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Estimating HIV-1 incidence using the serologic testing algorithm for recent HIV infections at HIV counseling and testing centers in the city of São Paulo, Brazil

BASSICHETTO, Katia Cristina; BERGAMASCHI, Denise Pimentel; VERAS, Maria Amelia; SUCUPIRA, Maria Cecilia Araripe; MESQUITA, Fabio; DIAZ, Ricardo Sobhie
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
56.2%
The network of HIV counseling and testing centers in São Paulo, Brazil is a major source of data used to build epidemiological profiles of the client population. We examined HIV-1 incidence from November 2000 to April 2001, comparing epidemiological and socio-behavioral data of recently-infected individuals with those with long-standing infection. A less sensitive ELISA was employed to identify recent infection. The overall incidence of HIV-1 infection was 0.53/100/year (95% CI: 0.31-0.85/100/year): 0.77/100/year for males (95% CI: 0.42-1.27/100/year) and 0.22/100/ year (95% CI: 0.05-0.59/100/year) for females. Overall HIV-1 prevalence was 3.2% (95% CI: 2.8-3.7%), being 4.0% among males (95% CI: 3.3-4.7%) and 2.1% among females (95% CI: 1.6-2.8%). Recent infections accounted for 15% of the total (95% CI: 10.2-20.8%). Recent infection correlated with being younger and male (p = 0.019). Therefore, recent infection was more common among younger males and older females.

Estudo das infecções pelo HTLV-I e pelo HTLV-II como fatores prognósticos em uma coorte de portadores do HIV acompanhados em Santos-SP; Study on infections caused by HTLV-I and HTLV-II as prognostic factors in a cohort of HIV-positive patients followed up in Santos-SP

Etzel, Arnaldo
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 06/08/2004 PT
Relevância na Pesquisa
46.34%
s retrovírus humanos incluem o vírus da imunodeficiência humana (HIV), agente causal da síndrome da imunodeficiência adquirida (AIDS), e os vírus linfotrópicos de células T humanas do tipo I (HTLV-I) e do tipo II (HTLV-II), estes associados etiologicamente a doenças de natureza linfoproliferativa e/ou neurodegenerativa. Apresentam as mesmas formas de transmissão, resultando em fatores comuns de risco e em sobreposição de populações expostas. Embora os três vírus sejam linfotrópicos, o HIV se apresenta com altas taxas de replicação e proporciona a morte celular em todos os estágios da infecção, enquanto o HTLV-I e o HTLV-II podem causar proliferação e eventualmente transformação celular. O efeito do HTLV-I e do HTLV-II sobre o sistema imunológico como um dos fatores que interferem na evolução da AIDS envolve um grande interesse e ainda é motivo de controvérsia. Pesquisas in vitro sugerem que o HTLV-I e o HTLV-II podem aumentar a replicação e a expressão do HIV. Alguns estudos clínico-epidemiológicos apontam na direção de que exista efeito da concomitância das infecções pelo HIV e pelo HTLV-I ou pelo HTLV-II sobre a evolução da progressão da AIDS. Em um estudo anterior, desenvolvido entre portadores do HIV atendidos no Centro de Referência em AIDS de Santos-SP...

Estimating HIV-1 incidence using the serologic testing algorithm for recent HIV infections at HIV counseling and testing centers in the city of São Paulo, Brazil

Bassichetto,Katia Cristina; Bergamaschi,Denise Pimentel; Veras,Maria Amelia; Sucupira,Maria Cecilia Araripe; Mesquita,Fabio; Diaz,Ricardo Sobhie
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2009 EN
Relevância na Pesquisa
56.2%
The network of HIV counseling and testing centers in São Paulo, Brazil is a major source of data used to build epidemiological profiles of the client population. We examined HIV-1 incidence from November 2000 to April 2001, comparing epidemiological and socio-behavioral data of recently-infected individuals with those with long-standing infection. A less sensitive ELISA was employed to identify recent infection. The overall incidence of HIV-1 infection was 0.53/100/year (95% CI: 0.31-0.85/100/year): 0.77/100/year for males (95% CI: 0.42-1.27/100/year) and 0.22/100/ year (95% CI: 0.05-0.59/100/year) for females. Overall HIV-1 prevalence was 3.2% (95% CI: 2.8-3.7%), being 4.0% among males (95% CI: 3.3-4.7%) and 2.1% among females (95% CI: 1.6-2.8%). Recent infections accounted for 15% of the total (95% CI: 10.2-20.8%). Recent infection correlated with being younger and male (p = 0.019). Therefore, recent infection was more common among younger males and older females.

