Provision of psychosocial support for young people living with HIV: voices from the field

This review provides a synthesis of the experiences of organisations providing psychosocial support for young people living with HIV (YPLHIV) from throughout the world. Little research exists on psychosocial support for YPLHIV, with many providers uncertain about how to address their complex needs. Eighty-six organisations were sent a survey containing 15 semi-structured, open-ended questions. Sixty-eight organisations from the United States, Europe, Africa, Asia, Latin America and the Middle East responded. The survey asked what challenges the organisation’s patient group face; what the organisational aims are; how, where and by whom psychosocial support is delivered; what types of psychosocial support have been effective and which have not; and what recommendations the organisation has for service provision and policy.Data were stratified by age of population, region of the world and whether youth were infected at birth or in adolescence. The problems and needs across groups were more consistent than disparate. Adherence to medication, disclosure of HIV status, issues relating to sex and lack of support networks are problems faced by all YPLHIV. Most organisations use a multi-disciplinary team of individuals to meet these needs, with particular emphasis on individual and group therapy, educational support, and skills-building programmes. The review stresses the importance of youth-centered and youth-led approaches that engage young people in the planning, implementation and evaluation of programmes. Organisations underlined the need for increased funding, capacity building and trained staff. They suggest that policy makers put more effort into understanding the distinctiveness of adolescence, particularly in the context of HIV, andchallenge them to make longer-term commitments to funding and  programme support. In order for organisations to provide better services, they need further evidence of effective solutions, programme guidance and support tools, and increased collaboration and communication with one another, and with policy-makers and donors.Keywords: HIV/AIDS, youth, psychosocial, interventions.Cette revue présente une synthèse des expériences d’associations du monde entier fournissant un soutien psychosocial pour les jeunes vivant avec le VIH (JVVIH). Peu de recherches sur le soutien psychosocial pour les JVVIH ont été réalisées, et de nombreux prestataires ne savent pas vraiment comment répondre à leurs besoins complexes. Quatre-vingt-six associations ont reçu un questionnaire contenant 15 questions semi-structurées et ouvertes. Soixante-huit associations, des États-Unis, d’Europe, d’Afrique, d’Asie, d’Amérique latine et du Moyen-Orient, ont répondu. L’enquête a demandé quels sont les défis dans l’organisation de groupes de patients; quels sont les objectifs organisationnels; comment, où et par qui le soutien psychosocial est fourni; quels types de soutien psychosocial ont été efficaces et lesquels ne l’ont pas été; et quelles sont les recommandations de l’association concernant la mise à disposition et la nature de ce service. Les données ont été stratifiées en fonction de l’âge de la population, de la région du monde et de la date de la contamination (à la naissance ou à l’adolescence). Les problèmes et les besoins des groupes étaient davantage cohérents que disparates. L’adhésion à la médication, la divulgation du statut VIH, les questions relatives au sexe et au manque de réseaux de soutien sont les problèmes rencontrés par tous les JVVIH. La plupart des associations utilisent une équipe multi-disciplinaire pour répondre à ces besoins, en mettant particulièrement l’accent sur la thérapie individuelle et de groupe, sur le soutien éducatif, et sur des programmes de renforcement des compétences. La revue souligne l’importance des approches centrées sur les jeunes et menées par eux, qui les impliquent dans la planification, la mise en oeuvre et l’évaluation des programmes. Les associations ont souligné la nécessité d’accroître le financement, les capacités d’accueil etle personnel qualifié. Ils suggèrent que les décideurs s’investissent davantage dans la compréhension de la spécificité de l’adolescence, en particulier dans le contexte du VIH; et les mettent aux défis de prendre des engagements à plus long terme pour le financement et le soutien du programme. Pour que les associations fournissent de meilleurs services, elles ont besoin de d’autres témoignages évoquant des solutions efficaces, d’outils d’orientation et de soutien du programme, et d’une plus grande collaboration et communication entre elles, ainsi qu’avec les décideurs et les donateurs

Pc1-Pc2 waves and energetic particle precipitation during and after magnetic storms: superposed epoch analysis and case studies

Magnetic pulsations in the Pc1-Pc2 frequency range (0.1-5 Hz) are often observed on the ground and in the Earth's magnetosphere during the aftermath of geomagnetic storms. Numerous studies have suggested that they may play a role in reducing the fluxes of energetic ions in the ring current; more recent studies suggest they may interact parasitically with radiation belt electrons as well. We report here on observations during 2005 from search coil magnetometers and riometers installed at three Antarctic stations, Halley (-61.84 degrees magnetic latitude, MLAT), South Pole (-74.18 degrees MLAT), and McMurdo (-79.96 degrees MLAT), and from energetic ion detectors on the NOAA Polar-orbiting Operational Environment Satellites (POES). A superposed epoch analysis based on 13 magnetic storms between April and September 2005 as well as case studies confirm several earlier studies that show that narrowband Pc1-Pc2 waves are rarely if ever observed on the ground during the main and early recovery phases of magnetic storms. However, intense broadband Pi1-Pi2 ULF noise, accompanied by strong riometer absorption signatures, does occur during these times. As storm recovery progresses, the occurrence of Pc1-Pc2 waves increases, at first in the daytime and especially afternoon sectors but at essentially all local times later in the recovery phase (typically by days 3 or 4). During the early storm recovery phase the propagation of Pc1-Pc2 waves through the ionospheric waveguide to higher latitudes was more severely attenuated. These observations are consistent with suggestions that Pc1-Pc2 waves occurring during the early recovery phase of magnetic storms are generated in association with plasmaspheric plumes in the noon-to-dusk sector, and these observations provide additional evidence that the propagation of waves to ground stations is inhibited during the early phases of such storms. Analysis of 30- to 250-keV proton data from four POES satellites during the 24-27 August and 18-19 July 2005 storm intervals showed that the location of the inner edge of the ring current matched well with the plasmapause model of O'Brien and Moldwin (2003). However, the POES data showed no evidence of the consequences of electromagnetic ion cyclotron waves (localized proton precipitation) during main and early recovery phase. During later stages of the recovery phase, when such precipitation was observed, it was coincident with intense wave events at Halley, and it occurred at L shells near or up to 1 RE outside the modeled plasmapause but well equatorward of the isotropy boundary

Methadone versus torture: The perspective of the European Court of Human Rights

For the first time, the European Court of Human Rights in Strasbourg has addressed the issue of whether persons with a heroin dependence syndrome in custodial settings are entitled to receive opioid agonist treatment (OAT). The court relied on Article 3 of the European Convention on Human Rights, which prohibits torture as well as inhuman or degrading treatment. It concluded that member states of the Council of Europe that refuse access to OAT have the burden of proving that an alternative medical approach would, in the case of an individual patient, be as effective as OAT. Such proof needs to be based on an independent medical opinion. This paper discusses the scope and limitations of the European Court of Human Rights’ judgment

Methadone versus torture: The perspective of the European Court of Human Rights

For the first time, the European Court of Human Rights in Strasbourg has addressed the issue of whether persons with a heroin dependence syndrome in custodial settings are entitled to receive opioid agonist treatment (OAT). The court relied on Article 3 of the European Convention on Human Rights, which prohibits torture as well as inhuman or degrading treatment. It concluded that member states of the Council of Europe that refuse access to OAT have the burden of proving that an alternative medical approach would, in the case of an individual patient, be as effective as OAT. Such proof needs to be based on an independent medical opinion. This paper discusses the scope and limitations of the European Court of Human Rights’ judgment