Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection

Ng, Brian; Butler, Lisa; Horváth, Hacsi; Rutherford, George W

doi:10.1002/14651858.cd001220.pub3

Cited by 39 publications

(39 citation statements)

References 71 publications

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“…A greater proportion of PLHIV also reported a history of STDs than the control (P < 0.001). These findings are in support of studies that report that multi-partner sex and STDs are risk factors for infection with HIV [9] [18] [19].…”

Section: Proportion (%)supporting

confidence: 90%

“…Other modes include contaminated blood transfusions, hypodermic needles, and modes from mother to child during pregnancy, delivery, or breastfeeding [6]. Risk factors of transmission include those that have to do with sexual behavior such as unprotected sex [7], anal sex [7] [8], presence of other STDs [9], commercial sex workers [10] [11]. Currently there is no cure or vaccine for HIV.…”

Section: Introductionmentioning

confidence: 99%

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Sexual Risk Behaviours among People Living with HIV and Implications for Control in the North West Region of Cameroon

Kwenti¹,

Nsagha²,

Kwenti³

et al. 2014

WJA

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In Cameroon, despite extensive control efforts against HIV/AIDS, the number of new HIV infections is still on the rise. The factors contributing to this are not clearly understood. We hypothesized that it may lie on people living with HIV (PLHIV). In a case-control descriptive study, we studied the characteristics and sexual risky behaviour of PLHIV in the North West Region of Cameroon which has the highest HIV prevalence. Participants were screened for HIV and a structured questionnaire was used in data collection. An equivalent number (350) of PLHIV and controls who did not differ with respect to age and sex participated. Relative to the control, PLHIV were generally less educated (P < 0.001), poorer and less privileged (P < 0.001) with no stable source of income. Among participants that were once married, a greater proportion of PLHIV were divorced (OR = 5.23, P = 0.007), and widows (OR = 2.73, P = 0.001). Among participants that were single, a relatively greater proportion of PLHIV practiced multi-partner sex (OR = 4.55, P< 0.001). History of STDs was higher in PLHIV than the control (OR = 1.88, P = 0.001). Out of 350 PLHIV, 280 (80%) admitted to having had sexual intercourse after being diagnosed of which only 127 (41.78%) admitted to using condoms and 132 (47.14%) admitted to concealing their HIV status from their sexual partner(s). These findings have implications in HIV control programs which should target the poor and the less educated, as well as the sexual behaviour of PLHIV, so as to reverse the current rising trend of new infections in the country.

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Section: Proportion (%)supporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Sexual Risk Behaviours among People Living with HIV and Implications for Control in the North West Region of Cameroon

Kwenti¹,

Nsagha²,

Kwenti³

et al. 2014

WJA

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“…Previous population-based interventions aimed at control of STIs as a means of HIV prevention have generally not been successful in reducing the incidence of HIV and have varied substantially in estimates of attributable risk associated with STI. 30,31 Some have suggested that populations with high-risk sexual behavior and high rates of STI may have a greater attributable risk associated with STI and benefit most from STI treatment interventions for HIV prevention, whereas populations with an advanced HIV epidemic may not. 32 While MSM comprise a group with high-risk sexual behavior and high rates of STI, the high prevalence of HIV in our cohort 13 shows that the HIV epidemic among MSM in Atlanta is certainly advanced.…”

Section: Discussionmentioning

confidence: 99%

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

Kelley

Vaughan

Luisi

et al. 2015

AIDS Research and Human Retroviruses

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Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.

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“…52,53 Although there is evidence that STI treatment of HIV-infected individuals reduces viral shedding in genital fluids, 54,55 populationbased randomized controlled trials have found conflicting evidence on the effectiveness of STI treatment in reducing HIV transmission. 52,53,56 Recently there had been debate over whether the increasing herpes prevalence was affecting the HIV epidemic and if treatment of genital herpes infection would impact HIV transmission rates. There is no doubt that genital herpes is associated with increased HIV acquisition.…”

Section: Screening and Treatment For Sexually Transmitted Infectionsmentioning

confidence: 99%

Advances in the Prevention of Heterosexual Transmission of HIV/AIDS Among Women in the United States

Chen

Meyer

Springer

2011

Infectious Disease Reports

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Despite recent advances in testing and treatment, the incidence of HIV/AIDS in the United States has remained stagnant with an estimated 56,300 new infections every year. Women account for an increasing proportion of the epidemic. The vulnerability of women to HIV stems from both increased biologic susceptibility to heterosexual transmission and also the social, economic, and structural disadvantages they often confront. This review describes the main reasons for the increased vulnerability of U.S. women to HIV transmission with particular emphasis on specific highrisk groups including: non-Hispanic blacks, women who use drugs, women with a history of incarceration, and victims of intimate partner violence. Although behavioral approaches to HIV prevention may be effective, pragmatic implementation is often difficult, especially for women who lack sociocultural capital to negotiate condoms with their male partners. Recent advances in HIV prevention show promise in terms of female-initiated interventions. These notably include female condoms, non-specific vaginal microbicides, and antiretroviral oral and vaginal pre-exposure prophylaxis. In this review, we will present evidence in support of these new female-initiated interventions while also emphasizing the importance of advocacy and the political support for these scientific advances to be successful.

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Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection

Cited by 39 publications

References 71 publications

Sexual Risk Behaviours among People Living with HIV and Implications for Control in the North West Region of Cameroon

Sexual Risk Behaviours among People Living with HIV and Implications for Control in the North West Region of Cameroon

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

Advances in the Prevention of Heterosexual Transmission of HIV/AIDS Among Women in the United States

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