In the wake of the 2010 results of the Pre-Exposure Prophylaxis Initiative (iPrEx) study – a multi-national trial of daily oral tenofovir/emtricitabine to prevent acquisition of HIV among men who have sex with men (MSM) indicating a 44% reduction in risk – there have been attempts to model the potential health impact and cost-effectiveness of […]
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Does Muslim religion have an impact on HIV transmission?
How is it that the nations of the Middle East and North Africa appear to have relatively low rates of HIV (see https://blogs.bmj.com/sti/2011/09/19/bringing-to-light-the-hiv-epidemiology-of-%E2%80%9Chidden%E2%80%9D-msm-populations-in-the-middle-east/)? A recent paper in the American Sociological Review – Adamczyk & Hayes – seeks to demonstrate that the predominance of the Muslim religion in a country may have a macro-level, cultural impact […]
Impact on sexual behaviour of “Don’t Ask, Don’t Tell” policy in US navy
Epidemiological research has sometimes addressed the impact on men who have sex with men (MSM) sexual behaviour of being “non-gay identifying” (NGI) (Yun, Wang et al. (http://sti.bmj.com/content/87/7/563.full?sid=a367a77d-f830-46ee-b761-eec8d9e22da2 ); Mercer & Cassell (http://ijsa.rsmjournals.com/content/20/2/87.full) or of belonging to a culture in which openness about sexuality by MSM is sometimes difficult and personally costly (Lane, Kegeles et al. (http://sti.bmj.com/content/84/6/430.full?sid=ab090fad-0769-479b-a7d5-e6ba10da5609). […]
Non-disclosure of HIV sero-status by Indian female sex workers
With the roll-out of the Bill and Melinda Gates initiated Avahan interventions in India over the last decade, a growing body of evidence has accumulated on the contribution of commercial sex-work to the spread of the HIV epidemic, and the effectiveness of behavioural interventions focussed on this sector. With the international effort concentrating elsewhere primarily […]
To circumcise or not to circumcise? Continued US debate on the benefits of infant male circumcision as an STI prevention tool
Last month saw two further developments in the ongoing US debate over infant male circumcision (MC). European readers may be surprised to discover that infant MC has traditionally been widely practised in the US – for complex historical reasons (https://blogs.bmj.com/sti/2011/10/15/to-circumcise-or-not-to-circumcise/?preview=true&preview_id=509&preview_nonce=9ecb80c216 ). MC has shown a sharp decline in the US from around 79% some twenty […]
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 […]
HPTN 061 trial reports: 6% annual HIV incidence for black MSM in the US
At the 19th International AIDS Conference meeting in Washington DC recently, researchers presented important data from the HIV Prevention Trials Network (HPTN) 061 study (due to publish November 2012) on incidence and social correlates of HIV in black men who have sex with men (MSM). With a view to investigating the acceptability and feasibility of […]
Ethical challenges threaten vital research on ART and HIV transmission
HPTN 052 is now widely known for the headline figure of 96% placed on the benefit of ART in reducing HIV transmission within sero-discordant couples. The same trial simultaneously assessed the benefits of immediate ART initiation (at the CD4 count <550 cells/mm3 required for trial entry) against delayed initiation at <250 cells/mm3. Less well known, […]
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 […]
Sustained health systems strengthening holds the key to prevention of mother-to-child transmission of syphilis
Half a million still-births annually are due to syphilis in pregnancy – deaths that could be averted by means of a single dose of penicillin. An important project, reported in PLoS Medicine by Mabey, Peeling et al., to introduce point-of-care syphilis tests (POCTs) at ante-natal clinics (ANCs) in six countries, has resulted in all six […]