UK National Health Service (NHS) kicks PrEP into the long grass

A recent BMJ editorial condemns the NHS position that it will not consider PrEP for direct NHS funding.  The decision was first communicated in an NHS statement issued in March, then confirmed by a review on 31st May, following reconsideration in response to objections raised by interested groups.  This brought to an end an eighteen-month process […]

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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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Retention in care rather than diagnosis may prove the ultimate challenge for US HIV response

The real challenge which the US HIV/AIDS epidemic poses for the US public health services is not simply to achieve higher levels of diagnosis – but, far more than that, to improve linkage to, and retention in, care.  This claim is hardly controversial. But it is thrown into stark relief in a recent study by […]

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Trialling innovative approaches to STI partner services: Partner-Delivered vv. Accelerated Partner Therapy

It is vital to treat partners of patients with curable STIs as quickly as possible.  But the effectiveness of interventions to achieve this proves hard to measure – and the case for increasing resources correspondingly difficult to make.  The inadequacy of the resources available to existing partner services has led some investigators in the US […]

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Should bisexuals be considered a population with specific sexual health needs?

Across many cultural contexts, men who have sex with both men and women (MSMW) have levels of STIs/HIV comparable to those we find in men who have sex only with men (MSM); but MSMW have often proved particularly hard for health services to access.  Mercer & Cassell (M&C) (UK) and STIs/Beyrer & Baral (B&B) (South Africa) […]

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HIV impact of ObamaCare reduced by US Supreme Court decision

What impact will the roll-out of the US Affordable Care Act (ACA) – ObamaCare – have on health insurance coverage of people with HIV?  A recently published “issue brief” on behalf of the US Centers for Disease Control and Prevention (CDC) offers a first estimate (Kates & Garfield (K&G)). The ACA includes a provision to […]

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Taking seriously the public health impact of disengagement from HIV care in the US

ART as a strategy for “treatment-as-prevention” is frequently acknowledged.  Public health efforts, in the US as elsewhere, have focussed on prompt initiation of ART for the newly-diagnosed so as to shorten the duration of viremia – and thereby also reduce transmission risk.  But what about the public health implications of people living with HIV (PLWH) […]

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Expedited Partner Therapy (EPT): Why in the US and not in the UK?

Expedited Partner Therapy (EPT) in sexual health is the practice of prescribing for the partner(s) of the patient without prior medical evaluation.  In many countries (e.g. UK and Australia) the practice is not current, since it does not comply with prescribing guidance.  But in the US it is being actively promoted by professional bodies (e.g. […]

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Could Millennium Development Goals be bad for your health?

A recent paper by a Belgian team discusses the health impact of the Millennium Development Goals (MDG) in sub-Saharan Africa, and highlights the potential short-termism of a strategic approach focussed on “quick wins”.  Many of the health issues discussed touch on sexual health. The year 2001 saw poverty become the focus of the global political […]

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