symptoms and decreased quality of life. We can all help reduce these negative stereotypes by learning the facts about HIV and aging, respecting this population, and fostering hope and empowerment among aging adults with HIV.

• Increased burden of symptoms, such as fatigue, pain and depression, perhaps worse in HIV-positive women. This negatively influences everything from daily functioning to employment to quality of life.

• Focus on HIV-related health issues at the expense of non-HIV-related health promotion and disease prevention.

There is no magic bullet for aging well, no matter your health status. Everyone needs to take their medications as prescribed, get a good night’s sleep, manage stress and see a health care provider regularly. However, there is new evidence that suggests that three promising, nonpharmacological strategies can help adults with HIV.

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Increasing the amount, intensity and frequency of physical activity. In HIV-positive adults, physical activity can improve cardiovascular health, can reduce distressing symptoms such as fatigue, and may improve cognitivefunctioning. In the general population, it reduces all types of chronic health conditions, including hypertension, diabetes and depression, but its effect on these conditions in aging adults with HIV has not yet been tested in a large clinical trial. Yet, we also know that most HIV-positive adults do not engage in regular, intense physical activity.

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Eating a nutritious, balanced diet can reduce chronic health conditions and may reduce symptom burden, but there has been less research on this since HIV became a chronic disease. What we do know is that limiting alcohol consumption is a critical part of the aging, HIV-positive person’s diet.


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Positive social interactions can improve HIV treatment adherence and aspects of quality of life and can reduce symptom burden. While researchers aren’t sure which types of interactions are the best, there is increasing evidence that regular, formal, paid employment can be beneficial. My research team also reported that volunteerism, activism and being involved in a spiritual community can also be sources of helpful social interactions.


Yet these strategies can be hard to engage in, particularly for a historically marginalized population that is dealing with aging for the first time. Several investigators, including my team, are studying new ways to help this aging population.

Over the past three years, a research team conducted a clinical trial with 109 HIV-positive adults to see if a group-based intervention improved exercise and healthy eating. In November, at the American Heart Association Scientific Sessions, they reported that behavioral intervention reduced carbohydrate intake, specifically the consumption of sugar-sweetened beverages. However,  failed to improve physical activity in aging adults with HIV. Recently, others have reported that their interventions also did not increase physical activity, and suggest that a new, personalized approach to initiating and maintaining physical activity in this population is needed.

Breakthroughs in this area can lead to new treatment strategies to help not only HIV-positive adults age well, but also others who are living with complex chronic conditions.

So while we focus on curing HIV, we must also recognize that a cure is likely several decades away. In the meantime, millions of people struggle to age well with HIV. Our HIV-positive brothers and sisters have shown incredible resiliency over the past 36 years. Together, we undoubtedly will find innovative and personalized strategies to overcome these struggles.

This article was originally published on The Conversation. Read the original article here

Nigeria: The World Second Highest HIV/AIDS Burden

The United Nations Programme on HIV/AIDS (UNAIDS) yesterday reiterated that Nigeria carries the second highest HIV/AIDS burden in the world with 3.4 million Nigerians living with the disease in 2014.The figure represents 4.1 national prevalence rate.

UNAIDS country director, Dr Bilali Camara said this during a courtesy visit to the majority leader, House of Representatives, Femi Gbajabiamila at the National Assembly.

Camara also disclosed that $700 million was expended on HIV/AIDS control in the country in 2014, with a meagre 25 per cent of the sum contributed by the Nigerian government.

Camara said 58 per cent of the infected Nigerians are women while 124,000 children were infected through mother-to-child transmission (MTCT).

The UNAIDS country director said Nigeria’s HIV/AIDS prevalence has put the country on the scale of nations that need to do more to contain the disease.

“Despite the success stories recorded in the past, we still need to double our efforts in the fight to mitigate the negative effects by collaborating and coordinating efforts by all stakeholders.

“We as Africans have a responsibility to take up the global initiative on AIDS for the benefit of our people. Domestic resources have proved inadequate to match the global drive for eradication of the disease,” he stated.

In the area of funding, Camara noted that Nigeria should strive to match foreign donations in the fight against HIV/AIDS.

