1.  Title: HIV / AIDs in Namibia: Behavioral and contextual factors driving the epidemic. Author: de la Torre C; Khan S; Eckert E; Luna J; Koppenhaver T Source: [Windhoek], Namibia, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2009 May. [98] p. (SR-09-53USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: This report identifies and describes what current evidence indicates are the main behavioral and contextual factors that are driving the HIV epidemic in Namibia. The report is intended to assist in the development of a national prevention strategy for combating the HIV / AIDS epidemic. Data from several sources are triangulated to assess which factors are most likely to contribute to the spread of HIV across the population. In the absence of a national seroprevalence survey, the following were examined to identify the main drivers of the Namibian HIV epidemic: 1. The prevalence, distribution, and trends over time of proximate determinants of HIV infection within Namibia (obtained from an analysis of the Namibia Demographic and Health Surveys [NDHS] and other local surveys); 2. Socio-demographic factors associated with HIV infection among clients who were tested for HIV in select New Start voluntary counseling and testing (VCT) facilities throughout Namibia (obtained from analysis of these data); 3. The findings and conclusions of other researchers who have investigated various aspects of HIV / AIDS vulnerability in Namibia; 4. Factors most associated with HIV infection in neighboring countries, and in other generalized epidemics for which representative HIV prevalence surveys exist. A number of factors are likely contributing to the high levels of HIV in Namibia. As described in this report, these various factors are often inter-related and operate in unison to create one of the worst HIV epidemics in the world. (Excerpt) Language: English Keywords: NAMIBIA | TECHNICAL REPORT | HIV INFECTIONS | AIDS | EPIDEMICS | PREVALENCE | EPIDEMIOLOGY | VOLUNTARY COUNSELING AND TESTING | SEX BEHAVIOR | ALCOHOL USE AND ABUSE | MALE CIRCUMCISION | PERCEPTION | CONDOM USE | MIGRATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Viral Diseases | Diseases | Measurement | Research Methodology | Public Health | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Behavior | Psychological Factors | Risk Reduction Behavior | Population Dynamics | Demographic Factors | Population Document Number: 331841 |
2.  Title: Advances and future directions in HIV surveillance in low- and middle-income countries. Author: Diaz T; Garcia-Calleja JM; Ghys PD; Sabin K Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):253-9. Abstract: PURPOSE OF REVIEW: To present recent advances in HIV/AIDS surveillance methods in low- and middle-income countries. RECENT FINDINGS: From 2001 to 2008, 30 low- and middle-income countries implemented national population-based surveys with HIV testing. Antenatal clinic HIV sentinel surveillance sites in sub-Saharan Africa increased from just over 1000 in 2003-2004 to almost 2500 in 2005-2006, becoming more representative of rural areas. Between 2003 and 2007, at least 122 behavioral surveys in low- and middle-income countries used respondent-driven sampling for surveillance among high-risk populations, although many countries with concentrated epidemics continue to have major sentinel surveillance gaps. Improvements have been made in modeling estimates of number of persons HIV infected, and systems are now in place to measure HIV drug resistance. However, the reliable monitoring of trends and the measuring of HIV incidence, morbidity, and mortality is still a challenge. SUMMARY: In the past 5 years, there have been substantial improvements in the quantity and quality of HIV surveillance studies, especially in the countries with high prevalence. Further efforts should be made in countries that lack fully implemented surveillance systems to improve HIV incidence, morbidity, and mortality surveillance and to use data more effectively. Language: English Keywords: GLOBAL | LITERATURE REVIEW | RECOMMENDATIONS | HIV INFECTIONS | AIDS | EPIDEMICS | MONITORING | MORTALITY | PREVALENCE | HIV TESTING | DRUG RESISTANCE | INCIDENCE | Viral Diseases | Diseases | Evaluation | Population Dynamics | Demographic Factors | Population | Measurement | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment Document Number: 342342 |
| 3. Title: Women's rights and women's health during HIV/AIDS epidemics: the experience of women in sub-Saharan Africa. Author: Dugassa BF Source: Health Care For Women International. 2009 Aug;30(8):690-706. Abstract: Twenty-five years have passed since HIV/AIDS was recognized as a major public health problem. Although billions of dollars are spent in research and development, we still have no medical cure or vaccination. In the early days of the epidemic, public health slogans suggested that HIV/AIDS does not discriminate. Now it is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalized, women, colonized, and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS demands the need to travel extra miles. My objective in this article is to promote the need to go beyond the biomedical model of "technical fixes" and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. In this article, I argue that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | HIV INFECTIONS | AIDS | EPIDEMICS | WOMEN'S HEALTH | WOMEN'S RIGHTS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | HIV TRANSMISSION | MALNUTRITION | SOCIOCULTURAL FACTORS | Africa | Developing Countries | Viral Diseases | Diseases | Health | Human Rights | Political Factors | Economic Factors | Nutrition Disorders Document Number: 342818 |
| 4. Peer Reviewed Title: Factors associated with an explosive HIV epidemic among injecting drug users in Sargodha, Pakistan. Author: Emmanuel F; Archibald C; Razaque A; Sandstrom P Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):85-90. Abstract: BACKGROUND: During a routine surveillance round, an extremely high prevalence of 51.3% was found among injecting drug users (IDUs) in Sargodha, a small town in Pakistan. This sharp increase of HIV among this group warranted an urgent need to explore the factors leading toward this explosion of HIV infection among IDUs at this very location to direct the policy makers in designing preventive activities, especially in the context of HIV prevention. METHODS: In 2007, 400 current IDUs were recruited through multistage cluster sampling based on mapping studies. Participants provided dried blood spot samples for HIV testing and completed a questionnaire on demographic characteristics and sexual/drug injecting behaviors. Logistic regression was used to examine the independent association of multiple variables with HIV infection. RESULTS: Of the 400 IDUs tested, 205 (51.3%) were HIV positive confirmed through enzyme-linked immunosorbent assay and Western blot. In multivariate analysis, geographical location of IDUs [adjusted odds ratio (aOR) 2.4 for IDUs located in the northern zone vs southern zone, 95% confidence interval (CI) 1.5 to 3.7], injected in groups (aOR 1.8, 95% CI 1.1 to 3.1), and sharing injecting paraphernalia with other IDUs (aOR 1.5, 95% CI 1.0 to 2.4) were strong correlates of HIV infection. CONCLUSIONS: Effective outreach programs need to be developed to provide a comprehensive package of HIV prevention services to IDUs not reached by existing services, entry into drug abuse treatment and medical care needs to be facilitated, and essential legal and social services need to be provided with community participation. Language: English Keywords: PAKISTAN | RESEARCH REPORT | SAMPLING STUDIES | STATISTICAL REGRESSION | IV DRUG USERS | HIV INFECTIONS | EPIDEMICS | PREVALENCE | RISK FACTORS | NEEDLE SHARING | SEX BEHAVIOR | QUESTIONNAIRES | KNOWLEDGE | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Data Analysis | Drug Use and Abuse | Behavior | Viral Diseases | Diseases | Measurement | Health | Risk Behavior | Sociocultural Factors Document Number: 342369 |
