The risk network approach to HIV detection: something like contact tracing?

There has been considerable debate on the most effective and cost-effective means of accessing untested HIV- or STI-infected individuals. One frequently canvassed strategy is that of respondent driven sampling (RDS). This involves issuing suitable ‘seeds’ (e.g. recently diagnosed MSM) with coupons to distribute to others in their sexual or social networks.  Wei & Raymond (STI) […]

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The recent trend towards multi-resistant gonorrhoea in coastal China

Alarming data have recent been reported (Yin & Chen) (Y&C) from the China Gonococcal Resistance Surveillance Programme (China-GRSP), covering seven (mostly coastal) provinces in the period 2013-2016. The study is relevant for Chinese national treatment policy, which currently recommends azithromycin monotherapy. However, with an estimated 45% of the world’s 78 million incident cases occurring in […]

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How should HIV-specific charitable interventions like PEPFAR be evaluated?

Fauci & Eisinger (F&E), in a short piece for New England Journal of Medicine, celebrate 15 years of the President’s Emergency Plan for AIDS Relief (PEPFAR) and count the lives saved. PEPFAR was established by President George W. Bush in 2003 in recognition of the obligation owed by a resource-rich country such as the US […]

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Presence of BV-related bacterial species in the vaginal microbiota may contribute to the vulnerability of African women to HIV

The association between disruptions of vaginal microbiota and vulnerability to STIs has been widely discussed. Tamarelle & Astagneau (STI) report a study based in a French STI clinic showing some evidence of greater vulnerability to Chlamydia in the case of microbiota not dominated by Lactobacillus crispatus. The more important question of an association of BV-related […]

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Overcoming the obstacles to routine HIV testing in hospital settings

In both the UK (2008) and the US (2006) routine opt-out HIV screening is recommended in areas where the prevalence of HIV exceeds a certain threshold. Hospital emergency departments (ED) and acute medical units (ACU) are obvious settings where testing can be offered. Elgalib & Sabapathy (E&S), in a systematic review focussing on 14 studies […]

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Estimating the added value of PrEP where it is not the only prevention tool in the box

LeVasseur & Welles (L&W) model the potential population-level impact of PrEP in combination with other prevention strategies. They seek to quantify the additional benefit of PrEP at various levels of uptake (0%-25%) in terms of prevented infections specifically attributable to that intervention in a range of contexts involving its combination with one or more of […]

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What is the right number and timing of cervical screens in the UK of the HPV vaccination era?

The introduction of widespread HPV vaccination for pre-adolescents has important implications for the conduct of cervical screening (What is the future of cervical screening in the era of vaccination?/STI/blogs). Ecological studies have shown the potential impact of vaccination on cervical cancer, by using various proxies for cervical cancer prevention, including declines in HPV infections (Garland & Jayasinghe/STI), genital warts (Chow & Fairley/STI; Ali & Donovan/STI; […]

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Empirical evidence that achievement of UNAIDS 90-90-90 can deliver promised HIV elimination?

The achievement of the UNAIDS 90-90-90 targets would reduce levels of viral suppression amongst HIV+ people to 73% by 2020. The target is set at this ambitious level because, modelers suggest, it would bring about the elimination of HIV by 2030. In sub-Saharan Africa the challenge seems so great – especially in regard to the […]

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HIV/AIDS in the US: the importance of local perspectives

Some recent studies, in STI and other journals, have sought to demonstrate the importance of spatial location as a determinant of STI prevalence in its own right (Haley & Cooper (STI); ‘Scoping Location’ (STI/blogs))). On the face of it, Brawner & Schensul appear to share this aim, in their comparative neighbourhood-based case study of multilevel factors affecting HIV transmission […]

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What is the potential of ‘Treatment for Prevention’ in fighting HIV/AIDS?

UNAIDS 90:90:90 appears to have set the course for a global ‘treatment as prevention’ strategy. In 2015 the US revised its National HIV/AIDS Strategy (NHAS) to harmonize its goals with UNAIDS 90% targets for testing, engagement in care, and virological suppression. Though the HIV/AIDS community have been nervous about the impact of the recent change […]

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