Thursday, May 1, 2008

Epidemiology of ano-rectal STIs


Click the above slide and go to IRMA's website where you can download the entire presentation. You will also find a plethora of Other Published Materials there.

Women's Anal Sex Practices: Implications for Formulation and Promotion of a Rectal Microbicide

Abstract - AIDS Education and Prevention, April 2008

To gain insight into practices that may inform formulation and use of rectal microbicides, in-depth interviews were conducted with an ethnically diverse sample of 28 women who engage in anal intercourse. Microbicides are compounds under development to decrease sexually transmitted infections. Most women practiced anal sex in conjunction with vaginal intercourse. Anal sex typically was not preplanned, and few women reported preparation. Condom use was rare. Most women relied on saliva, vaginal fluids, prelubricated condoms, or used no lubrication at last intercourse. Women were uncertain about the amount of lubricant used during sex, with typical estimates of 1 to 2 teaspoons. This may prove challenging to the formulation and promotion of rectal microbicides, as substantially higher amounts may be required. Additional challenges include infrequent use of packaged lubricants, and typical male lubricant application, which may make women's control of rectal microbicides more difficult. Women overwhelmingly expressed interest in rectal microbicides.

Click here for the full text, on IRMA's website.

Abnormal anal cells and high-risk HPV common in HIV-positive Australians


Over two-thirds of HIV-positive patients in an Australian cohort had abnormal cells in the anus, and 84% had anal infection with strains of human papilloma virus (HPV) that are associated with a high risk of anal cancer, according to an Australian study published in the April edition of Sexually Transmitted Infections. The investigators found that infection with high risk HPV was associated with the presence of high-grade pre-cancerous cells and pre-cancerous cells of undetermined, but potentially high-grade, significance.

Anal cancer is a serious condition associated with high rates of illness and death. The prevalence of anal cancer amongst gay men is thought to be similar to that amongst women before screening for cervical cancer was introduced (approximately 35 cases per 100,000). Higher rates of anal cancer have been observed in HIV-positive individuals, (but the condition is still rare in this patient group).

Read the rest on aidsmap.

Wednesday, April 30, 2008

A New Look at Sexual Prevention of HIV


Our good friends at Planeta Salud have produced a thoughtful article on placing new prevention technologies in the larger context of sexual well-being, and calling for a re-thinking of the traditional HIV prevention paradigm. Don't forget to visit our new web page for IRMA-ALC: IRMA América Latina y El Caribe for more resources in Spanish!

Una nueva mirada sobre la prevención sexual del VIH/SIDA
Autora: Marion Zibelli

El desarrollo de productos como las vacunas del SIDA o los microbicidas nos dará la posibilidad de disponer de otras herramientas para prevenir el VIH/SIDA además del preservativo. Lo que seguramente no se esperaba es que su búsqueda llevara además a alimentar todo un debate que no existía con el preservativo: el de la reducción de riesgos y daños en la prevención sexual del VIH/SIDA. La aplicación de este paradigma al campo de la prevención abre nuevas puertas para profundizar la reflexión acerca de la salud sexual al sacar a la luz las necesidades de tanto hombres como mujeres para vivir su sexualidad plenamente y de forma segura y placentera... (click here to read the rest of the article)

The Next Frontier in HIV Prevention

By: LAWRENCE D. MASS, M.D.
via Gay City News

In the field of harm reduction, we are currently engaged in two major initiatives, one a big success, the other a huge failure. The success is needle exchange, which has managed to reduce HIV transmission by as much as 80 percent in targeted urban areas.

The failure is in the application of harm reduction to sexual transmission of the virus, currently characterized by sharp increases in various populations, especially urban teenage African-American and Hispanic men who have sex with men (MSM).

The obvious question, which I pondered in an earlier Gay City News perspective piece, "The Success and Limits of Harm Reduction" (February 14-20, 2008), is how do we find a means of harm reduction for sexual transmission that will have the success of needle exchanges? In the absence of such an alternative, the piece concluded, we have little choice but to redouble the painstaking work of harm reduction, utilizing the methods we have, which still help countless individuals, even as the overall rates of transmission show increases. In the absence of an outright innovation, we must work at better and more intensive targeting of individuals, enclaves, communities, and communication technologies, especially the Internet, for safer-sex education and promotion.

Read the rest of this article here.
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