He also re-echoed the resolve expressed by President Muhammadu Buhari before world leaders that all that Nigeria and Africa needs is global assistance against corruption to enable it independently curb other social problems plaguing the continent.

“Like President Muhammadu Buhari told world leaders, Nigeria can face its problems alone provided it gets support in the fight against corruption. He said if we get help with corruption, Nigeria will stand alone, will fight alone and solve its problems as well as take the leadership role in Africa to the next level,” he added.

In his response, Hon Gbajabiamila said the global HIV/AIDS scourge has become a human right issue and cautioned against cutting foreign donor funding for HIV/AIDS in Africa.

From The Leadership
BY EDEGBE ODEMWINGIE AND BODE GBADEBO

Health Jobs at Management Sciences for Health

Management Sciences for Health (MSH) saves lives and improves health, especially among the world’s poorest and most vulnerable people, by closing the gap between knowledge and action in public health. Our mission is to save lives and improve the health of the world’s poorest and most vulnerable people by closing the gap between knowledge and action in public health.

Community Care Specialist

 
Overall Responsibilities

The objective of the Community Care Specialist position is to manage the MSH ProACT PHDP/Care and Support portfolio including HIV prevention, OVC services in a manner that strengthens linkages and synergy between community-based and facility-based services; in partnership with the state government, other implementing partners and the community itself.
 
Management responsibility

Together with ProACT headquarter and State Staff spearhead the effective and efficient implementation of the HIV prevention, OVC, Care and Support services, provided under the ProACT project.
Member of the State Project Management Team that is responsible for overall project performance.

Specific Responsibilities

*Provide technical input in the development of an integrated State project plan in collaboration with the State Teams.
*Together with the Clinical Care Specialist, take lead in the establishment of comprehensive HIV and TB services in supported health facilities.
*Conduct targeted advocacy to LGA and community leaders for implementation of OVC, care and support services and HIV prevention programs in target LGAs.
*Provide technical assistance to the implementing health facilities and target communities on HIV prevention programming, Care and Support including HTC, adherence support systems, and client retention strategies.
*In collaboration with the SCMS lead, monitor stock levels of Prevention, Care and Support commodities and OI drugs in the State and ensure timely procurement and distribution.
*Network with LGA, grantee CSO and community partners in the LGA to establish a functional referral system for clients between clinical and community-based HIV/AIDS services.
*Ensure timely relevant technical support to all grantee CBOs.
*Liaise with the M&E team to ensure functional monitoring, evaluation and reporting of HIV sexual prevention program, care and support/OVC services as required in the project PMPRepresent MSH ProACT project at the state and LGA level on matters of HIV Prevention, OVC and care and support.
*Document programmatic achievements and keep the State Team Leader informed on a monthly, quarterly and annual basis.
*Be part of the state capacity building and supervisory team ensuring quality HIV prevention program, OVC, care and support services are delivered
*Participate in activities to scale-up prevention interventions to target communities

ACCOUNTABILITY:

*Supervision:  Works independently with authority from the State Team Leader, within strategy and policy guidelines.
*Decision Making: Makes decisions with regards to work responsibilities and is accountable for them.
*Responsibility over data or information: Has access to information within project, and is responsible for guiding program data generation and management.

Qualifications

*Nurse with a graduate degree in a public health.  Social Worker with a graduate degree and  extensive experience working with PLHIV may be considered.
*Experience in HIV Sexual prevention programming and working with key populations, preferably in Nigeria. 
*Significant experience in HIV/AIDS Programs with a focus on HIV Care and Support, OVC in resource poor settings in Africa, preferably Nigeria.
*Experience working with CSOs and community structures as well as managing, and supervising allied health professionals.
*Experience with HIV/AIDS programs supported by bilateral agencies such as CDC/USAID and international agencies such as WHO and World Bank preferred, particularly those related to sub granting to CSOs, HTC, treatment adherence and provision for orphans and vulnerable children.
*Excellent oral and written communication skills and fluency in English.

Method of Application

Interested and suitably qualified candidates should click here to apply online.