The changing epidemiology of prevalent diagnosed HIV infections in England, Wales, and Northern Ireland, 1997 to 2003

Rice, B; Payne, L; Sinka, K; Patel, B; Evans, B; Delpech, V
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /06/2005 EN
Relevância na Pesquisa
56%
Objectives: To present the current epidemiology of prevalent diagnosed HIV infections in England, Wales, and Northern Ireland (E, W, & NI) and describe trends over time.

Leveraging HIV Treatment to End AIDS, Stop New HIV Infections, and Avoid the Cost of Inaction

Sidibé, Michel; Zuniga, José M.; Montaner, Julio
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
Publicado em 01/07/2014 EN
Relevância na Pesquisa
56.07%
We have the tools at our disposal to significantly bend AIDS-related morbidity and mortality curves and reduce human immunodeficiency virus (HIV) incidence. It is thus essential to redouble our efforts to reach the goal of placing 15 million people on life-saving and -enhancing antiretroviral therapy (ART) by 2015. In reaching this milestone, we can write a new chapter in the history of global health, demonstrating that a robust, multidimensional response can succeed against a complex pandemic that presents as many social and political challenges as it does medical ones. This milestone is also critical to advance our ultimate goal of ending AIDS by maximizing the therapeutic and preventive effects of ART, which translates into a world in which AIDS-related deaths and new HIV infections are exceedingly rare.

A Comprehensive Review of Empirical and Modeled HIV Incidence Trends (1990-2012)

Taaffe, Jessica; Fraser-Hurt, Nicole; Gorgens, Marelize; Harimurti, Pandu
Fonte: World Bank Group, Washington, DC Publicador: World Bank Group, Washington, DC
EN_US
Relevância na Pesquisa
56.29%
An accurate measurement of HIV incidence is a key for policy makers and HIV program managers directing national HIV response. However, there is no perfect method to measure or estimate the rate at which new HIV infections occur in a population. This review compiles and triangulates longitudinal HIV incidence and prevalence data from published studies and trials, national reports and surveys, and the Joint United Nations Programme on HIV/AIDS estimates from the Spectrum model, focusing on 20 countries in Sub-Saharan Africa with generalized HIV epidemics. Three main points can be taken from this analysis of HIV incidence trends. First, modeled HIV incidence and nationally reported HIV prevalence levels in young females suggest that national HIV incidence has declined since 2000 in all except three countries analyzed (stable estimated HIV trends in Burkina Faso, Burundi, and Uganda), but trial and survey data suggest that in some demographics, HIV incidence remains critically high. Second, all modeled national HIV incidence curves and most empirically observed trends commenced a downward trajectory prior to the introduction of anti-retroviral therapy programs around 2004...

Scaling up HIV Treatment for MSM in Bangkok

Zhang, Lei; Phanuphak, Nittaya; Henderson, Klara; Nonenoy, Siriporn; Srikaew, Sasiwan; Shattock, Andrew J.; Kerr, Cliff C.; Omune, Brenda; van Griensven, Frits; Osornprasop, Sutayut; Oelrichs, Robert; Ananworanich, Jintanat; Wilson, David P.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Trabalho em Andamento
EN_US
Relevância na Pesquisa
56.36%
The HIV epidemic amongst men who have sex with men (MSM) in Bangkok is substantial. The population size of MSM in Bangkok is 120,000-250,000, with approximately one-third (33.5 percent) considered high-risk, characterized by their young age, multiple partnerships, frequent unprotected anal intercourse, and sexual activities around MSM hotspots. In metropolitan Bangkok, HIV prevalence among MSM reportedly increased from 21 percent to 28 percent between 2000 and 2012. The Thai Working Group of Estimation and Projection (2013) projected an estimate of 39,000 new HIV infections would occur in Thailand during 2012-2016, based on the AIDS Epidemic Model (AEM). MSM will account for 44 percent of these new HIV cases, and 25-30 percent of these infections will likely to occur in Bangkok. In 2011, the United Nations held a high-level meeting on HIV/AIDS where they adopted the ambitious epidemiological targets of the United Nations Political Declaration on HIV/AIDS (UNPD), to be met by 2015. Attaining these specific targets would lead to substantial progress towards ending AIDS. UNAIDS has also been prioritizing the “Getting to Zero” initiative (“Zero new HIV infections. Zero AIDS-related deaths. Zero discrimination.”). The Bangkok Metropolitan Administration (BMA) recently responded with the “Bangkok: Getting to Zero” initiative...

