Voluntary medical male circumcision (VMMC) has been demonstrated to reduce HIV acquisition by 60% or more. WHO and UNAIDS have recommended that VMMC form a part of comprehensive HIV prevention programming in regions of high prevalence, such as sub-Saharan Africa. Mathematical modelling suggests that the achievement of 80% VMMC coverage within 5 years in 14 […]
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Gonorrhoea antimicrobial resistance: is UK antibiotic stewarding policy shows “some success”
A widely circulated press release from the Society of General Microbiology’s (SGM) Annual Conference 2014 (April 14th – 17th) reports that Health for England’s Gonorrhoea Resistance Action Plan, according to representative, Dr Catherine Ison, “has shown some success in delaying the onset of treatment failure to the oral antibiotic cefixime”. At issue here is the […]
Responding appropriately to differentials in HIV care outcomes – are local answers needed?
The recent discovery of the preventative potential of anti-retroviral therapy (ART) (STIs/blog/modelling ART impact) throws into sharp relief the challenge represented for the US by the very inadequate proportion of its 1.2 million HIV+ citizens (<30%) who are virally suppressed. Nunn & Mayer use new geographical mapping tools to bring home forcibly the epidemiological dimension […]
Shared needles for Viagra injection fuel STIs among the Korean elderly
UK BBC radio’s 4’s Korean correspondent, Lucy Williamson refers in last Tuesday’s Crossing Continents to a category of STI transmission through IVDU, which is unlikely to be familiar to our readers. A recent article in the Korea Times gives further details. The individuals at risk are the 16% of South Korean seniors (65+) in Seoul […]
Are African HIV epidemics sustained by exogenous introduction of infection?
What is the relative importance of exogenous and endogenous transmission in sustaining HIV epidemics? In a study of HIV sub-type distribution in the Middle East, Mumtaz & Abu Raddad (STIs) stress the role of multiple exogenous introductions, as evidenced in the wide diversity of genetic sub-types present in most countries. At a more local level, […]
HIV/hepatitis C co-infection increases risk of hepatic decompensation
A recent study (Lo Re & Vincent (L&J)) presents disquieting findings regarding the relative risk of severe liver complications in HIV/Hepatitis C co-infected patients. Hepatitis C (HCV) has received particular attention in STIs recently on account of its strong association with HIV sero-positivity in MSM (Yaphe & Klein (STIs)) and because of its growing incidence […]
Could Chlamydia treatment failure be the result of genital contamination from persistent gut infection
The persistence of Chlamydia trachomatis (Ct) infection in treated patients is generally attributed either to re-infection or poor treatment adherence. To some, however, the evidence has suggested the operation of an additional factor – such as treatment failure (STIs/ Goetz & Bruisten; STIs/ Pitt & Ison; STIs/ Horner). A recent study (Rank & Yeruva (R&Y)) […]
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 […]
Can mass isoniazid preventive therapy be used to control the TB-HIV epidemic in Africa?
“We cannot win the battle against AIDS if we do not also fight TB”, Nelson Mandela has famously said. His insistence on the importance of TB is understandable, when it is remembered that 82% of all cases of TB-HIV co-infection are concentrated in sub-Saharan Africa, and many Africans infected with HIV die from TB (STI/ […]
iPrEx finds no evidence that PrEP use is associated with risk compensation
A great concern in respect to the deployment of Pre-Exposure Prophylaxis (PrEP) as an HIV prevention tool is risk compensation – i.e. the possibility that the protection afforded by PrEP would itself encourage sexual risk-taking (STI blogs/Sugarman & Mayer). Recent studies of PrEP efficacy would seem an unpromising context in which to assess the likely impact […]