Recombinant HIV-1 Rev protein (SF162)

In many societies, the elderly take on the enormous role of being the caregivers of sick family members. Little is known about the context in which they provide HIV/AIDS-related care, and their role as caregivers is most often not documented. This study conducted interviews with 31 elderly carers to explore their care-giving activities in relation to adult children with AIDS-related illness, and to examine their perceived role in HIV prevention and management in rural communities in Mpumalanga Province, South Africa. The findings indicate that older adults who assume the natural role of caring for sick adult children live in multigenerational households. Key caring activities include the provision of physical and hygiene care, financial and emotional support, and health and nutritional care. Besides the physical caring activities, the elderly carers play a critical role in the prevention of HIV. They promoted condom use, encouraged HIV testing, and spoke openly about the HIV status of their sick adult children. Their critical role in administering antiretroviral treatment (ART) and encouraging adherence demonstrates a comprehensive understanding of the importance of adherence and the complex ART regimen. The findings underscore the need to train and incorporate older adults into adherence programmes to facilitate their role as long-term adherence partners. They are also an essential vehicle to reduce stigma and discrimination in their communities.

HIV stigma is a persistent barrier to curbing the spread of HIV and improving quality of life for people living with HIV. We developed and pilot tested Maisha, an HIV stigma reduction intervention in antenatal care (ANC) with two objectives: 1) among individuals living with HIV, reduce internalized and anticipated HIV stigma, with subsequent improvements in HIV care engagement, and 2) among individuals who are HIV-seronegative, reduce HIV stigmatizing attitudes. We enrolled and baselined 1039 women and 492 male partners presenting to a first ANC appointment and randomized them to standard of care or the Maisha intervention. All women living with HIV (WLHIV) and a subset of HIV-negative participants completed a 3-month follow-up assessment. Participation in the three Maisha sessions was high (99.6%, 92.8%, 89.3%), and nearly all participants noted satisfaction with the intervention content (99.8%) and counselor (99.8%). Among 55 WLHIV, care engagement outcomes did not differ by condition. Among 293 HIV-negative participants, Maisha participants had significantly greater reductions in the moral judgment sub-scale of the stigma attitudes measure (p < .001), but not the social distancing subscale. The ANC setting, where women and their partners are routinely tested for HIV, is an ideal venue for addressing HIV stigma. The Maisha intervention was feasible and acceptable, and had an impact on HIV stigma attitudes. A full trial is needed to examine impacts on HIV outcomes; modifications to the intervention should be considered to reduce social alienation of PLWH.