| 5. Peer Reviewed Title: HIV/AIDS epidemic features and trends in iran, 1986-2006. Author: Fallahzadeh H; Morowatisharifabad M; Ehrampoosh MH Source: AIDS and Behavior. 2009 Apr;13(2):297-302. Abstract: This study describes the reported HIV/AIDS data for all verified cases in Iran between 1986 and 2006. The cumulative number of the reported cases of HIV/AIDS among Iranians, up to the end of September 2006 was 13,702. Over the 20-year surveillance period, the rate of HIV/AIDS infections diagnosed annually among Iranian citizens gradually increased and, over the period 1997-2004, it reached from 1.38 to 4.6 cases per 100,000 populations per year. Our findings highlight the need for intensified HIV prevention efforts with men who use drugs via injection and strengthened efforts to encourage the individual at risk to get tested for HIV. Language: English Keywords: IRAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | LONGITUDINAL STUDIES | IV DRUG USERS | PERSONS LIVING WITH HIV/AIDS | MEN | PREVALENCE | HIV INFECTIONS | EPIDEMICS | INCIDENCE | HIV TESTING | Middle East | Developing Countries | Research Methodology | Studies | Drug Use and Abuse | Behavior | Viral Diseases | Diseases | Demographic Factors | Population | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 340129 |
| 6. Peer Reviewed Title: High HIV prevalence detected in 2006 and 2007 among men who have sex with men in China's largest municipality: an alarming epidemic in Chongqing, China. Author: Feng L; Ding X; Lu R; Liu J; Sy A; Ouyang L; Pan C; Yi H; Liu H; Xu J; Zhao J Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):79-85. Abstract: BACKGROUND: Data from many large cities in China show HIV prevalence among men who have sex with men (MSM) increasing dramatically over the recent years, making HIV transmission among MSM in China a growing concern. To facilitate targeted HIV prevention among MSM in Chongqing, surveys were conducted to examine HIV prevalence and its associated factors in 2006 and in 2007. METHODS: Surveys were conducted in 2006 and 2007 in 3 districts of Chongqing at venues and cruising areas where MSM frequent. Univariate and bivariate analysis were conducted on demographic, behavioral, and biological data. RESULTS: HIV prevalence was 19.7% in 2006 and 26.5% in 2007 among recruitees from bathhouses and saunas, more than 2 times higher than recruitees from other venues for both years. HIV prevalence increased from 10.4% in 2006 to 12.5% in 2007. HIV prevalence was more than 20% among those older than 40 years of age, much higher than HIV prevalence in younger age groups. HIV prevalence among married MSM was 15.9% in 2006 and 20.9% in 2007, compared with nonmarried MSM at 7.6% in 2006 and 9.2% in 2007. DISCUSSION: Urgent attention for prevention services is required to address the overall high HIV prevalence among MSM in the city, with special focus on subgroups as older, married MSM, and those recruited from bathhouses and saunas. Language: English Keywords: CHINA | RESEARCH REPORT | SURVEYS | SAMPLING STUDIES | MEN HAVING SEX WITH MEN | HIV INFECTIONS | PREVALENCE | EPIDEMICS | SYPHILIS | SEX BEHAVIOR | AGE FACTORS | MARITAL STATUS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Behavior | Viral Diseases | Diseases | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Population Characteristics | Demographic Factors | Population | Nuptiality Document Number: 342907 |
| 7. Peer Reviewed Title: How to contain generalized HIV epidemics? A plea for better evidence to displace speculation. Author: Gisselquist D; Potterat JJ; St Lawrence JS; Hogan M; Arora NK; Correa M; Dinsmore WW; Mehta G; Millogo J; Muth SQ; Okinyi M; Ounga T Source: International Journal of STD and AIDS. 2009 Jul;20(7):443-6. Abstract: In the worst generalized HIV epidemics in East and Southern Africa, from one-quarter to three-quarters of women aged 15 years can expect to be living with HIV or to have died with AIDS by age 40 years. This disaster continues in the face of massive HIV prevention programmes based on current inexact knowledge of HIV transmission pathways and risks. To stop this disaster, both the public and public health experts need better information about the specific factors that allow HIV to propagate so extensively in countries with generalized epidemics. This knowledge could be acquired by tracing HIV infections to their source - especially tracing HIV infections in women of all ages, and tracing unexplained HIV infections in children with HIV-negative mothers. Language: English Keywords: AFRICA | CRITIQUE | EPIDEMIOLOGIC METHODS | HIV INFECTIONS | AIDS | EPIDEMICS | GOALS | NEEDLE PIERCING | BLOOD TRANSFUSION | HIV TRANSMISSION | HIV PREVENTION | MALE CIRCUMCISION | Developing Countries | Research Methodology | Viral Diseases | Diseases | Planning | Organization and Administration | Risk Behavior | Behavior | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342830 |
| 8. Peer Reviewed Title: Sexual behavior change in countries with generalised HIV epidemics? Evidence from population-based cohort studies in sub-Saharan Africa. Author: Gregson S; Todd J; Zaba B Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i1-i2. Abstract: This introductory article describes the contents of the current issue which presents 10 recent analyses of sexual behaviour data from longitudinal studies in five countries-Uganda, Tanzania, Malawi, Zimbabwe and South Africa- experiencing different sizes and stages of the HIV epidemic. The results provide valuable information for use in evaluating trends in HIV epidemics and the impact of HIV prevention programmes. An underlying purpose of this is to highlight appropriate methods and to encourage better analysis and presentation of sexual behaviour data, especially as they relate to HIV and HIV prevention. Language: English Keywords: AFRICA, SUB SAHARAN | LITERATURE REVIEW | KAP SURVEYS | COHORT ANALYSIS | DEMOGRAPHIC AND HEALTH SURVEYS | LONGITUDINAL STUDIES | TARGET POPULATION | HIV TRANSMISSION | EPIDEMICS | SEX BEHAVIOR | RISK BEHAVIOR | SURVIVORSHIP | RISK FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Program Design | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Length of Life | Mortality | Health Document Number: 340100 |