Lingual Lesions in a HIV-Positive Patient; Lesões Linguais em Doente VIH Positivo

Brasileiro, Ana; Serviço de Dermatologia. Hospital S. António dos Capuchos. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.; Campos, Sara; Serviço de Dermatologia. Hospital S. António dos Capuchos. Centro Hospitalar de Lisboa Central. Lisboa. P
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; other; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 31/08/2015 POR
Relevância na Pesquisa
56%
Keywords: HIV Infections; Syphilis; Tongue Diseases.; Palavras-chave: Doenças da Língua; Infecções por VIH; Sífilis.

Liberdade de Escolha no Serviço Nacional de Saúde - o Caso do VIH; Freedom of Choice in the National Health Service - the Case of HIV

Perelman, Julian; Escola Nacional de Saúde Pública. Universidade Nova de Lisboa. Lisboa. Portugal.
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 29/05/2015 POR
Relevância na Pesquisa
56%
Palavras-Chave: Direitos do Doente; Infecções por VIH/tratamento; Portugal; Serviço Nacional de Saúde; Tomada de Decisão.; Keywords: Patient Rights; HIV Infections/therapy; Portugal; National Health Programs; Decision Making.

CMV and HCV infections in HIV/non-HIV mothers and newborns: prevalence, frequency and risk factors

Lopo, Sílvia; Pereira, Maria Amável; Mendonça, Joana; Vinagre, Elsa; Reis, Tânia; Cordeiro, Dora; Almeida, Catarina; Água-Doce, Ivone; Manita, Carla; Palminha, Paula; Pádua, Elizabeth; Paixão, Maria Teresa; Carreiro, Helena; Barroso, Rosalina; Camp
Fonte: Instituto Nacional de Saúde Doutor Ricardo Jorge Publicador: Instituto Nacional de Saúde Doutor Ricardo Jorge
Tipo: Conferência ou Objeto de Conferência
Publicado em 21/09/2011 ENG
Relevância na Pesquisa
46.33%
Abstract publicado em: ESCV2011-Program Book / European Society of Clinical Virology, p. 73. Disponível em: http://escv.ivdnews.net/public/show_abstract/1126; The incidence of HIV infections in gestational age is an important Public Health issue as are concerns about co-infection with opportunistic viruses, such as CMV/HCV. Several authors refer higher ratios of congenital CMV infection in children born to HIV infected mother than in uninfected. In the case of HCV, perinatal transmission increases in cases of mothers co-infected with HIV. Aims:To study CMV/HCV infection/co-infection in HIV/non-HIV women and their newborns between 2006-2010, according to epidemiological, laboratory and clinical data; to evaluate frequency of CMV/HIV/HCV maternal-fetal transmission and analyse risk factors for infections. Methods:Plasma and/or urine of 137 HIV and 140 non-HIV women, attending a Lisbon Hospital and their 140 newborns were analysed at NIH. HIV-1 and/or HIV-2 proviral DNA nested-PCR was performed on HIV mothers and their newborn’s plasma. Maternal plasma was screened for CMV and HCV antibodies; RNA determination, genotyping and viral load were performed on women with HCV antibodies, their newborn’s plasma was also screened for HCV. Newborn’s urine was inoculated for CMV detection. Data analysis was performed using SPSS 17.0 and Fisher's exact test. Results:HIV1 vertical transmission was diagnosed in 3/140(2.1%) cases. CMV congenital infection was diagnosed in 4(2.9%) newborns from HIV women and no congenital CMV infection was diagnosed in newborns from non-HIV women. 2/137(1.5%) HIV women and 14/140(10.0%) non-HIV women were CMV seronegative. HCV infection was detected in 6(4.4%) HIV women; all had HCV positive viral load; different genotypes were found. One case of HCV perinatal transmission was diagnosed. No HCV antibodies were found in non-HIV women. No children were HIV/HCV or CMV/HCV coinfected but 2 were HIV/CMV coinfected. There is evidence of significant statistical associations with race/ethnicity and time of pregnancy. Conclusion:In this study HIV women had higher CMV/HCV antibody prevalence and frequency of maternal-fetal transmission than non-HIV women. 2/137 HIV seronegative newborns and 2/3 HIV newborns were CMV congenitally infected; this difference should be further studied...

