Recent studies found a substantial fraction of 'extended high viremics' among HIV-1 subtype C, the most common subtype in southern Africa. Extended high viremics are HIV infected individuals who maintain a high viral load for a longer time period than usual after the initial infection. They are more infectious during this period, and their infection progresses to full-blown AIDS and death much faster than usual. This study investigates the impact of extended high viremics on the spread of the HIV epidemic in South Africa. We develop a simple deterministic compartmental model for HIV infection that includes extended high viremics. As the available data on extended high viremics are limited, we parameterize this model using only the fraction of extended high viremics among new infections and the reduced life-span of extended high viremics. We find that without extended high viremics, the HIV prevalence in South Africa would have remained close to its 1990 level, instead of increasing to the current epidemic levels. We also find that the greater the fraction of extended high viremics among susceptibles, the greater the steady-state HIV prevalence and the more sensitive the steady-state prevalence is to the HIV transmission probability. These results suggest that extended high viremics have an impact on the HIV epidemic in South Africa; justify the need for comprehensive epidemiological studies since the current data is limited; and suggest that future models of HIV for southern Africa should explicitly model extended high viremics.

Background: High levels of total cholesterol, low-density lipoprotein (LDL), and low levels of high-density lipoprotein (HDL) are risk factors for patients with coronary artery disease (CAD). Daily activities are very important for CAD patients due to their effect on improving heart functions, lipid profile, reduced risk factors, decreased incidence and the recurrence rate of CAD. Aims of the study: To find out the effectiveness of daily living activities program on Total Cholesterol, LDL, and HDL of Patients with coronary artery disease. Methodology: A pre-experimental study design was implemented of the period 20th of December 2020 to the 4th of April 2021.The study was carried out in AL-Nasiriya Heart Center in AL-Nasiriya city on 40 coronary artery disease patients selected by using A non-probability (purposive) sampling method was used for selecting the study sample. The study instrument is composed of 4 parts. The first is demographic characteristics, the second part is the clinical history of patient and unhealthy behaviors, the third part is about investigation of total cholesterol, low-density lipoprotein, and levels of high-density lipoprotein, and the fourth part consists of two items related to patients’ responses regarding risk factors, importance of activity, healthy diet, and stress management. Results: The study reveals that (50.0%) of the participants in the study sample at age group (56–66) years old, and (57.5%) of the participants in the study sample are females, (82.5%) of study sample is married and (85.0%) was urban resident, (35.0%) of the study sample was Graduated of middle school education, (52.5%) of study sample was housewives, and (52.0%) of them are in sufficient income, also (55.0%) of them have (7-9) persons in their family. The results indicate that there is significant statistically differences between pre and post-test for total cholesterol p value (0.044), high density lipoprotein p value (0.00), and low density lipoprotein p value (0.006). Also showed that the cholesterol normal category was (2.5%) changed to (12.5%); Borderline high category was (97.5%) decreased to (87.5%) at post-test, high density lipoprotein normal category was (00.0%) changed to (17.5%); borderline high category was (12.5%) changed to (37.5%); high category was (87.5%) changed to (45%) at post-test, low density lipoprotein normal category was (00.0%) increased to (17.5%); borderline high category was (100%) changed to (82.5). Conclusion: The study concluded that the instructional program of daily living activities was effective in improving the levels of total cholesterol, low-density lipoprotein (LDL), and levels of high-density lipoprotein (HDL) of the study sample after the program implementation. Recommendations: Educating coronary patients on the effects of hyperlipidemia on the health of their coronary arteries, as well as encouraging them to participate in daily activities. Increase patient awareness by using Mass Media about the importance of exercise and a healthy lifestyle and its impact on the lipid profile to reduce the incidence and the recurrence rate of CHD.