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营养不良是导致人免疫缺陷病毒(HIV)感染者和艾滋病患者出现不良预后的重要因素,国内一些研究证据发现,营养不良在HIV感染者和艾滋病患者中普遍存在。对接受抗病毒治疗的患者,都应定期对其进行常规营养不良筛查,以早期发现营养不良。营养咨询是医学营养治疗的基础,可有效促进蛋白质和热量摄入达到标准。对于经咨询后经口摄入仍不能达标的患者,应首先给予肠内营养支持。血脂是接受艾滋病抗病毒治疗(ART)患者需要长期关注的问题,对于脂代谢异常者,应首先考虑调整膳食结构。总之,营养不良已经成为中国HIV感染者和艾滋病患者面临的主要挑战。现有各种艾滋病关怀项目应重视患者的热量和蛋白质摄入问题。应将医学营养治疗纳入国家和社区艾滋病治疗指南的一部分。     

HIV感染者和AIDS病人的咨询需求

目的 对艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人的AIDS咨询需求进行调查。方法 对111名HIV感染者和AIDS病人进行流行病学问卷调查和个人深入访谈。结果 90％以上的第1次咨询是在感染以后。对于期望的咨询方式，HIV感染者最希望获得面对面咨询，占81．98％。结论 在今后的工作中需要加强咨询人员面对面的咨询能力。     

Association between HIV/AIDS knowledge and stigma towards people living with HIV/AIDS in Botswana

In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative data from the 2013 Botswana AIDS Impact Survey (BAIS) IV to examine the relationship between HIV/AIDS knowledge and stigmatising attitudes toward people living with HIV/AIDS (PLWHA). The mean (standard error) for stigma towards PLWHA score and HIV/AIDS knowledge score were 0.99 (0.02) and 5.90 (0.03) respectively. HIV/AIDS knowledge score and stigma towards PLWHA score were strongly positively correlated r (4,4045) = 0.415, p < 0.001). After adjusting for potential confounders, HIV/AIDS knowledge score significantly predicted stigma towards PLWHA score [coefficient β (95% CI)] [?0.25 (?0.29, ?0.20), p < 0.001]. These findings imply that programmes and interventions that increase HIV/AIDS knowledge may reduce the pervasive apprehension, blame, and stigmatising attitude held towards PLWHA in Botswana.     

老年HIV感染者/AIDS病人临床特征的研究

目的探讨分析老年艾滋病（AIDS）病人的临床特点以及治疗经验。方法回顾性研究1999-2007年收治的、年龄超过60岁的、老年艾滋病病毒（HIV）感染者/AIDS病人的临床数据资料,包括人口统计学、免疫学指标、病毒学指标、机会性疾病及HIV/AIDS诊断情况,以及老年抗病毒治疗情况等。结果13例病人中,男性10例,女性3例;年龄平均63.6岁（61～71岁）;4例经过性传播途径感染,2例经过输血传播,7例不详。CD4^＋T淋巴细胞26-1 395/μl,平均262/μl;CD8^＋T淋巴细胞484-7 591/μl,平均1 395/μl;病毒载量1例检测结果是〈50拷贝/ml,4例为3.43-5.46Log10拷贝/ml,平均4.44 Log10拷贝/ml。机会性感染中,真菌感染为40%,结核30%,CMV感染20%,消耗综合征20%。13例中7例进行了抗病毒治疗。结论老年人感染HIV/AIDS可以造成各种机会性疾病。老年HIV感染者/AIDS病人需要进行联合的抗逆转录病毒治疗。     

Food challenges facing people living with HIV/AIDS in Zimbabwe

This study explored the food challenges facing people living with HIV/AIDS in Tsholotsho, Zimbabwe. Tsholotsho is a socio-economically disadvantaged, rural district in Zimbabwe and has one of the highest HIV prevalence rates in the country. For this study, face to face in-depth interviews were held with men and women living with HIV/AIDS. The findings of the study indicate that the economic situation in the country coupled with the lack of adequate rainfall has posed challenges to the ability of HIV/AIDS patients to maintain a healthy diet. In addition, there were concerns about the departure of non-government organisations which used to provide them with food parcels. The interviews also reveal that indigenous foods are being replaced by processed foods that are less healthy. Lack of employment opportunities and safety networks were some of the other factors leading them to experience food challenges in their everyday lives particularly in terms of access. As food security and good nutrition are key for maintaining physical and emotional health, the cumulative effects of these factors create a difficult environment to access food.     