Oral substitution treatment of injecting opioid users for prevention of HIV infection (Review)

Gowing, L.; Farrell, M.; Bornemann, R.; Sullivan, L.; Ali, R.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
56.1%
Background: Injecting drug users are vulnerable to infection with Human Immunodeficiency Virus (HIV) and other blood borne viruses as a result of collective use of injecting equipment as well as sexual behaviour Objectives: To assess the effect of oral substitution treatment for opioid dependent injecting drug users on risk behaviours and rates of HIV infections. Search methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO to May 2011. We also searched reference lists of articles, reviews and conference abstracts Selection criteria: Studies were required to consider the incidence of risk behaviours, or the incidence of HIV infection related to substitution treatment of opioid dependence. All types of original studies were considered. Two authors independently assessed each study for inclusion Data collection and analysis: Two authors independently extracted key information from each of the included studies. Any differences were resolved by discussion or by referral to a third author. Main results: Thirty-eight studies, involving some 12,400 participants, were included. The majority were descriptive studies, or randomisation processes did not relate to the data extracted, and most studies were judged to be at high risk of bias. Studies consistently show that oral substitution treatment for opioid-dependent injecting drug users with methadone or buprenorphine is associated with statistically significant reductions in illicit opioid use...

The Global HIV Epidemics among People Who Inject Drugs

Dutta, Arin; Wirtz, Andrea; Stanciole, Anderson; Oelrichs, Robert; Semini, Iris; Baral, Stefan; Pretorius, Carel; Haworth, Caroline; Hader, Shannon; Beyrer, Chris; Cleghorn, Farley
Fonte: Washington, DC: World Bank Publicador: Washington, DC: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH; EN_US
Relevância na Pesquisa
56.32%
This publication addresses research questions related to an increase in the levels of access and utilization for four key interventions that have the potential to significantly reduce HIV infections among People Who Inject Drugs (PWID) and their sexual and injecting partners, and hence morbidity and mortality in low and middle-income countries (LMIC). These interventions are drawn from nine consensus interventions that comprise a 'comprehensive package' for PWID. The four interventions are: Needle and Syringe Programs (NSP), Medically Assisted Therapy (MAT), HIV Counseling and Testing (HCT), and Antiretroviral Therapy (ART). The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions...

Optimizing the Allocation of Resources among HIV Prevention Interventions in Honduras

Beeharry, Girindre; Schwab, Nicole; Akhavan, Dariush; Hernández, Rosalinda; Paredes, Carla
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
56.34%
This paper presents a model that policymakers can use to determine the resource allocation that will prevent the maximum number of new HIV infections at any given budget level. The optimal allocation exercise was conducted in Honduras, where the epidemic is still concentrated in high-risk groups but has begun spreading into the general population. Most transmissions occur through heterosexual sex, followed by sex between men, and mother-to-child transmission. Adult prevalence is estimated at 1.4 percent. The optimization exercise involves several steps:(a) choosing population subgroups targeted for intervention; (b) estimating the proportion of each subgroup that can be reached; (c) estimating the total number of new infections expected in each subpopulation; (d) defining the set of HIV prevention interventions to be considered; (e) estimating the unit cost of each intervention; and (f) estimating the expected effectiveness of each intervention. Most of the data required to run the model has to be guesstimated or derived from the literature. To address this challenge...

