259 research outputs found
AIDS research must link to local policy
HIV research in South Africa is world class. To halt the country's epidemic, scientists need to shift focus from global problems to priorities at home
HIV treatment in South Africa: overcoming impediments to get started.
No abstract available
Adolescent health
The period of adolescence is associated withcomplex psychological, physical and cognitivechanges as children transition to adulthood. In morerecent times this transition has taken on addedcomplexities, particularly in developing countriesundergoing social and political changes, in an era of increasingglobalisation and access to information through new technologies
Colliding epidemics of communicable and non-communicable diseases during adolescence in South Africa
Over the past 50 years, the improvement of health outcomes ininfants and young children has received more attention than that inadolescents, primarily because adolescence is not typically associatedwith ill health. However, this picture is rapidly changing, with thepresent generation of adolescents already encountering diversechallenges, with different biosocial and neurocognitive responsescompared with their parents and grandparents. These transitions areinfluenced by geographical, cultural, economic and genetic contexts.This issue of CME includes the final two articles on the topic ofadolescent health
Antiretroviral prophylaxis: a defining moment in HIV control
A defining moment in the global AIDS response has been reached. The discourse is no longer about HIV prevention or HIV treatment; it is now about HIV control through the implementation of antiretrovirals as key components of combination interventions. Barely a year ago, visions of HIV control would have been considered far-fetched. The impetus for this change in mindset, which has been building since the XVIII International AIDS Conference in Vienna last year, emanates from the compelling evidence that antiretroviral drugs prevent HIV infection in the general heterosexual population, which is released this week and presented at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Rome by the Partners PrEP and Botswana TDF2 trials
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Contraceptive Choices, Pregnancy Rates, and Outcomes in a Microbicide Trial
OBJECTIVE: Women who become pregnant during the conduct of biomedical human immunodeficiency virus prevention trials are taken off the study product for safety reasons. High pregnancy rates can compromise statistical integrity in these trials. The comprehensive contraceptive curriculum developed for the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 trial was evaluated for its ability to enhance contraceptive uptake, reduce pregnancy rates, and preserve statistical integrity. METHODS: Contraceptive- and pregnancy-related eligibility criteria were specified in the protocol. We enrolled women who opted for a nonbarrier method of contraceptive and provided hormonal contraceptives onsite at no cost. At each monthly study visit, we provided pregnancy prevention counseling and performed pregnancy testing. Study product was withheld on pregnancy diagnosis, but women continued with monthly follow-up. RESULTS: Contraceptive use was high throughout the study with 100% uptake at baseline and 94.71% use after a mean of 18 months follow-up at exit. Injectable progestins, particularly medroxyprogesterone acetate, remained the preferred choice of contraceptive. After 30 months of follow-up, 54 pregnancies were reported out of 889 participants, giving a pregnancy incidence rate of 3.95 per 100 woman-years (95% confidence interval 2.96-5.17). Of all pregnancies, two thirds (64.81%) resulted in a full-term live birth, whereas 18.52% and 11.11% pregnancies culminated as miscarriage and terminated pregnancies, respectively. There were no congenital anomalies in the early neonatal period. Pregnancies resulted in 1.56% of woman-years of study follow-up lost as a result of temporary product withdrawal. CONCLUSION: The CAPRISA 004 contraceptive curriculum was an effective strategy for maintaining low pregnancy rates, thereby minimizing product withdrawal and loss of follow-up time
HIV epidemic types and customized prevention responses.
Since the first reported case of AIDS 27
years ago, more than 70 million people have
been infected with HIV worldwide, and 25
million have died of AIDS. The Joint United
Nations Programme on HIV/AIDS (UNAIDS)
estimates that 33 million people are currently
living with HIV. The global prevalence
of HIV has leveled off, but the total number
of people living with HIV continues to grow.1
This article briefly discusses the roles
that different HIV transmission modes play
in the worldwide pandemic, and explains
how the global pandemic is actually a complex
mosaic of dynamic epidemics within
and between countries.2 Further, it discusses
matching appropriate prevention
responses to two different types of epidemics:
generalized and concentrated
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