Prospects for a high sensitivity point-of-care test for Chlamydia

A recent paper (Krölov&Langel) describes a technique for the diagnosis of Chlamydia trachomatis which, if developed into a point-of-care test (POCT), could be performed in just twenty minutes and would achieve a considerably greater sensitivity (83%) than any of the POCT alternatives to the current laboratory testing process using Polymerase Chain Reaction (PCR).  The technique […]

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Emergence in Guinea-Bissau of an HIV-1 recombinant variant associated with three-fold increase in disease progression

Studies, including some in STIs journal, have mapped the geographical distribution of HIV types, subtypes, recombinant variants (CRF): see: (Middle East) STIs/Mumtaz&Abu Raddad; (Sub-saharan Africa) STI blogs/Tatem&Salemi.  Such work has potential importance for our understanding of the evolution of HIV resistance, and also for the identification and targeting of established and nascent epidemics among core […]

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Partners PrEP sub-study finds no evidence that PrEP use is associated with risk compensation behaviour

How useful is pre-exposure prophylaxis (PrEP)?  The Partners PrEP randomized control study of daily pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-discordant couples in Uganda and Kenya has indicated that, given adequate adherence, PrEP has high biologic efficacy.  The study itself (Baeten & Celum) demonstrates levels of risk reduction of 75%; while a spin-off sub-study […]

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What can cost-effectiveness modelling tell us about the feasibility of eliminating congenital syphilis in sub-Saharan Africa?

The WHO global initiative for the elimination of congenital syphilis (2007) set the goal of expanding antenatal testing to >90% by 2015.  In sub-Saharan Africa (SSA) recent estimates place the number of mothers infected with active syphilis at 535,000 p.a..  Adverse outcomes – stillbirths, neo-natal morbidity and congenital disease – affect 53%-82% of these pregnancies, […]

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Are bisexuals well served by HIV interventions that assume gay identity?

Studies published in STI journal have examined the impact of bisexual concurrency on HIV epidemiology in South Africa (Behrer & Baral) (B&B) and China (Yun & Shang) (Y&S), where it is reckoned at 53.7% and 31.2% of the MSM population, respectively.  However, a recent randomized control study of an educational intervention in Los Angeles (Harawa […]

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RCT trial demonstrates: disappointing PrEP study outcomes probably down to poor adherence

The disappointingly varied results of recent clinical trials of antiretroviral prophylaxis for HIV prevention (PrEP) have not altogether dampened the interest in this intervention.  Contributions to STI journal include papers evaluating the potential acceptability of PrEP in various settings (see: Aghaizu & Nardone; Holt & De Wit).  Clearly, there remains a keen interest in the […]

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Universal vv. targeted HIV screening in US EDs

The US Centres for Disease Control and Prevention (CDC) recommends universal “opt-out” HIV screening in all health care settings, including emergency departments and primary care settings (CDC 2006 HIV testing guidelines); the UK Guidelines for HIV Testing (BHIVA, BASHH, BIS) have, since 2008, recommended universal “opt-out-screening” in communities where HIV prevalence ≥ 2 per 1000 […]

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