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Title: Male circumcision: a cancer prevention strategy?
Source: Lancet Oncology. 2009 May;10(5):431.
Abstract: Given that less than 20% of males are circumcised in many developing countries, and that male circumcision is relatively simple and reduces viral infection, might this practice be more widely used as a preventive measure against cancer? In developing countries, male circumcision could have a vital role in specific segments of the population depending on the answers to specific scientific and infrasturcture related questions. Discussions around male circumcision strategies should be encouraged within the context of cancer prevention, and these should include local communities alongside assessments of current capacities, measurable targets, cost analyses and modelling, and the development of practicable guidelines, so as to place male circumcision within the possible options available for disease prevention.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | PREVALENCE | MEN | MALE CIRCUMCISION | CANCER | PREVENTION AND CONTROL | HIV PREVENTION | STANDARDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Neoplasms | Diseases | HIV Infections | Viral Diseases
Document Number: 341199

Peer Reviewed

Title: A new agenda for children affected by HIV/AIDS [editorial]
Source: Lancet. 2009 Feb 14;373(9663):517.
Abstract: As is so often the case in the provision of health care and deciding research agendas, children have been sidelined in the fight against HIV/AIDS. According to the latest UNAIDS figures, nearly 2 million children live with HIV worldwide, two-thirds in sub-Saharan Africa. In addition, 12 million children in sub-Saharan Africa have lost one or two parents due to HIV/AIDS. Many more live with a parent or carer with HIV. A very small proportion of infected children receive antiretroviral treatment, and prevention of mother-to-child transmission is only given to a third of women. Diagnosis in infancy is difficult and therefore often delayed. Child-friendly medication is lacking. 60% of children in southern Africa live in poverty. Now that HIV/AIDS is evolving from an acute emergency into a chronic epidemic, the way to deliver treatment and achieve prevention needs to change radically from an individualistic approach to a broader strategic one. Children and families need to take centre stage. In an excellent report, based on 2 years of research and analyses, the Joint Learning Initiative on Children and HIV/AIDS-an independent alliance of researchers, implementers, activists, policy makers, and people living with HIV-has presented recommendations for such a change in direction. Home Truths: Facing the Facts on Children, AIDS, and Poverty, released on Feb 10, points out three broad policies that will make an immediate and long lasting difference to children: support children through immediate or extended families and deliver integrated family-centred services; strengthen community action to support families; and address family poverty through national social protection. Such policies are AIDS-sensitive but not AIDS-directed. The family is the most important support structure for children. The report argues that the way orphans have been defined (as having lost one or both parents) and have become the centre of attention for many HIV/AIDS policies has been unhelpful, if not damaging. 88% of children labelled as orphans have a surviving parent and overall 95% continue to live with extended families. Additionally, children who live with HIV-positive parents have needs long before their parents die. Children need to stay within a family or kinship structure. Infected children usually live with others who are infected with the virus. The whole family, not the individual, needs to become the unit for support and treatment. The report advocates home health visiting and early childhood development interventions together with strategies to encourage children's education. The use of schools as intervention platforms misses the opportunity to reach children early and to reach those who are not in education-the majority in some countries. Economic strengthening of families has to be the basis to allow many of these programmes to fully succeed. The best immediate support for families is given by com munity groups. International donors need to work with these groups in partnership to avoid duplication, confusion, and waste of time and money. The authors suggest that coordination could be strengthened with a district committee that maintains an active register of community activities and devises a system of accountability that is understood by all and serves the com munity. All activities should be delivered within a framework that is based on best practice. Communities also have a crucial role to act as a backstop when families break down or when children live in an abusive environment. Family poverty and undernutrition can be addressed through income-transfer programmes, such as Mexico's Oportunidades programme or South Africa's child support grants. These projects are efficient and simple, empower women, and can act as a springboard for other more complex schemes, such as microfinance loans. Such economic support increases school attendance, reduces illnesses, improves growth, and encourages uptake of health services. The largest portion of money is usually used to purchase food. Extreme poverty, rather than HIV infection, should be used as a criterion to avoid stigma and resentment. The report argues that "any developing country, no matter how poor, can afford social protection packages for children". The positive effect of this policy is now established beyond doubt and no further pilot studies are needed. To integrate all these strategies, governments need to take the lead with national plans and frameworks to scale-up programmes for children and families. With this approach, society as a whole will be strengthened with intergenerational effects that will go a long way towards, but also go well beyond, tackling the effects of HIV/AIDS. Putting children and families at the centre will show long-term vision with guaranteed future benefits. (fulll-text)
Language: English
Keywords:
AFRICA, SUB SAHARAN | SUMMARY REPORT | CHILDREN | HIV INFECTIONS | AIDS | POVERTY | MALNUTRITION | CHILD HEALTH | HEALTH SERVICES | DELIVERY OF HEALTH CARE | TREATMENT | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Nutrition Disorders | Health | Medical Procedures | Medicine
Document Number: 341049

