It is a criminal offence in the UK (as in some other countries) to transmit HIV “intentionally” or “recklessly”. Community advocates claim there have been over 200 investigations in the UK regarding HIV transmission on grounds of recklessness, leading to 20 prosecutions (http://www.hivandthelaw.com/information/fast-facts). (Canada & the US lead the world for HIV criminalization with a […]
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What clinical evidence is there for the association of gonorrhoea cephalosporin resistance with treatment failure?
Earlier blogs have featured the disquieting propensity of neisseria gonorrhoea to evolve resistance to every known line of treatment (https://blogs.bmj.com/sti/category/gonorrhoea/). Surveillance data indicate the prevalence of the infection in core populations, and the importance of focussing treatment on them ( http://sti.bmj.com/content/85/5/317.abstract?sid=c28b9898-65c9-4548-a10e-9f6ebade86f9); at the same time this is precisely the strategy most likely to disseminate resistance […]
Disappointing tenofovir PrEP trials: maybe “adherence” is not to blame
Reports of modest success from two trials (2010) of tenofovir as pre-exposure prophylaxis against HIV (PrEP)– CAPRISA 004 (1) (topical gel/women) relative risk reduction (RRR) 39%; iPrEX (2) (oral tablet/MSM) RRR 44% – have inspired recent contributions to STI journal. In particular, there have been attempts to model the possible impact on the epidemic of […]
Was the “sexual revolution” triggered by the decline of syphilis?
The year 1939 saw total US syphilis deaths at 15 per 100,000 and syphilis deaths of black males at 72.5 per 100,000: this is a death rate comparable to that for HIV/AIDS at the height of the epidemic in 1995 when total deaths and deaths of black males stood, respectively, at 16.2 and 80.2 per […]
HPV re-activation in older women: an increased cancer risk unrelated to sexual behaviour?
Older women who have had ≥5 lifetime sexual partners could turn out to be a relatively high-risk group for Human Papilloma Virus (HPV) and associated cervical lesions – regardless of declining sexual activity. If – that is – Gravitt, Viscidi et al. (http://jid.oxfordjournals.org/content/207/2/272.full.pdf+html?sid=4bc8141c-9b7c-4a13-8a43-451d6fa85fcf; http://jid.oxfordjournals.org/content/207/2/211.full.pdf+html?sid=4bc8141c-9b7c-4a13-8a43-451d6fa85fcf) are correct to see the results of their cohort study of […]
Tracking the history of HIV back to chimpanzees: is the evidence in the West African genome?
Papers explored in earlier STI blogs have traced the distribution through the world of the different HIV subtypes (https://blogs.bmj.com/sti/2013/01/04/reading-the-history-of-the-progress-of-the-hiv-epidemic-through-the-evidence-of-hiv-subtype-distribution/?q=w_sti_blog_sidetab; http://sti.bmj.com/content/87/2/101.full?sid=2b7658a8-4f84-4d8a-b2bc-d5104c523180), and have used this information to track the origins of HIV-AIDS in central/western Africa probably at the beginning of the last century (http://journals.lww.com/aidsonline/pages/results.aspx?k=Tatem%20AND%20Salemi&Scope=AllIssues&txtKeywords=Tatem%20AND%20Salemi). Now a research article published in Evolutionary Biology – Zhao, Roca et al. – has […]
Reading the history of the progress of the HIV epidemic through the evidence of HIV subtype distribution
The impact of human mobility on the spread of HIV is often recognized in the medical literature (http://sti.bmj.com/content/78/suppl_1/i91.abstract?sid=2b7658a8-4f84-4d8a-b2bc-d5104c523180). Does it follow that the existence and development of transport infrastructure may have had its part in the history of the epidemic? Can we go further, and read the whole history of an epidemic like HIV in […]
Home-based HIV testing: an acceptable intervention for sub-Saharan Africans?
HIV testing is the gateway to accessing care – but can involve issues of stigma. So improving accessibility to testing – by, amongst other things, overcoming the associated stigma – is a major concern for developed and underdeveloped countries alike, and has led to initiatives for testing in “non-traditional settings” (e.g. the UK based HINTS […]
Female circumcision: using facts to moderate the message
In a contemporary Western context female circumcision is hardly an issue that divides opinion. A WHO study, published in The Lancet (2006), and receiving considerable media coverage, appeared to corroborate widespread concerns as to its implications for the health of “cut” women and their babies (http://www.thelancet.com/search/results?searchTerm=WHO+Study+Group+on+Female+Genital+Mutilation&fieldName=AllFields&journalFromWhichSearchStarted=lancet). However, a paper in the latest Hastings Center Report […]
Expedited Partner Therapy (EPT): Why in the US and not in the UK?
Expedited Partner Therapy (EPT) in sexual health is the practice of prescribing for the partner(s) of the patient without prior medical evaluation. In many countries (e.g. UK and Australia) the practice is not current, since it does not comply with prescribing guidance. But in the US it is being actively promoted by professional bodies (e.g. […]