Assess social determinants as influential factors in HIV care continuum outcomes (late diagnosis, linkage to care, engagement/retention in care and viral suppression) among HIV-infected individuals in Trinidad and Tobago. Additionally, we will determine if there are differences by gender and mode of transmission (i.e. heterosexual, men who have sex with men (MSM)) and country of birth for continuum outcomes. (2) Cases (n>5000) will be analyzed among individuals, aged = 18, who met CDC HIV case definition for HIV. Late diagnosis will be defined as an AIDS diagnosis within 3 months of an HIV diagnosis; Engagement in care will be defined as one documented physician visit annually; Retention in care will be defined as engagement in care two or more times at least three months in one year; and, viral suppression will be defined as having a viral load of <200 copies/mL in the last laboratory test performed. Self-reported ART adherence will be measured with one of the three following indicators: percentage of patients with full adherence to ART percentage of ARV doses patients took during the recall period or percentage of patients with more than 95% adherence to ARV treatment (i.e., missed no more than 1 dose in 20, which for periods shorter than 3 days, is equivalent to full adherence). Chi square test will be used to evaluate differences by gender and mode of transmission. Multilevel logistic regression will be used to estimate adjusted odds ratios for each outcome.
Media communications development is experiencing a quick vamp to the future; the advancement is relatively exponential, from the simple sorts to 2Gs and after that at last the most recent portable development the 3G innovation. The 3G geek is the most recent on-stream line of interchanges which offers propelled voice correspondences and rapid information network, with remote Internet get to, versatile information applications and high media content. The 3G demonstrate typifies genuine modernity as far as portable innovation yet why was this expression used to depict it? To answer this an examination of the roots and procedures of 3G would be required. Versatile innovation's origination begun from the analogs. Simple systems, or original remote innovation has been presented in the mid 1980s in America, an innovation that was unbelievably district particular in character. As the interest for portable interchanges developed, the advanced 2G rose in the 1990s flanking the undercapacity of the 1G frameworks. Second era versatile frameworks work on the accompanying basics: TDMA, (IS-54 and IS-136), GSM and CDMA IS-95 or cdmaOne. GSM, utilized around the world, is a bundle exchanged innovation that vehicles speed hypothetically of up to 115 kbit/s. Sadly, these innovations were observed to be contrary with each other, and numerous portable geeks were staggeringly delimited to a particular district or nation. They are additionally manufactured for the most part for voice information and moderate transmission. Fast changes in client desire and correspondence needs, looked for the requirement for development. The determination: a binding together computerized remote interchanges that would make worldwide wandering with a solitary handset conceivable. 3G alludes to the third era remote innovation and arranges and was designed in 1999 (Xavier, ?). It is really a changed idea of 2G cell phone frameworks. It depends on an International Telecommunication Union (ITU) conspire setting up for single worldwide remote standard called International Mobile Telecommunications-2000 (IMT-2000), a determination to the imperfections of 2G framework. Framework limit and range proficiency more than 2G frameworks was the fundamental subject of the ITU institutionalization frameworks. Least transmission rates was set at 144 kbps in portable (open air) and 2 Mbps in settled (indoor) situations. (Qualcomm, 2001). Basically, it is an enhanced remote innovative gadget for an accumulation of universal norms and advances planned to expanded proficiency yield and enhanced versatile remote system execution. Since 3G is really a joining, the diverse systems attempting to institutionalized it, might be delegated takes after: WCDMA, CDMA2000, UMTS and EDGE. The variety rather than the institutionalization can't generally be settled since there are monetary powers or partners who have personal stake for that specific standard. WCDMA (Wideband Code Division Multiple Access) alludes to broadband computerized radio interchanges of Internet, sight and sound informing, video gushing and other limit requesting applications and is the favored 3G organize in Europe, Asia, Japan, United States and Africa. Transformation of information (e.g. picture, video, voice) to a narrowband computerized radio flag labeled with a particular marker is the technique for multi-rate transmission of the system. CDMA (Code Division Multiple Access) is the main 3g organize as of current giving over a hundred million customers around the world. It was chosen as the business standard by the ITU (International Telecommunications Union)..CDMA innovation is a blend of two systems administration resources: CDMA2000 1X and CDMA2000 1xEV-DO. The limit and execution of voice and information administrations of CDMA2000 1X is twice that of the previous CDMA frameworks and outperforms that of TDMA and GSM. Pinnacle information rates are come to around 153 kbps without interceding voice limit. It additionally offers longer standby circumstances. Its' high similarity with the previous CDMA encourage redesign of portable innovation to current. CDMA2000 1xEV-DO is an information enhanced adaptation of CDMA2000 giving pinnacle rates of in excess of 2 Mbps, with a normal yield of more than 700 kbps. This quick innovation is parallel to DSL benefit and can bolster video spilling information and extensive byte record downloads. The stipulation for CDMA2000 1xEV-DO is to conveys most extreme number of information (Megabyte) at the least cost