|Multi-drug regimens called highly active antiretroviral therapy (HAART) have changed HIV disease from a life-threatening, terminal illness to a chronic disease. Unfortunately, prolonged survival is accompanied by metabolic abnormalities in carbohydrate metabolism, including an increased incidence of insulin resistance, dyslipidemia, hypertension, and increased waist-to-hip ratio, a compilation of abnormalities now known as the metabolic syndrome and overt diabetes mellitus. The prevalence of insulin resistance among HIV infected individuals is high, with estimates of up to 46% reported by Behrens et al. with 13% classified as diabetic based on an oral glucose tolerance test. (McNurlan M, Chromium Therapy for Insulin Resistance Associated with HIV-Disease).
Open access to the scientific literature means the removal of barriers (including price barriers) from accessing scholarly work. There are two parallel roads towards open access: Open Access articles and self-archiving. Open Access articles are immediately, freely available on their Web site, a model mostly funded by charges paid by the author (usually through a research grant). The alternative for a researcher is self-archiving (i.e., to publish in a traditional journal, where only subscribers have immediate access, but to make the article available on their personal and/or institutional Web sites (including so-called repositories or archives)), which is a practice allowed by many scholarly journals.
Open Access raises practical and policy questions for scholars, publishers, funders, and policymakers alike, including what the return on investment is when paying an article processing fee to publish in an Open Access articles, or whether investments into institutional repositories should be made and whether self-archiving should be made mandatory, as contemplated by some funders.