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Title: Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. Recommendations and Reports. 2009 Apr 10;58(RR-4):[216] p..
Abstract: Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for the prevention and treatment of opportunistic infections (OIs), especially those OIs for which no specific therapy exists; 2) information regarding the diagnosis and management of immune reconstitution inflammatory syndromes; 3) information regarding the use of interferon-gamma release assays for the diagnosis of latent tuberculosis (TB) infection; 4) updated information about drug interactions that affect the use of rifamycin drugs for prevention and treatment of TB; 5) the addition of a section on hepatitis B virus infection; and 6) the addition of malaria to the list of OIs that might be acquired during international travel.
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | STANDARDS | MANUAL | ADULTS | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | HIV PREVENTION | TREATMENT | ANTIRETROVIRAL THERAPY | DRUG INTERACTIONS | EXAMINATIONS AND DIAGNOSES | Developed Countries | North America | Americas | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Youth | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Drugs
Document Number: 339985

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Title: HIV Infection--Guangdong Province, China, 1997-2007.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Apr 24;58(15):396-400.
Abstract: In 2007, an estimated 700,000 persons in China were living with human immunodeficiency virus (HIV) infection. An estimated 50,000 new HIV infections and 20,000 deaths related to acquired immunodeficiency syndrome (AIDS) occurred in 2007, and an estimated 71% of persons with HIV infection were unaware of their HIV status. In 2007, 40.6% of those living with HIV had been infected through heterosexual transmission and 38.1% through injection-drug use. Guangdong Province in southeastern China is the country's most populous province, with an estimated 75.6 million permanent residents and 16.5 million migrants; the province has undergone rapid economic development. Since 1986, a case-based surveillance system (CBSS) in China has collected data on persons infected with HIV, including demographic characteristics and transmission categories. To assess recent trends in HIV infection in the province, the Guangdong Center for Disease Control, with technical assistance from CDC, analyzed CBSS data for the period 1997--2007. The results of that analysis indicated that the number of HIV cases increased from 102 in 1997 to 4,593 in 2007, although this increase resulted, in part, from expanded testing and surveillance. Among males classified by HIV transmission category, 82.1% of newly diagnosed infections were attributed to injection-drug use. Among females classified by HIV transmission category, 53.7% engaged in high-risk heterosexual conduct. Despite substantial methodologic limitations, these results can be useful to Guangdong public health agencies in targeting and evaluating HIV prevention, care, and treatment programs.
Language: English
Keywords:
CHINA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | PREVALENCE | HIV INFECTIONS | SEX FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | INTERNET | AGE FACTORS | HUMAN GEOGRAPHY | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Measurement | Population Characteristics | Demographic Factors | Information Networks | Communication | Geography | Social Sciences | Science | Sociocultural Factors
Document Number: 331260

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Title: Incidence and diagnoses of HIV infection - Puerto Rico, 2006.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 5;58(21):589-91.
Abstract: In 2006, 33 U.S. states and five territories had confidential, name-based, human immunodeficiency virus (HIV) infection reporting; among territories, Puerto Rico had the second highest rate of HIV infection. To characterize the HIV epidemic in Puerto Rico in 2006 (the year with the most recent available data), the Puerto Rico Department of Health and CDC analyzed data on diagnoses of HIV infection (including infections that occurred in 2006 and in previous years) and used a stratified extrapolation approach developed by CDC to generate HIV incidence estimates (the number of persons newly infected with HIV in 2006). The results indicated that, in 2006, an estimated 1,440 persons aged >or=13 years were newly infected with HIV in Puerto Rico, resulting in an estimated incidence rate of 45.0 cases per 100,000 population, twice the rate for the 50 U.S. states and District of Columbia (DC). Males accounted for 65% of new HIV infections in Puerto Rico, and 38% of new HIV infections occurred among persons aged 30-39 years; 39% of new infections were associated with injection-drug use, and 37% with high-risk heterosexual contact. The results provide insight into HIV transmission patterns in Puerto Rico that can help guide allocation of resources and the planning, implementation, and evaluation of HIV prevention programs and other services.
Language: English
Keywords:
PUERTO RICO | SUMMARY REPORT | INCIDENCE | MEN | HISPANICS | IV DRUG USERS | MEN HAVING SEX WITH MEN | HIV INFECTIONS | PROGRAM EVALUATION | Caribbean | Americas | Developed Countries | Measurement | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Drug Use and Abuse | Behavior | Sex Behavior | Viral Diseases | Diseases | Programs | Organization and Administration
Document Number: 341589

