218 research outputs found
Higher risk behaviours and STD rates in Tanzania compared to Uganda - contribution to different outcomes of STD treatment trials? [abstract]
The effect of HIV, behavioural change, and STD syndromic management on STD epidemiology in sub-Saharan Africa: simulations of Uganda
The effect of HIV, behavioural change, and STD syndromic management on STD epidemiology in sub-Saharan Africa: simulations of Uganda
The effect of HIV, behavioural change, and STD syndromic management on STD epidemiology in sub-Saharan Africa: simulations of Uganda
An assessment was made of how the HIV epidemic may have influenced
sexually transmitted disease (STD) epidemiology in Uganda, and how HIV
would affect the effectiveness of syndromic STD treatment programmes
during different stages of the epidemic. The dynamic transmission model
STDSIM was used to simulate the spread of HIV and four bacterial and one
viral STD. Model parameters were quantified using demographic,
behavioural, and epidemiological data from rural Rakai and ot
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Envelopes Found Early After Acquisition Compared to Those in the Chronically Infected Partner Do Not Have Enhanced Alpha4 Beta7 Binding or Utilization
Uganda’s HIV Prevention Success: The Role of Sexual Behavior Change and the National Response. Commentary on Green et al. (2006)
The paper by Green et al. (vol. 10, this issue
HIV-1 transmitting couples have similar viral load set-points in Rakai, Uganda.
Published versio
A moving target: impacts of lowering viral load suppression cutpoints on progress towards HIV epidemic control goals
Use of injectable hormonal contraception and women’s risk of herpes simplex virus type 2 acquisition: a prospective study of couples in Rakai, Uganda
Background The injectable hormonal contraceptive depo-medroxyprogesterone acetate (DMPA) has been associated
with increased risk of HIV acquisition, but fi ndings are inconsistent. Whether DMPA increases the risk of other
sexually transmitted viral infections is unknown. We assessed the association between DMPA use and incident
herpes simplex virus type 2 (HSV2) infection in women.
Methods In this prospective study, we enrolled HIV-negative and HSV2-negative women aged 15–49 years whose
HIV-negative male partners were concurrently enrolled in a randomised trial of male circumcision in Rakai, Uganda.
We excluded women if either they or their male partners HIV seroconverted. The primary outcome was HSV2
seroconversion, assessed annually. The male circumcision trial was registered with ClinicalTrials.gov, number
NCT00425984.
Findings Between Aug 11, 2003, and July 6, 2006, we enrolled 682 women in this study. We noted HSV2
seroconversions in 70 (10%) women. Incidence was 13·5 per 100 person-years in women consistently using DMPA
(nine incident infections per 66·5 person-years), 4·3 per 100 person-years in pregnant women who were not using
hormonal contraception (18 incident infections per 423·5 person-years), and 6·6 per 100 person-years in women
who were neither pregnant nor using hormonal contraception (35 incident infections per 529·5 person-years).
Women consistently using DMPA had an adjusted hazard ratio for HSV2 seroconversion of 2·26 (95% CI
1·09–4·69; p=0·029) compared with women who were neither pregnant nor using hormonal contraception. Of
132 women with HSV2-seropositive partners, seroconversion was 36·4 per 100 person-years in consistent DMPA
users (four incident infections per 11 person-years) and 10·7 per 100 person-years in women who were neither
pregnant nor using hormonal contraception (11 incident infections per 103 person-years; adjusted hazard ratio
6·23, 95% CI 1·49–26·3; p=0·012).
Interpretation Consistent DMPA use might increase risk of HSV2 seroconversion; however, study power was low.
These fi ndings should be assessed in larger populations with more frequent follow-up than in this study, and other
contraceptive methods should also be assessed. Access to a wide range of highly eff ective contraceptive methods is
needed for women, particularly in sub-Saharan Africa
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