Why stimulant use may cause HIV progression independently of behavioural risk-factors

In many countries injection drug users (IDU) constitute a ‘key population’ for HIV/AIDS. There may in some contexts be substantial overlap with other groups – where, for example, the IDU are also sex-workers, or prisoners. In reality, IDU may be exposed to multiple risk factors, which can be hard to isolate from each other. However, […]

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Intervene fast to prevent lasting cognitive impairment during the primary phase of HIV infection

The impact of HIV/AIDS on cognitive function is the topic of a paper appearing in STIs as early as 1989, where some degree of neurological impairment is observed in patients who otherwise appear ‘well’ (Carne & Harrison (STI)). Dementia may be rarely seen nowadays, but quality-of-life limiting cognitive impairment remains a serious issue for some […]

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Anti-HIV strategies in limited resource settings set the pattern for combating other diseases

HIV-specific interventions in poor regions of the world like sub-Saharan Africa may have benefits for their health systems that exceed the initial aims of those interventions (How should HIV-specific charitable interventions like PEPFAR be evaluated? (STI/blog)). This is the encouraging message coming out of a recent evaluation of treatment of rheumatoid heart disease (RHD) in […]

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What is the potential of ‘Treatment for Prevention’ in fighting HIV/AIDS?

UNAIDS 90:90:90 appears to have set the course for a global ‘treatment as prevention’ strategy. In 2015 the US revised its National HIV/AIDS Strategy (NHAS) to harmonize its goals with UNAIDS 90% targets for testing, engagement in care, and virological suppression. Though the HIV/AIDS community have been nervous about the impact of the recent change […]

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Modelling the scale-down of HIV services in sub-Saharan Africa

Search BMJ STI archive, and you will find frequent references to ‘scaling up’, and few – if any – to ‘scaling back’ or ‘scaling down’ (other than Parker/STI).  Who knows if all this may not be about to change, if the US government goes ahead with threats to cut current foreign aid budget ear-marked for […]

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Achieving UNAIDS 90-90-90: More haste less speed?

UNAIDS (2014) has set targets for HIV management that seem ambitious, if not unrealistically so  (UNAIDS: 90-90-90): 90% of those living with HIV to know their status; 90% of known HIV+ individuals to undergo ART initiation; 90% of ART+ initiated to achieve viral suppression. A one-year-in report from a large cluster-randomized study of home-based testing […]

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The challenges and achievements of conducting a multi-country qualitative study to explore the Bottlenecks to HIV care and treatment in sub-Saharan Africa

Blog post by Joyce Wamoyi1, Dominic Bukenya2, Robert Ssekubugu3, Alison Wringe4 and Jenny Renju4 National Institute for Medical Research, Tanzania Medical Research Council, Uganda Rakai health Sciences Programme, Uganda London School of Hygiene and Tropical Medicine, UK A newly published supplement to Sexually Transmitted Infections on the HIV Bottlenecks study presents the multiple tensions that exist […]

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HPTN 071 attempts universal home-based HIV testing in sub-Saharan Africa: scaling the mountainous challenge of UNAIDS 90-90-90 target

Estimates of 96% for the preventative efficacy of ART against HIV transmission, reported in 2011 by Myron & Cohen (M&C), appeared at last to place long-term containment of the epidemic in our hands.  In the wake of this, UNAIDS: 90-90-90 proposed ambitious targets: 90% of those living with HIV to know their status; 90% of […]

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Health vulnerability of peri-natally HIV-infected youth: a growing problem throughout the world

Mother-to-child, or ‘vertical’, transmission of HIV is not just a problem for developing countries; even in countries like the US and the UK, peri-natal transmission has probably not been eliminated.  But, with routine ‘opt-out’ ante-natal testing (BHIVA guidelines on HIV testing), cases are increasingly likely to involve births that have taken place overseas or before […]

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‘Scoping’ location: the role of ‘place’/’space’ as an influence on HIV outcomes amongst young MSM

Bauermeister & Stephenson (B&S) is a scoping review addressing the impact of location – ‘space’ and ‘place’ – on HIV prevention and care outcomes for young MSM (YMSM).  It owes much to Diaz & Ayala and their concern to view human behaviour in terms of ‘social location’ ‘within a context of social oppressive factors’ rather […]

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