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Title: Progress toward the 2012 measles elimination goal--Western Pacific Region, 1990-2008.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 26;58(24):669-73.
Abstract: In 2003, the World Health Organization (WHO) Regional Committee of the Western Pacific Region (WPR) formally declared a measles elimination goal, and in 2005, the committee established a target date of 2012 for regional measles elimination. Key strategies recommended by WHO for achievement of measles elimination include 1) very high (>or=95%) vaccination coverage with 2 doses of measles-containing vaccine (MCV1 and MCV2) through routine vaccination and/or supplemental immunization activities (SIAs); 2) high-quality case-based measles surveillance; and 3) access to an accredited measles laboratory network for testing of suspected measles cases and identification of measles virus genotypes. This report describes progress toward measles elimination in the WPR through 2008. Measles likely has been eliminated or nearly eliminated in 24 of the 37 countries and areas in the WPR (referred to in this report as countries). However, large numbers of measles cases continue to be reported from several countries. During 2008, a total of 131,441 confirmed measles cases (98.4 per million population) were reported from China and 11,015 cases (86.1 per million population) from Japan, two countries that account for 82% of the region's population and >97% of its confirmed measles cases. Intensified efforts by WPR countries, particularly China and Japan, will be required to achieve the 2012 goal.
Language: English
Keywords:
OCEANIA | SUMMARY REPORT | INCIDENCE | MEASLES | VACCINES | IMMUNIZATION | PREVENTION AND CONTROL | MONITORING | SCREENING | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Evaluation | Examinations and Diagnoses
Document Number: 341752

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Title: Family Health International's Site Identification and Development Initiative (SIDI).
Author: Family Health International [FHI]
Source: [Research Triangle Park, North Carolina], FHI, [2009]. [3] p. (Research Briefs on HIV Prevention)
Abstract: Successful HIV prevention research requires the participation of tens of thousands of women and men at risk for HIV infection. Ultimately, success hinges on the development of multiple international research sites. To increase the number and readiness of such sites, Family Health International (FHI) began the Site Identification and Development Initiative (SIDI) in July 2006.
Language: English
Keywords:
AFRICA | ASIA | PROGRESS REPORT | CLINICAL RESEARCH | HIV PREVENTION | INCIDENCE | NEEDS | USAID | GOALS | STANDARDS | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Measurement | Economic Factors | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Planning | Organization and Administration
Document Number: 331712

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Title: Human resources for health: Tools and publications.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Mar. [2] p. (USAID Contract No. GPO-I-01-05-00040-00)
Abstract: The USAID | Health Policy Initiative, Task Order 1, fosters an enabling policy environment for improved health, especially HIV, family planning / reproductive health, and maternal health programs. Having adequate human resources is essential for scaling up and sustaining effective, accessible, high-quality health programs. To help ensure human resources, the project assists program planners to estimate human resource and training needs; identifies policy reforms to enable task-shifting and better workforce recruitment, training, and distribution; and mobilizes a multisectoral response by strengthening HIV-related human resources in workplaces, NGOs, and networks of people living with HIV (PLHIV). The project has also designed a Stigma Index that measures stigmatizing and discriminatory attitudes and behaviors among healthcare providers, highlighting an area that must be addressed by provider training initiatives. This flyer lists the project's computer models and publications on strengthening HIV-related human resource capacity.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | FAMILY PLANNING | REPRODUCTIVE HEALTH | MATERNAL HEALTH | WORKERS | RECRUITMENT ACTIVITIES | POLICY | COMPUTER PROGRAMS AND PROGRAMMING | STIGMA | SOCIAL DISCRIMINATION | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | Labor Force | Human Resources | Economic Factors | Program Activities | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Information Processing | Information | Social Problems
Document Number: 331545

