Behaviour changes following HIV diagnosis among men who have sex with men in the era of treatment as prevention: data from a prospective study

We described the longitudinal changes in sexual behaviour and associated factors among newly diagnosed with HIV men who have sex with men participating in a prospective observational study from a London HIV clinic (2015-2018). Participants self-completed questionnaires at baseline, months 3 and 12. Information collected included socio-demographic, sexual behaviour, health, lifestyle and social support. Trends in sexual behaviours over one year following diagnosis and associated factors were assessed using generalized estimating equations with logit link. Condomless sex (CLS) dropped from 62.2% at baseline to 47.6% at month-three but increased again to 61.8% at month-12 (p-trend = 0.790). Serodiscordant-CLS increased between month-three and month-12 (from 13.1% to 35.6%, p-trend < 0.001). The prevalence of serodiscordant-CLS with high risk of transmitting to their partners at month-three was 10.7%. CLS was higher among men who reported recreational drug use (adjusted Odds Ratio (aOR) 3.03, 95%CI 1.47-6.24, p = 0.003), those with undetectable viral load (aOR 2.17, 95%CI 1.22-3.84, p = 0.008) and those who agreed with a statement "condoms are not necessary when HIV viral load is undetectable" (aOR 3.41, 95%CI 1.58-7.38, p = 0.002). MSM continued to engage in CLS after HIV diagnosis, which coincided with U = U publications and increased throughout the study

Projections of Global Mortality and Burden of Disease from 2002 to 2030

BACKGROUND: Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. METHODS AND FINDINGS: Relatively simple models were used to project future health trends under three scenarios—baseline, optimistic, and pessimistic—based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. CONCLUSIONS: These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries

Improvement of existing coal fired thermal power plants performance by control systems modifications

publisher: Elsevier articletitle: Improvement of existing coal fired thermal power plants performance by control systems modifications journaltitle: Energy articlelink: http://dx.doi.org/10.1016/j.energy.2013.02.033 content_type: article copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.status: publishe

Decomposition of Projected Change in Numbers of Deaths into Demographic and Epidemiological Components, by Broad Cause Group and Income Group, 2002–2030

<p>Decomposition of Projected Change in Numbers of Deaths into Demographic and Epidemiological Components, by Broad Cause Group and Income Group, 2002–2030</p

Projections of Total AIDS Deaths (Thousands) by Income Group for Three Scenarios

<p>Scenarios are indicated: baseline (solid lines), optimistic (dotted lines), and pessimistic (dashed lines).</p

Projected Growth in Road Traffic Fatalities, 2002–2020: A Comparison of World Bank Projections with GBD Projections

<p>Projected Growth in Road Traffic Fatalities, 2002–2020: A Comparison of World Bank Projections with GBD Projections</p

Projections of Global Deaths (Millions) for Selected Causes, for Three Scenarios: Baseline, Optimistic, and Pessimistic, 2002–2030

<p>Projections of Global Deaths (Millions) for Selected Causes, for Three Scenarios: Baseline, Optimistic, and Pessimistic, 2002–2030</p

Projected Numbers of Tobacco-Caused Deaths for the World and for High-Income and Middle- plus Low-Income Countries, Three Scenarios, 2002–2030

<p>Projected Numbers of Tobacco-Caused Deaths for the World and for High-Income and Middle- plus Low-Income Countries, Three Scenarios, 2002–2030</p

Global Numbers of Deaths by Age and Sex: Baseline, Optimistic, and Pessimistic Scenarios for 2030 Compared with 2002 Estimates

<p>Global Numbers of Deaths by Age and Sex: Baseline, Optimistic, and Pessimistic Scenarios for 2030 Compared with 2002 Estimates</p