HIV This Week
We are happy to present here a selection of scientific articles related to women and girls extracted from HIV This Week (link), a publication produced 26 times a year by the office of the Chief Scientific Adviser to UNAIDS.
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This study takes stock of the exponential growth in the number of new civil-society organisations working in the HIV field in East and Southern Africa during the period 1996-2004. Kelly and Birdsall researched this development through a survey of 439 civil-society organisations in six countries and case studies focused on the evolution of community responses to HIV in specific communities in eight countries.
Women account for an increasing proportion of patients with HIV-1 but remain underrepresented in antiretroviral clinical trials. The objective of the analysis was to evaluate sex-based differences in efficacy and adverse events in treatment-experienced, HIV-positive women and men receiving darunavirritonavir therapy over 48 weeks. This was a multicentre, open-label, phase 3b study designed to enrol a high proportion of women, with sample size determined on the basis of a noninferiority design with a maximum allowable difference of 15% in virologic response favouring men.
Prevention-Circumcision: Male circumcision and risk of male-to-female HIV-1 transmission: a multinational prospective
Male circumcision reduces female-to-male HIV-1 transmission risk by approximately 60%. Data assessing the effect of circumcision on male-to-female HIV-1 transmission are conflicting, with one observational study among HIV-1-serodiscordant couples showing reduced transmission but a randomized trial suggesting no short-term benefit of circumcision. Data were collected as part of a prospective study among African HIV-1-serodiscordant couples were analyzed for the relationship between circumcision status of HIV-1-seropositive men and risk of HIV-1 acquisition among their female partners.
Zambia / Treatment: Antiretroviral therapy in antenatal care to increase treatment initiation in HIV-infected pregnant women: a
The objective of this study was to evaluate whether providing antiretroviral therapy (ART) integrated in antenatal care clinics resulted in a greater proportion of treatment-eligible women initiating antiretroviral therapy during pregnancy compared with the existing approach of referral to antiretroviral therapy. The evaluation used a stepped-wedge design and included all HIVinfected, antiretroviral therapy-eligible pregnant women in eight public sector clinics in Lusaka district, Zambia.
Tanzania / Prevention: Comparing couples’ and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzan
Voluntary counselling and testing for couples is an important HIV-prevention effort in sub-Saharan Africa where a substantial proportion of HIV transmission occurs within stable partnerships. This study aimed to determine the acceptance and effectiveness of couples voluntary counselling and testing as compared to individual voluntary counselling and testing.
Tanzania / Prevention: Microbicides Development Programme: Engaging the community in the standard of care debate in a vaginal mi
HIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care for participants in HIV prevention trials.
Rwanda / Prevention: Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-ch
The aim of the study was to assess the 9-month HIV-free survival of children with two strategies to prevent HIV mother-to-child transmission in a nonrandomized interventional cohort study. Four public health centres in Rwanda enrolled participants between May 2005 and January 2007. All consenting HIV-infected pregnant women were included. Women could choose the mode of feeding for their infant: breastfeeding with maternal antiretroviral therapy for 6 months or formula feeding. All received antiretroviral therapy from 28 weeks of gestation.
Prevention-Microbicides: Maraviroc concentrates in the cervicovaginal fluid and vaginal tissue of HIV-negative women
The authors compared single- and multiple-dose maraviroc exposures in cervicovaginal fluid (CVF) and vaginal tissue (VT) with blood plasma (BP) and quantified maraviroc protein binding in cervicovaginal fluid. In this open-label pharmacokinetic study of 12 HIV-negative women, 7 paired CVF and BP samples were collected over 12 hours after 1 maraviroc dose. Subjects then received maraviroc twice daily for 7 days. After the last dose, subjects underwent cervicovaginal fluid and blood plasma sampling as on day 1, with additional sampling during terminal elimination.
Prevention-microbicides: Safety and pharmacokinetics of dapivirine delivery from matrix and reservoir intravaginal rings to HIV-
Vaginal microbicides for the prevention of HIV transmission may be an important option for protecting women from infection. Incorporation of dapivirine, a lead candidate nonnucleoside reverse transcriptase inhibitor, into intravaginal rings (IVRs) for sustained mucosal delivery may increase microbicide product adherence and efficacy compared with conventional vaginal formulations. Twenty-four healthy HIV-negative women 18-35 years of age were randomly assigned (1:1:1) to dapivirine matrix intravaginal ring, dapivirine reservoir intravaginal ring, or placebo intravaginal ring.
Burkina Faso / Gender-Access to Treatment: Gender asymmetry in healthcare-facility attendance of people living with HIV/AIDS in
Anthropological research in Burkina Faso indicates that more HIV-positive women than HIV-positive men are attending care facilities for people living with HIV and accessing antiretroviral medicine. This article, situated in the field of study of interactions between gender and AIDS, offers a description of this asymmetry and an anthropological analysis of the socio-cultural determinants, through analysis of data from ethnographic research among people living with HIV and health actors. Examining social representations of femininity and masculinity in Burkinabe society and the organisation of