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Search Results: 1 - 10 of 30562 matches for " Anti-HIV agents/supply and distribution "
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Adapta??o brasileira do "Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral"
Remor,Eduardo; Milner-Moskovics,Jenny; Preussler,Gisele;
Revista de Saúde Pública , 2007, DOI: 10.1590/S0034-89102006005000043
Abstract: objective: the "cuestionario para la evaluación de la adhesión al tratamiento antiretroviral" (assessment of adherence to antiretroviral therapy questionnaire) is a self-administered instrument for the assessment of adherence rates to antiretroviral therapy in hiv-infected patients. the objective of the present study was to translate, adapt and validate the questionnaire for its use in brazil. methods: the questionnaire was translated from the spanish original into brazilian portuguese using the forward-backward translation method (spanish/portuguese/spanish), followed by verbal assessment of understanding in a small group of patients. then the instrument's psychometric properties were studied in a sample of 59 hiv-infected patients under antiretroviral therapy. patients were interviewed in an hiv/aids clinic in the city of porto alegre, southern brazil, between june and november 2005. the validation process of the questionnaire's reliability included the analysis of internal consistency, external criterion-related validity, sensitivity, and specificity. results: the results showed the questionnaire's adequate reliability (a=0.64) and external criterion-related validity (viral load; r=-0.48; p<0.001). adequate sensitivity (79.2%) and specificity (57.1%) for the detection of subjects with detectable versus undetectable viral loads were also found. conclusions: the brazilian portuguese version of the questionnaire proved to be useful, reliable and valid for the assessment of adherence rates to antiretroviral therapy in patients living with hiv.
International response to the HIV/AIDS epidemic: planning for success
Piot,Peter; Coll Seck,Awa Marie;
Bulletin of the World Health Organization , 2001, DOI: 10.1590/S0042-96862001001200006
Abstract: more assertive political leadership in the global response to aids in both poor and rich countries culminated in june 2001 at the un general assembly special session on aids. delegates made important commitments there, and endorsed a global strategy framework for shifting the dynamics of the epidemic by simultaneously reducing risk, vulnerability and impact. this points the way to achievable progress in the fight against hiv/aids. evidence of success in tackling the spread of aids comes from diverse programme areas, including work with sex workers and clients, injecting drug users, and young people. it also comes from diverse countries, including india, the russian federation, senegal, thailand, the united republic of tanzania, and zambia. their common feature is the combination of focused approaches with attention to the societywide context within which risk occurs. similarly, building synergies between prevention and care has underpinned success in brazil and holds great potential for sub-saharan africa, where 90% reductions have been achieved in the prices at which antiretroviral drugs are available. success also involves overcoming stigma, which undermines community action and blocks access to services. work against stigma and discrimination has been effectively carried out in both health sector and occupational settings. accompanying attention to the conditions for success against hiv/aids is global consensus on the need for additional resources. the detailed estimate of required aids spending in low- and middle-income countries is us$ 9.2 billion annually, compared to the $ 2 billion currently spent. additional spending should be mobilized by the new global fund to fight aids, tuberculosis and malaria, but needs to be joined by additional government and private efforts within countries, including from debt relief. commitment and capacity to scale up hiv prevention and care have never been stronger. the moment must be seized to prevent a global catastrophe.
International response to the HIV/AIDS epidemic: planning for success
Piot Peter,Coll Seck Awa Marie
Bulletin of the World Health Organization , 2001,
Abstract: More assertive political leadership in the global response to AIDS in both poor and rich countries culminated in June 2001 at the UN General Assembly Special Session on AIDS. Delegates made important commitments there, and endorsed a global strategy framework for shifting the dynamics of the epidemic by simultaneously reducing risk, vulnerability and impact. This points the way to achievable progress in the fight against HIV/AIDS. Evidence of success in tackling the spread of AIDS comes from diverse programme areas, including work with sex workers and clients, injecting drug users, and young people. It also comes from diverse countries, including India, the Russian Federation, Senegal, Thailand, the United Republic of Tanzania, and Zambia. Their common feature is the combination of focused approaches with attention to the societywide context within which risk occurs. Similarly, building synergies between prevention and care has underpinned success in Brazil and holds great potential for sub-Saharan Africa, where 90% reductions have been achieved in the prices at which antiretroviral drugs are available. Success also involves overcoming stigma, which undermines community action and blocks access to services. Work against stigma and discrimination has been effectively carried out in both health sector and occupational settings. Accompanying attention to the conditions for success against HIV/AIDS is global consensus on the need for additional resources. The detailed estimate of required AIDS spending in low- and middle-income countries is US$ 9.2 billion annually, compared to the $ 2 billion currently spent. Additional spending should be mobilized by the new global fund to fight AIDS, tuberculosis and malaria, but needs to be joined by additional government and private efforts within countries, including from debt relief. Commitment and capacity to scale up HIV prevention and care have never been stronger. The moment must be seized to prevent a global catastrophe.