HIV/AIDS病人结核病可疑症状筛查问卷初探

目的 探讨结核病筛查问卷在HIV/AIDS病人中确诊和排除活动性结核的作用,为基层医生HIV/AIDS中活动性结核的诊断提供参考。 方法 2006年9月至2007年2月,对4个县HIV/AIDS病人进行连续纳入,通过结核病筛查问卷收集了每个患者的结核病可疑症状信息,并对部分患者进行了进一步的临床检查。分析了单一症状,多个症状在活动性结核诊断上的敏感度、特异度、似然比、验后概率。分析采用的金标准是当地艾滋病诊断治疗专家组根据痰检、X线胸片等定诊结果。 结果我国当前采用的HIV/AIDS病人结核病筛查问卷灵敏度为100%,特异度为65.6%。HIV/AIDS病人中可疑症状出现频次排序依次为：咳嗽、咳痰、夜间盗汗、和容易疲劳。出现痰中带血、反复低烧的患者,患活动性结核的概率显著增加。单一症状分析,咳嗽、咳痰在诊断活动性结核上灵敏度最高为92.1%,特异度为73.8%。咳嗽、咳痰阴性是排除活动性结核的有力指标。可疑症状筛查阳性患者中,出现1～3个症状的可疑者占85.4%,发现了78.6%的确诊活动性结核。仅有1个症状可疑者,验后概率为5%,同时,拥有2～5个可疑症状的患者,验后概率均稳定在12%左右,应受到同等重视。 结论 结核病筛查问卷筛查成本低且有效。在资源有限,缺少诸如培养条件地区,简单可行的筛查问卷是发现活动性结核的有力工具。     

The potential role for probiotic yogurt for people living with HIV/AIDS

In demonstrating that it is feasible to create a community-run kitchen that produces probiotic yogurt, and that this can contribute to the health of people with HIV/AIDS, we embellished the 2001 Food and Agriculture Organization (FAO) and World Health Organization (WHO) report on probiotics that recommended efforts be made to take probiotics to developing countries. We proved that driven by humanitarian goals not profit, probiotic yogurt can be produced in the world''s poor regions. This food can be safely consumed by HIV/AIDS subjects, and in many of them benefits can be accrued in gut health, nutritional and potentially immune status. Such outcomes have a scientific rationale, many social implications, and perhaps most importantly raise the question, why have developed countries not tried harder to bring nutrition-based probiotics to people in need?Key words: probiotics, yogurt, HIV/AIDS, Africa, community kitchen, diarrhea     

Stigma,discrimination and the implications for people living with HIV/AIDS in South Africa

Stigma and discrimination play significant roles in the development and maintenance of the HIV epidemic. It is well documented that people living with HIV and AIDS experience stigma and discrimination on an ongoing basis. This impact goes beyond individuals infected with HIV to reach broadly into society, both disrupting the functioning of communities and complicating prevention and treatment of HIV. This paper reviews the available scientific literature on HIV/AIDS and stigma in South Africa, as well as press reports on the same subject over a period of 3 years. Analysis of this material indicates that stigma drives HIV out of the public sight, so reducing the pressure for behaviour change. Stigma also introduces a desire not to know one's own status, thus delaying testing and accessing treatment. At an individual level stigma undermines the person's identity and capacity to cope with the disease. Fear of discrimination limits the possibility of disclosure even to potential important sources of support such as family and friends. Finally, stigma impacts on behaviour change as it limits the possibility of using certain safer sexual practices. Behaviour such as wanting to use condoms could be seen as a marker of HIV, leading to rejection and stigma. All interventions need to address stigma as part of their focus. However, the difficulty of the task should not be underestimated, as has been shown by the persistence of discrimination based on factors such as race, gender and sexual orientation.     

