Cure Study

Abstract: Introduction Biomedical research towards an HIV cure is advancing in the United States and elsewhere, yet little is known about perceptions of risks and benefits among potential study participants and other stakeholders. We conducted a qualitative study to explore perceived risks and benefits of investigational HIV cure research among people living with HIV (PLWHIV), biomedical HIV cure researchers, policy-makers and bioethicists. Methods We conducted a qualitative research study using in-depth interviews with a purposive sample of PLWHIV, biomedical HIV cure researchers, policy-makers and bioethicists in 2015–2016. We analysed interview transcripts using thematic analysis anchored in grounded theory. Results We conducted and analyzed 36 key informant interviews. Qualitative analysis revealed four main findings. 1) Potential HIV cure study volunteers noted needing more information and education about the potential risks of HIV cure research. 2) Biomedical HIV cure researchers, policy-makers and bioethicists showed less awareness of social and financial risks of HIV cure research than PLWHIV. 3) Most respondents across the different categories of informants identified some risks that were too great to be acceptable in HIV cure research, although a subset of PLWHIV did not place an upper limit on acceptable risk. 4) PLWHIV showed a better awareness of potential psychological benefits of participating in HIV cure research than other groups of stakeholders. Conclusion Our research suggests that PLWHIV have a variable understanding of the individual risks, sometimes substantial, associated with participating in biomedical HIV cure research studies. Community engagement and increased research literacy may help improve community understanding. Intensive informed consent procedures will be necessary for ethical study implementation. The current state of HIV cure research offers greater potential benefits to society than to participants. There is likely to be disagreement among regulators, researchers, clinicians, and potential participants about what constitutes acceptable risk for HIV cure studies.

Abstract: The single-fibre pull-out test was employed to determine the effect of thermal history on a single-fibre composite. This was done by characterizing the fibre/coating/resin system with respect to the physical parameters of the polymer, the normal pressure exerted on the fibre by the polymer and the failure mechanism of the composite as a function of cure temperature. The experimental fracture data were quantified by determining the strain energy release rate for crack initiation and, with the consideration of friction, its propagation. Also determined were the interfacial shear stress of the bond ( τ bond ) and the interfacial shear stress associated with debonding ( τ debond ) and sliding ( τ pull-out ). The model material system was a polyimide-coated optical fibre embedded in uncatalysed tetraglycidyl-4,4′-diaminodiphenylmethane with 4,4′-diaminodiphenylsulfone. Cure temperatures ( T cure ) of 150, 177, 230 and 250°C were employed. The average critical strain energy release rates increased from the 150 to 177 to 230°C sample sets, then decreased for the 250°C sample set. Since the glass transition temperature ( T g ) of the fully cured resin is 260°C, these results support the hypothesis of increasing residual stress as a function of T cure for cure in the vitreous state. With regard to the 250°C cure data set, since T cure = T g ± 15°C, it is hypothesized that the internal pressures due to crosslinking were minimized due to cure in a rubber-like state. The residual pressure, independently determined from both the resin characterization and fracture data, increased by a factor of 2.4 with a temperature increase from 150 to 230°C for the 2 h cure period. The strain energy release rate and τ pull-out increased by a factor of 2.64 and 2.1, respectively. The coefficient of friction remained statistically constant at 0.6.