Case report: HIV-associated neurocognitive disorder & myelopathy in patient with preserved CD4, but high viral load

HIV-associated neurocognitive disorder and HIV-associated myelopathy in a patient with a preserved CD4, but high viral load-a rarely reported phenomenon: a case report and literature review. 

Ayele, B.A., Amogne, W. & Gemechu, L.

BMC Infect Dis 20, 574 (2020). https://doi.org/10.1186/s12879-020-05297-9

This case supports the current understanding regarding the persistent occurrence of HIV-associated neurocognitive disorder and HIV-associated myelopathy even decades after introduction of cART. Therefore, it’s important to screen HIV+ patients for the HAND and HAM even if they have relatively preserved immunity.

Because patient can be easily shifted to ART drugs with better CNS penetrating potential to achieve acceptable virological suppression level, to observe sound clinical improvement.

It’s hard to think about, but frail older women in nursing homes get sexually abused too

The Conversation, November 22, 2018 6.02am AEDT

We don’t often think of older women being victims of sexual assault, but such assaults occur in many settings and circumstances, including in nursing homes. Our research, published this week in the journal Legal Medicine, analysed 28 forensic medical examinations of female nursing home residents who had allegedly been victims of sexual assault in Victoria over a 15-year period.

The majority of the alleged victims had some form of cognitive or physical impairment. All 14 perpetrators who were reported were male, half of whom were staff and half other residents.

 

 

Grey area: The fragile frontier of dementia, intimacy and sexual consent

The Globe & Mail (Canada), July 14, 2018

Amid ever-widening cultural conversations about sexual consent, dementia remains uncharted territory. As Canadians live longer, more are moving into long-term care with advancing dementia disorders. It’s a growing population with complex needs, not least of all in their intimate lives.

In the close-quarters environment of nursing homes, these people’s sexuality poses difficult ethical dilemmas for staff and for families

 

Sexual activity and sexual health among young adults with/without intellectual disability

BMC Public Health 201818:667

https://doi.org/10.1186/s12889-018-5572-9

Abstract

Background

There is widespread concern about the sexual ‘vulnerability’ of young people with intellectual disabilities, but little evidence relating to sexual activity and sexual health.

Method

This paper describes a secondary analysis of the nationally representative longitudinal Next Steps study (formerly the Longitudinal Survey of Young People in England), investigating sexual activity and sexual health amongst young people with mild/moderate intellectual disabilities. This analysis investigated family socio-economic position, young person socio-economic position, household composition, area deprivation, peer victimisation, friendships, sexual activity, unsafe sex, STIs, pregnancy outcomes and parenting.

Results

Most young people with mild/moderate intellectual disabilities have had sexual intercourse by age 19/20, although young women were less likely to have sex prior to 16 than their peers and both men and women with intellectual disabilities were more likely to have unsafe sex 50% or more of the time than their peers. Women with intellectual disabilities were likely to have been pregnant and more likely to be a mother.

Conclusion

Most young people with mild/moderate intellectual disabilities have sex and are more likely to have unsafe sex than their peers. Education and health services need to operate on the assumption that most young people with mild/moderate intellectual disabilities will have sex.

What does the Anna Stubblefield case teach us about sentencing and sexual assault?

A former chair of philosophy at Rutgers University had sex with a man who can’t speak. The resulting court battle raised questions about when and why suffering matters in sentencing — and Anna Stubblefield went to jail.

Stubblefield had slept with a man known only by the pseudonym DJ, who has cerebral palsy and to this day has never spoken.

That’s not to say he can’t communicate, though it’s not to say he can, either — that’s what is at issue.

Read more here 

Studies look at brain and cognitive changes in people with HIV as they age

 

nam/aidsmap, published: 14 March 2017

People with HIV often show persistent signs of cognitive impairment and abnormalities in brain structure despite suppressive antiretroviral therapy (ART), but they do not appear to experience accelerated decline compared to HIV-negative people as they age, according to research presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) last month in Seattle.