Warding off the scourge of untreatable gonorrhoea?

  A recent analysis (Kircaldy & Papp (K&P) of 2006-2014 US CDC (Centre for Disease Control and Prevention) data on Neisseria gonorrhea (NG) susceptibility to cefixime and ceftriaxone in isolates suggests a halt in the drift to resistance over the period 2011-13 followed by a return in 2014 to the upward trend. Among isolates from […]

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So how much do we actually know about the risks posed by ‘chemsex’?

A recent BMJ editorial (3rd November) calls for ‘chemsex’ (the term used by the gay community to designate sex under the influence of drugs taken to heighten pleasure) to be made a ‘public health priority’.  The editorial has evidently been triggered by the publication of findings from a research project conducted by Sigma Research and […]

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Changes in the WHO Guidelines for treatment of HIV

The WHO has released early its revised guidelines on the treatment of those infected with HIV (WHO early release guideline; WHO press release).  There are two important changes.  First, ART is recommended to all HIV infected individuals regardless of their CD4+ count.  Second, PrEP is recommended for people at ‘substantial’ risk of HIV infection as […]

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A case for immediate ART initiation in all HIV diagnosed, regardless of CD4+ count?

The year 2013 saw the WHO recommended threshold for treatment of HIV+ patients with ART rise from a count of 350 CD4+ per mm3 to one of 500 CD4+ per mm3.. The threshold had been fixed as early as three years before (2010) at 350 CD4+ per mm3 (WHO ART recommendations). These recommendations have doubtless […]

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Does fear work? New York City experience with “hard-hitting” public health advertising campaigns.

“Young gay men glance fearfully (even shamefully) at the camera.  As the sound of a heartbeat quickens,  … the viewer sees … a femur, shown in x-ray, snapping,  … gray matter shrivelling,  … a digitally enhanced internal view of the body fades to a bloody, raw anus, with Frankenstein-like surgery scars, of an African American […]

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Can we ensure adherence to STI treatment guidelines in a world threatened by antimicrobial resistance?

Sexual health care in the UK has traditionally centred on specialist GUM (genitor-urinary medicine) services.  Since the turn of the twenty-first century primary care has played an increasing role, however.  The 2012 Health and Social Care Act is in line with this tendency, with most GP (general practitioner) practices now being commissioned to provide level […]

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Why Tanzania seems unlikely to meet UNAIDS targets for HIV/AIDS prevention.

The UNAIDS 90-90-90 Target has set the goal that, by 2020, 90% of the HIV infected should know their status, 90% of those diagnosed should be in treatment, and 90% of those in treatment should achieve viral suppression.  The  UNAIDS GAP Report (2014) presses the need for countries to achieve a major redeployment of effort […]

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Achieving HPV herd immunity cost-effectively. When does it make sense to allocate resources preferentially to boys?

Recent empirical studies of HPV vaccination have provided evidence that marginal vaccination costs increase with coverage.  Let us take into account – they argue – not just the vaccine price, but the cost of education and outreach programmes that would be needed so as to reach the yet unvaccinated population.  If we do so, we […]

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“Hispanic” label masks the specificity of the Puerto Rican #HIV problem in US Northeast

Interventions for HIV prevention should be informed by an understanding of the long-term source of infection, and not just by recent distribution (Mishra & Boily (STIs)).  Amongst recent studies that have sought to inform future interventions are investigations of known subgroups thought to be a potential bridge into the wider population – such as migrant […]

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