Armed conflict effects in intimate partner violence: Revealing pathways using the socioecological framework.

We explored women's narratives about their experiences as victim-survivors of multiple forms of armed conflict violence and intimate partner violence (IPV) in Colombia and examined pathways that clarify the relationships between these two types of violence. Thematic analysis of 47 interviews identified connections that explain how armed conflict influences IPV at all levels of the socio-ecology. At the societal level, armed conflict events amplified patriarchal notions and intensified men's expressions of hypermasculinity through violence. At the community level, rules imposed by armed groups excused IPV if women did not comply with their traditional gender roles as wives and caretakers. At the relationship level, husbands/partners blamed victim-survivors of sexual violence perpetrated by armed groups, which intensified IPV situations. At the individual level, the armed conflict generated high levels of stress that contributed to increasing IPV. Results highlight the need to recognise armed conflict as an IPV risk factor that penetrates multiple socio-ecological domains. Post-conflict societies should consider the effects of the armed conflict on family dynamics and intimate partner relationships. Interventions should be developed to deconstruct hyper-militarised masculinity identities and traditional gender roles as an integral part of peace efforts.

Exploring the Multifaceted Biological Activities of Anthocyanins Isolated from Two Andean Berries.

Natural pigments extracted from plant species are used in foods, cosmetics, and pharmaceuticals. This study evaluates the comprehensive biological activities of anthocyanins isolated from Andean blueberry (Vaccinium floribundum Kunth) and Andean blackberry (Rubus glaucus Benth), focusing on their antimicrobial, antioxidant, antitumoral, anti-inflammatory, and hemolytic properties. Chemical characterization revealed significant anthocyanin content with complex mass spectrometric profiles indicating diverse glycosylation patterns that may influence their bioactivity. The antimicrobial assays showed that the extracts were particularly effective against Gram-positive bacteria, with minimal inhibitory concentrations (MICs) as low as 1 mg/mL for Rubus glaucus, indicating strong potential for therapeutic use. The antioxidant capacity of the berries was substantial, albeit slightly lower than that of ascorbic acid. The extracts also exhibited notable antitumoral activity in various cancer cell lines, showing promise as adjunctive or preventive treatments. The anti-inflammatory effects were confirmed by inhibiting nitric oxide production in macrophage cells, highlighting their potential in managing inflammatory diseases. In terms of hemolytic activity, Rubus glaucus exhibited dose-dependent effects, potentially attributable to anthocyanins and phenolics, while Vaccinium floribundum demonstrated no significant hemolytic activity, underscoring its safety. These findings suggest that anthocyanins from Andean berries possess potent biological activities, which could be leveraged for health benefits in pharmaceutical and nutraceutical applications. Further studies are needed to isolate specific bioactive compounds and investigate their synergistic effects in clinical and real-world contexts.

Stigmatisation and resistance processes: Reflections on the field of HIV research and an agenda for contemporary stigma studies.

Stigmatisation processes constitute key barriers to effectively addressing the HIV pandemic. In this article, we provide a critical overview of this field's current state of the art, highlighting some key emerging issues that merit greater research attention in the future to ensure that contemporary research on stigmatisation and resistance processes continues to engage with changing social and political circumstances. We look at how resistance to stigma has developed in the context of HIV and highlight some of the most important programmatic strategies that have emerged over the history of the pandemic. We present the key concepts of 'moral panics' and 'necropolitics', and we articulate them in relation to new global phenomena that deepen the processes of stigmatisation. Moreover, we identify an agenda for investigation which merits greater attention in future research, intervention, and advocacy: 1) changing political environments, neoliberalism, growing political polarisation, and the rise of political extremism; 2) the rise of the information age, technological change, and social media; and 3) rebuilding civil society and governmental responses to stigma.

Analyzing One Health governance and implementation challenges in Mexico.

Establishing a robust One Health (OH) governance is essential for ensuring effective coordination and collaboration among human, animal, and environmental health sectors to prevent and address complex health challenges like zoonoses or antimicrobial resistance. This study conducted a mixed-methods environmental scan to assess to what extent Mexico displays a OH governance and identify opportunities for improvement. Through documentary analysis, the study mapped OH national-level governance elements: infrastructure, multi-level regulations, leadership, multi-coordination mechanisms (MCMs), and financial and OH-trained human resources. Key informant interviews provided insights into enablers, barriers, and recommendations to enhance a OH governance. Findings reveal that Mexico has sector-specific governance elements: institutions, surveillance systems and laboratories, laws, and policies. However, the absence of a OH governmental body poses a challenge. Identified barriers include implementation challenges, non-harmonised legal frameworks, and limited intersectoral information exchange. Enablers include formal and ad hoc MCMs, OH-oriented policies, and educational initiatives. Like other middle-income countries in the region, institutionalising a OH governance in Mexico, may require a OH-specific framework and governing body, infrastructure rearrangements, and policy harmonisation. Strengthening coordination mechanisms, training OH professionals, and ensuring data-sharing surveillance systems are essential steps toward successful implementation, with adequate funding being a relevant factor.

Self-efficacy and consistent condom use by people living with HIV and seroconcordant and serodiscordant sexual partners in the Ceará, Brazil.

