AIDS. Resource needs for HIV/AIDS.
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Biomedical subjects
Publications and source records attributed to S Bertozzi.
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SCOPE: This review summarizes the main issues discussed during Track D, which examined the societal impact of HIV/AIDS, and responses to the epidemic by individuals, families, communities and societies worldwide. Micro- and macrolevel issues addressed included the development, implementation and evaluation of programmes for prevention and care; policy development and implementation; structural issues such as the impact of gender relations, development and migration on the development of the epidemic; and the social and economic impact of HIV/AIDS on affected societies and communities. RECURRENT THEMES: Presentations provided strong evidence that peer-led, community-based programmes offer particularly effective ways of working, and that participatory research involving affected communities provides useful results for the design and evaluation of programmes and policies. This is the case across settings, issues, populations and countries. FUTURE DIRECTIONS: Emerging needs include how best to ensure sustainability of national and international responses, how best to scale up successful interventions for wider reach, and how best to work with systematically marginalized, neglected groups and populations. Research priorities include the characterization of the multiple determinants of HIV-related vulnerability, and the evaluation of interventions that take these complex determinants as their starting point. A more coherent and strategic response requires less separation between the different constituencies involved in AIDS work, and the more sustained involvement of people living with HIV/AIDS themselves.
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To determine the accuracy and cost efficiency of pooling sera prior to HIV-1 testing, sera from 8,000 Kinshasa factory workers and their spouses were screened individually (2.44% seropositive) and in 800 pools of 10 sera each. There were no false-negative or false-positive pools, resulting in a calculated seroprevalence estimate of 2.42%. Further testing of all sera in positive pools can identify HIV-positive individuals. These applications were modeled to compare the cost-efficiency of pooling with individual testing under different conditions. The results suggest that pooling provides an alternative test format for use in both developing and industrialized countries when the seroprevalence and/or the marginal cost of obtaining a sample are sufficiently low. For our cohort, testing only the pools for seroprevalence estimation resulted in a 78% cost saving compared with individual testing; pooling with subsequent identification of individual seropositives represented a 56% cost reduction.
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The economic impact of AIDS may be especially severe in developing nations because of the additional burden on scarce health care resources and the potential loss of human capital. We describe a methodology for estimating the direct and indirect costs of HIV infection. Our approach is designed for the typical environment of international economic consulting, where time is short, and data sparse. We focus on HIV rather than AIDS because the only way now known to prevent AIDS is to prevent HIV infection.
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25 active-principle forms of pharmaceutical drugs belonging to 5 chemical series have been tested for mutagenic activity. To screen these drugs we used the Salmonella typhimurium assay on 5-histidine-requiring strains, with and without microsomal activation. Only the 3 nitroimidazole derivatives were mutagenic for strains TA100, TA1535 and TA98.
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