Inmagic CS/WebPublisher PRO found 943 records

Your search found 943 record(s).
New Basic Search | New Advanced Search | POPLINE Document Delivery Policy

Subscription may be needed for full text

Peer Reviewed

Title: Sexual risk behaviour of the first cohort undergoing screening for enrollment into Phase I/II HIV vaccine trials in South Africa.
Author: Andersson KM; Van Niekerk RM; Niccolai LM; Mlungwana ON; Holdsworth IM; Bogoshi M; McIntyre JA; Gray GE; Vardas E
Source: International Journal of STD and AIDS. 2009 Feb;20(2):95-101.
Abstract: We assessed risk behaviour in a heterosexual cohort undergoing prescreening for the first Phase I/II HIV vaccine trials in Soweto. We developed a survey and collected self-reported data from HIV-negative potential volunteers. Of 488 participants, most were single and approximately half were from households with incomes below the poverty level. Males reported higher rates of heavy alcohol use (P < 0.001), marijuana use (P < 0.001) and other recreational drug use (P < 0.01). Males reported more sex partners than females in the previous six months (P < 0.001), as well as more casual/anonymous partners (P < 0.001) and one-night stands (P < 0.001). Multivariate analyses revealed substance use and male gender predicted higher risk behaviours, including <100% condom use with known/suspected HIV-positive partners, having casual/anonymous partners and having more than two partners. For this population, male volunteers may need increased risk-reduction counselling during Phase I/II trials and additional recruitment methods may be necessary to identify high-risk female volunteers for Phase III efficacy trials.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | CLINICAL TRIALS | MULTIVARIATE ANALYSIS | HETEROSEXUALS | SEXUAL PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | VACCINES | ALCOHOL USE AND ABUSE | SCREENING | POVERTY | DRUG USE AND ABUSE | SEX FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Clinical Research | Data Analysis | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population
Document Number: 331093

Peer Reviewed

Title: Infidelity, Trust, and Condom Use Among Latino Youth in Dating Relationships.
Author: Brady SS; Tschann JM; Ellen JM; Flores E
Source: Sexually Transmitted Diseases. 2009 Apr;36(4):227-231.
Abstract: BACKGROUND:: Latino youth in the United States are at greater risk for contracting sexually transmitted infections (STIs) in comparison with non-Hispanic white youth. METHODS:: Sexually active heterosexual Latino youth aged 16 to 22 years (N = 647) were recruited for interviews through a large health maintenance organization or community clinics. RESULTS:: Adjusting for gender, age, ethnic heritage, and recruitment method, woman's consistent use of hormonal contraceptives, ambivalence about avoiding pregnancy, longer length of sexual relationship, and greater overall trust in main partner were independently associated with inconsistent condom use and engagement in a greater number of sexual intercourse acts that were unprotected by condom use. Perception that one's main partner had potentially been unfaithful, but not one's own sexual concurrency, was associated with consistent condom use and fewer acts of unprotected sexual intercourse. Sexually concurrent youth who engaged in inconsistent condomuse with other partners were more likely to engage in inconsistent condom use and a greater number of unprotected sexual intercourse acts with main partners. CONCLUSIONS:: Increasing attachment between youth may be a risk factor for the transmission of STIs via normative declines in condom use. Perception that one's partner has potentially been unfaithful may result in greater condom use. However, many Latino adolescents and young adults who engage in sexual concurrency may not take adequate steps to protect their partners from contracting STIs. Some youth may be more focused on the emotional and social repercussions of potentially revealing infidelity by advocating condom use than the physical repercussions of unsafe sex.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | COMPARATIVE STUDIES | ETHNIC GROUPS | WOMEN | WHITES | YOUTH | HETEROSEXUALS | SEXUALLY TRANSMITTED DISEASES | RISK BEHAVIOR | CONDOM USE | Developed Countries | North America | Americas | Studies | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Age Factors | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior
Document Number: 330495

Peer Reviewed

Title: Lack of evidence for frequent heterosexual transmission of human herpesvirus 8 in Zimbabwe.
Author: Campbell TB; Borok M; Ndemera B; Fiorillo S; White IE; Zhang XQ; Machekano RN; Katzenstein D; Gwanzura L
Source: Clinical Infectious Diseases. 2009 Jun 1;48(11):1601-8.
Abstract: BACKGROUND: There is conflicting evidence about the contribution of heterosexual transmission to the spread of human herpesvirus 8 (HHV-8) in southern Africa. This study evaluated the hypothesis that HHV-8 infection is associated with risk factors for human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections among Zimbabwean men. METHODS: HHV-8 seroprevalence was determined for 2750 participants in the Zimbabwe AIDS Prevention Project cohort of male factory workers in Harare, Zimbabwe. Potential associations of HHV-8 antibody detection with risk factors for HIV-1 infection were examined by univariate analysis. Variables with [Formula: see text] in the univariate analysis were included in a multivariate logistic regression model. HHV-8 seroprevalence was also determined among 297 heterosexual couples. RESULTS: Prevalence of HHV-8, HIV-1, and HHV-8 and HIV-1 coinfection was 28.5% (95% confidence interval [CI], 26.8%-30.2%), 19.5% (95% CI, 18.0%-20.9%), and 6.5% (95% CI, 5.6%-7.5%), respectively. Detection of HHV-8 antibodies was independently associated with older age and HIV-1 infection but not with number of recent sex partners, marital status, education, condom use, prior sexually transmitted infections, payment for sex, chronic hepatitis B infection, or incident HIV-1 infection. HHV-8 seroprevalence was 31.7% (95% CI, 26.3-37.0) among wives in the couples tested, but HHV-8 infection of wives was not associated with HHV-8 infection of husbands (odds ratio, 1.08; 95% CI, 0.62-1.88; P = .8). CONCLUSIONS: HHV-8 and HIV-1 infection did not have common sexual risk factors among urban Zimbabwean men. Sexual transmission does not explain the high prevalence of HHV-8 in this population.
Language: English
Keywords:
ZIMBABWE | RESEARCH REPORT | STATISTICAL STUDIES | HETEROSEXUALS | HERPES GENITALIS | TRANSMISSION | HIV INFECTIONS | RISK FACTORS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Health
Document Number: 341676