| 9. Peer Reviewed Title: The obstetric face and challenge of HIV/AIDS. Author: Guidozzi F; Black V Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):270-84. Abstract: The human immunodeficiency virus (HIV) pandemic is one of the most serious health crises facing the world. Of the estimated 33.2 million people living with HIV worldwide, 22.5 million (68%) live in Sub-Saharan Africa, where women of childbearing age are most severely affected. Children primarily acquire HIV infection through mother-to-child transmission. Despite recent encouraging success, low-income countries have not been able to effectively curtail transmission of HIV to the infant during or after pregnancy, resulting in about 90% of the estimated 420,000 newly infected children per annum occurring in Sub-Saharan Africa. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | HIV INFECTIONS | AIDS | EPIDEMICS | OBSTETRICS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | BREASTFEEDING | HIV TESTING | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | Viral Diseases | Diseases | Medicine | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Infant Nutrition | Nutrition | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | HIV | Treatment | Drugs Document Number: 342173 |
| 10. Title: Monitoring HIV epidemics: declines in prevalence do not always mean good news [editorial] Author: Hallett T Source: AIDS. 2009 Jan 2;23(1):131-2. Abstract: The future of HIV epidemic monitoring is likely to rely on HIV prevalence for many years to come. After years of intensive research, direct measurements of incidence in local cohort studies are becoming less and less representative of whole countries, and assays that discriminate recent infections in cross-sectional serosurveys have been shown to be unreliable in African countries without calibration. Antiretroviral therapy will add a further layer of complexity, as longer survival times will tend to increase HIV prevalence; so that upturns in epidemics may not indicate increased risk behaviour, and stable prevalence rates could mask substantial reductions in incidence. It will, therefore, be essential to make maximum use of mathematical modelling in the interpretation of trends in HIV prevalence. To be conservative and defensible, these modelsmust reasonably account for all other potential sources of natural changes in epidemics, so that the contribution of actual reductions in risk-if any-can be resolved. And only from that starting point, can the important investigations into the proximal and distal causes and reasons for the behaviour changes begin. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | MATHEMATICAL MODEL | EVALUATION INDEXES | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | MONITORING | HIV INFECTIONS | EPIDEMIOLOGY | EPIDEMICS | RELIABILITY | VALIDITY | ERROR SOURCES | Africa | Developing Countries | Research Methodology | Theoretical Models | Quantitative Evaluation | Evaluation | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Measurement | Public Health | Health Document Number: 330256 |
| 11. Peer Reviewed Title: Enhancing HIV prevention requires addressing the complex relationship between prevention and treatment. Author: Henderson K; Worth H; Aggleton P; Kippax S Source: Global Public Health. 2009;4(2):117-30. Abstract: Globally each year, HIV continues to infect millions of people, and the number of people living with HIV and AIDS grows. While there has been an increase in funding for HIV and AIDS, there is a growing gap between the funds available and the funds needed for both prevention and treatment. Yet, one of the means of closing that gap - preventing new infections - has slipped down the agenda. In arguing for a significant intensification of the HIV prevention response, and the relevance of a strong social stance within this response, this paper addresses the need to manage finding a balance between prevention and treatment and care. Not only is there not enough being spent on HIV prevention, but also in some instances, the prevention agenda has been hijacked by those who favour morally conservative, but ineffective, HIV prevention strategies. We argue that effective prevention needs to be firmly located within the everyday realities affecting communities and societies, and needs to focus on what is known to work. In particular, we need to move beyond a public health underpinned by neo-liberal notions of agency and individual responsibility to a public health that recognises the collective nature of epidemics, and works with communities and networks to transform social relations. This latter, more 'social' public health, is concerned with the social, political and economic factors that produce HIV risk and responses to it. Contrary to what some might suggest, HIV prevention has not failed, rather, governments and donors have failed HIV prevention. Language: English Keywords: GLOBAL | CRITIQUE | AIDS PREVENTION | HIV PREVENTION | EPIDEMICS | FUNDS | PROGRAM EFFECTIVENESS | PUBLIC HEALTH | ANTIRETROVIRAL THERAPY | AIDS | HIV Infections | Viral Diseases | Diseases | Financial Activities | Economic Factors | Program Evaluation | Programs | Organization and Administration | Health | HIV Document Number: 341398 |
| 12. Peer Reviewed Title: A piece of my mind. The quiet storm. Author: Heysell SK Source: JAMA. 2009 Jul 1;302(1):13-4. Abstract: XDR-TB (extensively drug resistant tuberculosis) is a devastating plight that proves fatal in more than 85% of cases, and is a major concern in 55 countries. This is an account of two physicians’ journey from Tuegla Ferry, South Africa to the AIDS and TB affected area of the KwaZulu-Natal Province, and their exchange with an HIV positive, and possibly TB infected, mother and child. Faced with limited immediate access to dependable, low-cost, and time appropriate diagnostics, an unlikely success story emerges. Language: English Keywords: SOUTH AFRICA | CRITIQUE | HIV INFECTIONS | TUBERCULOSIS | EPIDEMICS | LABORATORY EXAMINATIONS AND DIAGNOSES | PROGRAM ACCESSIBILITY | TREATMENT | DRUG RESISTANCE | FUNDS | HOSPITALS | TIME FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Financial Activities | Economic Factors | Health Facilities | Population Dynamics | Demographic Factors | Population Document Number: 341916 |
| 13. Peer Reviewed Title: HIV/AIDS behavioral interventions in China: a literature review and recommendation for future research. Author: Hong Y; Li X Source: AIDS and Behavior. 2009 Jun;13(3):603-13. Abstract: In the past two decades, China has witnessed an alarming increase of HIV/AIDS epidemic. Meanwhile, a number of HIV prevention interventions have been conducted. This study reviews existing studies in literature on behavioral interventions on HIV/AIDS in China. Of 25 studies we identified, most have been concentrated in South and South-West China, mainly targeting injection drug users and female sex workers. The most commonly used intervention strategy was individual-oriented HIV-related knowledge education and behavioral skill training. All studies reported positive intervention effects including improved HIV-related knowledge, increased condom use, reduced needle sharing, and reduced STI. Literature also suggests a lack of intervention among other at-risk populations such as MSM, migrant workers, and non-injecting drug users, lack of studies with rigorous evaluation design, inadequate follow-up, limited outcome measurement, and lack of multi-faceted structural interventions. The existing intervention studies document strong evidence of controlling HIV/AIDS epidemic through effective behavioral intervention. More efforts are needed to control the growing HIV/AIDS epidemic in China. Future studies need to employ more rigorous methodology and incorporate environmental or structural factors for different populations at risk of HIV infection in China. Language: English Keywords: CHINA | LITERATURE REVIEW | IV DRUG USERS | SEX WORKERS | EPIDEMICS | HIV PREVENTION | AIDS PREVENTION | INTERVENTIONS | HEALTH EDUCATION | KNOWLEDGE | RISK REDUCTION BEHAVIOR | Asia, Eastern | Asia | Developing Countries | Drug Use and Abuse | Behavior | Sex Behavior | Diseases | HIV Infections | Viral Diseases | AIDS | Programs | Organization and Administration | Education | Sociocultural Factors Document Number: 342110 |
