Antiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe

Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10-30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10-15 (young adolescents) 15.1-19 years (adolescents), 19.1-24 years (young adults) and 24.1-29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17-4.35). Young adults and adolescents had a 2-3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62-4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults

Strangers As Neighbors: Religious Lanugage and the Response to Immigrants in the United States

With funding from the Carnegie Corporation of New York, Fairfield University’s conducted its Strangers as Neighbors: Religious Language and the Response to Immigrants pilot project, from August 2008 to July 2009. The project aimed for faith communities to agree on common language for speaking about migration, drawing upon some of the shared sensibilities of religious language words like “neighbor,” “brother,” “sister,” “pilgrim,” and similar concepts that have more nuanced and welcoming connotation than “migrant” or “newcomer” then to disseminate that common language across different faith communities. The study strongly suggests that a faith-based perspective allows for a more collaborative discursive environment, which could shift us away from the usual “winner-takes-all” atmosphere more commonly found in a highly charged political discourse. This results of this project led to the next phase, Strangers as Neighbors on Long Island funded by the Hagedorn Foundation, which is helping to develop a model for discussing difficult social issues, such as immigration, within a faith-based framework that will be transferable to other regions around the country

The case for viral load testing in adolescents in resource-limited settings.

INTRODUCTION: The success of HIV treatment programmes globally has resulted in children with perinatally acquired HIV reaching adolescence in large numbers. The number of adolescents living with HIV is growing further due to persisting high HIV incidence rates among adolescents in low- and middle-income settings, particularly in sub-Saharan Africa. Although expanding access to HIV viral load monitoring is necessary to achieve the 90-90-90 targets across the HIV care continuum, implementation is incomplete. We discuss the rationale for prioritizing viral load monitoring among adolescents and the associated challenges. DISCUSSION: Adolescents with HIV are a complex group to treat successfully due to extensive exposure to antiretroviral therapy for those with perinatally acquired HIV and the challenges in sustained medication adherence in this age group. Given the high risk of treatment failure among adolescents and the limited drug regimens available in limited resource settings, HIV viral load monitoring in adolescents could prevent unnecessary and costly switches to second-line therapy in virologically suppressed adolescents. Because adolescents living with HIV may be heavily treatment experienced, have suboptimal treatment adherence, or may be on second or even third-line therapy, viral load testing would allow clinicians to make informed decisions about increased counselling and support for adolescents together with the need to maintain or switch therapeutic regimens. CONCLUSIONS: Given scarce resources, prioritization of viral load testing among groups with a high risk of virological failure may be required. Adolescents have disproportionately high rates of virological failure, and targeting this age group for viral load monitoring may provide valuable lessons to inform broader scale-up

Strangers as Neighbors: Religious Language and the Response to Immigrants in the United States.

From the Project Overview by Rev. Richard Ryscavage, S.J.: During the past year, my colleague and co-director of this project, Dr. Jocelyn M. Boryczka... and I led a Fairfield University academic research team which directly engaged a national group of over 100 scholars, advocates, religious leaders, and journalists from across academic disciplines and faith communities on the complexities of U.S. immigration... the project invited participants to consider immigration through the lens of various faith perspectives and to deliberate on how these perspectives might help transform the national discourse on this issue.https://digitalcommons.fairfield.edu/archives-researchreports/1004/thumbnail.jp

International Comparisons of Earnings Inequality for Men in the 1980 s

LIS database is used to compare various nations' earnings distributions with respect of earnings inequality during the mid 1980's. The paper also addresses whether or not earnings inequality changed in some of these countries between the beginning of the decade and the mid-1980's

Virologic Response, Early HIV-1 Decay, and Maraviroc Pharmacokinetics With the Nucleos(t)ide-Free Regimen of MaravIroc Plus Darunavir/Ritonavir in a Pilot Study

To address the need for nucleos(t)ide reverse transcriptase inhibitor (NRTI)-sparing regimens, we explored the virologic and pharmacokinetic characteristics of maraviroc plus ritonavir-boosted darunavir in a single-arm, open-label, 96-week study