Peer Reviewed

Title: Estimating HIV prevalence and risk behaviors among high-risk heterosexual men with multiple sex partners: use of respondent-driven sampling.
Author: Chopra M; Townsend L; Johnston L; Mathews C; Tomlinson M; O'bra H; Kendall C
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):72-7.
Abstract: OBJECTIVES: To collect HIV data from high-risk men who have multiple, younger, female sex partners in a periurban township in South Africa. DESIGN: Unlinked anonymous cross-sectional survey using respondent-driven sampling. METHODS: Survey conducted among men aged 18 years or older who reported having had sex with more than 1 female partner in the previous 3 months (one of whom was either 3 or more years younger than the participant or below the age of 24) and lived in the area of recruitment. RESULTS: The median age of the 421 recruited men was 28 years (range: 18-62 years). They reported a median of 6 sexual partners (range: 2-39) during the past 3 months, and 51% (confidence interval: 45.0 to 59.6) reported inconsistent condom use with their casual partners. During the 3 months before the survey, 98% of men reported having concurrent sexual relationships. HIV prevalence was 12.3% (confidence interval: 8.3% to 16.9%). Being older than 24 years and not using a condom during the last sexual intercourse with a 1-time sexual partner were significantly associated with HIV infection. CONCLUSIONS: This group of heterosexual urban men practice high levels of risky sexual behavior and are an important group that require more targeted HIV surveillance and prevention interventions.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | HETEROSEXUALS | MEN | URBAN POPULATION | HIV INFECTIONS | PREVALENCE | MULTIPLE PARTNERS | CONDOM USE | RISK BEHAVIOR | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Demographic Factors | Population | Population Characteristics | Viral Diseases | Diseases | Measurement | Sexual Partners | Risk Reduction Behavior
Document Number: 342370

Title: Recent heterosexual partnerships and patterns of condom use: a weighted analysis.
Author: Copas AJ; Mercer CH; Farewell VT; Nanchahal K; Johnson AM
Source: Epidemiology. 2009 Jan;20(1):44-51.
Abstract: BACKGROUND: In epidemiologic studies of sexual partnerships, characteristics are often collected in part through detailed questions concerning recent partnerships. These data present challenges for analysis. First, although research interest generally lies in all partnerships in a certain time period, participants may be asked to provide detailed information only concerning their most recent, up to a fixed number. As more recent partnerships may differ from others, a simple analysis of these data may lead to bias. Second, the total number of partnerships for a study participant may be informative, so the analyst must choose between inference for the population of partnerships or for a typical partnership from the population of individuals. Third, data may be more fully recorded for study participants than their partners, and not all partners may be eligible to participate. METHODS: We propose weighting to deal with these challenges. Weighting provides a sensitivity analysis for the possible selection bias due to incomplete reporting. We analyze heterosexual condom use in Britain, using data from the National Survey of Sexual Attitudes and Lifestyles 2000. RESULTS: The sensitivity of estimates to possible selection bias is low. We find that the choice of population for inference is important for prevalence estimates, but has relatively little impact on measures of association. By defining within-participant partnership predictors we demonstrate how participants vary their condom use. We establish that, at least for male participants, shorter partnership duration is linked to a higher probability of condom use at last sex but lower probability at first sex. CONCLUSION: We recommend a weighted analysis approach to recent partnership data, which can be simply implemented in standard survey analysis software. In other surveys the sensitivity of estimates to possible selection bias may be substantial and this will need to be assessed in each case.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | HETEROSEXUALS | SEXUAL PARTNERS | ATTITUDES | LIFE STYLE | CONDOM USE | Developed Countries | Europe, Western | Europe | Sex Behavior | Behavior | Psychological Factors | Risk Reduction Behavior
Document Number: 341365

Peer Reviewed

Title: Condom use and high-risk sexual acts in adult films: a comparison of heterosexual and homosexual films.
Author: Grudzen CR; Elliott MN; Kerndt PR; Schuster MA; Brook RH; Gelberg L
Source: American Journal of Public Health. 2009 Apr;99 Suppl 1:S152-6.
Abstract: OBJECTIVES: We compared the prevalence of condom use during a variety of sexual acts portrayed in adult films produced for heterosexual and homosexual audiences to assess compliance with state Occupational Health and Safety Administration regulations. METHODS: We analyzed 50 heterosexual and 50 male homosexual films released between August 1, 2005, and July 31, 2006, randomly selected from the distributor of 85% of the heterosexual adult films released each year in the United States. RESULTS: Penile-vaginal intercourse was protected with condoms in 3% of heterosexual scenes. Penile-anal intercourse, common in both heterosexual (42%) and homosexual (80%) scenes, was much less likely to be protected with condoms in heterosexual than in homosexual scenes (10% vs 78%; P < .001). No penile-oral acts were protected with condoms in any of the selected films. CONCLUSIONS: Heterosexual films were much less likely than were homosexual films to portray condom use, raising concerns about transmission of HIV and other sexually transmitted diseases, especially among performers in heterosexual adult films. In addition, the adult film industry, especially the heterosexual industry, is not adhering to state occupational safety regulations.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | QUALITATIVE RESEARCH | MEN HAVING SEX WITH MEN | HETEROSEXUALS | CONDOM USE | FILM AND VIDEO | CONTRACEPTIVE PREVALENCE | OCCUPATIONAL HEALTH | ANAL SEX | ORAL SEX | Developed Countries | North America | Americas | Research Methodology | Sex Behavior | Behavior | Risk Reduction Behavior | Mass Media | Communication | Contraceptive Usage | Contraception | Family Planning | Health
Document Number: 330956

Peer Reviewed

Title: The relationship of sexual dyad and personal network characteristics and individual attributes to unprotected sex among young injecting drug users.
Author: Gyarmathy VA; Neaigus A
Source: AIDS and Behavior. 2009 Apr;13(2):196-206.
Abstract: We examine in the heterosexual partnerships (dyads) of IDUs the correlates of engaging in unprotected sex on three levels: individual attributes, social network characteristics, and dyad characteristics. Unprotected sex was significantly less likely to occur in dyads where the participant injected daily or had high safe-sex attitude scores, and in dyads where both members encouraged each other to use condoms. Unprotected sex was significantly more likely to occur in dyads that smoked crack together, shared needles with each other, and where the participant knew that the sex partner had concurrent sex partners. In the sexual dyads of IDUs there is a combined risk of unsafe injecting and unsafe sex. Both injecting and sexual risk, and their combination need to be addressed in interventions that target the sexual partnerships of IDUs. Such interventions should also aim to reduce injected and noninjected crack and other stimulant use associated with high-risk sex.
Language: English
Keywords:
NEW YORK | RESEARCH REPORT | KAP SURVEYS | SEXUAL PARTNERS | IV DRUG USERS | SOCIAL NETWORKS | COUPLES | HETEROSEXUALS | SEX BEHAVIOR | RISK BEHAVIOR | SAFER SEX | ATTITUDES | CONDOM USE | NEEDLE SHARING | DRUG USE AND ABUSE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Friends and Relatives | Family and Household | Sociocultural Factors | Family Characteristics | Psychological Factors | Risk Reduction Behavior
Document Number: 340121