| 14. Title: Epidemiology of HIV-associated tuberculosis. Author: Lawn SD; Churchyard G Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):325-33. Abstract: PURPOSE OF REVIEW: We review literature concerning the epidemiology of HIV-associated tuberculosis (HIV-TB), focusing on articles published between 2007 and 2008. RECENT FINDINGS: An estimated 1.37 million new cases of HIV-TB occurred in 2007, representing 15% of the total global burden of TB. In addition, an estimated 456 000 HIV-TB deaths accounted for 23% of global HIV/AIDS mortality. Sub-Saharan Africa is the worst affected region with 79% of the disease burden. The epicentre of the coepidemic lies in the south of the continent, with South Africa alone accounting for over one quarter of all cases. A critical overlap between HIV and the global multidrug-resistant TB epidemics is emerging. Although it is as yet unclear whether HIV is driving a disproportionate increase in multidrug-resistant TB cases at a population level, HIV has nevertheless been a potent risk factor for institutional outbreaks, especially in South Africa and eastern Europe. Increasing data have highlighted the risk of TB among HIV-infected healthcare workers in resource-limited settings. However, many studies also show the major benefits to be derived from antiretroviral therapy in high-income and low-income countries. SUMMARY: HIV-TB remains a major challenge to global health that requires substantial increases in resource allocation and concerted international action. Language: English Keywords: GLOBAL | LITERATURE REVIEW | EPIDEMIOLOGY | HIV INFECTIONS | TUBERCULOSIS | EPIDEMICS | ANTIRETROVIRAL THERAPY | AIDS | MORTALITY | DRUG RESISTANCE | IMMUNOLOGICAL EFFECTS | Public Health | Health | Viral Diseases | Diseases | Infections | HIV | Population Dynamics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Immunity | Immune System | Physiology | Biology Document Number: 342337 |
| 15. Peer Reviewed Title: Fitting the HIV epidemic in Zambia: a two-sex micro-simulation model. Author: Leclerc PM; Matthews AP; Garenne ML Source: PloS One. 2009;4(5):e5439. Abstract: BACKGROUND: In describing and understanding how the HIV epidemic spreads in African countries, previous studies have not taken into account the detailed periods at risk. This study is based on a micro-simulation model (individual-based) of the spread of the HIV epidemic in the population of Zambia, where women tend to marry early and where divorces are not frequent. The main target of the model was to fit the HIV seroprevalence profiles by age and sex observed at the Demographic and Health Survey conducted in 2001. METHODS AND FINDINGS: A two-sex micro-simulation model of HIV transmission was developed. Particular attention was paid to precise age-specific estimates of exposure to risk through the modelling of the formation and dissolution of relationships: marriage (stable union), casual partnership, and commercial sex. HIV transmission was exclusively heterosexual for adults or vertical (mother-to-child) for children. Three stages of HIV infection were taken into account. All parameters were derived from empirical population-based data. Results show that basic parameters could not explain the dynamics of the HIV epidemic in Zambia. In order to fit the age and sex patterns, several assumptions were made: differential susceptibility of young women to HIV infection, differential susceptibility or larger number of encounters for male clients of commercial sex workers, and higher transmission rate. The model allowed to quantify the role of each type of relationship in HIV transmission, the proportion of infections occurring at each stage of disease progression, and the net reproduction rate of the epidemic (R(0) = 1.95). CONCLUSIONS: The simulation model reproduced the dynamics of the HIV epidemic in Zambia, and fitted the age and sex pattern of HIV seroprevalence in 2001. The same model could be used to measure the effect of changing behaviour in the future. Language: English Keywords: ZAMBIA | RESEARCH REPORT | THEORETICAL MODELS | DEMOGRAPHIC AND HEALTH SURVEYS | HETEROSEXUALS | SEX WORKERS | HIV INFECTIONS | EPIDEMICS | AGE FACTORS | SEX FACTORS | EPIDEMIOLOGY | MARRIAGE | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Behavior | Viral Diseases | Diseases | Population Characteristics | Public Health | Health | Nuptiality Document Number: 341943 |
| 16. Peer Reviewed Title: New methods for estimating the tuberculosis case detection rate in high-HIV prevalence countries: the example of Kenya. Author: Mansoer J; Scheele S; Floyd K; Dye C; Sitienei J; Williams B Source: Bulletin of the World Health Organization. 2009 Mar;87(3):186-92, 192A-192B. Abstract: OBJECTIVE: To develop new methods for estimating the sputum smear-positive tuberculosis case detection rate (CDR) in a country where infection with HIV is prevalent. METHODS: We estimated the smear-positive tuberculosis CDR in HIV-negative and HIV-positive adults, and in all adults in Kenya. Data on time trends in tuberculosis case notification rates and on HIV infection prevalence in adults and in tuberculosis patients were used, along with data on tuberculosis control programme performance. FINDINGS: In 2006, the estimated smear-positive tuberculosis CDR in HIV-negative adults was 79% (95% confidence interval, CI: 64-94) and in HIV-positive adults, 57% (95% CI: 26-88), giving a weighted mean of 68% (95% CI: 49-87). The separate estimate for all smear-positive tuberculosis cases was 72% (95% CI: 53-91), giving an overall average for the three estimates of 70% (95% CI: 58-82). As the tuberculosis CDR in 1996 was 57% (95% CI: 47-67), the estimated increase by 2006 was 13 percentage points (95% CI: 6-20), or 23%. This increase was accompanied by a more than doubling of the resources devoted to tuberculosis control in Kenya, including facilities and staff. CONCLUSION: Using three approaches to estimate the tuberculosis CDR in a country where HIV infection is prevalent, we showed that expansion of the tuberculosis control programme in Kenya led to an increase of 23% in the CDR between 1996 and 2006. While the methods developed here can be applied in other countries with a high prevalence of HIV infection, they rely on precise data on trends in such prevalence in the general population and among tuberculosis patients. Language: English Keywords: KENYA | RESEARCH REPORT | ESTIMATION TECHNIQUES | ADULTS | TUBERCULOSIS | INCIDENCE | TRANSMISSION | HIV INFECTIONS | PREVALENCE | EPIDEMICS | COMMUNICABLE DISEASE CONTROL | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Measurement | Viral Diseases | Health Services | Delivery of Health Care | Health Document Number: 342352 |
