study was to look at the current and expected impact of the vaccination programme on genital warts in men. Methods Eight Australian sexual health services provided data on all new patients. We compared trends in proportion of patients diagnosed with genital warts in the pre-vaccination (2004 to mid-2007) and vaccination (mid-2007 to 2011) periods. Furthermore, we used a mathematical model of HPV transmission to predict the impact of male vaccination on the incidence of genital warts. Results In the pre-vaccination period, there was no change in proportion of men diagnosed with genital warts. In the vaccination period, there were significant declines in proportions of < 21 (81.8%, compared to 92.6% decline in women) and 21-30 year old (51.1%, compared to 72.6% in women) heterosexual men diagnosed with genital warts; from 12.1% in 2007 to 2.2% in 2011 and from 18.2% in 2007 to 8.9% in 2011 respectively. There was no significant decline in diagnosis in men > 30 years of age, or in homosexual or bisexual men. Results of the model are in-line with this decline in men. With the introduction of male vaccination programme, the model predicts a much lower incidence, approaching elimination, in coming decades. Conclusion Although there has been a decline in the proportion of young heterosexual men diagnosed with genital warts suggesting herd immunity, the decline is slower than that of young females and no decline is observed in homosexual/bisexual men. The male vaccination programme will lead to near elimination of genital warts in both females and males in Australia. Background Of late, there has been discussion around the potential for vaccinating males in addition to the routine female human papillomavirus (HPV) vaccination programme against cervical cancer. While men who have sex with women (MSW) will likely receive some protection from female vaccination, men who have sex with men (MSM) remain vulnerable. Incidence rates of vaccine preventable cancers are disproportionately represented among MSM. Methods Based on the natural history of infection progression for HPV subtypes 6, 11, 16 and 18, mathematical transmission dynamics and cost-effectiveness analysis models were developed to assess the prevalence and incidence of these subtypes among the MSM population in the Greater Vancouver Area, British Columbia, Canada. Model parameters, demographic, and epidemiological data were informed from provincial data and the literature. Evaluating thE COst EffECtivEnEss Of targEtEd vaCCinatiOn stratEgiEs tO rEduCE inCidEnCEWe simulated three additional vaccination strategies, in combination with the current programme (Grade 6 schoolgirls (with 70% vaccine coverage)): first, vaccination of Grade 6 boys (with 70% vaccine coverage); second, vaccinating 18-year old self-identified MSM (with 25, 50 or 75% vaccine coverage); and finally, vaccinating any MSM within the vaccine-approved age range (with 25, 50 or 75% vaccine coverage). Results There is significant variability of cost estimates associated with clinical outcomes related ...
Poster presentations Methods Kenya has Prevention of MTCT Technical Working Group with members from Ministry of Health, PEPFAR agencies, UN family, implementing partners focusing on guideline and policy development. From single dose nevirapine in 2005 to Option A in 2010, Kenya is rolling out new guidelines with Option B+, elimination framework, mentor mother programmes, health systems strengthening activities, community strategies, private partnerships, and maternal/child health integration of anti-retroviral (ARV) therapy. Appointment diaries, mobile telephones, home visits are retention strategies. Longitudinal antenatal registers, mother-baby booklet, HIV-Exposed Infant (HEI) registers for easy identification and tracking of mothers and infants used. HEI are identified and tested at 6-8 weeks through PCR. Capacity building, infrastructure, supportive supervision, commodity security, safe infant feeding are monitored. EID dashboard (website) shows EID results from all PCR labs in real-time. Results Kenya demonstrates tremendous progress from 2005 to 2012: PMTCT sites from 926 to 4,500; pregnant women counselled and tested for HIV from 318,000 to 1.2 million (80% coverage); ARV prophylaxis from 52% to 90% of HIV-positives identified; CD4 access from < 50% to > 72%; over 57% attending 4+ antenatal visits. Exclusive breastfeeding for 6 months increased from 3.2% to 32% (KDHS). The number of infants tested by PCR increased from 4,500 in 2006 to 64,000 in 2011. PCR positivity has dropped from 11.2% (2010) to 7.6% (2011) and 5.2% (2012) at 6-week testing of infants. Conclusion Use of more efficacious regimen including Option B+, integration of services, implementation of new guidelines and eMTCT framework should enable Kenya to attain a transmission rate less than 5% by 2015. ExPloring ExPEriEncEs with community BasEd Promotion of ExclusivE BrEastfEEding in thE contExt of hiv in thE rural malawi
infectious status for some discrepant samples. It is likely that 10-12 instances can be attributed to false culture readings, and 3-5 to false NAAT results. Self-limited infections were noted more frequently among younger macaques. Friable tissue was noted more frequently among older animals. Four of the five animals that were re-challenged with TV developed infection.Conclusions The NAAT gave fewer false results, when we had the luxury of a timeline of serial samples to refer to for determining test accuracy. Similar infection rates were observed in both age cohorts. Older animals had a greater incidence of cervicovaginal irritation evidenced primarily by friability in this study, and younger animals tended to self-clear T. vaginalis infection faster than older animals. Finally, TV re-infection is possible in the macaque model.
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