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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Does it ever make sense to target HPV screening at HIV-infected individuals?

A number of recent studies have considered the case for HPV-related cancer prevention interventions that are targeted at specific populations. In the developed world, interventions of cervical screening and teenage vaccination aim to cover the female, or male and female, population (at a certain age) in order to prevent cervical cancer.  The question of more […]

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Susceptibility of heterosexual sub-Saharan women to HIV could be the result of cervicovaginal microbiome characteristics

Could part of the explanation for the apparent susceptibility of sub-Saharan African heterosexual women to HIV infection (eight-fold that of males) lie in the bacterial flora of their female genital tract (FGT)? Studies published in STI journal have considered the relationship between a certain state of the FGT bacterial microbiome – especially the depletion of […]

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UNAIDS 2016 Report: How a ‘life-cycle’ approach can help the world ‘get on the fast track’ to HIV prevention

‘Get on the Fast Track: a Life-cycle Approach to HIV’ is the latest UNAIDS report, following on from the UN Assembly’s 2016 declaration of commitment to ‘Fast Track’ goals for ending the HIV/AIDS epidemic. The major theme of the ‘life-cycle’ appears to owe much to the findings of the South African CAPRISA study – above […]

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PrEP highly effective against HIV in MSM and has limited impact on risk compensation

The year 2015 is likely to turn out a decisive one for the story of PrEP (pre-exposure prophylaxis for HIV).  After a slow and faltering beginning, with trials in sub-Saharan Africa dogged by problems of poor adherence (Haberer & Bangsburg/STI/blog; VOICE D/STI/blog; Hendrix & Bumpus/STI/blog), this intervention appears at last to have proved its worth […]

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Reported 86% effectiveness for MSM PrEP by PROUD study makes this intervention a viable option for UK health services

The Conference on Retroviruses and Opportunistic Infections has recently taken place.  At that event the UK PROUD (PRe-exposure Option for reducing HIV in the UK: immediate or Deferred) study of pre-exposure prophylaxis (PrEP) for MSM reported its results, prior to publication in the coming months.  The headline figure is an astonishing 86% for the reduction […]

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Does risk compensation behaviour neutralize the benefits of voluntary medical male circumcision?

The effectiveness and feasibility of voluntary medical male circumcision (VMMC) as a preventative intervention against HIV has been demonstrated in a variety of non-circumcising African communities.  The WHO has designated 14 countries in southern and eastern Africa as priority areas for VMMC scale-up.  Attempts to model the progress of the epidemic have long sought to […]

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HIV epidemic among heterosexual non-intravenous drug-users: could HSV-2 co-infection be the driver?

Why such high HIV prevalence reported for non-injecting drug users who are predominantly heterosexual?  This reaches 37% in Porto Alegre, Brazil; 43% in China; 13% in Canada; 20% in Florida; 19% in New York City; 24% in Portugal; 29% in Russia?  Possible factors include impaired decision making under the influence of drugs or the exchange of sex […]

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Emergence in Guinea-Bissau of an HIV-1 recombinant variant associated with three-fold increase in disease progression

Studies, including some in STIs journal, have mapped the geographical distribution of HIV types, subtypes, recombinant variants (CRF): see: (Middle East) STIs/Mumtaz&Abu Raddad; (Sub-saharan Africa) STI blogs/Tatem&Salemi.  Such work has potential importance for our understanding of the evolution of HIV resistance, and also for the identification and targeting of established and nascent epidemics among core […]

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Partners PrEP sub-study finds no evidence that PrEP use is associated with risk compensation behaviour

How useful is pre-exposure prophylaxis (PrEP)?  The Partners PrEP randomized control study of daily pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-discordant couples in Uganda and Kenya has indicated that, given adequate adherence, PrEP has high biologic efficacy.  The study itself (Baeten & Celum) demonstrates levels of risk reduction of 75%; while a spin-off sub-study […]

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