Peer Reviewed

Title: Understanding the HIV epidemic in the Dominican Republic: a prevention success story in the Caribbean?
Author: Halperin DT; de Moya EA; Perez-Then E; Pappas G; Garcia Calleja JM
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S52-9.
Abstract: OBJECTIVE: To analyze the general dynamics and trends of the HIV epidemic in the Dominican Republic (DR). METHODS: Thorough review of available HIV seroprevalence and sexual behavioral data from the DR. RESULTS: Multiple sources of data suggest that the DR's HIV epidemic has generally declined. Between the mid-1990s and about 2002, HIV-1 prevalence fell among pregnant women in the capital, Santo Domingo, particularly among young women. Declines in prevalence were also observed over the same period among sexually transmitted infection clinic patients, blood bank donors, US entry visa applicants, and female sex workers. National household surveys found 1.0% (confidence interval: 0.9% to 1.1%) adult prevalence in 2002 and 0.8% (0.6% to 0.9%) in 2007. Among largely Haitian immigrant residents of the impoverished former "sugarcane plantations," prevalence was much higher but declined from 5.0% to 3.2% between 2002 and 2007. The DR's heterogeneous epidemic includes an important men-having-sex-with-men (MSM) and bisexual component. The proportion of reported AIDS cases among men remained constant from 1989 to 2006, accounting for about two thirds of both total cumulative and year 2006 cases. Some survey and qualitative data also suggest a considerable occurrence of MSM-related risk behaviors. HIV prevalence remains relatively high in MSM, with no evidence of significant decrease. CONCLUSIONS: As in several other developing countries that have succeeded in slowing HIV transmission, HIV reductions in the DR seem mainly due to changes in sexual behavior, particularly increased condom use, especially for sex work, and partner reduction in men. Similarly favorable HIV declines and reported behavior change have occurred in some other Caribbean countries, including neighboring Haiti. However, of concern is that anal sex, both male-male and heterosexual, remains a taboo yet apparently common practice largely ignored by existing prevention campaigns. And although the DR epidemic has generally stabilized, there is a danger of complacency, and some recent data suggest that HIV prevalence is no longer declining (and may even be increasing) in some populations.
Language: English
Keywords:
DOMINICAN REPUBLIC | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HETEROSEXUALS | HIV PREVENTION | HIV TRANSMISSION | ANAL SEX | Developing Countries | Americas | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases
Document Number: 341320

10.

Peer Reviewed

Title: Sexual behaviour, condom use and rates of sexually transmitted infections in HIV clinic attendees in South East London.
Author: Hamlyn E; Welz T; Rebaudengo S; Simms H; Poulton M
Source: International Journal of STD and AIDS. 2009 Sep 16;
Abstract: The aim of this study was to examine sexual behaviour, condom use and rates of sexually transmitted infections (STIs) among attendees at a dedicated on-site STI clinic at a South London HIV centre. Data were prospectively collected by using a nurse-completed questionnaire. Ninety-eight percent of women reported one or no sexual partners in the preceding three months, whereas 57% of men who have sex with men (MSM) reported two or more partners. Only 28% of women, 53% of heterosexual men and 29% of MSM always used a condom for vaginal or anal intercourse. Positive STI diagnoses were found in 17.5% of women, 20% of heterosexual men and 49% of MSM. Twenty percent of patients who reported always using a condom and 38% of MSM reporting no sexual activity in the preceding three months had an STI. These results highlight the need for safe sex promotion and STI screening in HIV-infected patients regardless of self-reported sexual activity.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | CONDOM USE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | QUESTIONNAIRES | CLINIC ACTIVITIES | SCREENING | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342841

11.

Peer Reviewed

Title: The relationship-oriented information-motivation-behavioral skills model: a multilevel structural equation model among dyads.
Author: Harman JJ; Amico KR
Source: AIDS and Behavior. 2009 Apr;13(2):173-84.
Abstract: Transmission rates of HIV infection have increased steadily among heterosexual adults, however current theoretical models have not been tested statistically at the dyadic level in which risk behaviors occur. The purpose of the current study was to test an Information-Motivation-Behavioral skills (IMB) model of HIV risk behavior (IMB) specifically articulated for heterosexual couples in established relationships using data from both members of 75 dyads. The multilevel relationship-oriented information-motivation-behavioral skills (RELO-IMB) model was evaluated at the individual and dyadic level of analysis to examine partner differences on core variables. Results indicated that not only did the RELO-IMB model provide a good fit to the data when analyzed at the dyadic level, but that the structural relations among the core variables were quite different between the individual- and dyadic-level models. This is the first theoretical model of HIV risk behavior to be analyzed at the dyadic level, and the results suggest ways to effectively design intervention strategies for individuals in intimate relationships.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | HETEROSEXUALS | COUPLES | HIV PREVENTION | MOTIVATION | SEX BEHAVIOR | PSYCHOSOCIAL FACTORS | INTERPERSONAL RELATIONS | CONDOM USE | PARTNER COMMUNICATION | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Behavior | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Psychological Factors | Risk Reduction Behavior
Document Number: 342860

12.

Title: Heterosexual transmission of human immunodeficiency virus type 1 subtype C: Macrophage tropism, alternative coreceptor use, and the molecular anatomy of CCR5 utilization.
Author: Isaacman-Beck J; Hermann EA; Yi Y; Ratcliffe SJ; Mulenga J; Allen S; Hunter E; Derdeyn CA; Collman RG
Source: Journal of Virology. 2009 Aug;83(16):8208-20.
Abstract: Human immunodeficiency virus type 1 transmission selects for virus variants with genetic characteristics distinct from those of donor quasispecies, but the biological factors favoring their transmission or establishment in new hosts are poorly understood. We compared primary target cell tropisms and entry coreceptor utilizations of donor and recipient subtype C Envs obtained near the time of acute infection from Zambian heterosexual transmission pairs. Both donor and recipient Envs demonstrated only modest macrophage tropism, and there was no overall difference between groups in macrophage or CD4 T-cell infection efficiency. Several individual pairs showed donor/recipient differences in primary cell infection, but these were not consistent between pairs. Envs had surprisingly broad uses of GPR15, CXCR6, and APJ, but little or no use of CCR2b, CCR3, CCR8, GPR1, and CXCR4. Donors overall used GPR15 better than did recipients. However, while several individual pairs showed donor/recipient differences for GPR15 and/or other coreceptors, the direction of the differences was inconsistent, and several pairs had unique alternative coreceptor patterns that were conserved across the transmission barrier. CCR5/CCR2b chimeras revealed that recipients as a group were more sensitive than were donors to replacement of the CCR5 extracellular loops with corresponding regions of CCR2b, but significant differences in this direction were not consistent within pairs. These data show that sexual transmission does not select for enhanced macrophage tropism, nor for preferential use of any alternative coreceptor. Recipient Envs are somewhat more constrained than are donors in flexibility of CCR5 use, but this pattern is not universal for all pairs, indicating that it is not an absolute requirement.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | HIV TRANSMISSION | HETEROSEXUALS | GENETICS | HIV | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Sex Behavior | Behavior | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342733

13.

