Addressing Research Priorities for Prevention of HIV Infection in the United States

Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-0242, USA.
Clinical Infectious Diseases (Impact Factor: 8.89). 05/2010; 50 Suppl 3(s3):S149-55. DOI: 10.1086/651485
Source: PubMed


More than half a million Americans became newly infected with human immunodeficiency virus (HIV) in the first decade of the new millennium. The domestic epidemic has had the heaviest impact on men who have sex with men and persons from racial and ethnic minority populations, particularly black persons. For example, black men who have sex with men represent <1% of the US population but 25% of new HIV infections, according to Centers for Disease Control and Prevention estimates published in 2008. Although black and Hispanic women constitute 24% of all US women, they accounted for 82% of HIV infections among women in 2005, according to data from 33 states with confidential name-based reporting. There is a nearly 23-fold higher rate of AIDS diagnoses among black women (45.5 diagnoses per 100,000 women) and a nearly 6-fold higher rate among Hispanic women (11.2 diagnoses per 100,000 women), compared with the rate among white women (2.0 diagnoses per 100,000 women). Investigators from the HIV Prevention Trials Network, a National Institutes of Health-sponsored collaborative clinical trials group, have crafted a domestic research agenda with community input. Two new domestic studies are in progress (2009), and a community-based clinical trial feasibility effort is in development (2010 start date). These studies focus on outreach, testing, and treatment of infected persons as a backbone for prevention of HIV infection. Reaching persons not receiving health messages and services with novel approaches to both prevention and treatment is an essential priority for control of HIV infection in the United States; our research is designed to guide the best approaches and assess the impact of bridging treatment and prevention.

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    • "mercial sex workers , injecting drug users and other groups at high risk of HIV , offers valuable lessons for the design of surveys of rural labour markets in Africa . Indeed , the method adopted in the FTEPRP shares many features with Venue - based Sampling as developed by the US Centers for Disease Control and Prevention ( Muhib et al . , 2001 , Vermund et al . , 2010 ) . As Landry and Shen ( 2005 : 1 ) explain , excluded populations tend not to be missing at random , so that census or survey data is usually biased , ' particularly with respect to minorities , immigrant groups , or the homeless ' ."
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    ABSTRACT: Research for the Fair Trade, Employment and Poverty Reduction Project (FTEPR) in Ethiopia and Uganda is gathering new evidence on the consequences of Fair Trade for poor people engaged in wage labour for certified producers. This has broader significance for understanding the mechanisms through which agricultural commodity exports affect the welfare of poor people. This paper discusses the methodological contribution of this research, contrasting the project with standard approaches to rural development economics research and in particular with the shortcomings of the vast majority of research on the impact of Fair Trade. The paper highlights four methodological innovations. First, in marked contrast to virtually all previous evaluations of fair trade schemes, FTEPR methods were designed specifically to collect evidence on wage workers rather than producers. Second, the project adopted a form of contrastive venue-based sampling, aided by the use of GPS devices and handheld computers (PDAs). Third, within the selected research sites, stratified random sampling procedures were based on clearly identifiable 'residential units' as opposed to ill-defined 'households'. And, fourth, when constructing a 'household roster' the research used an economic definition rather than the more common and often misleading residential rules.
    Revue canadienne d'études du développement = Canadian journal of development studies 04/2014; 35(1). DOI:10.1080/02255189.2014.873022 · 0.17 Impact Factor
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    • "HIV prevention services, including the distribution of condoms, HIV testing, and testing and treatment for sexually transmitted infections (STIs), have been documented as effective measures in reducing HIV transmission [17] [18] [19] [20] [21]. HIV testing is the entry point to access other interventions and treatment services, while HIV infected individuals who know their infection status have been shown to reduce their risky sexual behavior and lower the risk of onward transmission [17] [19]; moreover timely treatment of HIV infected individuals may reduce community level viral load and prevent HIV transmission at the population level [22] [23]. Though HIV prevention services and HIV testing have been scaled up in China over the past few years, gaps in the use of these services still remain [24] [25] [26]. "
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    ABSTRACT: Objective: To investigate barriers and correlates of the use of HIV prevention services and HIV testing behaviors among men who have sex with men in Chongqing. Methods: Three consecutive cross-sectional surveys provided demographic, sexual behavior, HIV/syphilis infection, HIV prevention service, and testing behavior data. Results: Of 1239 participants, 15.4% were infected with HIV, incidence was 12.3 per 100 persons/year (95% CI: 9.2-15.3), 38% of the participants reported ever having unprotected insertive anal sex, 40% ever received free condom/lubricants in the past year, and 27.7% ever obtained free sexually transmitted infection examination/treatment in the past year. Multivariable logistic regression revealed that lower levels of HIV/AIDS related stigmatizing/discriminatory attitudes, full-time jobs, and sex debut with men at a younger age were independently associated with use of free condom/lubricants. Large social networks, higher incomes, and sexual debut with men at a younger age were associated with use of any HIV prevention and HIV testing services. Lower levels of stigmatizing/discriminatory attitudes were also associated with HIV testing. Fearing needles and being unaware of the venues for testing were top barriers for testing service utilization. Conclusion: It is imperative to address HIV/AIDS related stigmatizing/discriminatory attitudes and other barriers while delivering intervention and testing services.
    03/2014; 2014:174870. DOI:10.1155/2014/174870
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    Clinical Infectious Diseases 05/2010; 50 Suppl 3(supplement 3):S67-70. DOI:10.1086/651475 · 8.89 Impact Factor
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