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How many times have you started to have a conversation with someone about Hepatitis C only to have it blow up in your face? Have you ever heard someone say something about Hep C that didn't seem quite right to you? You were probably right something was amiss. A discussion about Hepatitis C can...
As per Wikipedia, the definition of a stigma is as follows: "Stigma is a word that originally means a "sign", "point", or "branding mark"." Wikipedia goes on to call stigma "A badge of shame, a physical mark of infamy or disgrace." Damn that w...
Recently, the CDC (Center for Disease Control) issued a statement that all Baby Boomers should be tested for Hepatitis C. The question often comes up as to why this particular segment of people is so vulnerable. What does being born between 1945 and 1965 have to do with Hepatitis C? What was di...
Buyer Beware! There are several snake oil salesmen out there who are claiming to have cured their own Hepatitis C with herbs, supplements and parking lot gravel. Okay, maybe not the parking lot gravel but it might as well be. What you need to remember is that there are two different types of...
Most every adult woman (and an occasional man) has enjoyed a manicure and a pedicure at a nail salon or spa. That 30 minute pedicure can be so relaxing but are you aware of the danger lurking in that nail salon? Although few individuals recognize the medical risks associated with this common pr...
Introduction.
Approximately 2.4 million people live with HIV/AIDS in India today [1]. While this represents a relatively small proportion of India's 1.2 billion people, a large absolute burden and the potential for epidemic spread demands a full understanding of HIV transmission in that country. It is important to study risk factors because the nature of the epidemic should be taken into consideration when choosing prevention approaches. Thailand experienced a very successful HIV prevention campaign in the 1990s by achieving a high rate of condom use for high-risk sex contacts in brothels[2].
HIV incidence subsequently fell but due to a combination of the drying up of the free condom supply, due to the Asiatic Crisis of 1997, and the shift of sex work typology from brothel to home- and street-based, HIV incidence began to increase again.
Previous studies on HIV in India have identified heterosexual sex (chiefly through commercial sex between male clients and female sex workers) as the primary driver of HIV incidence in the population [3], [4], [5], [6], [7], [8]. Key risk factors that have been identified in the literature are use of, or engaging in, commercial sex work [8], [9], bacterial and viral sexually transmitted infections (STI) [5], [7], [10], numbers of sex partners [11], [12], [13], [14] and male circumcision [6], [11], [15], [16]. These are examples of “proximal” risk factors [17]. Distal risk factors have been identified including: proximity to brothel, highways and impaired access to STI clinical services[17], [18]. In this study we focus on proximal factors as important targets for interventions.
The Indian HIV epidemic exhibits a large amount of geographic heterogeneity in terms of HIV risk [19], [20]. We were interested in understanding the effects of these risk factors, and estimating their size, for each gender and in different epidemiologic settings (populations at higher or lower risk of HIV infection due to their behaviours and different types of STIs such as bacterial versus viral), to improve understanding of transmission dynamics [21], [22]. Documenting and explaining this variation would improve our understanding of the epidemic in India. We know of no published systematic review that has quantified the effects of these risk factors in India.
Abstract
Background
Approximately 2.4 million people are living with HIV in India. This large disease burden, and potential for epidemic spread in some areas, demands a full understanding of transmission in that country. We wished to quantify the effects of key sexual risk factors for HIV infection for each gender and among high- and low-HIV risk populations in India.
Methodology
We conducted a systematic review of sexual risk factors for HIV infection from 35 published studies. Risk factors analyzed were: male circumcision/religion, Herpes Simplex Virus 2, syphilis, gonorrhoea, genital ulcer, multiple sexual partners and commercial sex. Studies were included if they met predetermined criteria. Data were extracted and checked by two researchers and random-effects meta analysis of effects was conducted. Heterogeneity in effect estimates was examined by I2 statistic. Publication bias was tested by Begg's test and funnel plots. Meta regression was used to assess effect modification by various study attributes.