Peer Reviewed

Title: [Trends in the AIDS epidemic in groups at highest risk in Brazil, 1980-2004] Tendencias da epidemia de AIDS entre subgroupos sob maior risco no Brasil, 1980-2004.
Author: Junior AB; Szwarcwald CL; Pascom AR; Souza Junior PB
Source: Cadernos�de Saude Publica. 2009 Apr;25(4):727-737.
Abstract: The objective of this paper was to present the trends in the AIDS epidemic in the population groups at highest risk in Brazil. Discriminant analysis was used to reclassify cases with unknown risk into one of the three groups: IDU (injecting drug users), MSM (men who have sex with men), and heterosexuals. AIDS incidence rates by gender and exposure category were estimated for the period 1980-2004. In 1980-1988, 63.6% of AIDS cases were homosexual or bisexual males and 10% were females. Since 1988, there has been a decrease in the proportion of MSM and an increase in the other categories. Despite the incidence trends observed by exposure category, when the incidence rates were compared, the risk was much higher among MSM as compared to heterosexuals. Analysis of the AIDS epidemic dynamics in Brazil emphasizes the importance of MSM and male IDU as higher-risk groups.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | INCIDENCE | COMPARATIVE STUDIES | IV DRUG USERS | MEN HAVING SEX WITH MEN | HETEROSEXUALS | AIDS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Studies | Drug Use and Abuse | Behavior | Sex Behavior | HIV Infections | Viral Diseases | Diseases
Document Number: 341869

14.

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

15.

Peer Reviewed

Title: Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study.
Author: Lingappa JR; Kahle E; Mugo N; Mujugira A; Magaret A
Source: PloS One. 2009;4(4):e5272.
Abstract: BACKGROUND: The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort. METHODS: HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count >or=250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed. RESULTS: Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2-9) with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (<5%), except for Trichomonas vaginalis in 14% of HIV-1 infected women. Median baseline CD4 count for HIV-1 infected participants was 462cells/mcL and median HIV-1 plasma RNA was 4.2 log(10) copies/mL. After adjusting for age and African region, correlates of HIV-1 RNA level included male gender (+0.24 log(10) copies/mL; p<0.001) and CD4 count (-0.25 and -0.55 log(10) copies/mL for CD4 350-499 and >500 relative to <350, respectively, p<0.001). CONCLUSIONS: The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT00194519.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | CLINICAL TRIALS | SEXUAL PARTNERS | HETEROSEXUALS | HERPES GENITALIS | ANTIVIRAL DRUGS | HIV PREVENTION | HIV TRANSMISSION | RISK FACTORS | Developing Countries | Clinical Research | Research Methodology | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases
Document Number: 342450

16.

Peer Reviewed

Title: Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998 2003.
Author: Lopman BA; Nyamukapa C; Hallett TB; Mushati P; Spark-du Preez N; Kurwa F; Wambe M; Gregson S
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i41-i48.
Abstract: Background: AIDS is the main driver of young widowhood in southern Africa. Methods: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal populationbased cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission. Results: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period. Conclusions: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.
Language: English
Keywords:
ZIMBABWE | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | MATHEMATICAL MODEL | EPIDEMIOLOGIC METHODS | FOLLOW-UP STUDIES | WIDOWED | WOMEN IN DEVELOPMENT | HETEROSEXUALS | SEX WORKERS | MULTIPLE PARTNERS | HIV INFECTIONS | PREVALENCE | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Theoretical Models | Marital Status | Nuptiality | Demographic Factors | Population | Economic Development | Economic Factors | Behavior | Sexual Partners | Viral Diseases | Diseases | Measurement
Document Number: 340106

17.
Peer Reviewed

Title: Transmission probabilities of HIV and herpes simplex virus type 2, effect of male circumcision and interaction: a longitudinal study in a township of South Africa.
Author: Mahiane SG; Legeai C; Taljaard D; Latouche A; Puren A; Peillon A; Bretagnolle J; Lissouba P; Nguema EP; Gassiat E; Auvert B
Source: AIDS. 2009 Jan 28;23(3):377-383.
Abstract: OBJECTIVES: A synergy between HIV and herpes simplex virus type 2 (HSV-2) infections has been reported in observational studies. The objectives of this study were to estimate the per-sex-act female-to-male transmission probabilities (FtoMTPs) of HIV and HSV-2, the effect of each infection on the FtoMTP of the other and the effect of male circumcision on these FtoMTPs. DESIGN: We used longitudinal data collected during the male circumcision trial conducted in Orange Farm (South Africa). METHODS: Results were obtained by specific mathematical modeling of HIV and HSV-2 statuses of the men as functions of their sexual behavior and male circumcision status. The model took into account an estimation of the HIV and HSV-2 statuses of each of their female partners. Confidence intervals (CI) were estimated using a bootstrap resampling method. RESULTS: The HIV and HSV-2 FtoMTPs, during an unprotected sexual contact for an uncircumcised male in the absence of the other virus in both partners, were 0.0047 (95% CI: 0.0014-0.017) and 0.0067 (95% CI: 0.0028-0.014), respectively. HSV-2 in either partner increased HIV FtoMTP with a relative risk (RR) of 3.0 (95% CI: 1.01-7.3). Conversely, HIV in either partner increased HSV-2 FtoMTP (RR= 2.5; 95% CI: 1.1- 6.3). Male circumcision significantly decreased these probabilities with RRs of 0.24 (95% CI: 0.11-0.44) and 0.59 (95% CI: 0.36-0.91), respectively. CONCLUSION: This study gave the first estimates of HSV-2 per-sex-act FtoMTPs in Africa. It demonstrated a synergy between HIV and HSV-2 infections and a protective effect of male circumcision on HSV-2 acquisition by males.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | LONGITUDINAL STUDIES | MEN | HETEROSEXUALS | MALE CIRCUMCISION | HERPES GENITALIS | MATHEMATICAL MODEL | HIV INFECTIONS | HIV TRANSMISSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Theoretical Models | Viral Diseases
Document Number: 330895

18.

