Emerging antibiotic resistance to the last-ditch treatment of Neisseria gonorrhoeae compels health policy-makers to balance opposing concerns. On the one hand, successfully combating spread of the infection requires targeted treatment of core-group individuals. On the other, a focus on the core-group causes a rebound in core-group incidence, with maximal dissemination of resistance (Chan & McCabe/STIs (C&M); […]
Category: health policy
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 […]
Modeling the potential effectiveness of PrEP as against other preventative interventions in addressing MSM HIV
Despite the known preventative benefits of ART, the incidence of HIV among UK MSM population has remained relatively constant over the last 10 years and looks set to remain so. The UN 90:90:90 target will soon be achieved for this population, yet the goal of eliminating the infection seems no nearer. Not surprisingly there […]
Health professionals violate human rights of sex workers in Kenya
‘Key’ populations – such as sex workers – are now seen as crucial to turning the tide of the HIV epidemic. Given the recognized epidemiological potential of such marginalized groups to act as ‘bridging populations’ into the wider population, much importance has rightly been attached to countering the kind of routine violations of human […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]