| 17. Title: The contributing role of tourism in the HIV/AIDS epidemic in the Caribbean. Author: Orisatoki RO; Oguntibeju OO; Truter EJ Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):143-8. Abstract: The first confirmed case of HIV/AIDS in the Caribbean was reported in 1982, however a recent report by UNAIDS shows that the epidemic has risen to over 250,000 persons living with the virus with the highest prevalence rates shown to be in the Dominican Republic and Haiti. Various factors ranging from commercial sex trading to unsafe injection employed for drug abuse have been identified to play a contributing role in this increase. Also, the role and impact of tourism on the spread of HIV infection has been reported. Due to concerns shown by countries and territories who are dependent on tourism and that they rank amongst the most highly affected by HIV/AIDS in the region, this paper endeavours to examine the impact of HIV/AIDS and the contributing role of tourism to HIV/AIDS epidemic in the Caribbean. Language: English Keywords: CARIBBEAN | CRITIQUE | SEX WORKERS | HIV INFECTIONS | AIDS | EPIDEMICS | TRAVEL AND TOURISM | PREVALENCE | HIV TRANSMISSION | SEX BEHAVIOR | ECONOMIC FACTORS | Developing Countries | Americas | Behavior | Viral Diseases | Diseases | Measurement | Research Methodology Document Number: 342685 |
| 18. Title: The Pope, condoms, and the evolution of HIV. Author: Ponce de Leon S; Jimenez-Corona ME; Velasco AM; Lazcano A Source: Lancet Infectious Diseases. 2009 Aug;9(8):461-2. Abstract: This reflection focuses on HIV, resistance to antiretroviral therapy, and the importance of using condoms. It touches on the Pope’s statements on the use of condoms and their inefficiency to prevent HIV transmission and argues against it stating that condoms play a key role in limiting the HIV pandemic. Language: English Keywords: AFRICA | VATICAN CITY | CRITIQUE | INFLUENTIALS | EPIDEMICS | HIV PREVENTION | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | CONDOM USE | RELIGIOUS ASPECTS | CHRISTIANITY | Developing Countries | Europe, Southern | Europe | Developed Countries | Knowledge Sources | Communication | Diseases | HIV Infections | Viral Diseases | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Reduction Behavior | Behavior | Religion | Sociocultural Factors Document Number: 342130 |
| 19. Title: Leveraging the role of public health nursing in managing HIV/AIDS in Thailand: a journey of international collaboration. Author: Potempa K; Phancharoenworakul K; Glass N; Chasombat S; Cody BJ Source: Collegian. 2009;16(2):49-53. Abstract: Thailand is one of the first countries to have achieved significant advances in control over the HIV/AIDS epidemic occurring within its borders. Despite this impressive accomplishment, the disease continues to be a Leading cause of death in Thailand and is migrating into Thai populations heretofore relatively free of it, such as married women. In 2003, a unique Thai, American, academic, and government collaboration formed to address the on-going challenges of HIV/AIDS in Thailand and its emerging characteristics. The objective of this collaboration was to increase the capacity of Thailand's public health infrastructure to address the challenges of HIV/AIDS by utilizing a Larger and more empowered role for nurses within the country's existing health care system. This collaboration consisted of the Deans' Consortium of Nursing Educational Institutions, the Thai Ministry of Public Health, the Faculty of Nursing at Mahidol University, and United States university nursing educators. This paper describes the process that brought this collaboration into being. It also describes the outcomes achieved by this collaboration; a collaboration that realized a national strategy to Leverage and expand the role of public health nurses and the initiation of a nurse practitioners' role in the prevention and treatment of HIV/AIDS. This collaboration and strategy increased the capacity of the health care system in Thailand to more effectively meet the challenges posed by all infectious diseases in Thailand and, in particular, HIV/AIDS. Language: English Keywords: THAILAND | SUMMARY REPORT | NURSES AND NURSING | PUBLIC HEALTH | HIV INFECTIONS | EPIDEMICS | PREVENTION AND CONTROL | INTERNATIONAL COOPERATION | CAPACITY BUILDING | CURRICULUM | IMPLEMENTATION | Developing Countries | Asia, Southeastern | Asia | Health Personnel | Delivery of Health Care | Health | Viral Diseases | Diseases | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | Education Document Number: 342653 |
| 20. Peer Reviewed Title: Trends in three decades of HIV/AIDS epidemic in Thailand by nonparametric backcalculation method. Author: Punyacharoensin N; Viwatwongkasem C Source: AIDS. 2009 Jun 1;23(9):1143-52. Abstract: OBJECTIVES: To reconstruct the past HIV incidence and prevalence in Thailand from 1980 to 2008 and predict the country's AIDS incidence from 2009 to 2011. METHODS: Nonparametric backcalculation was adopted utilizing 100 quarterly observed new AIDS counts excluding pediatric cases. The accuracy of data was enhanced through a series of data adjustments using the weight method to account for several surveillance reporting issues. The mixture of time-dependent distributions allowed the effects of age at seroconversion and antiretroviral therapy to be incorporated simultaneously. Sensitivity analyses were conducted to assess model variations that were subject to major uncertainties. Future AIDS incidence was projected for various predetermined HIV incidence patterns. RESULTS: HIV incidence in Thailand reached its peak in 1992 with approximately 115,000 cases. A steep decline thereafter discontinued in 1997 and was followed by another strike of 42,000 cases in 1999. The second surge, which happened concurrently with the major economic crisis, brought on 60,000 new infections. As of December 2008, more than 1 million individuals had been infected and around 430,000 adults were living with HIV corresponding to a prevalence rate of 1.2%. The incidence rate had become less than 0.1% since 2002. The backcalculated estimates were dominated by postulated median AIDS progression time and adjustments to surveillance data. CONCLUSION: Our analysis indicated that, thus far, the 1990s was the most severe era of HIV/AIDS epidemic in Thailand with two HIV incidence peaks. A drop in new infections led to a decrease in recent AIDS incidence, and this tendency is likely to remain unchanged until 2011, if not further. Language: English Keywords: THAILAND | RESEARCH REPORT | HISTORICAL REVIEW | ESTIMATION TECHNIQUES | DATA ADJUSTMENT | AIDS | HIV INFECTIONS | EPIDEMICS | INCIDENCE | PREVALENCE | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Viral Diseases | Diseases | Measurement Document Number: 342452 |