Tuberculose e infec??o pelo HIV no Brasil: magnitude do problema e estratégias para o controle
Jamal,Leda Fátima; Moherdaui,Fábio;
Revista de Saúde Pública , 2007, DOI: 10.1590/S0034-89102007000800014
Abstract: the aim of the article was to propose, based on an analysis of the current scenario and of the interaction between tuberculosis and aids, strategies to minimize the epidemiological impact of one disease over the other in brazil. the manner by which health policies aimed at controlling the hiv/aids epidemic is analyzed - such as access to antiretroviral drugs and campaigns for the early detection of hiv infection and for encouraging adherence to treatment - and their impact on the achievement of goals related to controlling tuberculosis. the implementation of measures for preventing the onset of tuberculosis in hiv-infected individuals, early detection of tuberculosis disease, and ensuring treatment adherence, is discussed. it is commented upon the role that brazil may assume in the global effort to develop a therapeutic arsenal and the need for integrated work between the fields of tuberculosis and hiv/aids.
Avalia??o das metas de recursos previstos na declara??o sobre HIV/Aids das Na??es Unidas
Teixeira,Luciana;
Revista de Saúde Pública , 2006, DOI: 10.1590/S0034-89102006000800008
Abstract: this study evaluates the targets of the united nations declaration on hiv/aids resource targets, the attainment of which are premised on promoting three fronts: reduction of material and services costs, increased efficiency in access to and management of funds, and the channeling of new funds. data were derived from studies of national accounts of hiv/aids in latin america and the caribbean and from the recent available literature on the global dynamics of hiv/aids resources. the economic concept of global public good occurs throughout the text. the article discusses factors that constrain funding, and thus compel the adoption of new strategies in brazil. the issues addressed include: difficulties in maintaining the downward tendency in the cost of items related to the hiv/aids epidemic, the incorporation each year of thousands of persons needing antiviral therapy, the rise in patient survival and increased diagnosis for the control of hiv/aids transmission. it is concluded that, in order to guarantee additional resources to combat the epidemic, the discussion on funding must necessarily focus on both the share of aids support for the brazilian ministry of health, and, more importantly, on an increase in health funding as a whole. the recognition that hiv/aids control contributes to the global public good should facilitate increases in development assistance from international funding sources.
Assistência aos pacientes com HIV/Aids no Brasil
Portela,Margareth Crisóstomo; Lotrowska,Michel;
Revista de Saúde Pública , 2006, DOI: 10.1590/S0034-89102006000800010
Abstract: this study was intended to assess care provided to those living with hiv/aids in brazil and the brazilian unified health system (sus) capacity of delivering interventions to cope with the epidemic as well as to discuss the sustainability of the brazilian initiative of providing universal free access to antiretrovirals (arvs). original data from a study comprising 119 respondents on the potential capacity of delivering a prospective hiv vaccine in brazil was used. inpatient and pharmaceutical care was based on data from the sus hospital information system and drug logistics management systems of the national program for std/aids. the study results indicate good performance of the brazilian arv access program but access to treatment of opportunistic infections was, however, unsatisfactory. the rates covered by sus for aids hospital admissions remained very low, on average around r$700 in 2004. health care to hiv/aids patients has been considered a citizen's right strongly supported by an effective joint action of the brazilian government and civil society. the current challenges are fine monitoring of processes and program results and ensuring sustainability of universal free arv access.
Usuários de drogas injetáveis e terapia anti-retroviral: percep??es das equipes de farmácia
Yokaichiya,Chizuru Minami; Figueiredo,Wagner dos Santos; Schraiber,Lilia Blima;
Revista de Saúde Pública , 2007, DOI: 10.1590/S0034-89102007000900005
Abstract: objective: to understand the perceptions of pharmacy teams about their role in the healthcare assistance challenges and adherence to antiretroviral therapy by injecting drug users living with hiv/aids. methods: qualitative study through focus groups and thematic discourse analysis of pharmacists, technicians and assistants with more than six months of experience with medication supply, in 15 assisting units for std/aids in the city of s?o paulo, in 2002. results: three groups were formed, totaling 29 participants, originating from 12 out of the 15 existing services, and including 12 university level professionals and 17 high-school level professionals. the groups concluded that the pharmacy has an important role in the antiretroviral drug supply, which is reflected in the treatment adherence, because trust-based relationships can be built up through their procedures. in spite of this, they pointed out that such building-up does not take place through excessively bureaucratic activities. this has negative repercussions for all patients, especially for injecting drug users, considered "difficult people". such concept sums up their behavior: they are supposed to be confused and incapable to adhere to treatment, and have limited understanding. staff members, however, affirm they treat these patients equally. they do not realize that, by this acting, the specific needs of injecting drug users may become invisible in the service. there is also the possibility that stigmatizing stereotypes may be created, resulting in yet another barrier to the work on adherence. conclusions: although the pharmacy is recommended as a potentially favorable place to listen to and form bonds with users, the results show objective and subjective obstacles to render it suitable for the work on adherence.
