Preventing HIV Infection in Women: A Global Health Imperative

Women account for approximately one-half of all human immunodeficiency virus (HIV) infections worldwide. Sexual transmission is the dominant mode of HIV transmission to women, and there is a concomitant associated epidemic of transmission to infants. The majority of HIV infections in women are in sub-Saharan Africa, with a disproportionate burden in young women < 25 years of age. Acquisition and prevention of HIV infection in women is complex and influenced by biological, behavioral, and structural factors. Efforts to reduce the incidence of HIV infection among women in sub-Saharan African could play a substantial role in altering global trajectories of HIV infection. Increasing access to sexual and reproductive health services, addressing gender-based violence and social instability, reducing poverty and the need to engage in sex for survival, and encouraging greater male responsibility are critical short-to-medium-term interventions. Efforts to find a microbicide and HIV vaccine need to be matched with efforts to deepen understanding of acquisition of HIV in the female genital tract to inform development of targeted molecules for prevention of HIV infection

Improving adolescent maternal health.

CAPRISA, 2015.Abstract available in pdf

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

Combination HIV prevention options for young women in Africa.

CAPRISA, 2016.Abstract available in PDF file

HIV vaccines and immunity.

No abstract available

Prevention of HIV in adolescent girls and young women : key to an AIDS-free generation.

CAPRISA, 2017.Abstract available in pdf

Lack of Toluene-Induced Dominant Lethals in Rats

Author Institution: Department of Biology, Central State UniversityThe mutagenic potential of toluene was investigated with the dominant lethal mutation assay. Male Sprague Dawley rats (8-10 wk old) were injected intraperitoneally for 5 consecutive days with 346 and 692 mg per kg body weight of toluene in corn oil. To analyze for the effect of toluene on several germ cell stages, each male was mated with one untreated, virgin female per week for up to 7 weeks. Females were sacrificed 14 to 17 d after insemination for analysis of their uterine contents. The total number of implantations and the number of dead and living embryos per pregnant female were determined. From these data the dominant lethal mutation index was calculated. There was no significant effect of toluene on the number of implantations (total, dead, or alive) per pregnant female per week. The different stages of spermatogenesis from late primary spermatocyte to fully mature sperm were not affected by the action of toluene as measured by the dominant lethal mutation assay. The dominant lethal mutation indices were small positive and negative percentages, suggesting that toluene did not induce dominant lethal mutations in the germ cells of male Sprague Dawley rats under the conditions tested

The Trail, 1963-10-23

https://soundideas.pugetsound.edu/thetrail_all/1876/thumbnail.jp

The Trail, 1964-02-26

https://soundideas.pugetsound.edu/thetrail_all/1882/thumbnail.jp

Strengthening HIV services for pregnant women: an opportunity to reduce maternal mortality rates in Southern Africa/sub-Saharan Africa

Reliable data from South Africa emanating from WHO recommendations for the Safe Motherhood programme underscores HIV/AIDS as the most common cause of maternal deaths. The strengthening of HIV services for pregnant women especially in countries with a high burden of HIV infection will reduce HIV-related and un-related maternal mortality rates. High-quality and complete data on maternal deaths is a critical foundation for reliably monitoring temporal trends in maternal deaths, and causes thereof, but needs substantial strengthening in many resource-constrained settings. HIV/AIDS is an increasing contributor to direct and indirect causes of maternal deaths in sub-Saharan Africa. A review of published data on maternal deaths and its association with HIV shows that reliable data come from the Confidential Enquiries into Maternal Deaths from South Africa, population-based surveys in sentinel populations, and facility-based data. Despite an increase in knowledge of the HIV status of pregnant women and the initiation of antiretroviral treatment, reversals in trends towards increased maternal deaths are not being observed. The strengthening of HIV services provides an opportunity to alter HIV epidemic trajectories and reduce maternal deaths