Vulnerability of women in southern Africa to infection with HIV: biological determinants and priority health sector interventions

Chersich, Matthew; Rees, Helen

doi:10.1097/01.aids.0000341775.94123.75

Cited by 100 publications

(77 citation statements)

References 137 publications

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“…Gender differences in survival may also result from differences in the uptake or adherence to antiretroviral therapy (ART). Women's greater susceptibility is attributed to a number of biological mechanisms, including differences in genital immunology that are well described in the literature (Chersich and Rees 2008;Higgins, Hoffman, and Dworkin 2010;Yi et al 2013). A variety of co-factors may alter susceptibility to HIV infection, including the presence of both viral and bacterial sexually transmitted infections (STI) (Cohen 2004;Glynn et al 2001;Hertog 2008;UNAIDS/WHO 2000) 8 and male circumcision (Auvert et al 2005;Hertog 2008).…”

Section: Introductionmentioning

confidence: 99%

“…The contributions of pregnancy Marston et al 2013;Morrison et al 2007) and hormonal contraceptives to women's disproportionally high infection rates are less certain (WHO 2012). Other factors with repercussions for HIV transmission pertain to the sex act itself, including vaginal versus anal sex, the use of vaginal drying agents, and forced sex (Chersich and Rees 2008). Finally, gender differences in ART uptake might alter the gender ratio of infections because onward transmission is reduced due to viral suppression.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sexual networks, partnership mixing, and the female-to-male ratio of HIV infections in generalized epidemics

Reniers¹,

Armbruster²,

Lucas³

2015

DemRes

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BACKGROUNDEmpirical estimates of the female-to-male ratio of infections in generalized HIV epidemics in sub-Saharan Africa range from 1.31 in Zambia to 2.21 in Ivory Coast. Inequalities in the gender ratio of infections can arise because of differences in exposure (to HIV-positive partners), susceptibility (given exposure), and survival (once infected). Differences in susceptibility have to date received most attention, but neither the relatively high gender ratio of infections nor the heterogeneity in empirical estimates is fully understood. OBJECTIVEDemonstrate the relevance of partnership network attributes and sexual mixing patterns to gender differences in the exposure to HIV-positive partners and the gender ratio of infections. METHODAgent-based simulation model built in NetLogo. RESULTSThe female-to-male ratio of infections predicted by our model ranges from 1.13 to 1.75. Gender-asymmetric partnership concurrency, rapid partnership turnover, elevated partnership dissolution in female-positive serodiscordant couples, and lower partnership re-entry rates among HIV-positive women can produce (substantial) differences in the gender ratio of infections. Coital dilution and serosorting have modest moderating effects. CONCLUSIONPartnership network attributes and sexual mixing patterns can have a considerable effect on the gender ratio of HIV infections. We need to look beyond individual behavior and gender differences in biological susceptibility if we are to fully understand, and remedy, gender inequalities in HIV infection in generalized epidemics.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sexual networks, partnership mixing, and the female-to-male ratio of HIV infections in generalized epidemics

Reniers¹,

Armbruster²,

Lucas³

2015

DemRes

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“…[34][35][36][37] Earlier studies showed that pregnant women are at a higher risk of HIV infection than lactating or other women, possibly due to physiological changes that a woman undergoes during pregnancy. 38 High levels of oestrogen and progesterone either during pregnancy or from exogenous sources could cause changes in the structure of the genital mucosa or cause immunological changes, such as an increase in mucosal lymphoid aggregates or hormone-induced over expression of co-receptors associated with HIV infection. Supporting evidence suggests that women have a window of vulnerability approximately seven to ten days after ovulation during their menstrual cycle in which the potential for viral infectivity in the female reproductive tract is increased.…”

Section: Discussionmentioning

confidence: 99%

Gender-Based Differences In Hematological and Cd4+ T-Lymphocyte Counts among HIV-Patients in Ido-Ekiti

Jacob¹

2017

HTIJ

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Background: Differences in prevalence and severity of HIV/AIDS between males and females remain complex and controversial; this may vary with time in the same location during the course of the epidemic, and vary greatly by place of residence. The aim of the study was to assess existent sex variations, the efficacy and ability of HAART to resolve hematological and immunological abnormalities in HIV infected.Methodology: A total of 400 HIV infected participants were recruited for the study from Federal Teaching Hospital, Ido-Ekiti between Agust-2013 to February 2014. 4ml of blood samples were collected into K 2 EDTA bottles for the analysis of hematological and immunological parameters. The volunteers comprised of both male and female respectively 123 (54 on HAART and 69 HAART naïve) 277 (146 on HAART and 131 HAART naïve).Results: Hematological and immunological parameters were found to be significantly different (p<0.05) among male and female patients under HAART. Conclusion:This study revealed that there is significant difference in hematological and immunological parameters between male and female on HAART and HAART naïve patients.

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“…There are many advantages gained from incorporation of STI control into HIV program or rather from providing a major integrated approach preventive interventions for reproductive and sexually transmitted infections of which HIV is just one [26,27].…”

Section: Concurrent Stis and Hiv Acquisitionmentioning

confidence: 99%

Study of HIV Status in 400 Cases of S.T.D in Shanti ID Clinic, Vadodara, Gujarat, India

Chopra

2016

JHVRV

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The prospective study was carried out for detecting the prevalence of HIV in sexually transmitted diseases (S.T.D) cases at Shanti infectious diseases clinic at Vadodara, Gujarat, India from January 2010 to May 2013. Out of 400 cases of sexually transmitted diseases, 317 (79.23 %) were males and 83 cases (20.75%) were females. Screening of HIV test was done by Elisa test and was confirmed by Western blot test. Amongst 400 cases 300 cases (75.00%) were in age group of 20 to 50 years, 34 cases (8,55%) wer+++e of 0 to 20 years, 66 cases 916.25%) were above 50 years. Out of 400 cases 87 cases (21.75%) were syphilis, 45 cases(11.25%) were cancroid, 73 cases (18,25%) were gonorrhea, 110 cases (27.50%) were genital herpes, 11 cases (2.75%) moll -scum contagiosum 44 cases(11,00%)genital scabies, 9 cases (2.755) cytomegalovirus infection and 21 cases (5,24%) were having lympho-granuloma venerium. Out of 400 cases of sexually transmitted diseases, 67 cases (16.76%) were HIV positive, amongst which 61 cases (91.04%) were HIV1 and remaining 6 cases (8.96%) were HIV2. Although there is plausible link between STI and HIV risk, intervention studies continue to be disappointing. This does not disprove a causal link but mechanisms of action and the design and implementation of interventions need to be better understood.

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Vulnerability of women in southern Africa to infection with HIV: biological determinants and priority health sector interventions

Cited by 100 publications

References 137 publications

Sexual networks, partnership mixing, and the female-to-male ratio of HIV infections in generalized epidemics

Sexual networks, partnership mixing, and the female-to-male ratio of HIV infections in generalized epidemics

Gender-Based Differences In Hematological and Cd4+ T-Lymphocyte Counts among HIV-Patients in Ido-Ekiti

Study of HIV Status in 400 Cases of S.T.D in Shanti ID Clinic, Vadodara, Gujarat, India

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