Causes of death among people living with HIV/AIDS in Brazil

BackgroundThe monitoring of the underlying causes of death in people living with HIV/AIDS is important so that actions to reduce morbidity and mortality can be taken.ObjectiveTo describe the temporal trends of underlying causes of death among people living with HIV/AIDS between 2000 and 2007 in Brazil and to identify factors associated with it.MethodsThe Mortality Information System data for deaths occurred in Brazil between 2000 and 2007 that contained reference to HIV/AIDS in any of the death certificate fields was analyzed. Temporal trends of the underlying cause of death were studied. Differences in the underlying cause of death according to gender, age, region of residence, level of education, certifying officer, race and year of death were verified.ResultsBetween 2000 and 2007 the percentage of deaths not related to HIV/AIDS among people living with HIV/AIDS increased from 2.5% to 7.0%. People with higher level of formal education, living in the South-East region of Brazil and aged under 13 or over 60 years old were more likely to have their underlying cause of death reported as not related to HIV/AIDS.ConclusionThe results suggest the importance of implementing actions aimed at improving the quality of life of PLWHA, and which could include behavioral changes, such as smoking and alcoholism cessation, early screening to detect neoplasms and the monitoring of chronic conditions, such as diabetes. That is to say, the need exists to integrate the actions of HIV/AIDS programs with other public health programs.     

Disclosure and religion among people living with HIV/AIDS in France

The aim of this study was to examine associations between the importance of religion and disclosure of HIV seropositivity within sero-nonconcordant couples. In 2003, a face-to-face survey was conducted among patients selected in a random stratified sample of 102 French hospital departments delivering HIV care. Respondents who reported being in a couple with a non-HIV-positive partner were asked whether they had disclosed their HIV positive status to their partner and if religion represented an important aspect of their life. Among the 2932 respondents, 1285 were in a sero-non-concordant regular partnership. Among these, 37.5% reported that religion played an important role in their life; 7.2% had not disclosed their HIV-positive status to their partner, and 11.6% were unaware of their partner's HIV status. Lack of HIV disclosure to the partner was encountered more often among those who considered religion as an important aspect of their life. After multiple adjustment for socio-demographic factors, and for partnership characteristics, the importance of religion in the respondent's life remained independently associated with a lack of HIV disclosure to the regular partner. In conclusion, individuals who place importance on religion appear to have difficulties in disclosing their HIV-positive status due to the associated stigma and fear of discrimination.     

HIV/AIDS患者并发贫血的临床研究

目的　了解艾滋病病毒 /艾滋病 (HIV/AIDS)患者贫血并发情况 ,探讨贫血程度对判定HIV/AIDS患者病情进展的意义。方法　对未经治疗的HIV/AIDS患者检测免疫功能指标 (CD+ 4 T细胞 )和全血细胞计数。遵循美国疾病控制与预防中心 (CDC) 1993年诊断标准 ,对 94例HIV/AIDS患者按病情阶段分为A、B、C组。对血红蛋白浓度 (HGB)和病情阶段及CD+ 4 T细胞之间的关系进行统计学分析。结果　 94例HIV/AIDS患者中有 37例并发贫血 ,在A、B、C组贫血的发生率分别为 5 6 %、2 4 1%、6 1 7% ,贫血发生率在 3组间差异有非常显著的统计学意义 (χ2 =2 1 2 6 3,P <0 0 0 1)。 37例贫血患者的HGB在 3组间差异有显著的统计学意义 (F =4 978,P =0 0 13)。对 94例AIDS患者的CD+ 4 T细胞与HGB进行曲线拟合分析 ,发现二者之间存在曲线相关 (P <0 0 0 1) ,曲线回归方程为HGB =2 3 2 4 6×ln(CD+ 4 )。结论　AIDS患者贫血的发生率较高 ,贫血的发生率及严重程度随着病情的进展而发展。HGB随着免疫功能的衰减而下降。贫血的程度对AIDS患者的病情评判有重要意义     

Use of alternative therapies by people living with HIV/AIDS in Australia

Few studies of use of complementary and alternative medicine (CAM) among people living with HIV/AIDS (PLWHA) have been conducted since combination antiretroviral (ARV) drug therapy became widespread. In the context of changing ARV treatment options, it is important to consider the prevalence and correlates of use of CAM. In this study, a sample of 924 Australian PLWHA completed a self-administered survey that included questions on use of CAM. Half (55%) of the respondents reported using CAM. Most PLWHA did not choose CAM as an alternative to ARV drugs, but use CAM to complement ARV drugs. Use of CAM was not related to measures of progression of HIV/AIDS disease. In contrast, CAM use was related to characteristics of the ways respondents live with HIV/AIDS, and their attitudes toward treatment. The popularity of CAM among PLWHA highlights a need to ensure that PLWHA can make informed choices about CAM use.