The objectives were to assess the self-efficacy and consistent condom use by people living with HIV (PLHIV). A cross-sectional, comparative study was carried out in outpatient clinics in Ceará State, Brazil, with a sample of 190 PLHIV, 95 serodiscordant and 95 seroconcordant. Interviews were conducted using the Socio-Demographic, Clinical, Epidemiological and Vulnerability Form and the Condom Use Self-Efficacy Scale. Descriptive analysis, associations between variables, odds ratio and 95% confidence interval were determined. P < 0.05 was considered statistically significant. Of the sample, 43.1% consistently used condoms (50.5% serodiscordant and 35.7% seroconcordant). Serodiscordant PLHIV without guidance on HIV prevention (P = 0.027) and without access to testing (P = 0.002) had lower self-efficacy and 11.5 times more chances for inconsistent condom use (P = 0.006), while those satisfied with follow-up in health were less likely to use condoms inconsistently (P = 0.011). We conclude that there is low consistent use of condoms among PLHIV, which increases the risk of HIV transmission and the acquisition of other sexually transmitted infections. Consistent condom use was greater among serodiscordant individuals, although there was no difference in self-efficacy in condom use between the groups.

Prevalence and predictors of cigarette smoking among people with HIV in Western Jamaica.

With highly active antiretroviral therapy, HIV infection has become a treatable chronic disease. However, modifiable risk factors such as cigarette smoking continue to impact the morbidity and mortality of people with HIV (PWH). We assessed the prevalence and factors associated with cigarette smoking and motivation to quit among PWH in Western Jamaica. A cross-sectional study was conducted in which 392 adults seeking HIV care at health facilities in Western Jamaica completed an interviewer-administered questionnaire. Current smoking prevalence among participants was 17.4%. Current smoking was significantly associated with being male (OR = 2.99), non-Christian/non-Rastafarian (OR = 2.34), living or working with another smoker (aOR =1.86), being moderate to severely depressed (OR = 3.24), having an alcohol drinking problem (OR = 1.84), and never being asked by a healthcare provider if they smoked (OR = 3.24). Among the PWH who currently smoke, 36.7% are moderately to highly dependent on nicotine. One-third of people who smoke (33.8%) started smoking for the first time after HIV diagnosis, while 66.2% initiated smoking before; 88% were willing to quit smoking. These findings provide baseline information for designing and implementing a comprehensive smoking cessation program that considers the needs of PWH in Jamaica, with the potential of becoming a replicable model for other HIV-specialized healthcare settings in the Caribbean.

Antiretroviral adherence among people living with HIV during the postpartum period: a retrospective cohort study at a PMTCT reference center in Rio de Janeiro before and during the COVID-19 pandemic.

Despite success in achieving viral suppression during pregnancy in people living with HIV (PLWH), postpartum adherence remains a challenge. We aimed to describe rates of adherence at a Prevention of Mother-to-Child HIV Transmission (PMTCT) Center before and during the COVID-19 pandemic. This study was conducted from a cohort of PLWH who received prenatal care and were virally suppressed near delivery. We tracked combined antiretroviral therapy (cART) pickups for 12 months and HIV viral load (VL) from 2 to 12 months after delivery. We defined flexible adherence as a monthly pickup of cART and strict adherence as also having VL < 200 copies/mL and at least one maternal HIV VL between two and twelve months postpartum. Pre-pandemic was defined as delivery from March 2017-February 2019 and pandemic as March 2020-February 2022. During the study, 1119 PLWH were followed, and 965 (86%) were suppressed near delivery. There were 511 pre-pandemic and 290 pandemic participants. Adherence rates were 66/511 (13%) and 38/290 (13%), respectively. During the pandemic, more participants conceived using cART and were undetectable at the start of prenatal care; nevertheless, postpartum adherence was no better than pre-pandemic underscoring the need to improve strategies for adherence specific to this subset of PLWH in the postpartum period.

The HIV epidemic in Haiti: is disability a factor?

People with disabilities (PWD) are thought to be low risk for HIV because of social norms regarding disability and sex. However, qualitative studies indicate they are at risk and are not being reached by HIV programs. The Demographic and Health Survey (DHS) conducted in Haiti in 2016 included HIV biomarker data and disability status. Crude and adjusted odds ratios were calculated using a disability severity indicator as the independent variable and HIV infection as the dependent variable. Covariates were selected based on theory and previous studies. Individuals reporting milder disabilities had a higher odds of HIV infection in the crude model (OR:1.65; CI: 1.16-2.34) and those adjusted for demographics (OR:1.73; CI:1.19-2.51) and sexual activity (OR:1.60; CI:1.06-2.42). Those with moderate and more severe disabilities have the same odds of HIV infection as the general population. PWD are HIV-positive and at risk of HIV infection. Based on this, it is essential that HIV education, testing, and treatment programs are inclusive of PWD. Accessible HIV education materials need to be created. HIV testing programs should involve PWD in planning and implementation. Providers of HIV care must be trained regarding the needs of PWD for reproductive healthcare.

Spatial analysis of HIV detection rates among Brazilian young men, 2007-2021.

The main goal of this study was to spatially analyze the HIV epidemic scenario in young men in Brazil, 2007-2021. We used secondary data obtained from the Brazilian Information System for Notifiable Diseases. Individuals aged 15-29 years with permanent residence in Brazil who were diagnosed with HIV during the study period were included in the analysis. Municipality HIV age-adjusted detection rates were analyzed through spatial distribution, autocorrelation, and spatiotemporal risk analyses. During the study period, 108,392 HIV cases were reported in young Brazilian men. The HIV epidemic increased territorially in the northern, northeastern, midwestern, and southeastern regions but decreased in the southern region. Although the number of clusters comprising municipalities with high HIV detection rates (hotspots) decreased, new ones appeared, expanded, or stopped changing size. Hotspots and spatio-temporal risk zones (spatial areas with increased HIV detection in a specific period) comprised economically developed municipalities with high demographic density surrounded by less developed municipalities. The period of the spatiotemporal risk zones was between 2008 and 2021. Our study showed that HIV detection rates continue to increase among young Brazilian men, and health authorities should reinforce efforts mainly in capitals and surrounded municipalities in the north, northeast, southeast, and midwest regions.