Cost-Effectiveness of Preventing Loss to Follow-up in HIV Treatment Programs: A Côte d'Ivoire Appraisal

Based on data from West Africa, Elena Losina and colleagues predict that interventions to reduce dropout rates from HIV treatment programs (such as eliminating copayments) will be cost-effective

WHO 2010 Guidelines for Prevention of Mother-to-Child HIV Transmission in Zimbabwe: Modeling Clinical Outcomes in Infants and Mothers

The Zimbabwean national prevention of mother-to-child HIV transmission (PMTCT) program provided primarily single-dose nevirapine (sdNVP) from 2002-2009 and is currently replacing sdNVP with more effective antiretroviral (ARV) regimens.Published HIV and PMTCT models, with local trial and programmatic data, were used to simulate a cohort of HIV-infected, pregnant/breastfeeding women in Zimbabwe (mean age 24.0 years, mean CD4 451 cells/µL). We compared five PMTCT regimens at a fixed level of PMTCT medication uptake: 1) no antenatal ARVs (comparator); 2) sdNVP; 3) WHO 2010 guidelines using "Option A" (zidovudine during pregnancy/infant NVP during breastfeeding for women without advanced HIV disease; lifelong 3-drug antiretroviral therapy (ART) for women with advanced disease); 4) WHO "Option B" (ART during pregnancy/breastfeeding without advanced disease; lifelong ART with advanced disease); and 5) "Option B+:" lifelong ART for all pregnant/breastfeeding, HIV-infected women. Pediatric (4-6 week and 18-month infection risk, 2-year survival) and maternal (2- and 5-year survival, life expectancy from delivery) outcomes were projected.Eighteen-month pediatric infection risks ranged from 25.8% (no antenatal ARVs) to 10.9% (Options B/B+). Although maternal short-term outcomes (2- and 5-year survival) varied only slightly by regimen, maternal life expectancy was reduced after receipt of sdNVP (13.8 years) or Option B (13.9 years) compared to no antenatal ARVs (14.0 years), Option A (14.0 years), or Option B+ (14.5 years).Replacement of sdNVP with currently recommended regimens for PMTCT (WHO Options A, B, or B+) is necessary to reduce infant HIV infection risk in Zimbabwe. The planned transition to Option A may also improve both pediatric and maternal outcomes

Humans do not perceive conspecifics with a greater exposed sclera as more trustworthy

https://link.springer.com/article/10.1007/s10211-018-0296-5Understanding the adaptive function of the unique morphology of the human eye, in particular its overexposed white sclera, may have profound implications for the fields of evolutionary behavioural science, and specifically the areas of human interaction and social cognition. Existing hypotheses, such as the cooperative eye hypothesis, have attracted a lot of attention but remain untested. Here, we: (i) analysed variation in the visible sclera size in humans from different ethnic backgrounds and (ii) examined whether intraspecific variation of exposed sclera size is related to trust. We used 596 facial photographs of men and women, assessed for perceived trustworthiness, from four different self-declared racial backgrounds. The size of the exposed sclera was measured as the ratio between the width of the exposed eyeball and the diameter of the iris (sclera size index, SSI). The SSI did not differ in the four examined races and was sexually monomorphic except for Whites, where males had a larger SSI than females. In general, the association between the SSI and trustworthiness was statistically insignificant. An inverted U-shaped link was found only in White women, yet the strength of the effect of interaction between sex and race was very small. Our results did not provide evidence for the link between exposed sclera size and trustworthiness. We conclude that further investigation is necessary in order to properly assess the hypotheses relating to the socially relevant functions of overexposed sclera