| 21. Peer Reviewed Title: Breaking the silence: South African HIV policies and the needs of men who have sex with men. Author: Rispel LC; Metcalf CA Source: Reproductive Health Matters. 2009 May;17(33):133-142. Abstract: Although the HIV epidemic among men who have sex with men (MSM) in South Africa preceded the onset of the generalised HIV epidemic by several years, current policies and programmes focus on heterosexual transmission and mother-to-child transmission. We used an adaptation of the UNAIDS Country Harmonised Alignment Tool (CHAT) to assess whether existing HIV policies and programmes in South Africa address the needs of MSM. This covered mapping of key risk factors and epidemiology of HIV among MSM; participation of MSM in the HIV response; and an enabling environment for service provision, funding and human resources. We found that current policies and programmes are unresponsive to the needs of MSM and that epidemiologic information is lacking, in spite of policy on MSM in the National Strategic Plan. We recommend that government initiate sentinel surveillance to determine HIV prevalence among MSM, social science research on the contexts of HIV transmission among MSM, and appropriate HIV prevention and care strategies. MSM should be closely involved in the design of policies and programmes. Supportive programme development should include dedicated financial and human resources, appropriate guidelines, and improved access to and coverage of HIV prevention, treatment and care services for MSM. Spanish Abstract: Aunque en Sudáfrica la epidemia del VIH entre hombres que tienen relaciones sexuales con hombres (HSH) precedió por varios ańos al inicio de la epidemia generalizada del VIH, las políticas y los programas actuales se centran en la transmisión heterosexual y la transmisión materno-infantil. Usamos una adaptación del Mecanismo Nacional de Armonización y Concordancia (CHAT), creado por ONUSIDA, con el fin de determinar si las políticas y los programas de VIH en Sudáfrica satisfacen las necesidades de los HSH. Se abarcó el mapeo de los factores de riesgo clave y la epidemiología del VIH entre HSH; la participación de los HSH en respuesta al VIH; y un ambiente propicio para la prestación de servicios, financiamiento y recursos humanos. Encontramos que las políticas y los programas vigentes no son receptivos a las necesidades de los HSH y que falta información epidemiológica, pese a la política de HSH del Plan Estratégico Nacional. Recomendamos que el gobierno inicie vigilancia centinela para determinar la prevalencia de VIH entre HSH, investigación en ciencias sociales sobre el contexto de la transmisión del VIH entre HSH, y estrategias adecuadas para la prevención y el tratamiento del VIH. Los HSH deben participar estrechamente en la formulación de políticas y programas. El desarrollo de programas de apoyo debe incluir recursos financieros y humanos dedicados, directrices apropiadas y mejor acceso a los servicios de prevención, tratamiento y atención del VIH entre HSH, así como mejor cobertura de estos. French Abstract: Męme si en Afrique du Sud, l'épidémie de VIH chez les hommes ayant des rapports sexuels avec des hommes (HSH) a précédé de plusieurs années le début de l'épidémie généralisée, les politiques et programmes actuels sont focalisés sur la transmission hétérosexuelle et mčre-enfant. Nous avons adapté l'outil d'harmonisation et d'alignement national (CHAT) de l'ONUSIDA pour évaluer si les politiques et programmes sud-africains répondent aux besoins des HSH. Nous avons pour cela examiné les principaux facteurs de risque et l'épidémiologie du VIH chez les HSH ; la participation des HSH ŕ la riposte au VIH ; et l'environnement propice pour la prestation des services, le financement et les ressources humaines. Nous avons découvert que les politiques et programmes ne satisfont pas les besoins des HSH et que l'information épidémiologique fait défaut, en dépit de la politique sur les HSH dans le Plan stratégique national. Nous recommandons au Gouvernement commence une surveillance sentinelle afin d'évaluer la prévalence du VIH chez les HSH, une recherche en sciences sociales sur les contextes de la transmission du VIH chez les HSH et des stratégies adaptées de prévention et de soins du VIH. Les HSH doivent ętre étroitement associés ŕ la conception des politiques et des programmes. La définition de programmes positifs devrait inclure des ressources humaines et financičres dédiées, des directives appropriées et une couverture étendue de la prévention, du traitement et des soins, ainsi qu'un accčs élargi des HSH ŕ ces services. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | LITERATURE REVIEW | MEN HAVING SEX WITH MEN | HIV INFECTIONS | RISK FACTORS | EPIDEMICS | HEALTH POLICY | HIV PREVENTION | PROGRAM DEVELOPMENT | PARTICIPATION | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Sex Behavior | Behavior | Viral Diseases | Diseases | Health | Policy | Political Factors | Sociocultural Factors | Programs | Organization and Administration | Social Behavior | Program Evaluation Document Number: 342022 |
| 22. Title: Measles in Children Younger Than 9 Months in Pakistan. Author: Saleem AF; Zaidi A; Ahmed A; Warraich H; Mir F Source: Indian Pediatrics. 2009 Jul 1; Abstract: Pakistan has one of the highest burden of measles and measles related deaths in the world. We compared the clinical course and outcomes of measles in infants aged <9 months with those < 9 month old amongst children admitted to a tertiary care hospital. Data were collected by a retrospective chart review, and compared between age < 9 months (Group A) and age > 9 months (Group B). Severe malnutrition (P=0.039, AOR=3.02), anemia (P=0.017), leukocytosis (P<0.001, AOR 4.1), and conjunctivitis (P=0.021) were higher in Group A children. All four deaths occurred in Group B. Language: English Keywords: PAKISTAN | RESEARCH REPORT | COMPARATIVE STUDIES | DATA COLLECTION | MEASLES | IMMUNIZATION | EPIDEMICS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 342539 |
| 23. Peer Reviewed Title: HIV surveillance and epidemic profile in the Middle East and North Africa. Author: Shawky S; Soliman C; Kassak KM; Oraby D; El-Khoury D; Kabore I Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51 Suppl 3:S83-95. Abstract: HIV infection is the most devastating infection that has emerged in the recent history. The risk of being infected can be associated with both individual's knowledge and behavior and community vulnerability influenced by cultural norms, laws, politics, and social practices. Despite that the countries in the Middle East and North Africa have succeeded in keeping low the HIV epidemic rates, the number of identified infected cases are increasing. Since the appearance of the first AIDS cases, all the national authorities devoted their efforts to abort the epidemic in its early stages. The rate of new HIV infections across the Middle East and North Africa region are not at an alarming level, but the need for a concerted effort from nation-states and nongovernmental organizations to stem the spread of the virus across the region is vital.Most countries of the region have put in place better information systems to track the HIV epidemic, yet the passive HIV/AIDS reporting remains the cornerstone in the HIV surveillance systems. Several countries still believe that their current strategies are optimal to the HIV status within their territories and that their national strategies are appropriate to their low epidemic status that is not expected to grow. Additionally, these countries fear that establishing an HIV national program to survey risk behaviors may be perceived as an approval of these behaviors that are culturally and religiously unacceptable. This background article aims to summarize the HIV surveillance strategies and epidemic profile in 17 Arab countries in the Middle East and North Africa. The article, also, displays the national surveillance system and the epidemic profile in Egypt and Lebanon as models for the region. This information aims to provide useful insights that may help the national authorities in finding out the best surveillance strategies that allow merging and collecting biological and risk data which is an integral part of their efforts to fight the HIV epidemic in the region. Language: English Keywords: MIDDLE EAST | AFRICA, NORTH | RESEARCH REPORT | EPIDEMICS | SCREENING | HIV TESTING | HIV INFECTIONS | HIV | Africa | Developing Countries | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Viral Diseases Document Number: 342678 |