Title: Genetic variability of human immunodeficiency virus-1 in Bahia state, Northeast, Brazil: high diversity of HIV genotypes.
Author: Monteiro JP; Alcantara LC; de Oliveira T; Oliveira AM; Melo MA; Brites C; Galvao-Castro B
Source: Journal of Medical Virology. 2009 Mar;81(3):391-9.
Abstract: The HIV-1 genetic variability in Bahia state, Brazil, was investigated. DNA samples from 229 and 213 HIV-1-infected individuals were analyzed using the heteroduplex mobility assay (HMA) in gag and env fragments, respectively. One hundred seventy-five samples were characterized in both genes. Thirty-two subtype F and BF recombinant viruses were sequenced and analyzed by phylogenetic methods. The combination of HMA and sequencing results showed that seven different HIV-1 genotypes comprised this sample: 147 (84%) B/B, 4 (2.3%) F/F, 3 (1.7%) B/F, 1 (0.6%) F/B, 1 (0.6%) F/D, 1 (0.6%) BF/F, and 18 (10.3%) BF/B. A significant divergence was observed between these two techniques results (84.4%). This is explained by the low accuracy of the HMA for detecting recombinant viruses. These recombinants were unrelated to CRF12, while two sequences were related to CRF28 and CRF29. Nineteen BF mosaics shared the same gag breakpoint. In conclusion, the use of HMA may be inappropriate in regions where different subtypes are co-circulating. Subtype B is the most common genotype, however, an increased prevalence (13.1%) of different BF variants and a potentially new CRF suggest that recombination is occurring frequently in Bahia. These viruses were associated with women infected heterosexually. Finally, this study identified the presence of an F/D recombinant HIV-1 in Brazil.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | GENETIC TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | HETEROSEXUALS | PREVALENCE | HIV INFECTIONS | CHROMOSOME ABNORMALITIES | GENETICS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Economic Development | Economic Factors | Sex Behavior | Behavior | Measurement | Neonatal Diseases and Abnormalities | Biology
Document Number: 330231

19.

Title: Pioneering HIV prevention strategies in rural Kenya: a case study of Marie Stopes International's male circumcision outreach project.
Author: Nelson E; Quinn H
Source: London, United Kingdom, Marie Stopes International, 2009 Jul. 4 p. (MSI Innovations)
Abstract: The HIV epidemic continues to grow, in spite of global efforts to prevent the disease. Millions of people die each year of preventable HIV infections. It is projected that 60 million new HIV infections will occur by 2015, if current rates are not reversed. In 2006, new research confirmed for the first time that male circumcision could reduce the risk of HIV infection for heterosexual men by up to 60%. Marie Stopes International (MSI) responded quickly to these significant findings by pioneering a new outreach model for male circumcision (MC) provision in Western Kenya and the Nyanza Province, a region with the lowest MC rates and the highest HIV infection rates in the country. MSI was the one of the first organisations to deliver this critical HIV prevention service directly to Kenyans living in remote and rural areas. Responding to evidence that MC could potentially avert up to three million deaths in 20 years if all sexually active men in sub-Saharan Africa were circumcised, MSI now plans to bring this innovative outreach model to Malawi, Zambia and Swaziland.
Language: English
Keywords:
KENYA | ZAMBIA | SWAZILAND | MALAWI | SUMMARY REPORT | HETEROSEXUALS | MEN | MALE CIRCUMCISION | HIV PREVENTION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Southern | Sex Behavior | Behavior | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases
Document Number: 331471

20.
Title: Impact of relationship dynamics and gender roles in the protection of HIV discordant heterosexual couples: an exploratory study in the Puerto Rican context.
Author: Orengo-Aguayo R; Perez-Jimenez D
Source: Puerto Rico Health Sciences Journal. 2009 Mar;28(1):30-9.
Abstract: BACKGROUND: Most of the HIV/AIDS prevention efforts have not taken into consideration the context of the relationship and the gender constructs that influence relationship dynamics. These efforts have failed to view HIV prevention as a collaborative process between partners. Therefore, it is important to explore how relationship dynamics and gender constructs influence how men and women involved in an HIV discordant heterosexual relationship, visualize their role in the protection of their partners in order to design more effective prevention interventions. METHODS: Five Puerto Rican HIV discordant heterosexual couples were interviewed via a qualitative semi-structured interview. The taped interviews were transcribed and analyzed using content analysis according to a set of defined categories. RESULTS: Women visualized their role as one of convincing their partners to use protection as well as being strong and firm in the demand of its use. Men viewed their role as one of being more supportive and willing to use protection, but recognized their resistance towards the use of condoms. Relationship dynamics such as communication and support promoted protection. CONCLUSIONS: Traditional and non-traditional gender roles were assumed by both men and women. Traditional gender roles inhibited protection but were also used in positive ways to promote it. Men showed a greater initiative to break with traditional gender norms. A positive relationship, marked by communication and support could serve as a facilitator in the protection and in the transformation of traditional gender norms. This points out to the need of viewing HIV/AIDS prevention as a collaborative rather than individualistic process.
Language: English
Keywords:
PUERTO RICO | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | COUPLES | SPOUSE | HETEROSEXUALS | GENDER RELATIONS | HIV INFECTIONS | SPOUSAL SUPPORT | SEX FACTORS | CONDOM USE | PARTNER COMMUNICATION | Caribbean | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Family Characteristics | Family and Household | Sociocultural Factors | Family Relationships | Sex Behavior | Behavior | Gender Issues | Microeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Interpersonal Relations
Document Number: 341066

21.

Title: Barriers and facilitators of HIV prevention with heterosexual Latino couples: beliefs of four stakeholder groups.
Author: Perez-Jimenez D; Seal DW; Serrano-Garcia I
Source: Cultural Diversity and Ethnic Minority Psychology. 2009 Jan;15(1):11-7.
Abstract: Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men's involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed.
Language: English
Keywords:
DOMINICAN REPUBLIC | PUERTO RICO | MEXICO | RESEARCH REPORT | COUPLES | HETEROSEXUALS | MEN | HIV PREVENTION | BELIEFS | Developing Countries | Caribbean | Americas | Developed Countries | North America | Family Characteristics | Family and Household | Sociocultural Factors | Sex Behavior | Behavior | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Culture
Document Number: 330815

22.

