ABSTRACT
We conducted a parallel-group randomized controlled trial in three HIV clinics in Mexico to evaluate a user-centred habit-formation intervention to improve ART adherence among MSM living with HIV. We randomized 74 participants to the intervention group and 77 to the control group. We measured adherence at one, four, and ten months through medication possession ratio and self-reported adherence. Additionally, we measured viral load, CD4 cell count, major depression disorder symptoms, and alcohol and substance use disorder at baseline, fourth and tenth months. We found no statistically significant effect on adherence between groups. However, the intervention demonstrated positive results in major depression disorder symptoms (21% vs. 6%, p = 0.008) and substance use disorder (11% vs. 1%, p = 0.018) in the fourth month. The latter is relevant because, in addition to its direct benefit, it might also improve the chances of maintaining adequate adherence in the long term. This trial was retrospectively registered at ClinicalTrials.gov (trial number NCT03410680) on 8 January 2018.Trial registration: ClinicalTrials.gov identifier: NCT03410680.
Subject(s)
Anti-HIV Agents , HIV Infections , Homosexuality, Male , Medication Adherence , Viral Load , Humans , Male , Mexico , HIV Infections/drug therapy , HIV Infections/psychology , Adult , Homosexuality, Male/psychology , Medication Adherence/statistics & numerical data , Medication Adherence/psychology , Anti-HIV Agents/therapeutic use , Middle Aged , Substance-Related Disorders , CD4 Lymphocyte Count , Depressive Disorder, Major/drug therapyABSTRACT
OBJETIVO: Describir y caracterizar las redes formadas detrás del continuo de atención a personas que viven con VIH en México. Material y métodos. Bajo un enfoque de análisis de redes sociales se analizó información sobre las relaciones que establecen los actores que participan en el continuo de atención del VIH. RESULTADOS: Existe una formación de re-des de atención con distintos actores y, conforme se avanza en el continuo de atención, las redes tienden a fragmentarse y se observa una baja conectividad. CONCLUSIONES: La provisión de servicios para VIH en México es un proceso de gober-nanza múltiple; sin embargo, la configuración de las redes no implica que la provisión de servicios sea óptima. No obstante, la formación de redes es una potencial herramienta que los Centros Ambulatorios para la Prevención y Atención de Sida e Infecciones de Transmisión Sexual y Servicios de Atención Integral Hospitalaria han establecido para lograr su objetivo de ofrecer atención oportuna y continua, ante un contexto de recursos limitados y de gestión pública por resultados.
Subject(s)
Continuity of Patient Care , HIV Infections , Humans , Mexico , Retrospective StudiesABSTRACT
Here, we report the first complete genome sequence of a Stenotrophomonas acidaminiphila strain, generated with PacBio RS II single-molecule real-time technology, consisting of a single circular chromosome of 4.13 Mb. We annotated mobile genetic elements and natural product biosynthesis clusters, including a novel class-II lasso peptide with a 7-residue macrolactam ring.