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 […]
Category: health policy
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 […]
“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 […]
“Fast-tracking” the end of the HIV epidemic
At a high-level event on the margin of the UN General Assembly meeting in New York last month, convened with the support of UNAIDS, world leaders agreed that ending the AIDS epidemic as a global threat by 2030 was possible, and should be placed at the centre of health development goals. The brochure, Fast Track […]
Population-based evidence for the preventative efficacy of quadrivalent HPV in Australia
The HPV vaccination programmes introduced by many countries over the last few years (since 2007) reveal considerable diversity in the coverage they have achieved, the mode of access (i.e. school, public health, private clinics) and responsibility for cost (i.e. publically vv. privately funded) – even in Europe (see ECDC Guidance). In the light of the […]
Pre-test HIV risk reduction counselling is not worth the money
A large US randomized control trial of the impact on STI risk of HIV risk reduction counselling in conjunction with the HIV test (Metsch & Colfax) challenges the view that pre-test counselling constitutes an efficient use of limited resources – at least in the US setting. Counselling has long had an important place in the […]
UNAIDS assesses progress towards #HIV Millennium Development Goal
In the run-up to the 2013 General Assembly of the UN in New York, a new report from the Joint United National Program on HIV/AIDS seeks to give an overview of progress to date towards Millenium Goal 6 – the goal of halting and beginning to reverse the HIV/AIDS epidemic by 2015 (UNAIDS Report 2013). […]
Should ART provision be decentralized to health centres in low and middle income countries?
With the realization of the value of ART as a means of preventing HIV transmission, the question of how best to retain HIV-diagnosed in care becomes all the more pressing. Recent STI blogs have covered such topics as the potential role of computer-generated reminders in retaining patients (sti blogs03/05/13), as well as the re-engagement of […]
Social Enterprise for Sexual Health (SESH): a new model for service provision?
Have you heard of SESH – social enterprise for sexual health? It holds the answer to many of the problems that the dominant model, based on centralized public clinic service delivery has failed to resolve, according to Tucker, Fenton et al. in this month’s PLoS – Medicine. The paper acclaims an alternative approach focussing on […]
The dapivirine ring: success at last for a vaginal microbicide?
The International Partnership for Microbicides (IPM) has just announced the launch of a trial (IPM 027) to evaluate the effectiveness of the antiretroviral (ARV) drug dapivirine delivered by means of a monthly replaceable vaginal ring (http://www.ipmglobal.org/node/670). The IPM study, which has enrolled 1,650 women at four sites in South Africa, is part of a broader […]