Title: HIV transmission networks.
Author: Rothenberg R
Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):260-5.
Abstract: PURPOSE OF REVIEW: Over the past several years, one segment of the complex field of HIV transmission dynamics - heterosexual networks - has dominated theoretical and empirical investigation. This review provides an overview of recent work on HIV risks and networks, with a focus on recent findings in heterosexual network dynamics. RECENT FINDINGS: Qualitative (ethnographic) assessments have demonstrated the heterogeneity and complexity of heterosexual connections, particularly in Africa, where tradition, official polygamy, and unofficial multiperson arrangements have lead to concurrency of sexual partnerships. A large, quantitative study on Likoma Island, Malawi, demonstrated the considerable, interlocking sexual connections that arise from a high-concurrency sexual setting, even with a low average number of partnerships (low degree) of long duration. Such settings, as suggested by ethnographic studies, may be common in Africa and, coupled with newer information about transmissibility during acute and early infection, may provide a plausible explanation for endemic transmission and possibly for rapid HIV propagation. SUMMARY: Recognition of high-concurrency, low-degree networks is an important development for understanding HIV transmission dynamics. Their relevance to heterosexual transmission, and possible extension to other epidemiologic settings, reinforces the heterogeneity and complexity of HIV transmission dynamics.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | THEORETICAL MODELS | HETEROSEXUALS | HIV TRANSMISSION | EPIDEMIOLOGY | PREVALENCE | RISK FACTORS | SEX BEHAVIOR | MULTIPLE PARTNERS | Research Methodology | Behavior | HIV Infections | Viral Diseases | Diseases | Public Health | Health | Measurement | Sexual Partners
Document Number: 342341

23.

Peer Reviewed

Title: Current HIV type 1 molecular epidemiology profile and identification of unique recombinant forms in Jakarta, Indonesia.
Author: Sahbandar IN; Takahashi K; Djoerban Z; Firmansyah I; Naganawa S; Motomura K; Sato H; Kitamura K; Pohan HT; Sato S
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):637-46.
Abstract: HIV infection is a major problem in Indonesia. The number of people living with HIV has been increasing from year to year, especially among injecting drug users (IDUs). Since there were only limited data about molecular epidemiology profiles of HIV/AIDS in Indonesia, a cross-sectional study involving 208 HIV-1-seropositive individuals was conducted in 2007 in Jakarta. The majority of participants were 16-30 years of age (64.9%) and 74.5% were male. The most frequent risk factor was injecting drug use (IDU) (45.7%) followed by heterosexual transmission (34.1%). Phylogenetic analysis of gag (p17 and p6) and env C2V3 regions showed 200 (96.2%) of 208 DNA samples were CRF01_AE and only 3 (1.4%) were subtype B. Five samples (2.4%) indicated discordant subtypes between the three aforementioned regions: three of them showed unique CRF01_AE/B recombination patterns in 2.3-kbp nucleotide sequences (from p17 to part of RT), including one sample showing similarity to CRF33_01B, reported previously in Malaysia. This study shows the current predominant subtype is CRF01_AE in every risk group, with a decreasing number of pure subtype B, and the first identification of CRF01_AE/B recombinant forms among HIV-1-seropositive Indonesians.
Language: English
Keywords:
INDONESIA | RESEARCH REPORT | EPIDEMIOLOGY | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | HETEROSEXUALS | HIV INFECTIONS | HIV | LABORATORY PROCEDURES | Developing Countries | Asia, Southeastern | Asia | Public Health | Health | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Sex Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 342881

24.

Title: Male circumcision for prevention of heterosexual acquisition of HIV in men.
Author: Siegfried N; Muller M; Deeks JJ; Volmink J
Source: Cochrane Database of Systematic Reviews. 2009;(2):CD003362.
Abstract: BACKGROUND: Male circumcision is defined as the surgical removal of all or part of the foreskin of the penis and may be practiced as part of a religious ritual, as a medical procedure, or as part of a traditional ritual performed as an initiation into manhood. Since the 1980s, over 30 observational studies have suggested a protective effect of male circumcision on HIV acquisition in heterosexual men. In 2002, three randomised controlled trials to assess the efficacy of male circumcision for preventing HIV acquisition in men commenced in Africa. This review evaluates the results of these trials, which analysed the effectiveness and safety of male circumcision for preventing acquisition of HIV in heterosexual men. OBJECTIVES: To assess the evidence of an interventional effect of male circumcision for preventing acquisition of HIV-1 and HIV-2 by men through heterosexual intercourse SEARCH STRATEGY: We formulated a comprehensive and exhaustive search strategy in an attempt to identify all relevant studies regardless of language or publication status (published, unpublished, in press, and in progress). In June 2007 we searched the following electronic journal and trial databases: MEDLINE, EMBASE, and CENTRAL. We also searched the electronic conference databases NLM Gateway and AIDSearch and the trials registers ClinicalTrials.gov and Current Controlled Trials. We contacted researchers and relevant organizations and checked reference lists of all included studies. SELECTION CRITERIA: Randomised controlled trials of male circumcision versus no circumcision in HIV-negative heterosexual men with HIV incidence as the primary outcome. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed study eligibility, extracted data, and graded methodological quality. Data extraction and methodological quality were checked by a third author who resolved differences when these arose. Data were considered clinically homogeneous and meta-analyses and sensitivity analyses were performed. MAIN RESULTS: Three large RCTs of men from the general population were conducted in South Africa (N = 3 274), Uganda (N = 4 996) and Kenya (N = 2 784) between 2002 and 2006. All three trials were stopped early due to significant findings at interim analyses. We combined the survival estimates for all three trials at 12 months and also at 21 or 24 months in a meta-analysis using available case analyses using the random effects model. The resultant incidence risk ratio (IRR) was 0.50 at 12 months with a 95% confidence interval (CI) of 0.34 to 0.72; and 0.46 at 21 or 24 months (95% CI: 0.34 to 0.62). These IRRs can be interpreted as a relative risk reduction of acquiring HIV of 50% at 12 months and 54% at 21 or 24 months following circumcision. There was little statistical heterogeneity between the trial results (chi(2) = 0.60; df = 2; p = 0.74 and chi(2) = 0.31; df = 2; p = 0.86) with the degree of heterogeneity quantified by the I(2) at 0% in both analyses. We investigated the sensitivity of the calculated IRRs and conducted meta-analyses of the reported IRRs, the reported per protocol IRRs, and reported full intention-to-treat analysis. The results obtained did not differ markedly from the available case meta-analysis, with circumcision displaying significant protective effects across all analyses.We conducted a meta-analysis of the secondary outcomes measuring sexual behaviour for the Kenyan and Ugandan trials and found no significant differences between circumcised and uncircumcised men. For the South African trial the mean number of sexual contacts at the 12-month visit was 5.9 in the circumcision group versus 5 in the control group, which was a statistically significant difference (p < 0.001). This difference remained statistically significant at the 21-month visit (7.5 versus 6.4; p = 0.0015). No other significant differences were observed.Incidence of adverse events following the surgical circumcision procedure was low in all three trials.Reporting of methodological quality was variable across the three trials, but overall, the potential for significant biases affecting the trial results was judged to be low to moderate given the large sample sizes of the trials, the balance of possible confounding variables across randomised groups at baseline in all three trials, and the employment of acceptable statistical early stopping rules. AUTHORS' CONCLUSIONS: There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months. Incidence of adverse events is very low, indicating that male circumcision, when conducted under these conditions, is a safe procedure. Inclusion of male circumcision into current HIV prevention measures guidelines is warranted, with further research required to assess the feasibility, desirability, and cost-effectiveness of implementing the procedure within local contexts.
Language: English
Keywords:
SOUTH AFRICA | UGANDA | KENYA | RESEARCH REPORT | CONTROL GROUPS | DATA ANALYSIS | HETEROSEXUALS | MEN | MALE CIRCUMCISION | HIV PREVENTION | INCIDENCE | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Research Methodology | Behavior | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Measurement
Document Number: 341773

