Back to basics in HIV prevention: focus on exposure

Pisani, Elizabeth; Garnett, Geoff P.; Grassly, Nicholas C; Brown, Tim; Stover, John; Hankins, Catherine; Walker, Neff; Ghys, Peter D.

doi:10.1136/bmj.326.7403.1384

Cited by 97 publications

(77 citation statements)

References 4 publications

(5 reference statements)

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“…Recent calls for "combination HIV prevention" and "back to basics" approaches to HIV emphasize the use of combinations of feasible and proven interventions. 10,11 A recent review listed priority STI control interventions to include "STI treatment of high-risk sub-populations, comprehensive case management of symptomatic STIs, antenatal syphilis screening and treatment and ophthalmia neonatorum prophylaxis, condom promotion and risk reduction counselling" with increased emphasis on the role of STI clinics in identifying and counselling HIV-infected persons and in diagnosing and managing their STIs. 12 The review pragmatically provides evidence for the effectiveness of individual intervention components within the fragmented domains of STI control and HIV prevention, while making a case for better alignment of efforts.…”

Section: Back To Basicsmentioning

confidence: 99%

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Steen¹,

Wi²,

Kamali³

et al. 2009

Bull World Health Org

112

103

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Control of sexually transmitted infections (STIs) is feasible, leads to improved sexual and reproductive health and contributes to preventing HIV transmission. The most advanced HIV epidemics have developed under conditions of poor STI control, particularly where ulcerative STIs were prevalent. Several countries that have successfully controlled STIs have documented stabilization or reversal of their HIV epidemics.STI control is a public health outcome measured by reduced incidence and prevalence. The means to achieve this include: (i) targeting and outreach to populations at greatest risk; (ii) promoting and providing condoms and other means of prevention; (iii) effective clinical interventions; (iv) an enabling environment; and (v) reliable data.Clinical services include STI case management, screening and management of STIs in sex partners. Syndromic case management is effective for most symptomatic curable STIs and screening strategies exist to detect some asymptomatic infections. Presumptive epidemiologic treatment of sex partners and sex workers complement efforts to interrupt transmission and reduce prevalence. Clinical services alone are insufficient for control since many people with STIs do not attend clinics. Outreach and peer education have been effectively used to reach such populations.STI control requires effective interventions with core populations whose rates of partner change are high enough to sustain transmission. Effective, appropriate targeting is thus necessary and often sufficient to reduce prevalence in the general population. Such efforts are most effective when combined with structural interventions to ensure an enabling environment for prevention. Reliable surveillance and related data are critical for designing and evaluating interventions and for assessing control efforts.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬ a

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Section: Back To Basicsmentioning

confidence: 99%

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Steen¹,

Wi²,

Kamali³

et al. 2009

Bull World Health Org

112

103

View full text Add to dashboard Cite

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“…The prevalence in overall population is below 1%; this rate, however, has surpassed 5% in some high-risk groups such as IDUs [6,7]. For effective management and planning on the prevention and control of HIV, it is crucial to focus on people living with HIV and to identify prime high-risk groups, as well as concentrating on the HIV/AIDS epidemic in the country and its longitudinal patterns of changes [8][9][10]. There are three major groups of risk factors that have been reported to increase mortality among the HIV-infected patients on highly active antiretroviral therapy (HAART) including HIV-related risk factors (AIDS defining diseases and insufficient response to HAART), co-morbidities such as hepatitis C, and non-HAART-related lifestyle factors such as drug, smoking, and alcohol abuse [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Impact of HIV risk factors on survival in Iranian HIV-infected patients: A Bayesian approach to retrospective cohort

Maracy¹,

Mostafaei²,

Moghoofei³

et al. 2017

HIV & AIDS Review

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“…Mereka bukan saja mudah terinfeksi, tetapi juga mudah menularkan penyakit tersebut pada kelompok rentan yang lain. 13,14 Berdasarkan laporan WHO, 8 diketahui bahwa prevalensi HIV positif pada para pengguna narkotika suntik di Jakarta (48%), di Bali (53%) dan Papua (26%) terbukti sangat tinggi.…”

Section: Akar Permasalahanunclassified

“…14 Pada tahun 2004, pemerintah memperkirakan jumlah kasus pengguna narkotika adalah sekitar 150.000 orang. 3 Namun, diyakini bahwa jumlah yang sebenarnya di dalam masyarakat jauh lebih besar daripada angka yang dilaporkan tersebut.…”

Section: Akar Permasalahanunclassified

HIV/AIDS di Indonesia : Fenomena Gunung Es dan Peranan Pelayanan Kesehatan Primer

Hardisman

2009

Kesmas: National Public Health Journal

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AbstrakMasalah HIV/AIDS di Indonesia diyakini bagaikan fenomena gunung es karena laporan resmi jumlah kasus tidak mencerminkan masalah yang sebenarnya. Prediksi besar masalah HIV/AIDS tersebut didasarkan atas jumlah penyalahgunaan narkotika suntik dan prostitusi yang tinggi. Keduanya merupakan faktor utama yang berperan sangat besar dalam penyebaran dan penularan HIV. Berbagai faktor risiko tersebut tidak hanya berkaitan dengan pelayanan kesehatan tetapi juga dengan masalah sosial ekonomi. Permasalahan tersebut perlu diatasi dengan pendekatan pelayanan kesehatan primer komprehensif yang langsung menyentuh akar permasalahan mencakup masalah sosial ekonomi dan lingkungan kultural. Strategi tersebut dilakukan melalui berbagai langkah yang bersifat menyeluruh, meliputi preventif, promotif, kuratif dan rehabilitatif dengan partisipasi dan kerja sama yang luas yang melibatkan berbagai sektor dan organisasi non pemerintah dan masyarakat. Beberapa langkah yang harus dilakukan meliputi edukasi dan promosi, pelayanan kesehatan yang merata dan terjangkau. Selain itu yang juga tidak kalah pentingnya adalah pengentasan kemiskinan melalui peningkatan lapangan kerja dan kelibatan partisipasi masyarakat. Kata kunci : HIV/AIDS, pelayanan kesehatan komprehensifAbstract HIV/AIDS problem in Indonesia is considered as iceberg phenomenon, where the reported cases in the government official record do not represent the real situation. This prediction is based on high number of vulnerable groups such as sexual workers and injecting drug users. These factors are not only related to healthcare services but also social economic structure. Therefore, to address this problem, comprehensive Primary Health Care (PHC) must be implemented. The comprehensive PHC concerns on underlying problem which includes socioeconomic issues and environment problems. This strategy is conducted through holistic activities from preventive, promotive, curative and rehabilitative through collaboration with other sectors and community involvement. Based on underlying HIV/AIDS problem in Indonesia, there are several strategies that should be done to address the problem, such as education campaign, addressing poverty issue, equitable health services and community participation.

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Back to basics in HIV prevention: focus on exposure

Abstract: Despite worldwide efforts to prevent HIV infection, the number of people affected continues to rise. The authors of this article argue that a commonsense approach based on simple country by country analyses could improve the situation

Cited by 97 publications

References 4 publications

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Impact of HIV risk factors on survival in Iranian HIV-infected patients: A Bayesian approach to retrospective cohort

HIV/AIDS di Indonesia : Fenomena Gunung Es dan Peranan Pelayanan Kesehatan Primer

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