conceivable. Being the chosen innovation, CDMA offers the best bundles in versatile innovation. CDMA expands on the previous CDMA frameworks and ad libbed on it like the Orthogonal Frequency Division Multiplexing (OFDM and OFDMA), propelled control and flag method, enhanced obstruction signalmanagement strategies, end-to-end Quality of Service (QoS), and new reception apparatus procedures, for example, Multiple Inputs Multiple Outputs (MIMO) and Space Division Multiple Access (SDMA). The benefit of this enhanced bundles incorporate the accompanying: (1) lead execution (e.g. information speed, limit, inactivity), (2) range proficiency, (3) propelled portable administrations bolster (4) IP good (5) gadget determination (6) consistent development way and ;(7) worldwide/organize scope adaptability. Best of all it drives bring down cost of aggregate proprietorship (CDMA Development Group, 2007). UMTS (Universal Mobile Telecommunications System) is the cell phone standard in Europe, set by ETSI. Dissimilar to GSM, the UMTS takes after layering convention for information organizing. The highest, being the administrations layer, is for portion and information speed. The control layer found focal, helps with overhauling activities and permits dynamic portion and labeling of information to a particular transmission capacity. Bottommost is the network layer where any transmission innovation can be favored and the voice movement will transport over ATM/AAL2 or IP/RTP henceforth trafficking by flag transfer speed is avoided (GSM server, 2007). EDGE (Enhanced Data For Global Evolution) permits GSM the fitness to deal with administrations for the 3g communication. It encourages information transmission at a rapid of 384 kb/sec. EDGE utilizes TDMA (Time Division Multiple Access) outline structure, rationale channel and 200kilohertz bearer transmission capacity. A similar data transmission with that of GSM sytems empowers framework similarity (3G, 2006). Framework similarity guarantees redesign productivity and minimal effort which had been the issue of most G3 organizing frameworks (Lapping, 2006). The constituents of 3G is huge and takes into account the mechanical impulses of the geek addicts and the businesspeople all finished Europe, Asia, South America and Africa, nonetheless, similar to every single new innovation, there has been a bone of conflict among producers. From the time that the possibility of 3G emerges and the time when it was advertised, impediments appear to be dependably around the bend. As specified before, there are different systems of 3G which had really prompt authorizing differences emerging from various terms of conditions from various gatherings included. High obligations increased by the media transmission parties amid the previous years, which may really act like a danger to the improvement of 3G. Additionally, administrator inconveniences are unsupported by state back. The costs related with permit are terrible. The fundamental issue of 3G all comes down to cash. 3G benefit is new consequently arrange scope is constrained. Additionally, the cost of innovation is lumbering for the ordinary people and the web level rate is high at a few nations. The principle issue with the update of innovation to 3G is that there are some value apprehensions related with the presented and propelled innovation. Luckily, a large portion of the main handset makers like Broadcom puts a conclusion to this whole on edge value tirade, and in the end figured out how to create more 3G innovations planning to encourage its spread universally and presumably to fortify its financial request. Broadcom created the Cellairity chipset with bewildering expense of $100 (Hyatt, 2007). This value determination may, over the long haul, anticipate to be a decent beginning of shopper accessibility for 3G. Broadcom may have started diminishment underway cost however would different organizations take after? 3G is an enormous danger of interest in shopper advertise. 3G's complexity really takes into account that businessperson who directs their organizations helped by the remote systems. Tragically, the unforeseen development is that representatives constitute just a little populace in the worldwide systems administration field. For the modern innovation to be genuinely cosmopolitan in character it must be utilized by a large portion of the organizers and versatile clients everywhere throughout the world. Until further notice, it is unusually delimited to the individuals who can truly manage the cost of it. Taking a gander at the positive side of things, the circumstance of 3G purchaser proportion would not generally be the same. Like all things, needs change, and watching the advancement of portable innovation from the provincial simple model to the most recent 3G writes, one can just anticipate that buyer needs would be slanted towards mechanical upgrade and that innovative improvement would be more qualified to the requirements of the purchaser. What is more is that necessities change, portable nerd patterns may likewise change. The 3G show is presently as of now being extemporized from more than 3G to 4G. 4G Technology: Super-fulfillment ensured? The truth will surface eventually. References 3G. (2006). 3G store. Recovered Nov 22, 2007 from http://www.3g.co.uk/All%20About%203G.htm 3G Technology. (22 Aug 2007). Qualcomm. Recovered Nov 22, 2007 from http://www.3gtoday.com/wps/entry/endorsers. CDMA Development Group. (2007). 3G-CDMA2000. Recovered Nov 22, 2007 from http://www.cdg.org/innovation/3g.asp. GSM server.(2007). Advancement to 3G. Recovered Nov 22, 2007 from http://www.gsmserver.com/articles/evolution_to_3g.php. Hyatt, J. (2007). Broadcom Enables 3G Mobile Phones at 2G Prices with New CellAirityâ„¢ Chipset. Recovered Nov 22, 2007 from http://www.broadcom.com/press/release.php?id=815794. Lapping, K. (2006). Cost and Software Incompatibility Stymie 3G Growth. Ernst and Young Ltd. Recovered Nov 22, 2007 from http://www>GET ANSWER