Other jobs available too.

HIV drugs should be given at diagnosis

HIV drugs should be given at the moment of diagnosis, according to a major trial that could change the way millions of people are treated.
People currently get antiretroviral therapy only when their white blood cell levelsd rop.
But a US-led study has now been cut short as early treatment was so beneficial for patients.
The United Nations Aids agency has called for everyone to get immediate access to the drugs.
Around 35 million people are living with HIV and more than 2 million start antiretroviral therapy each year.
The discovery of drugs to attack the virus has profoundly changed the way the disease is treated.
But there has been fierce debate about when treatment should start.

Timing

World Health Organization guidelines say treatment should start when there are fewer than 500 white blood cells in every cubic millimetre of blood.
The trial on 4,685 people in 35 countries, organised by the US National Institutes of Health, compared this approach with immediate treatment.
The trial started in 2011 and was due to run until the end of 2016.
But an interim analysis of the data showed that cases of Aids, deaths and complications, such as kidney or liver disease, had already been halved by early treatment.

All patients on the trial are now being offered antiretroviral drugs.
The director of NIH's National Institute of Allergy and Infectious Diseases, Anthony Fauci, said: "We now have clear-cut proof that it is of significantly greater health benefit to an HIV-infected person to start antiretroviral therapy sooner rather than later.
"Moreover, early therapy conveys a double benefit, not only improving the health of individuals but at the same time, by lowering their viral load, reducing the risk they will transmit HIV to others.
"These findings have global implications for the treatment of HIV."

Early access

Michel Sidibe, executive director of at UNAids, argued: "Every person living with HIV should have immediate access to life-saving antiretroviral therapy.

"Delaying access to HIV treatment under any pretext is denying the right to health."

Dr Steve Taylor, the lead HIV Consultant at the Birmingham Heartlands HIV Service, told the BBC the trial was hugely important.
"Not least that they will they will change the way HIV treatment is prescribed in the UK and around the world.

"Based on this study, people will be able to access treatment much earlier than currently, which is good for their own health and will reduce HIV transmission."

Deborah Gold, chief executive of the National Aids Trust, said: "These exciting results should dramatically change the approach to treatment for people living with HIV, both in the UK and internationally

BBC.com

Ground Zero for HIV/AIDS

 

The deadly virus responsible for the global HIV/AIDS pandemic emerged around 1920 in the city of Kinshasa, the capital of the Democratic Republic of the Congo, according to new research that has relevance to the effort to understand how another deadly virus, Ebola, reestablished itself in West Africa.
The study, published in the journal Science, reveals that the HIV virus was already established and spreading in Africa long before the U.S. Centers for Disease Control and Prevention first took note of it. The CDC's first record of the illness occurred on June 5, 1981, when an unusual type of "pneumonia" was detected in five homosexual men from Los Angeles.
No one then knew that the deadly strain of the virus, which has since killed an estimated 39 million people, had already taken hold in the Congo some 60 years earlier.

Why First 30 Hours Critical for Killing HIV

"It seems a combination of factors in Kinshasa in the early 20th century created a 'perfect storm' for the emergence of HIV, leading to a generalized epidemic with unstoppable momentum that unrolled across sub-Saharan Africa," co-author Oliver Pybus, an Oxford University zoologist, said.
Lead author Nuno Faria, also from Oxford University's Department of Zoology, explained that "by the end of the 1940's, over one million people were traveling through Kinshasa on the railways each year." At the time, what is now the Democratic Republic of the Congo was under Belgian colonial rule and experiencing steady urban growth
Faria and his team examined the genetics of 348 "HIV-1 group M" samples from the former Belgian Congo, and 466 additional samples from nearby regions. This particular viral strain, "M," has proven to be the deadliest in humans, but virologist Beatrice Hahn of the University of Pennsylvania explained to Discovery News that it represents just one of several different instances where the illness jumped from a non-human primate to people -- likely by the consumption or handling of bushmeat.