Results
All risk factors were significantly associated with HIV status. The factor most strongly associated with HIV for both sexes was HSV-2 infection (ORmen: 5.87; 95%CI: 2.46–14.03; ORwomen: 6.44; 95%CI: 3.22–12.86). The effect of multiple sexual partners was similar among men (OR = 2.46; 95%CI: 1.91–3.17,) and women (OR = 2.02; 95%CI: 1.43–2.87) and when further stratified by HIV-risk group. The association between HSV-2 and HIV prevalence was consistently stronger than other STIs or self-reported genital ulcer. If the strong associations between HSV-2 and HIV were interpreted causally, these results implied that approximately half of the HIV infections observed in our study population were attributable to HSV-2 infection.
Conclusions
The risk factors examined in our analysis should remain targets of HIV prevention programs. Our results confirm that sexual risk factors for HIV infection continue to be an important part of Indian HIV epidemic 26 years after it began.
Please sign the ATC Salvage Therapy Petition Join us in asking Congressman Alcee Hastings and Congresswomen Maxine Waters to send a ‘Dear Colleague’ letter to Anthony Fauci, Director of NIAID, asking for the federal facilitation of apricitabine (ATC). ATC is a phase III nucleoside reverse transcriptase inhibitor (NRTI) that has been shown to be safe and effective in treating people with HIV. It works against viruses that are resistant to several other nukes and could ...
Researchers from Johns Hopkins Children’s Center, the University of Mississippi Medical Center and the University of Massachusetts Medical School announced today at CROI2013 the discovery of the first infant functionally cured of HIV. The baby, a female now two and a half years old, received 3 HIV medications when brought to the hospital at 30 hours old. Viral load tests were performed during the first few weeks that showed a rapidly decreasing viral load which reached ...
At the 19th International AIDS Conference (AIDS 2012) in Washington D.C., the CDC reported that only 1 out of 4 HIV patients in the U.S. have HIV under control, which is defined as complete viral suppression. Warning bells should be ringing in the scientific and HIV advocacy communities. While much progress has been made in the last three decades in the treatment of HIV, tens of thousands of people living with HIV (PLWH) are currently struggling to construct viable treat...
Paige Rawl is 17 and HIV positive, but while her life has been shaped by HIV it isn't ruled by it. When Paige Rawl starts her senior year at Indianapolis’s Herron High School next month, she'll be cheer captain and a member of the student government and prom committee. This summer, the 17-year-old held down a part-time job at Hollister, hawking the popular Southern California-inspired clothing brand. The all-American girl — who happens to be HIV positive. Paige was in...
The HIV community has been abuzz with the August FDA approval of what had been termed “the Quad”, the second one-pill-once-a-day combination antiretroviral drug. Marketed by Gilead under the name Stribild, the drug contains two NRTIs (tenofovir and emtricitabine), an integrase inhibitor (elvitegravir) and an integrase booster (cobicistat) and is approved for use in treatment naïve patients with either drug resistant or wild type virus. In comparison to Atripla, the first...
Bristol-Myers Squibb Company (NYSE: BMY) today announced that the U.S. Food and Drug Administration (FDA) has approved a supplemental new drug application (sNDA) for SUSTIVA® (efavirenz), including dosing recommendations for...
California and other states would be pressured to amend or repeal criminal laws that single out HIV-positive people under a bipartisan bill co-authored and introduced this week by Rep. Barbara...
Mission Statement
At HIV Haven we wish to provide our readers with vital cutting edge information to help expand HIV knowledge and promote activism, particularly that which works towards an end to the HIV pandemic. It is our desire to bring to you the scientific, medical and social advances that given the appropriate attention and support, could change the course of the HIV pandemic, lessen the devastating effects of HIV and AIDS, better the quality and quantity of life for people living with HIV and even yield an eventual end to the HIV pandemic. We also provide the basics of HIV transmission and treatment.
We will focus on issues such as innovative drug development, strategic activist campaigns, HIV relationships and novel HIV and HIV cure research. We also will bring you advances in Hepatitis C (HCV), a common HIV co-infection. Whether you are living with HIV/AIDS, HIV and HCV, love someone who is, are an activist, advocate, researcher, physician or just an interested party, we hope here at HIV Haven we can help you find what you are looking for.
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