RESUMO
OBJECTIVE: Diabetes mellitus (DM) is associated with lower antiretroviral (ART) drug exposure among persons with HIV (PWH) compared to PWH without DM. The association between DM and virologic control in PWH, however, remains unknown. METHODS: We included participants in the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study (MWCCS) who had initiated ART between 1999 and 2020 and had a suppressed HIV viral load (≤200âcopies/mL) within 1âyear of ART initiation. We compared the frequency of incident HIV viremia (HIV-1 RNA >200âcopies/mL) between adult PWH with and without DM. Poisson regression was used to examine the rate of incident viremia based on the diagnosis of DM among PWH. DM was defined as two consecutive fasting glucose measurements ≥126âmg/dL, use of anti-diabetic medications, pre-existing DM diagnosis, or a confirmed HbA1c >6.5%. RESULTS: 1,061 women (112 with DM, 949 without DM) and 633 men (41 with DM, and 592 without DM) were included in the analysis. The relative rate (RR) of incident HIV viremia for women with HIV and DM was lower when compared to women without DM (0.85 [95% CI: 0.72-0.99]; pâ=â0.04). The RR of incident viremia for women with uncontrolled DM (HbA1c>7.5%) was higher when compared to women with controlled DM (HbA1c <7.5%) (1.46 [95%CI: 1.03-2.07]; pâ=â0.03). In contrast, the RR of incident viremia for men with HIV and DM was not statistically different compared to men without DM (1.2 [95%CI: 0.96- 1.50]; pâ=â0.12). The results were stratified by adherence levels (100%, 95-99%, and less than 95% based on self-report). CONCLUSIONS: Women with DM who are highly adherent to ART (100% self-reported adherence) have a lower risk of viremia compared to women with HIV without DM. However, women with poorly controlled DM were at higher risk of HIV viremia than women with controlled DM. Further research is necessary to understand the impact of sex, DM, and ART adherence on HIV viremia.
RESUMO
OBJECTIVES: This study describes prevention behavior and psychosocial health among people living with HIV (PLHIV) and HIV-negative people during the early wave of the coronavirus disease 2019 (COVID-19) pandemic in the United States. We assessed differences by HIV status and associations between social disruption and psychosocial health. DESIGN: A cross-sectional telephone/videoconference administered survey of 3411 PLHIV and HIV-negative participants in the Multicenter AIDS Cohort Study/WIHS Combined Cohort Study (MWCCS). METHODS: An instrument combining new and validated measures was developed to assess COVID-19 prevention efforts, social disruptions (loss of employment, childcare, health insurance, and financial supports), experiences of abuse, and psychosocial health. Interviews were performed between April and June 2020. Associations between social disruptions and psychosocial health were explored using multivariable logistic regression, adjusting for sociodemographics and HIV status. RESULTS: Almost all (97.4%) participants reported COVID-19 prevention behavior; 40.1% participants reported social disruptions, and 34.3% reported health care appointment disruption. Men living with HIV were more likely than HIV-negative men to experience social disruptions (40.6% vs. 32.9%; P < 0.01), whereas HIV-negative women were more likely than women with HIV to experience social disruptions (51.1% vs. 39.8%, P < 0.001). Participants who experienced ≥2 social disruptions had significantly higher odds of depression symptoms [aOR = 1.32; 95% confidence interval (CI): 1.12 to 1.56], anxiety (aOR = 1.63; 95% CI: 1.17 to 2.27), and social support dissatisfaction (aOR = 1.81; 95% CI: 1.26 to 2.60). CONCLUSIONS: This study builds on emerging literature demonstrating the psychosocial health impact related to the COVID-19 pandemic by providing context specific to PLHIV. The ongoing pandemic requires structural and social interventions to decrease social disruption and address psychosocial health needs among the most vulnerable populations.
Assuntos
COVID-19/epidemiologia , Soronegatividade para HIV , Soropositividade para HIV/epidemiologia , Soropositividade para HIV/psicologia , Saúde Mental/estatística & dados numéricos , COVID-19/psicologia , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Estados Unidos/epidemiologiaRESUMO
Microgreen based functional juice blends containing fenugreek (Trigonella foenum-graecum), kinnow mandarin (Citrus reticulate) and aloe vera (Aloe brobadensis) in different ratios were blended with sorbitol and stevia. The different ratios of juice blends were analyzed for total soluble solids, sedimentation, viscosity and titrable acidity. They were also screened for total phenolic content, total carotenoid content and antioxidant properties such as DPPH, reducing power and metal chelating activity. The formulation with highest TPC, TCC and antioxidant property was selected to optimize a microgreen based functional juice. The optimized microgreen blend formulation had 20 ml 100-1 ml microgreen juice, 40 ml 100-1 ml kinnow juice, 8.5 ml 100-1 ml sorbitol, 1.78 g 100-1 ml stevia and 29.72 ml 100-1 ml aloe vera juice. It had high protein, minerals (sodium and potassium) and vitamin (vitamin C) content as well as good source beta-carotene, phenols and antioxidants. Antioxidant helps in reducing diabetic complications by reducing the oxidative stress and because of their protective action against reactive oxygen species.