Archive for December 24, 2011

HIV incidence among men who have sex with men in China: a meta-analysis of published studies.

PLoS One. 2011;6(8):e23431.

Li HM, Peng RR, Li J, Yin YP, Wang B, Cohen MS, Chen XS.

Source

Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, China.

Abstract

BACKGROUND:

Men who have sex with men (MSM) have now become one of the priority populations for prevention and control of HIV pandemic inChina. Information of HIV incidence among MSM is important to describe the spreading of the infection and predict its trends in this population. We reviewed the published literature on the incidence of HIV infection among MSM inChina.

METHODS:

We identified relevant studies by use of a comprehensive strategy including searches of Medline and two Chinese electronic publication databases from January 2005 to September 2010. Point estimate of random effects incidence with corresponding 95% confidence intervals (CI) of HIV infection was carried out using the Comprehensive Meta-Analysis software. Subgroup analyses were examined separately, stratified by study design and geographic location.

RESULTS:

Twelve studies were identified, including three cohort studies and nine cross-sectional studies. The subgroup analyses revealed that the sub-overall incidence estimates were 3.5% (95% CI, 1.7%-5.3%) and 6.7% (95% CI, 4.8%-8.6%) for cohort and cross-sectional studies, respectively (difference between the sub-overalls, Q=5.54, p=0.02); and 8.3% (95% CI, 6.9%-9.7%) and 4.6% (95% CI, 2.4%-6.9%) for studies in Chongqing and other areas, respectively (difference between the sub-overalls, Q=7.58, p<0.01). Syphilis infection (RR=3.33, p<0.001), multiple sex partnerships (RR=2.81, p<0.001), and unprotected receptive anal intercourse in the past six months (RR=3.88, p=0.007) represented significant risk for HIV seroconversion.

CONCLUSIONS:

Findings from this meta-analysis indicate that HIV incidence is substantial in MSM inChina. High incidence of HIV infection and unique patterns of sexual risk behaviors in this population serve as a call for action that should be answered with the innovative social and public health intervention strategies, and development of biological prevention strategies.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162552/pdf/pone.0023431.pdf

December 24, 2011 at 12:03 am Leave a comment

Methodologies for evaluating HIV prevention intervention (populations and epidemiologic settings).

Curr Opin HIV AIDS. 2009 Jul;4(4):274-8.

Gray RH.

Source

Reproductive Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, E4132, 615 N Wolfe Street, Baltimore, MD 21205, USA. rgray@jhsph.edu

Abstract

PURPOSE OF REVIEW:

There have been over 30 HIV-prevention trials of which only four reported evidence of efficacy. The reasons for these negative findings may be due to ineffective interventions, but in part reflect the inappropriate selection of study populations and epidemiologic settings.

RECENT FINDINGS:

Three trials showed that male circumcision reduces HIV acquisition in men by 50-60%. In contrast, seven out of eight trials of bacterial and viral sexually transmitted infection (STI) control, and multiple microbicide trials show no efficacy for HIV prevention. Several microbicide trials found vaginal irritation and microulceration, which may increase HIV risk. Three vaccine trials failed to show efficacy and one trial suggested increased HIV risk in a subgroup of uncircumcised men.

SUMMARY:

The failure of most prevention trials reflects inadequate pretrial screening of potentially efficacious interventions, insufficient information on background HIV incidence, selection of high-risk populations with poor compliance and lack of generalizability, and treatment interruption during pregnancy all of which compromise power.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883269/pdf/nihms202778.pdf

December 24, 2011 at 12:02 am Leave a comment


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