25.

Peer Reviewed

Title: HIV/AIDS in Latin America and the Caribbean [editorial]
Source: Lancet. 2008 Jul 26;372(9635):263.
Abstract: The amalgam of cultures and populations, socioeconomic disparities, languages, and sexual proprieties means the HIV epidemic is not homogeneous and it is hard to make generalisations from one country to the next. In this region the subject of HIV/AIDS is often swept under the carpet. Some of the common factors that characterise this region and prohibit an effective response include: generalised poverty, homophobia, gender inequality, lack of access to health-care and educational services, immigration and emigration, the absence of leadership in some countries, the lack of research into patterns of transmission, pressure from the Catholic Church that hinders prevention efforts, and laws that are inadequate in the context of the epidemic. One of the major themes at the 2008 Mexico City conference will be tackling stigma and discrimination, which is particularly pervasive in the region but also happens elsewhere. For too long the needs of vulnerable populations have been neglected. In Mexico the adoption of a rights-based perspective to address the challenge of HIV/AIDS globally needs to reaffirm that universal access to prevention, treatment, and care is a human right and that no form of stigma and discrimination will be tolerated. There is still an enormous amount to do to bring about the large reductions in HIV prevalence in the high-risk groups. The global-health architecture needs to put Latin America in their plans. Not to do so is unfair and shortsighted, because there are likely to be good returns on investment. At the meeting, people from Latin America and the Caribbean will have the chance to show the world the reality of the different epidemics the region is confronting, the responses in place, and the obstacles to overcome. Garnering the world's attention for 5 days must have a lasting impact and re-energise the HIV community in the region. (excerpt)
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | CONFERENCES AND CONGRESSES | PREVALENCE | SEX WORKERS | IV DRUG USERS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | HIV INFECTIONS | AIDS | STIGMA | ANTIRETROVIRAL DRUGS | PROGRAM ACCESSIBILITY | Americas | Developing Countries | Measurement | Research Methodology | Sex Behavior | Behavior | Drug Use and Abuse | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 328462

26.

Peer Reviewed

Title: Measure of HIV/STD risk-reduction: strategies for enhancing the utility of behavioral and biological outcome measures for African American couples.
Author: NIMH Multisite HIV/STD Prevention Trial for African American Couples Group
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49 Suppl 1:S35-41.
Abstract: OBJECTIVE: Numerous studies have discussed the value of including biological outcome measures as a complement to behavioral outcome measures to assess the efficacy of HIV risk-reduction interventions. This article highlights strategies used to minimize the limitations of including both self-reported sexual behaviors and biologically confirmed sexually transmitted diseases as primary outcome measures in an HIV/sexually transmitted disease (STD) prevention program for African American serodiscordant couples (Eban). DESIGN: Couples receiving an HIV intervention condition (Eban) were compared with couples receiving a time-equivalent General Health Promotion condition on behavioral and biological outcomes. Both behavioral and biological data were collected at baseline, immediately postintervention, and at 6 and 12 months postintervention. METHODS: Literature reviews, consulting other researchers who conducted couples studies, our investigative team's experience in previous HIV interventions, and formative work were used to develop procedures to minimize potential limitations associated with the inclusion of behavioral and biological outcome measures for Eban. RESULTS: Given the strengths of including behavioral and biological outcome measures, the Eban study chose to have both measures serve as primary outcomes. The primary behavioral outcome for the trial is the proportion of protected vaginal and anal intercourse episodes that occurred within the index couple in 90 days before each follow-up assessment and over the 12-month postintervention follow-up period. The primary biological outcome is the proportion of participants (male or female study partners) with an incident STD (Chlamydia, gonorrhea, or trichomoniasis) over the 12-month postintervention follow-up period. CONCLUSIONS: Employing procedures to minimize limitations of using self-reported sexual behaviors and STDs as complementary primary outcomes enhances their utility as measures of the efficacy of HIV/STD prevention interventions.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | MEASUREMENT | COUPLES | BLACKS | HETEROSEXUALS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK REDUCTION BEHAVIOR | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Reproductive Tract Infections | Infections | Diseases | Programs | Organization and Administration | Program Evaluation
Document Number: 328591

