Heterosexual HIV-1 infectiousness and antiretroviral use : systematic review of prospective studies of discordant couples

Background: Recent studies have estimated the reduction in HIV-1 infectiousness with antiretroviral therapy (ART), but high-quality studies such as randomized controlled trials, accompanied by rigorous adherence counseling, are likely to overestimate the effectiveness of treatment-as-prevention in real-life settings. Methods: We attempted to summarize the effect of ART on HIV transmission by undertaking a systematic review and meta-analysis of HIV-1 infectiousness per heterosexual partnership (incidence rate and cumulative incidence over study follow-up) estimated from prospective studies of discordant couples. We used random-effects Poisson regression models to obtain summary estimates. When possible, the analyses were further stratified by direction of transmission (man-to-woman or woman-to-man) and economic setting (high- or low-income countries). Potential causes of heterogeneity of estimates were explored through subgroup analyses. Results: Fifty publications were included. Nine allowed comparison between ART and non-ART users within studies (ART-stratified studies), in which summary incidence rates were 3.6/100 person-years (95% confidence interval = 2.0-6.5) and 0.2/100 person-years (0.07-0.7) for non-ART- and ART-using couples, respectively (P < 0.001), constituting a 91% (79-96%) reduction in per-partner HIV-1 incidence rate with ART use. The 41 studies that did not stratify by ART use provided estimates with high levels of heterogeneity (I2 statistic) and few reported levels of ART use, making interpretation difficult. Nevertheless, estimates tended to be lower with ART use. Infectiousness tended to be higher for low-income than high-income settings, but there was no clear pattern by direction of transmission (man-to-woman and woman-to-man). Conclusions: ART substantially reduces HIV-1 infectiousness within discordant couples, based on observational studies, and could play a major part in HIV-1 prevention efforts. However, the non-zero risk from partners receiving ART demonstrates that appropriate counseling and other risk-reduction strategies for discordant couples are still required. Additional estimates of ART effectiveness by adherence level from real-life settings will be important, especially for persons starting treatment early without symptoms

Report of the Scientific Council Meeting 01 -15 June 2017

Council met at the Sobey Building, Saint Mary’s University, Halifax, NS, Canada, during 01 – 15 June 2017, to consider the various matters in its Agenda. Representatives attended from Canada, Denmark (in respect of Faroe Islands and Greenland), the European Union (France, Germany (via WebEx), Portugal, Spain, the United Kingdom and the European Commission), Japan, the Russian Federation and the United States of America. Observers from the Ecology Action Centre and Dalhousie University were also present. The Executive Secretary, Scientific Council Coordinator and other members of the Secretariat were in attendance. The Executive Committee met prior to the opening session of the Council to discuss the provisional agenda and plan of work. The Council was called to order at 1000 hours on 01 June 2017. The provisional agenda was adopted with modification. The Scientific Council Coordinator was appointed the rapporteur. The Council was informed that the meeting was quorate and authorization had been received by the Executive Secretary for proxy votes from the European Union, Denmark (in respect of Faroe Islands and Greenland), Iceland, Japan, Republic of Korea, and Norway. The opening session was adjourned at 1200 hours on 01 June 2017. Several sessions were held throughout the course of the meeting to deal with specific items on the agenda. The Council considered adopted the STACFEN report on 8 June 2017, and the STACPUB, STACFIS and STACREC reports on 15 June 2017. The concluding session was called to order at 0830 hours on 15 June 2017. The Council considered and adopted the report the Scientific Council Report of this meeting of 01 -15 June 2017. The Chair received approval to leave the report in draft form for about two weeks to allow for minor editing and proof-reading on the usual strict understanding there would be no substantive changes. The meeting was adjourned at 1430 hours on 15 June 2017. The Reports of the Standing Committees as adopted by the Council are appended as follows: Appendix I - Report of the Standing Committee on Fisheries Environment (STACFEN), Appendix II - Report of Standing Committee on Publications (STACPUB), Appendix III - Report of Standing Committee on Research Coordination (STACREC), and Appendix IV - Report of Standing Committee on Fisheries Science (STACFIS). The Agenda, List of Research (SCR) and Summary (SCS) Documents, and List of Representatives, Advisers and Experts, are given in Appendix V-VII. The Council’s considerations on the Standing Committee Reports, and other matters addressed by the Council follow in Sections II-XV

Report of the Marine Chemistry Working Group (MCWG) [7–11 March 2005, Vigo, Spain]

Contributor: Jarle Klungsøy

A poverty analysis macroeconomic simulator (PAMS) linking household surveys with macro-models

The Poverty Analysis Macroeconomic Simulator (PAMS) is a model that links standard household surveys with macro frameworks. It allows users to assess the effect of macroeconomic policies-in particular, those associated with Poverty Reduction Strategies papers-on sectoral employment and income, the incidence of poverty, and income distribution. PAMS (in Excel) has three interconnected components: o A standard aggregate macro-framework that can be taken from any macro-consistency model (for example, RMSM-X, 123) to project GDP, national accounts, the national budget, the BoP, price levels, and so on, in aggregate consistent accounts. o A labor market model breaking down labor categories by skill level and economic sectors whose production total is consistent with that of the macro framework. Individuals from the household surveys are grouped in representative groups of households defined by the labor category of the head of the household. For each labor category, labor demand depends on sectoral output and real wages. Wage income levels by economic sector and labor category can thus be determined. In addition, different income tax rates and different levels of budgetary transfers across labor categories can be added to wage income. o A model that uses the labor model results for each labor category to simulate the income growth for each individual inside its own group, assumed to be the average of its group. a abstr After projecting individual incomes, PAMS calculates the incidence of poverty and the inter-group inequality. PAMS can produce historical or counterfactual simulations of: o Alternative growth scenarios with different assumptions for inflation, fiscal, and current account balances. These simulations allow test tradeoffs within a macro stabilization program. o Different combinations of sectoral growth (agricultural or industrial, tradable or non-tradable goods sectors), within a given aggregate GDP growth rate. o Tax and budgetary transfer policies. For example, PAMS will simulate a baseline macro-scenario for Burkina Faso corresponding to an existing IMF/World Bank-supported program and introduce changes in tax, fiscal, and sectoral growth policies to reduce poverty and inequality more effectively than the base scenario. So, the authors argue that there are several possible"equilibria"in terms of poverty and inequality within the same macro framework.Banks&Banking Reform,Environmental Economics&Policies,Health Economics&Finance,Labor Policies,Economic Theory&Research,Environmental Economics&Policies,Poverty Assessment,Health Economics&Finance,Economic Theory&Research,Achieving Shared Growth

The Link between the Marital Bond and Future Triadic Family Interactions

This study examined how the marital bond, as indexed through the Oral History Interview (OHI), is related to future triadic family interactions. Families (N = 108), with a 7 – 9 year old child, participated in a longitudinal study (the Family Health Project) examining children’s emotional development throughout the transition to adolescence. Parental cohesion and family cohesion, warmth, structure, and problem solving were assessed via behavioral observation during family problem solving discussions and parent-child teaching interactions 18 – 24 months after the OHI. Results indicated that the marital bond was predictive of parental cohesion, family cohesion, warmth, and structure during teaching interactions. The marital bond was not significantly predictive of family problem solving or parental cohesion in problem solving interactions