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Title: Integrating multiple gender strategies to improve HIV and AIDS interventions: a compendium of programs in Africa.
Author: John Snow [JSI]. AIDS Support and Technical Resources [AIDSTAR-One]
Source: Washington, D.C., International Center for Research on Women [ICRW], 2009 May. [220] p. (USAID Contract No. GHH-I-00-07-00059-00)
Abstract: The United States Agency for International Development (USAID) AIDSTAR-One project created this compendium of selected HIV programs in sub-Saharan Africa that integrate multiple gender strategies. Featured programs address at least two of the following gender strategies: 1) reducing violence and sexual coercion; 2) addressing male norms and behaviors; 3) increasing women's legal protection; and 4) increasing women's access to income and productive resources. The compendium describes each of the 31 selected programs, and synthesizes trends and findings to provide initial insights on using multiple gender strategies in HIV programming, including how strategies are employed together, where gaps exist, and what lessons and experiences are common across programs. Though not meant to be exhaustive, the compendium represents the depth and breadth of current HIV programming that includes multiple gender strategies. Overall, we found that many innovative programs exist in sub-Saharan Africa and that implementers are successfully integrating multiple gender approaches into HIV programs. Program implementers report numerous benefits of combining gender strategies, including ensuring project salience and relevance, extending project reach, and reflecting the multiple, interrelated needs of beneficiaries. (Excerpts)
Language: English
Keywords:
AFRICA | SUMMARY REPORT | CASE STUDIES | RECOMMENDATIONS | HIV PREVENTION | INCOME GENERATION PROGRAMS | TREATMENT | CARE AND SUPPORT | FINANCIAL ACTIVITIES | VIOLENCE AGAINST WOMEN | GENDER ISSUES | PROGRAM ACTIVITIES | PROGRAM DESIGN | INTEGRATED PROGRAMS | POLICY | Developing Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Programs | Organization and Administration | Political Factors
Document Number: 331479

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Title: The long wait: reproductive health care in Haiti.
Author: John Snow [JSI]. Research and Training Institute, Inc.
Source: Arlington, Virginia, JSI, Research and Training Institute, Inc., 2009. 22 p.
Abstract: The reproductive health status of Haiti's communities contributes to a life expectancy of 62.8 years for women in comparison to 75.5 years in neighboring Dominican Republic or 80.8 years for women in the U.S. According to Haiti's 2005-2006 Demography Health Survey, 37.5% of women have unmet family planning needs. Additionally, youth and rural area residents report greater unmet needs for family planning than the national average. Unmet family planning contributes to a high total fertility rate of 4.79 (5 in rural versus 2.8 in urban areas), a high infant morality (57 deaths per 1000 live births) and the highest maternal mortality rate in the western world-630 deaths per 100,000 live births. These alarming RH indicators prompted a team from JSI Research & Training Institute, Inc. (JSI) to visit Haiti in January 2009. The objectives of the study were: 1) to identify gaps in the availability and accessibility of comprehensive RH services including: Safer motherhood and emergency obstetric care (EmOC), Family planning, HIV/AIDS and sexually transmitted infections (STI) prevention, care and support, Gender-based violence (GBV) prevention, care and support, and Adolescent-focused RH programming for each of the above RH components. 2) to identify community-level responses and opportunities for strengthening the quality and availability of comprehensive RH services. This report presents the findings of this assessment.
Language: English
Keywords:
HAITI | SUMMARY REPORT | MOTHERS | SAFE MOTHERHOOD | REPRODUCTIVE HEALTH | HIV PREVENTION | AIDS PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | VIOLENCE AGAINST WOMEN | PREVENTION AND CONTROL | FAMILY PLANNING | HEALTH SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Caribbean | Americas | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Maternal Health | Health | HIV Infections | Viral Diseases | Diseases | AIDS | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Domestic Violence | Crime | Social Problems | Program Evaluation | Programs | Organization and Administration
Document Number: 341307

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Title: Development of Assays to Estimate HIV Incidence. Meeting proceedings, Chapel Hill, North Carolina, May 13-14, 2009.
Author: Meeting on the Development of Assays to Estimate HIV Incidence (2009: Chapel Hill)
Source: [Research Triangle Park], North Carolina, Family Health International [FHI], 2009. [70] p.
Abstract: Family Health International (FHI) convened a meeting on the Development of Assays to Estimate HIV Incidence on May 13-14, 2009 at the Carolina Inn in Chapel Hill, North Carolina. The purpose of this meeting was to assess how new and existing technologies and research could be applied to advance the development of assays to estimate HIV incidence. Nearly fifty leading experts including immunologists, epidemiologists, HIV transmission experts, assay developers, virologists, industry representatives, and potential users of assays participated in the meeting. The meeting was primarily supported by the Bill & Melinda Gates Foundation and in conjunction with and the support of the World Health Organization (WHO), the HIV Prevention Trials Network (HPTN), and the Center for HIV / AIDS Vaccine Immunology (CHAVI). (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | RESEARCH METHODOLOGY | VALIDITY | ESTIMATION TECHNIQUES | INCIDENCE | EPIDEMIOLOGY | STUDY DESIGN | HIV INFECTIONS | AWARENESS | TREATMENT | PROGRAM ACTIVITIES | PROGRAM EVALUATION | Measurement | Public Health | Health | Viral Diseases | Diseases | Knowledge | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Programs | Organization and Administration
Document Number: 331753

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