Kenya - HIV Prevention Response and Modes of Transmission Analysis

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Other Health Study
ENGLISH
Relevância na Pesquisa
46.33%
In 2007, an estimated 33.2 million people in the world were living with HIV, and despite twenty years of prevention programmes, an estimated 2.5 million new infections occurred in that year. Underpinning the shortcoming in the prevention response is the inadequate use of evidence to inform the response. The result has been largely ineffective prevention interventions, with non-optimal use of available resources and the loss of early opportunities to address the unique factors driving infection in the populations most at risk within the country. The overall objective of this study is: 'to contribute to the ongoing efforts to understand the epidemic and response in Kenya and thus help the country improve the scope (doing the right kind of activities), relevance (with the right populations) and comprehensiveness (reaching all members of target populations) with HIV prevention efforts', with an ultimate goal of helping Kenya make more effective HIV/AIDS-related decisions. The report then assesses the relevance...

Perception of risk of HIV infections and sexual behaviour of the sexually active university students in Zimbabwe

Nkomazana, Njabulo; Maharaj, Pranitha
Fonte: Routledge Publicador: Routledge
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
56.19%
The study sought to establish university students' perceptions of risk of HIV infections. A cross-sectional survey was conducted on 345 sexually active students at two universities in Zimbabwe (one state and one private). Results revealed that above a quarter of the respondents felt at risk of getting HIV due to their regular partners' sexual behaviours and more than half felt at risk of getting HIV due to their casual partners' sexual behaviours. In addition, a third of the respondents acknowledged the HIV risk due to their own sexual behaviours. More state university respondents felt exposed to HIV infections due to own sexual behaviours than their private university counterparts. Despite these revelations, only 66.56% had earlier thought of their chances of getting infected with HIV. Personal HIV risk perceptions were low, reported by 27.76% of the sexually active respondents. Almost all respondents described their fellows' sexual behaviours as either risky or very risky.

Identifying Recent HIV Infections: From Serological Assays to Genomics

Moyo, Sikhulile; Wilkinson, Eduan; Novitsky, Vladimir; Vandormael, Alain; Gaseitsiwe, Simani; Essex, Max; Engelbrecht, Susan; de Oliveira, Tulio
Fonte: MDPI Publicador: MDPI
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
56.13%
In this paper, we review serological and molecular based methods to identify HIV infection recency. The accurate identification of recent HIV infection continues to be an important research area and has implications for HIV prevention and treatment interventions. Longitudinal cohorts that follow HIV negative individuals over time are the current gold standard approach, but they are logistically challenging, time consuming and an expensive enterprise. Methods that utilize cross-sectional testing and biomarker information have become an affordable alternative to the longitudinal approach. These methods use well-characterized biological makers to differentiate between recent and established HIV infections. However, recent results have identified a number of limitations in serological based assays that are sensitive to the variability in immune responses modulated by HIV subtypes, viral load and antiretroviral therapy. Molecular methods that explore the dynamics between the timing of infection and viral evolution are now emerging as a promising approach. The combination of serological and molecular methods may provide a good solution to identify recent HIV infection in cross-sectional data. As part of this review, we present the advantages and limitations of serological and molecular based methods and their potential complementary role for the identification of HIV infection recency.

Infecção pelo HIV, hepatites B e C e sífilis em moradores de rua, São Paulo; HIV infection, hepatitis B and C and syphilis in homeless people, in the city of São Paulo, Brazil

Brito, Valquiria O. C.; Parra, Deolinda; Facchini, Regina; Buchalla, Cassia Maria
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf; application/pdf
Publicado em 01/12/2007 POR; ENG
Relevância na Pesquisa
56.23%
OBJETIVO: Estimar a prevalência das infecções pelo HIV, vírus das hepatites B e C, e da sífilis em moradores de rua. MÉTODOS: Estudo transversal com intervenção educativa, realizado no município de São Paulo, de 2002 a 2003. Selecionou-se amostra de conveniência de moradores de rua que utilizavam albergues noturnos, segundo os critérios: >;18 anos e não apresentar distúrbios psiquiátricos. Em entrevistas, foram coletados dados sociodemográficos e de comportamento, e realizados exames laboratoriais para HIV, hepatite B e C e sífilis, e aconselhamento pós-teste. RESULTADOS: Participaram 330 usuários dos albergues, com 40,2 anos (média), 80,9% homens, nas ruas, em média, há um ano. Observaram-se prevalências de 1,8% de HIV, 8,5% de vírus de hepatite C, 30,6% de infecção pregressa por hepatite B, 3,3% de infecção aguda ou crônica pelo vírus hepatite B e 5,7% de sífilis. Uso consistente de preservativo foi referido por 21,3% e uso de droga injetável, por 3% dos entrevistados. A positividade para HIV foi de 10% e 50% para vírus da hepatite C entre usuários de drogas injetáveis, versus 1,5% para HIV e 7,3% para hepatite C nos demais, evidenciando associação entre esse vírus e uso de droga injetável. Prisão anterior foi referida por 7...

Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics

Salomon,Joshua A.; Murray,Christopher J.L.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2001 EN
Relevância na Pesquisa
56.17%
OBJECTIVE: To improve the methodological basis for modelling the HIV/AIDS epidemics in adults in sub-Saharan Africa, with examples from Botswana, Central African Republic, Ethiopia, and Zimbabwe. Understanding the magnitude and trajectory of the HIV/AIDS epidemic is essential for planning and evaluating control strategies. METHODS: Previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. In this project, we have extended these models in order to take full advantage of the available data. We developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. FINDINGS: In the four countries analysed, there were an estimated half a million new adult HIV infections in 1999 (range: 260 to 960 thousand), 4.7 million prevalent infections (range: 3.0 to 6.6 million), and 370 thousand adult deaths from AIDS (range: 266 to 492 thousand). CONCLUSION: While this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of HIV and AIDS in the general population.

Fighting HIV/AIDS: is success possible?

Okware,Sam; Opio,Alex; Musinguzi,Joshua; Waibale,Paul
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
Relevância na Pesquisa
56.24%
The fight against HIV/AIDS poses enormous challenges worldwide, generating fears that success may be too difficult or even impossible to attain. Uganda has demonstrated that an early, consistent and multisectoral control strategy can reduce both the prevalence and the incidence of HIV infection. From only two AIDS cases in 1982, the epidemic in Uganda grew to a cumulative 2 million HIV infections by the end of 2000. The AIDS Control Programme established in 1987 in the Ministry of Health mounted a national response that expanded over time to reach other relevant sectors under the coordinating role of the Uganda AIDS Commission. The national response was to bring in new policies, expanded partnerships, increased institutional capacity for care and research, public health education for behaviour change, strengthened sexually transmitted disease (STD) management, improved blood transfusion services, care and support services for persons with HIV/AIDS, and a surveillance system to monitor the epidemic. After a decade of fighting on these fronts, Uganda became, in October 1996, the first African nation to report declining trends in HIV infection. Further decline in prevalence has since been noted. The Medical Research Council (UK) and the Uganda Virus Research Institute have demonstrated declining HIV incidence rates in the general population in the Kyamulibwa in Masaka Districts. Repeat knowledge...

Condom use within marriage: a neglected HIV intervention

Ali,Mohamed M.; Cleland,John; Shah,Iqbal H.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2004 EN
Relevância na Pesquisa
56.04%
OBJECTIVE: To assess the contraceptive effectiveness of condoms versus oral contraceptive pills and estimate the reproductive consequences of a major shift from pill to condom use. METHODS: Secondary analysis was performed on nationally representative cross-sectional surveys of women in 16 developing countries. FINDINGS: In the 16 countries, the median per cent of married couples currently using condoms was 2%, compared with 13% for the pill. Condom users reported a higher 12-month failure and higher method-related discontinuation rates than pill users (9% and 44% vs 6% and 30%, respectively). Condom users were more likely to report subsequent abortion following failure (21% vs 14%), and also more likely to switch rapidly to another method (76% vs 58%). The reproductive consequences, in terms of abortion and unwanted births, of a hypothetical reversal of the relative prevalence of condom and pill were estimated to be minor. The main reason for this unexpected result is that the majority of abortions and unwanted births arise from non-use of any contraceptive method. CONCLUSION: A massive shift from the more effective oral contraceptive pills to the less effective condom would not jeopardize policy goals of reducing abortions and unwanted births. However...