| 24. Peer Reviewed Title: Men who have sex with men and HIV/AIDS in sub-Saharan Africa. Author: Smith AD; Tapsoba P; Peshu N; Sanders EJ; Jaffe HW Source: Lancet. 2009 Jul 17; Abstract: Globally, men who have sex with men (MSM) continue to bear a high burden of HIV infection. In sub-Saharan Africa, same-sex behaviours have been largely neglected by HIV research up to now. The results from recent studies, however, indicate the widespread existence of MSM groups across Africa, and high rates of HIV infection, HIV risk behaviour, and evidence of behavioural links between MSM and heterosexual networks have been reported. Yet most African MSM have no safe access to relevant HIV/AIDS information and services, and many African states have not begun to recognise or address the needs of these men in the context of national HIV/AIDS prevention and control programmes. The HIV/AIDS community now has considerable challenges in clarifying and addressing the needs of MSM in sub-Saharan Africa; homosexuality is illegal in most countries, and political and social hostility are endemic. An effective response to HIV/AIDS requires improved strategic information about all risk groups, including MSM. The belated response to MSM with HIV infection needs rapid and sustained national and international commitment to the development of appropriate interventions and action to reduce structural and social barriers to make these accessible. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | LITERATURE REVIEW | MEN HAVING SEX WITH MEN | HIV INFECTIONS | AIDS | EPIDEMICS | SOCIAL DISCRIMINATION | HEALTH POLICY | GOALS | HIV PREVENTION | INTERVENTIONS | Africa | Developing Countries | Sex Behavior | Behavior | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Policy | Political Factors | Planning | Organization and Administration | Programs Document Number: 342229 |
| 25. Peer Reviewed Title: Is HIV infection a risk factor for multi-drug resistant tuberculosis? A systematic review. Author: Suchindran S; Brouwer ES; Van Rie A Source: PloS One. 2009;4(5):e5561. Abstract: BACKGROUND: Tuberculosis (TB) is an important cause of human suffering and death. Human immunodeficiency virus (HIV), multi-drug resistant TB (MDR-TB), and extensive drug resistant tuberculosis (XDR-TB) have emerged as threats to TB control. The association between MDR-TB and HIV infection has not yet been fully investigated. We conducted a systematic review and meta-analysis to summarize the evidence on the association between HIV infection and MDR-TB. METHODS AND RESULTS: Original studies providing Mycobacterium tuberculosis resistance data stratified by HIV status were identified using MEDLINE and ISI Web of Science. Crude MDR-TB prevalence ratios were calculated and analyzed by type of TB (primary or acquired), region and study period. Heterogeneity across studies was assessed, and pooled prevalence ratios were generated if appropriate. No clear association was found between MDR-TB and HIV infection across time and geographic locations. MDR-TB prevalence ratios in the 32 eligible studies, comparing MDR-TB prevalence by HIV status, ranged from 0.21 to 41.45. Assessment by geographical region or study period did not reveal noticeable patterns. The summary prevalence ratios for acquired and primary MDR-TB were 1.17 (95% CI 0.86, 1.6) and 2.72 (95% CI 2.03, 3.66), respectively. Studies eligible for review were few considering the size of the epidemics. Most studies were not adjusted for confounders and the heterogeneity across studies precluded the calculation of a meaningful overall summary measure. CONCLUSIONS: We could not demonstrate an overall association between MDR-TB and HIV or acquired MDR-TB and HIV, but our results suggest that HIV infection is associated with primary MDR-TB. Future well-designed studies and surveillance in all regions of the world are needed to better clarify the relationship between HIV infection and MDR-TB. Language: English Keywords: GLOBAL | LITERATURE REVIEW | DATA ANALYSIS | TUBERCULOSIS | DRUG RESISTANCE | PREVALENCE | RISK FACTORS | HIV INFECTIONS | EPIDEMICS | Research Methodology | Infections | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Viral Diseases Document Number: 342446 |
| 26. Title: The global epidemic of HIV infection among men who have sex with men. Author: van Griensven F; de Lind van Wijngaarden JW; Baral S; Grulich A Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):300-7. Abstract: PURPOSE OF REVIEW: In the last few years, there have been reports of new, newly identified and resurging epidemics of HIV infection among men who have sex with men (MSM). This article reviews and summarizes the global epidemic of HIV infection among MSM. RECENT FINDINGS: In the Western world, the increase in notifications of new HIV infections among MSM is continuing. Steep increases in reports of new HIV diagnoses among MSM were also seen in the developed economies of East Asia. In the developing world, epidemiologic studies have now established the presence of MSM populations in Africa, China and Russia and a high HIV prevalence among them. High and increasing HIV prevalence was also reported from South and Southeast Asia, and Latin America and the Caribbean. SUMMARY: HIV continues to spread among MSM on a global level. Current prevention efforts have been unable to contain or reduce HIV transmission in this population. Additional behavioral and biomedical interventions are urgently needed. Language: English Keywords: GLOBAL | LITERATURE REVIEW | MEN HAVING SEX WITH MEN | EPIDEMIOLOGY | HIV INFECTIONS | PREVALENCE | INCIDENCE | EPIDEMICS | HIV PREVENTION | Sex Behavior | Behavior | Public Health | Health | Viral Diseases | Diseases | Measurement | Research Methodology Document Number: 342338 |
| 27. Title: HIV-prevention science at a crossroads: advances in reducing sexual risk. Author: Vermund SH; Allen KL; Karim QA Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):266-73. Abstract: PURPOSE OF REVIEW: We review the current state of evidence-based prevention strategies for reducing sexual transmission of HIV. The combined programmatic and scientific efforts through 2008 to reduce sexual transmission of HIV have failed to reduce substantially the global pandemic. RECENT FINDINGS: Prevention interventions to reduce HIV infection target behavioral, biomedical, and structural risk factors. Some of these prevention strategies have been evaluated in randomized clinical trials (RCTs) with HIV seroincidence endpoints. When RCTs are not feasible, a variety of observational and quasiexperimental research approaches can provide insight as to program effectiveness of specific strategies. Only five RCTs have demonstrated a notable decrease in sexually acquired HIV incidence. These include the Mwanza study of syndromic management of sexually transmitted diseases and three male circumcision trials in East Africa; a microbicide trial reported in 2009 shows substantial promise for the efficacy of PRO 2000 (0.5% gel). SUMMARY: The combined programmatic and scientific efforts to reduce sexual transmission of HIV have made incremental progress. New prevention tools are needed to stem the continued spread of HIV, though microbicides and vaccines will take many more years to develop, test, and deploy. Combination strategies of existing modalities should be tested to evaluate the potential for more proximate prevention benefits. Language: English Keywords: GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | EPIDEMICS | HIV PREVENTION | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | PREVENTION AND CONTROL | MICROBICIDES | MALE CIRCUMCISION | ANTIRETROVIRAL THERAPY | VACCINES | BEHAVIOR CHANGE | Clinical Research | Research Methodology | Diseases | HIV Infections | Viral Diseases | Behavior | Reproductive Tract Infections | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Document Number: 342340 |