Ebola's Deadly Jump From Animal to Animal

The researchers next compared the relatedness of the HIV genetic sequences to create phylogenies, or family trees. The scientists then calculated the rate at which the virus mutates to date the origin of each "branch" on the trees.
This reconstruction of the genetic history of HIV-1 group M revealed both the date and location of the epidemic's origins, placing Kinshasa at ground zero.
Prior research suggests that one or more people first contracted the virus from an infected chimpanzee in southeastern Cameroon. The new study holds that the individual(s) traveled to Kinshasa, where the virus became established in humans and spread.

From 1920 to 1960, the deadly viral strain and another HIV variant gradually infected people in places like Mbuji-Mayi and Lubumbashi to the south of Kinshasa. Those towns were major mining centers, so workers would travel to them via the rail lines. The virus also spread to the city of Kisangani in the north and to other outlying locations.
Beginning in 1960, however, the group M HIV virus spread tremendously escalated. The researchers attribute this to ever-increasing travel, involving Europeans, Americans and others in addition to Africans, as well as to unsterilized needles.
The needles are widely thought to have been used by public health workers attempting to eradicate other sexually transmitted diseases at a time when prostitution in the area was prevalent.

A Way to Fight the AIDS Virus With a Virus

Anthropologist James Moore of the University of California at San Diego previously studied HIV/AIDS in Kinshasa and surrounding regions.
Moore told Discovery News "that sincere, well-meaning people cutting corners in order to address genuine problems can create even worse ones."
Moore, however, is not fully convinced that the unsterilized needle usage believed to transmit the virus from person to person was limited to health campaigns targeting sex workers.

How Can Ebola Be Stopped?

He said that "the role of colonial doctors, such as Eugene Jamot, performing massive numbers of injections during smallpox and sleeping sickness campaigns in the origin of the disease keeps getting minimized. We can't learn from what we ignore."
Moore and others hope that further studies on the origins of HIV will help to unravel not only how this virus originated in humans, but also how other viruses that transmit via blood and bodily fluids, such as Ebola and Hepatitis C, became established in humans and continue to spread.
All three are believed to be zoonotic diseases, meaning that they jumped from non-human animals to people.

reference:
 http://news.discovery.com/human/health/ground-zero-for-hiv-aids-idd-1410021.htm

Preventing HIV Transmission

There are a number of effective tools available to help prevent HIV infection.

These include

• ·       condom use
• ·       male circumcision
• ·       PrEP (pre-exposure prophylaxis --the use of anti-retroviral (ARV)medication in HIV-negative people at high risk for HIV) and
• ·       post-exposure prophylaxis (which involves taking ARV medication as soon as possible after exposure to HIV).

For people who inject drugs, syringe exchange programs and substance abuse treatment are important elements of HIV prevention.

Furthermore, the appropriate use of ARV medications by people who are HIV positive can lower viral load and reduce HIV transmission to their HIV negative partners by 96 percent.

EARLY SYMPTOMS OF HIV/AIDS IN WOMEN.

Question: What are the Symptoms of HIV / AIDS in Women?

Answer:

While it's possible that a woman infected with HIV could display no symptoms, it's more typical that women infected with HIV will experience some subtle signs and symptoms of HIV that they may not perceive as warning signs of HIV infection.

The three most common symptoms experienced by women after exposure to HIV are:

• ·       Frequent or severe vaginal infections
• ·       Abnormal Pap smears
• ·       Pelvic infections such as PID that are difficult to treat

Other signs and symptoms of HIV infection include:

• ·       Recurrent vaginal yeast infections
• ·       Pelvic inflammatory disease or PID
• ·       Pap smears that indicate abnormal changes or dysplasia
• ·       Genital ulcers
• ·       Genital warts
• ·       Severe mucosal herpes infections

Frequently, women exposed to HIV experience flu-like symptoms within a couple of weeks of becoming infected. In other cases, there are no symptoms for many years.

As the infection progresses, it is not uncommon to experience symptoms such as:

• ·       Swollen lymph glands in the neck, underarm area, or groin
• ·       Frequent fevers that include night sweats
• ·       Rapid weight loss without dieting
• ·       Constant fatigue
• ·       Decreased appetite and diarrhoea
• ·         White spots or abnormal blemishes in the mouth