Avalia??o da estrutura organizacional da assistência ambulatorial em HIV/Aids no Brasil
Melchior,Regina; Nemes,Maria Ines Battistella; Basso,Cáritas Relva; Castanheira,Elen Rose Lodeiro; Britto e Alves,Maria Teresa Soares de; Buchalla,Cássia Maria; Donini,Angela Aparecida; ,;
Revista de Saúde Pública , 2006, DOI: 10.1590/S0034-89102006000100022
Abstract: objective: in the context of universal access to antiretroviral treatment, the results of the brazilian aids program will depend on the quality of the care provided. the aim of the present study was to evaluate the healthcare provided by outpatient services for the treatment of aids patients. methods: the present study was carried out in seven brazilian states between 2001 and 2002. we evaluated the quality of the care provided to aids patients from the standpoint of resource availability and care process organization. a questionnaire comprising 112 structured questions addressing these aspects was sent to 336 services. results: response rate was 95.8% (322). greater adequacy is seen for indicators of resource availability than for those of work organization. the supply of antiretroviral medication is sufficient in 95.5% of services. cd4 and viral load tests are available at adequate amounts in 59 and 41% of services, respectively. in 90.4% of services there is at least one non-medical professional (psychologist, nurse, or social worker). as to work organization, 80% scheduled the date but not the time of medical appointments; 40.4% scheduled more than 10 appointments per period; 17% did not have exclusive managers; and 68.6% did not hold systematic staff meetings. conclusions: the results indicate that, in addition to ensuring the more homogeneous distribution of resources, the program must invest in the training and dissemination of care management skills, as confirmed by the results of care process organization.
Sustentabilidade da política de acesso a medicamentos anti-retrovirais no Brasil
Grangeiro,Alexandre; Teixeira,Luciana; Bastos,Francisco I.; Teixeira,Paulo;
Revista de Saúde Pública , 2006, DOI: 10.1590/S0034-89102006000800009
Abstract: objective: the expense of acquiring antiretroviral drugs in brazil has given rise to debate about the sustainability of the policy of universal access to aids medications, despite the evident benefits. the objective of this study was to analyze the evolution of the ministry of health's spending on acquiring antiretroviral drugs from 1998 to 2005, the determining factors and the medium-term sustainability of this policy (2006-2008). methods: the study on the evolution of spending on antiretrovirals included analysis of their prices, the year-by-year expenditure, the number of patients utilizing the medication, the mean expenditure per patient and the strategies for reducing the prices maintained during this period. to analyze the sustainability of the policy for access to antiretrovirals, the cost of acquiring the drugs over the period from 2006 to 2008 was estimated, along with the proportion of gross domestic product and federal health expenditure represented by this spending. the data were collected from the ministry of health, the brazilian institute for geography and statistics (ibge) and the ministry of planning. results: the expenditure on antiretrovirals increased by 66% in 2005, breaking the declining trend observed over the period from 2000 to 2004. the main factors associated with this increase were the weakening of the national generics industry and the unsatisfactory results from the process of negotiating with pharmaceutical companies. conclusions: the brazilian policy for universal access is unsustainable at the present growth rates of the gross domestic product, unless the country compromises its investments in other fields.
The Anti-HIV Actions of 7- and 10-Substituted Camptothecins
Yu-Ye Li,Shi-Wu Chen,Liu-Meng Yang,Rui-Rui Wang,Wei Pang,Yong-Tang Zheng
Molecules , 2010, DOI: 10.3390/molecules15010138
Abstract: Camptothecin (CPT), a traditional anti-tumor drug, has been shown to possess anti-HIV-1 activity. To increase the antiviral potency, the anti-HIV activities of two CPT derivatives, 10-hydroxy-CPT and 7-hydroxymethyl-CPT, were evaluated in vitro. The therapy index (TI) of CPT, 10-hydroxy-CPT and 7-hydroxymethyl-CPT against HIV-1IIIB in C8166 were 24.2, 4.2 and 198.1, and against clinical isolated strain HIV-1KM018 in PBMC were 10.3, 3.5 and 66.0, respectively. While the TI of CPT, 10-hydroxy-CPT and 7-hydroxymethyl-CPT against HIV-2CBL-20 were 34.5, 10.7 and 317.0, respectively, and the TI of the three compounds against HIV-2ROD showed the similar values. However, when the antiviral mechanisms were considered, we found there was no inhibition of 7-hydroxymethyl-CPT on viral cell-to-cell transmission, and was no inhibition on reverse transcriptase, protease or integrase in cell-free systems. 7-Hydroxymethyl-CPT showed no selective killing of chronically infected cells after 3 days of incubation. In conclusion, 7-hydroxymethyl-CPT showed more potent anti-HIV activity, while 10-hydroxy-CPT had less efficient activity, compared with the parent CPT. Though the antiviral mechanisms remain to be further elucidated; the modification of -OH residues at C-7 of CPT could enhance the antiviral activity, while of -OH residues at C-10 of CPT had decreased the antiviral activity, which provides the preliminary modification strategy for anti-viral activities enhancement of this compound.
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