HIV/AIDS and Biological Citizenship: The Role of Activism in the Formulation of Public Policy in Mexico

(INGLES) Biological citizenship can be considered, among other interpretations, as a collective and individual survival strategy of people sharing a biological disorder to gain political recognition and access to some form of welfare inclusion, using science to make policy and law. The focus of this investigation is to explore the way that the concept of biological citizenship can be applied in the HIV/AIDS activism in Mexico. Specifically, it explores and seeks to answer how biological citizenship has influenced the formation and implementation of public policy regarding public access to antiretroviral (ARV) treatment. Through a series of visits to some governmental and non-governmental institutions working with HIV/AIDS in Mexico and in Puebla, I discovered that non-governmental organizations played a central role in defining the current government policy related to ARV treatment. (ESPAÑOL) Ciudadanía biológica puede ser considerada, entre otras interpretaciones, como una estrategia de sobrevivencia, colectiva e individual, utilizada por personas que comparten un desorden biológico a fin de ganar reconocimiento político y acceso a algunas formas de beneficio público, utilizando conocimiento científico para hacer leyes y políticas de salud. La idea principal de esta investigación es explorar la manera como el concepto de ciudadanía biológica puede ser aplicado en el activismo del VIH/SIDA en México. Específicamente, busca responder como ciudadanía biológica ha influenciado la formación e implementación de políticas públicas de salud relacionadas al acceso al tratamiento con los antirretrovirales (ARV). A través de una serie de visitas y entrevistas a instituciones gubernamentales y no-gubernamentales que trabajan con VIH/SIDA en México y en Puebla, descubrí que las organizaciones no-gubernamentales tuvieron papel central para la definición de la política actual del gobierno relacionada al tratamiento con los ARV

Immune Responses to Circulating and Vaccine Viral Strains in HIV-Infected and Uninfected Children and Youth Who Received the 2013/2014 Quadrivalent Live-Attenuated Influenza Vaccine

The live attenuated influenza vaccine (LAIV) has generally been more efficacious than the inactivated vaccine in children. However, LAIV is not recommended for HIV-infected children because of insufficient data. We compared cellular, humoral and mucosal immune responses to the 2013-2014 LAIV quadrivalent (LAIV4) in HIV-infected and uninfected children 2 to 25 years of age (yoa). We analyzed the responses to the vaccine H1N1 (H1N1-09), to the circulating H1N1 (H1N1-14), which had significant mutations compared to H1N1-09 and to B Yamagata (BY), which had the highest effectiveness in 2013-2014. Forty-six HIV-infected and 56 uninfected participants with prior influenza immunization had blood and nasal swabs collected before and after LAIV4 for IFN T and IgG/IgA memory B cell responses (ELISPOT), plasma antibodies [hemagglutination inhibition (HAI) and microneutralization (MN)], and mucosal IgA (ELISA).The HIV-infected participants had median CD4+ T cells=645 cells/µL and plasma HIV RNA=20 copies/mL. Eighty-four% were on cART. Regardless of HIV status, significant increases in T cell responses were observed against BY, but not against H1N1-09. H1N1-09 T cell immunity was higher than H1N1-14 both before and after vaccination. LAIV4 significantly increased memory IgG B cell immunity against H1N1-14 and BY in uninfected, but not in HIV-infected participants. Regardless of HIV status, H1N1-09 memory IgG B cell immunity was higher than H1N1-14 and lower than BY. There were significant HAI titer increases after vaccination in all groups and against all viruses. However, H1N1-14 MN titers were significantly lower than H1N1-09 before and after vaccination overall and in HIV-uninfected vaccinees. Regardless of HIV status, LAIV4 increased nasal IgA concentrations against all viruses. The fold-increase in H1N1-09 IgA was lower than BY. Overall, participants <9 yoa had decreased BY-specific HAI and nasal IgA responses to LAIV4.In conclusion, HIV-infected and uninfected children and youth had comparable responses to LAIV4. H1N1-09 immune responses were lower than BY and higher than H1N1-14, suggesting that both antigenic mismatches between circulating and vaccine H1N1 and lower immunogenicity of the H1N1 vaccine strain may have contributed to the decreased H1N1 effectiveness of 2013-2014 LAIV4

Seroprevalence of high incidence congenital infections among pregnant women in Coatepeque, Guatemala and surrounding areas, 2017-2018.

Maternal infections during pregnancy can potentially cause birth defects and severe adverse effects in infants. From 2017 to 2018, we investigated the seroprevalence of five antibodies among 436 mother-infant pairs enrolled in a pregnancy cohort study in Coatepeque, Guatemala. Upon enrollment (< 20 weeks gestational age) and shortly after delivery, we measured the prevalence of IgG and IgM antibodies against Toxoplasma gondii (T. gondii), rubella, and cytomegalovirus (CMV) in mothers and newborns and used rapid tests to detect HIV and syphilis (Treponema pallidum) in mothers. The mean cohort age was 24.5 years. Maternal T. gondii IgM and IgG seropositivity was 1.9% and 69.7%, respectively. No women were positive for HIV, syphilis, or rubella IgM. Maternal rubella IgG seropositivity was 80.8% and significantly increased with age. Maternal CMV IgM and IgG seropositivity were 2.3% and 99.5%, respectively. Of the 323 women tested at both timepoints, IgM reactivation occurred in one woman for T. gondii infection and in eight for CMV. No newborn was seropositive for CMV IgM or rubella IgM. One newborn was seropositive for T. gondii IgM. Congenital T. gondii and CMV infections are important public health issues for pregnant women, newborns, and healthcare providers in Coatepeque and Guatemala