Sexual health for all 2000: Identifying key obstacles to sexual health for lesbians, gay and bisexual people

Duration: March 2000 - May 2000 This was a short, joint investigation between the National AIDS Trust, The Lesbian and Gay Foundation (formerly Healthy Gay Manchester and Manchester Lesbian & Gay Switchboard) and Sigma Research. It was intended to inform the development of the English National Sexual Health Strategy (prior to its merger with the National HIV Strategy) by the Department of Health. The Department of Health commissioned this research on the sexual health needs of Gay men and Lesbians, and identified access to services and health promotion as two areas of special interest. A survey was developed to elicit the views of Lesbians, Gay men and Bisexuals on what the forthcoming strategy (a) should be trying to achieve and (b) how to achieve it. A short, self-completion questionnaire was used (two sides of a single sheet of A4), with a Freepost return facility. The questions covered: demographics; health concerns; obstacles to sexual health; and experiences of sexual health service. Respondents were recruited from Gay and Lesbian community groups, Lesbian & Gay pubs and bookstores in London and Manchester. Respondents were included if they were 16 years or older and resident in England and either: (i) homosexually active in last five year, and / or (ii) Lesbian, Gay or Bisexual identity. The final sample included 497 women and 417 men. The report to the Department of Health included twenty specific recommendations intended to inform the National Strategy

Potential impact of pre-exposure prophylaxis for female sex workers and men who have sex with men in Bangalore, India: a mathematical modelling study

Introduction: In Bangalore, new HIV infections of female sex workers and men who have sex with men continue to occur, despite high condom use. Pre-exposure prophylaxis (PrEP) has high anti-HIV efficacy for men who have sex with men. PrEP demonstration projects are underway amongst Indian female sex workers. We estimated the impact and efficiency of prioritising PrEP to female sex workers and/or men who have sex with men in Bangalore. Methods: A mathematical model of HIV transmission and treatment for female sex workers, clients, men who have sex with men and low-risk groups was parameterised and fitted to Bangalore data. The proportion of transmission attributable (population attributable fraction) to commercial sex and sex between men was calculated. PrEP impact (infections averted, life years gained) and efficiency (life years gained/infections averted per 100 person years on PrEP) were estimated for different levels of PrEP adherence, coverage and prioritisation strategies (female sex workers, high-risk men who have sex with men, both female sex workers and high-risk men who have sex with men, or female sex workers with lower condom use), under current conditions and in a scenario with lower baseline condom use amongst key populations. Results: Population attributable fractions for commercial sex and sex between men have declined over time, and they are predicted to account for 19% of all new infections between 2016 and 2025. PrEP could prevent a substantial proportion of infections amongst female sex workers and men who have sex with men in this setting (23%/27% over 5/10 years, with 60% coverage and 50% adherence), which could avert 2.9%/4.3% of infections over 5/10 years in the whole Bangalore population. Impact and efficiency in the whole population was greater if female sex workers were prioritised. Efficiency increased, but impact decreased, if only female sex workers with lower condom use were given PrEP. Greater impact and efficiency was predicted for the scenario with lower condom use. Conclusions: PrEP could be beneficial for female sex workers and men who have sex with men in Bangalore, and give some benefits in the general population, especially in similar settings with lower condom use levels

Life is sexually transmitted: Live with it

This article explores issues of sexual health relevant to client care that is, could, or should be offered by nurses in general practice. Sexual health is often the most important element of a person’s holistic health and well-being to be overlooked during consultations. Sadly, some professional carers consider it is not their job, is too embarrassing, morally ‘problematic’ or outside their area of expertise. Sexual health is part of life: not to address it means that health professionals fail to fully address all aspects of their clients’ holistic health and well-being. The result is selective or reduced—not holistic—care. This article will point to ways for practice nurses to remedy this situation

HCV-related burden of disease in Europe: a systematic assessment of incidence, prevalence, morbidity, and mortality

Background Hepatitis C virus (HCV) is a leading cause of chronic liver disease, end-stage cirrhosis, and liver cancer, but little is known about the burden of disease caused by the virus. We summarised burden of disease data presently available for Europe, compared the data to current expert estimates, and identified areas in which better data are needed. Methods Literature and international health databases were systematically searched for HCV-specific burden of disease data, including incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and liver transplantation. Data were collected for the WHO European region with emphasis on 22 countries. If HCV-specific data were unavailable, these were calculated via HCV-attributable fractions. Results HCV-specific burden of disease data for Europe are scarce. Incidence data provided by national surveillance are not fully comparable and need to be standardised. HCV prevalence data are often inconclusive. According to available data, an estimated 7.3–8.8 million people (1.1–1.3%) are infected in our 22 focus countries. HCV-specific mortality, DALY, and transplantation data are unavailable. Estimations via HCV-attributable fractions indicate that HCV caused more than 86000 deaths and 1.2 million DALYs in the WHO European region in 2002. Most of the DALYs (95%) were accumulated by patients in preventable disease stages. About one-quarter of the liver transplants performed in 25 European countries in 2004 were attributable to HCV. Conclusion Our results indicate that hepatitis C is a major health problem and highlight the importance of timely antiviral treatment. However, data on the burden of disease of hepatitis C in Europe are scarce, outdated or inconclusive, which indicates that hepatitis C is still a neglected disease in many countries. What is needed are public awareness, co-ordinated action plans, and better data. European physicians should be aware that many infections are still undetected, provide timely testing and antiviral treatment, and avoid iatrogenic transmission

Development of a national HIV strategy

SIGLEAvailable from British Library Document Supply Centre-DSC:98/30448 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Living for tomorrow The National AIDS Trust Youth Initiative

SIGLEAvailable from British Library Document Supply Centre-DSC:q96/22531 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

A strategy for the future A summary of NAT's strategic plan

SIGLEAvailable from British Library Document Supply Centre-DSC:98/18054 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

HIV funding in England

SIGLEAvailable from British Library Document Supply Centre-DSC:0773.083408(1) / BLDSC - British Library Document Supply CentreGBUnited Kingdo