| 28. Peer Reviewed Title: A new way of perceiving the pandemic: the findings from a participatory research process on young Africans' stories about HIV/AIDS. Author: Winskell K; Enger D Source: Culture, Health and Sexuality. 2009 May;11(4):453-467. Abstract: This paper presents the findings, shares the methodology and outlines the benefits of a multi-country participatory research process on a unique data source: stories about HIV and AIDS written by young Africans. Between 1997 and 2005, more than 105,000 young people from 37 countries participated in competitions inviting them to think up storylines for short fiction films to educate their communities about HIV and AIDS as part of the 'Scenarios from Africa' communication process. The winning stories were selected by juries made up of: PLWH and other local specialists in prevention, treatment and care; former contest winners and other young people; and communication specialists, including the top African directors, who went on to transform the ideas into short films. In 2005, over 200 jurors selected 30 winners from the 22,894 stories submitted that year by 63,327 contest participants. After reading around 200 stories each and participating in the selection process, jurors compiled their observations and recommendations. The jurors' findings reveal notable persistent shortcomings in existing communication efforts and identify key emerging needs. In some areas, they show remarkable consistency across the continent. Jurors view this as a powerful needs assessment, networking and capacity building process that motivates action. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | METHODOLOGICAL STUDIES | CROSS-CULTURAL COMPARISONS | ACTION RESEARCH | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | PERCEPTION | HIV INFECTIONS | EPIDEMICS | FILM AND VIDEO | DRAMA AND THEATER | HEALTH EDUCATION | COMMUNITY HEALTH SERVICES | CONTESTS | Africa | Developing Countries | Studies | Research Methodology | Comparative Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Psychological Factors | Behavior | Mass Media | Communication | Culture | Sociocultural Factors | Education | Primary Health Care | Health Services | Delivery of Health Care | Health | Incentives | Policy | Political Factors Document Number: 341091 |
| 29. Title: Jhpiego’s response to Africa’s malaria epidemic. Author: JHPIEGO Source: [Baltimore, Maryland], JHPIEGO, [2008]. [2] p. Abstract: hpiego and the ACCESS Program, implemented by Jhpiego in partnership with Save the Children, Constella Futures, Academy for Educational Development, American College of Nurse-Midwives and IMA World Health, promote an approach recommended by the World Health Organization (WHO) for the prevention and control of malaria. This comprehensive approach includes intermittent preventive treatment with an anti-malarial during the second and third trimesters of pregnancy; the use of insecticide-treated bed nets; education and counseling; and rapid treatment for pregnant women showing signs of malaria. Because the majority of pregnant women receive antenatal care at least once during pregnancy, linking prevention and treatment of malaria with antenatal care represents an ideal opportunity to effect change. For example, in three districts of Tanzania where Jhpiego first introduced focused antenatal care, uptake of the first dose of intermittent preventive treatment was 74% among antenatal care clients on average,1 compared with 52% nationally, as documented in the most recent Demographic and Health Survey.2 Furthermore, 52% of antenatal care clients in these districts received at least two doses of the treatment,1 compared with 22% of pregnant women nationally. (Excerpt) Language: English Keywords: AFRICA | SUMMARY REPORT | VOLUNTARY HEALTH AGENCIES | MALARIA PREVENTION | EPIDEMICS | PREGNANCY COMPLICATIONS | ANEMIA | ANTIMALARIAL DRUGS | BED NETS | ANTENATAL CARE | INTERNATIONAL COOPERATION | TECHNICAL ASSISTANCE | POLICY DEVELOPMENT | PROGRAM DEVELOPMENT | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Programs | Organization and Administration | Planning Document Number: 331768 |
| 30. Title: Harm reduction developments, 2008. Countries with injection-driven HIV epidemics. Author: Open Society Institute. International Harm Reduction Development Program Source: New York, New York, Open Society Institute, 2008. 80 p. Abstract: In 2007, injecting drug users (IDUs) comprised the largest share of total HIV cases in at least 20 nations in Asia and the former Soviet Union. The percentage of cases attributed to injecting drug use is over 70 percent in some countries in Eastern Europe and Central Asia, the region where HIV grew fastest in 2006. In many of these countries, harm reduction has made important inroads-all countries in Eastern Europe and the former Soviet Union except Turkmenistan had needle exchange programs in 2007. In most, they remain too small to contain the HIV epidemic. Reports that new HIV cases among drug users have stabilized often reflect trends in testing rather than the impact of prevention. In Asia, home to more than half the world's population, even low percentage rates of HIV cases translate into huge numbers of people infected, with profound economic and social implications. China, Indonesia, Malaysia, and Vietnam all have injection-driven HIV epidemics, and have all shown a willingness to adopt some of the measures necessary to halt the spread of HIV among IDUs and their sexual partners. The challenge for many of the hardest-hit countries, however, lies in turning commitments into practice, without sacrificing protection of human rights. This OSI report provides a snapshot of some key developments in HIV prevention, policy, and treatment for IDUs in developing and transitional countries with injection-driven epidemics, and includes overviews on such issues as community mobilization, methadone and buprenorphine treatment availability, harm reduction in prisons, and HIV treatment for IDUs. Language: English Keywords: ASIA | EUROPE, CENTRAL | EUROPE, EASTERN | SUMMARY REPORT | IV DRUG USERS | PRISONERS | HIV INFECTIONS | EPIDEMICS | SUBSTANCE ADDICTION | RISK REDUCTION BEHAVIOR | ADVOCACY | ANTIRETROVIRAL THERAPY | DRUGS | Developing Countries | Europe | Developed Countries | Drug Use and Abuse | Behavior | Crime | Social Problems | Sociocultural Factors | Viral Diseases | Diseases | Communication | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 327144 |
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