Barriers and facilitators to HIV prevention and care for Venezuelan migrant/refugee women and girls in Colombia.

Venezuelan migrant and refugee women and girls (VMRWG) face risks of exposure to and infection from HIV and threats of multiple forms of violence (including GBV) during and after migration. Yet, there is a lack of evidence on barriers and facilitators to VMRWGs' access to HIV prevention and care services this population at all stages of their migration. We addressed this evidence gap by conducting a qualitative study composed of fifty-four semi-structured interviews with practitioners (n = 24) and VMRWG (n = 30) in the two largest receiving cities of migrants in Colombia. We sought to identify perceived barriers and facilitators to HIV prevention and care to inform policies and programmatic efforts. Analysis followed a theory-informed approach using the Socioecological Model. Findings describe multi-level barriers to access to HIV prevention and care related to discrimination, gender-based violence, rigid gender norms, lack of information and system fragmentation. Policies that integrate community-based networks and support intersectoral work are pivotal to breach the gaps between services and communities and develop a gender-sensitive approach that tackles the relationship between gender-based violence and HIV risk.

Evaluation of delivery conditions for cutaneous plasmid electrotransfer using a multielectrode array.

Electroporation (EP) is a simple in vivo method to deliver normally impermeable molecules, such as plasmid DNA, to a variety of tissues. Delivery of plasmid DNA by EP to a large surface area is not practical because the distance between the electrode pairs, and therefore the applied voltage, must be increased to effectively permeabilize the cell membrane. The design of the multielectrode array (MEA) incorporates multiple electrode pairs at a fixed distance to allow for delivery of plasmid DNA to the skin, potentially reducing the sensation associated with in vivo EP. In this report, we evaluate the effects of field strength and pulse width on transgene expression and duration using a plasmid encoding the luciferase reporter gene delivered by intradermal injection in a guinea pig model followed by EP with the MEA. As expected, the level of luciferase expression increased with the magnitude and duration of the voltage applied. In addition to adjusting transgene expression levels by altering fielding strength, levels could also be controlled by adjusting the plasmid dose. Our results indicate that the design of the MEA is a viable option for cutaneous plasmid DNA delivery by in vivo EP to a large surface area.

Estudio comparativo de la adhesión terapéutica en pacientes VIH+ de larga evolución con y sin coagulopatías congénitas" / Comparative study of compliance in long survival HIV- patients with and without congenital coagulopathy

La introducción de las nuevas terapias antirretrovirales (HAART) ha ocasionado un importante descenso de la morbi-mortalidad asociada a la infección por VIH. En ellas, asegurar una buena adhesión terapéutica constituye una cuestión prioritaria, no sólo para asegurar un adecuado control medicamentoso de los pacientes sino también para evitar la aparición de cepas víricas resistentes debida a los tratamientos administrados en dosis subóptimas.El objetivo del presente trabajo es averiguar si el hecho de que las personas infectadas con el VIH tengan experiencia previa con una enfermedad crónica congénita que exija un cumplimiento riguroso de normas preventivas y tratamiento compensador terapéutico, puede suponer un factor facilitador importante en la consecución de una buena adhesión terapéutica a las terapias antirretrovirales (HAART).Para alcanzar este objetivo se ha comparado la adhesión terapéutica a las terapias antirretrovirales en dos grupos de pacientes infectados con el VIH del mismo hospital: a) pacientes con coagulopatía congénita (hemofílicos), con una larga historia de apoyo psicosocial; y b) pacientes sin coagulopatía congénita.Los resultados que asimismo contemplan la posible influencia de variables intermedias moduladoras, tales como las creencias sobre el tratamiento, la relación entre los pacientes y los profesionales sanitarios y, la percepción de efectos secundarios atribuidos a los medicamentos - muestran que la adhesión a las terapias antirretrovirales (HAART) es superior en los pacientes VIH hemofílicos que en los no hemofílicos. (AU)