27.
Title: [Relationship between awareness of sexually transmitted diseases and condom use by university students: development of an awareness scale for prediction of condom use]
Author: Amazaki M; Shimizu Y
Source: Japanese Journal of Public Health. 2008 May;55(5):306-17.
Abstract: OBJECTIVES: The purpose of this study was 1) to develop a psychological scale for preventing STDs and 2) to examine whether such an awareness scale might be used for predicting condom use by Japanese heterosexual university students. METHODS: The sample data were collected in January 2006 for our first survey and January 2007 for our second survey. In the first survey, 362 Japanese university students (males = 180, females = 182, mean age = 20.14, SD = 1.41) were asked to answer a questionnaire composed of a face sheet and 20 items during lecture periods. In order to explore the factor structure of these 20 items and confirm the reliability for each factor, Exploratory Factor Analysis (EFA), Step Wise Exploratory Factor Analysis (SEFA) and Reliability Analysis were conducted on the questionnaires. In the second survey, 248 Japanese university students (males = 121, females = 127, mean age = 20.07, SD = 1.50) were asked to answer a questionnaire composed of a face sheet and an STDs Awareness Scale for University Students with 16 items that were newly developed based on the EFA results of the first survey. In order to confirm the structural validity of this scale, Confirmation Factor Analysis (CFA) was conducted on these 16 items. Logistic Regression Analysis was conducted to examine whether the awareness scale might be used in predicting condom use. RESULTS: 1) EFA using the maximum likelihood method with a Promax rotation identified a four-factor solution with 20 items. 2) The results of the SEFA found a four-factor solution with 16 items as the most statistically acceptable model of the scale. 3) Each of the factors demonstrated acceptable internal consistency with Cronbach's alpha reliability values from 0.759 to 0.879. 4) The CFA showed that the structural validity of this scale satisfied the high level of statistical requirements. 5) The results of Logistic Regression Analysis demonstrated that there was a statistically significant partial regression coefficient between the scale and condom use or non-condom use at the last sexual intercourse. CONCLUSION: The results of the analyses supported the reliability and the structural validity of an STDs Awareness Scale for University Students as a means of assessing Japanese university students' awareness of STDs prevention and also indicated that the scale can be used in predicting students' condom use. Future research with other age groups will be needed to clarify the relationship between models for young people and models for other age groups.
Language: Japanese
Keywords:
JAPAN | RESEARCH REPORT | QUESTIONNAIRES | STUDENTS | HETEROSEXUALS | UNIVERSITIES | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | AWARENESS | RELIABILITY | VALIDITY | DATA QUALITY | PROGRAM EVALUATION | Asia, Eastern | Asia | Developed Countries | Education | Sex Behavior | Behavior | Schools | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Knowledge | Sociocultural Factors | Measurement | Research Methodology | Data Analysis | Programs | Organization and Administration
Document Number: 328919

28.

Title: Herpes simplex virus 2 infection: A risk factor for HIV infection in heterosexuals.
Author: Anuradha K; Singh HM; Gopal KV; Rao GR; Ramani TV
Source: Indian Journal of Dermatology, Venereology and Leprology. 2008 May-Jun;74(3):231-234.
Abstract: Genital ulcerative disease is one of the risk factors for acquisition of HIV. As HSV-2 infection is currently the most common cause of genital ulcerative disease, it acts as a potential risk factor for HIV infection. The present study was undertaken to know the seroprevalence of antibodies to HSV-2 in HIV seropositive individuals and in the general population, and to ascertain if HSV-2 is a risk factor for developing HIV infection. The study group included one hundred new HIV seropositive persons irrespective of active genital herpes or history of genital herpes. Fifty age- and sex- matched healthy volunteers were included as controls. In all patients and controls, diagnostic serology was done for HSV-2 using HSV-2-specific glycoprotein IgG2 by indirect immunoassay using the ELISA test. Statistical value 'P' was calculated using the Chi-squared test. Out of the 100 HIV seropositives, 66 were males and 34 were females with an age range of 20-54 years. In only 22 (19 males and 3 females) of these, positive history of genital herpes was obtained. In 49 out of the 100 HIV seropositives, IgG2 antibodies against HSV-2 were detected. In the control group, 11 out of 50 controls were seropositive for HSV-2 IgG2 antibody. There was a statistically significant association between HSV-2 and HIV seropositivity with 'P' value. The high prevalence of HSV-2 seropositivity in the HIV-infected group (49%) as compared to normal controls (22%) was statistically significant. Prior HSV-2 infection could be an important risk factor for acquisition of HIV in our patients. (author's)
Language: English
Keywords:
INDIA | HIV INFECTIONS | HERPES GENITALIS | RISK FACTORS | SEX BEHAVIOR | AGE FACTORS | HETEROSEXUALS | Developing Countries | Asia, Southern | Asia | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Biology | Behavior | Population Characteristics | Demographic Factors | Population
Document Number: 327366

29.

Peer Reviewed

Title: Source of new infections in generalised HIV epidemics [letter]
Author: Becker S; Gray R
Source: Lancet. 2008 Oct 11;372(9646):1299-300; author reply 1300-1.
Abstract: In their Article on HIV transmission in married and cohabiting couples in urban Zambia and Rwanda,1 Kristin Dunkle and colleagues estimate that 55-93% of newly hetero sexually acquired HIV infections in these populations "occurred within serodiscordant marital or cohabiting relationships". These estimates are too high, since logically a maximum of 50% of new infections can be within couples, because in any stable couple, at least one partner had to acquire the initial infection outside the relationship. (In actual populations the proportion will be less than 50% because of heterosexual transmission between individuals who are not in stable couples.) We cannot assess whether Dunkle and colleagues' anomalous finding results from violations of the model assumptions or problems with the Demographic and Health Survey data used. (full-text)
Language: English
Keywords:
ZAMBIA | RWANDA | CRITIQUE | METHODOLOGICAL STUDIES | ESTIMATION TECHNIQUES | EPIDEMIOLOGIC METHODS | HETEROSEXUALS | COUPLES | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | HIV TRANSMISSION | AIDS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Central | Research Methodology | Sex Behavior | Behavior | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Measurement
Document Number: 329071

30.

Peer Reviewed

Title: Late presentation to care for HIV infection in Croatia and the effect of interventions during the Croatian Global Fund Project.
Author: Begovac J; Gedike K; Lukas D; Lepej SZ
Source: AIDS and Behavior. 2008 Jul;12(4 Suppl 1):S48-S53.
Abstract: There are limited data on how HIV prevention interventions affect individuals presenting to care in settings with a low-level HIV epidemic. We examined whether interventions undertaken during the Croatian Global Fund Project in 2004-2006 had an influence on patients entering care. The number of men who have sex with men (MSM) presenting in 2004-2006 (n = 86) was 59% higher than in 2001-2003 (n = 54); in heterosexual patients the increase was 14% (n = 51 in 2001-2003; n = 58 in 2004-2006). MSM presented at a younger age (median 32 years) in 2004-2006 than in 2001-2003 (median 36 years). Late presentation to care was found in 28% of MSM and in 59% of heterosexual patients in 2004-2006. MSM were less frequently late presenters in 2004-2006 compared with 2001-2003 (odds ratio, 0.48; 95% confidence interval, 0.24 to 0.99; P = 0.046). Additional strategies for earlier initiation of care must be developed for MSM and particularly for heterosexual patients. (author's)
Language: English
Keywords:
CROATIA | RESEARCH REPORT | HIV INFECTIONS | AIDS | HETEROSEXUALS | TUBERCULOSIS | MALARIA | MEN HAVING SEX WITH MEN | UTILIZATION OF HEALTH CARE | Developing Countries | Europe, Southeastern | Europe | Viral Diseases | Diseases | Sex Behavior | Behavior | Infections | Parasitic Diseases | Health Services | Delivery of Health Care | Health
Document Number: 328479


	Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy