***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction In order to assess the health outcomes of the South African public sector antiretroviral treatment ( ART ) programme , it is important to gain a better underst and ing of the complex relationship between ART and the multidimensional construct quality of life ( QoL ) . Because of the gap between supply and dem and , equity issues arise concerning the provisioning of ART . Objective The aim of this paper is to examine how and to what extent public sector ART is related to the physical and emotional health of people living with HIV/AIDS ( PLWHA ) . Methods The stratified r and om sample consisted of 371 AIDS patients on ART or medically certified for ART , but still awaiting treatment . A model of the relationships between patient characteristics ( age and gender ) and socio-economic position ( educational level , income , type of dwelling , number of rooms ) , ART duration , and physical and emotional QoL was tested using structural equation modelling . Results Patients with a higher personal income ( β = .19 , P < .05 ) and a larger dwelling ( β = .45 , P < .01 ) were significantly more likely to enter the programme at this early stage . The model showed that the initial months of ART have been associated with significant improvements in the physical QoL ( β = .21 , P < .01 ) . Furthermore , patients on ART reported significantly higher levels of emotional well-being than patients awaiting treatment ( β = .10 , P < .01 ) . Finally , the results indicate that ART is not only directly associated with emotional QoL , but is also indirectly associated with emotional QoL via the mediating variable physical QoL ( β = .30 , P < .01 ) . Conclusions The study suggests that the poorest of the poor are not the first beneficiaries of the public programme . Most importantly , the present findings demonstrate the positive physical and emotional health outcomes of the first 6 months of ART in the Free State , South Africa BACKGROUND HIV infection causes a range of cognitive and behavioral symptoms that become more frequent and severe as the immune system deteriorates and symptomatic illness ensues . OBJECTIVE To determine the impact of disease progression on cognitive abilities of Nigerian Africans who present in the HIV/AIDS clinic of the University Teaching Hospital , Benin City , Nigeria , using the CD4 levels as the measure of disease progression . METHODS A total of 288 subjects comprising 96 r and omly selected symptomatic AIDS patients , 96 r and omly selected asymptomatic HIV-positive patients and 96 HIV-negative controls participated in the study .  Enzyme-linked immunosorbent assay ( ELISA ) method was used to detect HIV infection , and CD4 levels were obtained for all subjects . The Community Screening Interview for Dementia ( CSI ' D ' ) was used to assess cognitive performance of subjects . Subjects were matched for age , sex and level of education . RESULTS Each category of subjects comprised 48 males and 48 females . The mean ages were 32.94 + /- 8.0 years , 31.47 + /- 6.7 years and 33.56 + /- 7.1 years for the controls , asymptomoatic HIV-positive and symptomatic AIDS subjects respectively ( p = 0.127 ) . The mean CD4 levels were 684 + /- 44/microL ( controls ) , 284 + /- 62/microL ( asymptomatic HIV positive ) and 142 + /- 36/microL ( symptomatic AIDS ) . The mean CS1 ' D ' scores were 66.46 + /- 1.90 ( controls ) , 66.31 + /- 2.14 ( asymptomatic HIV positive ) and 56.62 + /- 4.23 ( symptomatic AIDS ) . CONCLUSION Cognitive abilities of HIV/AIDS patients decline as the disease progresses . This is reflected in the cognitive performances of the symptomatic AIDS patients . The lower the CD4 levels , the worse the cognitive deficits . There was , however , no significant difference in the performance of asymptomatic HIV-positive patients and the controls OBJECTIVES Despite the high prevalence of both mental illness and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome ( AIDS ) in developing countries , there are few data on the association between different forms of mental illness and sexual risk behaviours in re source -poor setting s. The objective of this study was to examine the association between mental illness and HIV risk behaviours in a South African township . STUDY DESIGN A cross-sectional study was performed among 645 individuals living in households selected at r and om . METHODS A self-administered translated question naire investigated sexual risk behaviours [ including sexual partners , condom use , casual sexual contacts , and sex in exchange for money , drugs or a place to stay ( transactional sex ) ] , depression ( measured using the Center for Epidemiological Studies Depression Scale ) , alcohol abuse ( from the Alcohol Use Disorders Identification Test ) , and post-traumatic stress disorder ( based on the Life Event Checklist ) . RESULTS Of the 645 individuals who completed the survey , 33 % reported depression , 17 % reported alcohol abuse , and 15 % reported post-traumatic stress disorder . After adjusting for demographic characteristics , the presence of any of these three conditions was strongly associated with experiences of forced sex [ adjusted odds ratio ( AOR ) 2.53 ; 95 % confidence intervals ( CI ) 1.60 - 4.02 ] , transactional sex ( AOR 2.88 ; 95 % CI 1.29 - 6.48 ) and increased condom use ( AOR 2.07 ; 95 % CI 1.32 - 3.25 ) . CONCLUSIONS These findings emphasize the substantial burden of mental illness in this setting , and its association with forced and transactional sex . The temporal nature of these associations is not always clear from this cross-sectional study , and additional prospect i ve research is required . Public health interventions are needed to address the dual burden of HIV/AIDS and mental illness in this and similar setting CONTEXT Despite the importance of mental illness in Africa , few controlled intervention trials related to this problem have been published . OBJECTIVES To test the efficacy of group interpersonal psychotherapy in alleviating depression and dysfunction and to evaluate the feasibility of conducting controlled trials in Africa . DESIGN , SETTING , AND PARTICIPANTS For this cluster r and omized , controlled clinical trial ( February-June 2002 ) , 30 villages in the Masaka and Rakai districts of rural Ug and a were selected using a r and om procedure ; 15 were then r and omly assigned for study ing men and 15 for women . In each village , adult men or women believed by themselves and other villagers to have depressionlike illness were interviewed using a locally adapted Hopkins Symptom Checklist and an instrument assessing function . Based on these interviews , lists were created for each village totaling 341 men and women who met Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition ( DSM-IV ) criteria for major depression or subsyndromal depression . Interviewers revisited them in order of decreasing symptom severity until they had 8 to 12 persons per village , totaling 284 . Of these , 248 agreed to be in the trial and 9 refused ; the remainder died or relocated . A total of 108 men and 116 women completed the study and were reinterviewed . INTERVENTION Eight of the 15 male villages and 7 of the 15 female villages were r and omly assigned to the intervention arm and the remainder to the control arm . The intervention villages received group interpersonal psychotherapy for depression as weekly 90-minute sessions for 16 weeks . MAIN OUTCOME MEASURES Depression and dysfunction severity scores on scales adapted and vali date d for local use ; proportion of persons meeting DSM-IV major depression diagnostic criteria . RESULTS Mean reduction in depression severity was 17.47 points for intervention groups and 3.55 points for controls ( P<.001 ) . Mean reduction in dysfunction was 8.08 and 3.76 points , respectively ( P<.001 ) . After intervention , 6.5 % and 54.7 % of the intervention and control groups , respectively , met the criteria for major depression ( P<.001 ) compared with 86 % and 94 % , respectively , prior to intervention ( P = .04 ) . The odds of postintervention depression among controls was 17.31 ( 95 % confidence interval , 7.63 - 39.27 ) compared with the odds among intervention groups . Results from intention-to-treat analyses remained statistically significant . CONCLUSIONS Group interpersonal psychotherapy was highly efficacious in reducing depression and dysfunction . A clinical trial proved feasible in the local setting . Both findings should encourage similar trials in similar setting s in Africa and beyond Background and Purpose — This study examined depressive disorder as a risk factor for incident stroke  in a prospect i ve , population -based design . Methods — The Baltimore Epidemiologic Catchment Area Study is a prospect i ve 13-year follow-up of a probability sample of household residents from Baltimore , Md.  Depressive disorder  was measured with the  diagnostic interview schedule  , and stroke was assessed by questions from the health interview survey or by documentation on a death certificate . Results — During the 13-year follow-up of 1703 individuals , 66 strokes were reported and 29 strokes were identified by death certificate search . Individuals with a history of depressive disorder were 2.6 times more likely to report stroke than those without this disorder after controlling for heart disease , hypertension , diabetes , and current and previous use of tobacco . Medications used in the treatment of depressive disorder at baseline did not alter this finding . A history of dysthymia demonstrated a similar relationship to stroke , although the estimate was not statistically significant . Conclusions — Depressive disorder is a risk factor for stroke that appears to be independent of traditional cardiovascular risk factors . Further research on mechanisms for the association and the impact of treatment for depressive disorder on subsequent stroke is needed Background Clear , transparent , and sufficiently detailed abstract s of conferences and journal articles related to r and omized controlled trials ( RCTs ) are important , because readers often base their assessment of a trial solely on information in the abstract . Here , we extend the CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement to develop a minimum list of essential items , which authors should consider when reporting the results of a RCT in any journal or conference abstract . Methods and Findings We generated a list of items from existing quality assessment tools and empirical evidence . A three-round , modified-Delphi process was used to select items . In all , 109 participants were invited to participate in an electronic survey ; the response rate was 61 % . Survey results were presented at a meeting of the CONSORT Group in Montebello , Canada , January 2007 , involving 26 participants , including clinical trialists , statisticians , epidemiologists , and biomedical editors . Checklist items were discussed for eligibility into the final checklist . The checklist was then revised to ensure that it reflected discussion s held during and subsequent to the meeting . CONSORT for Abstract s recommends that abstract s relating to RCTs have a structured format . Items should include details of trial objectives ; trial design ( e.g. , method of allocation , blinding/masking ) ; trial participants ( i.e. , description , numbers r and omized , and number analyzed ) ; interventions intended for each r and omized group and their impact on primary efficacy outcomes and harms ; trial conclusions ; trial registration name and number ; and source of funding . We recommend the checklist be used in conjunction with this explanatory document , which includes examples of good reporting , rationale , and evidence , when available , for the inclusion of each item . Conclusions CONSORT for Abstract s aims to improve reporting of abstract s of RCTs published in journal articles and conference proceedings . It will help authors of abstract s of these trials provide the detail and clarity needed by readers wishing to assess a trial 's validity and the applicability of its results Background Health Related Quality of Life ( HRQoL ) is an important outcome in times of Highly Active Antiretroviral Treatment ( HAART ) . We compared the HRQoL of HIV positive patients receiving HAART with those awaiting treatment in public sector facilities in the Free State province in South Africa . Methods A stratified r and om sample of 371 patients receiving or awaiting HAART were interviewed and the  EuroQol-profile , EuroQol-index and Visual Analogue Scale ( VAS ) were compared . Independent associations between these outcomes and HAART , socio-demographic , clinical and health service variables were estimated using linear and ordinal logistic regression , adjusted for intra-clinic clustering of outcomes . Results Patients receiving HAART reported better HRQoL for 3 of the 5 EuroQol-dimensions , for the VAS score and for the EuroQol index in bivariable analysis . They had a higher mean EuroQol index ( 0.11 difference , 95 % confidence interval [ CI ] 0.04 ; 0.23 ) , and were more likely to have a higher index ( odds ratio 1.9 , 95 % CI 1.1 ; 1.3 ) , compared to those awaiting HAART , in multivariate analysis . Higher mean VAS scores were reported for patients who were receiving HAART ( 6.5 difference , 95 % CI 1.3 ; 11.7 ) , were employed ( 9.1 , 95 % CI 4.3 ; 13.7 ) or were female ( 4.7 , 95 % CI 0.79 ; 8.5 ) . Conclusion HAART was associated with improved HRQoL  in patients enrolled in a public sector treatment program in South Africa . Our finding that the EuroQol instrument was sensitive to HAART supports its use in future evaluation of HIV/AIDS care 
    Output:
    
Neurocognitive changes in adults with HIV were also prevalent , with reported deficits of up to 99 % in symptomatic PLHIV and 33 % in non-symptomatic PLHIV .