Skip to main content
Erschienen in: Current HIV/AIDS Reports 3/2016

02.05.2016 | The Global Epidemic (SH Vermund, Section Editor)

Factors Driving the HIV Epidemic in Southern Africa

verfasst von: Lyle R. McKinnon, Quarraisha Abdool Karim

Erschienen in: Current HIV/AIDS Reports | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

The HIV pandemic has disproportionately impacted sub-Saharan Africa and Southern Africa in particular. The concurrent presence of overlapping epidemic drivers likely underpins how and why the HIV epidemic is so explosive in this region, with implications for understanding approaches to reduce transmission. In this review, we discuss the relative contribution and interaction between epidemic drivers in the Southern African context, including factors both distally and proximally associated with the likelihood and degree of exposure to HIV and factors that increase the probability of transmission when exposure occurs. In particular, we focus on young women as a key population in need of HIV prevention and highlight factors that increase their risk on several levels.
Literatur
2.
Zurück zum Zitat Kharsany ABM et al. Trends in HIV prevalence in pregnant women in rural South Africa. J Acquir Immune Defic Syndr. 2015;70:289–95.PubMedCrossRef Kharsany ABM et al. Trends in HIV prevalence in pregnant women in rural South Africa. J Acquir Immune Defic Syndr. 2015;70:289–95.PubMedCrossRef
3.
Zurück zum Zitat World AIDS Day Report 2014 | UNAIDS. google.co.za at  http://www.google.co.za/search?client = safari&rls = 10_7_4&hl = en-ZA&source = hp&q = http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dweb%26cd%3D2%26ved%3D0CDUQFjAB%26url%3Dhttp%253A%252F%252Fwww.unaids.org%252Fen%252Fmedia%252Funaids%252Fcontentassets%252Fdocuments%252Fepidemiology%252F2013%252Fgr2013%252FUNAIDS_Global_Report_2013_en.pdf%26ei%3DzG65VKinOcPXatWFgsAP%26usg%3DAFQjCNH9ox1sW4Af9x61I07_wa_Kqz7_mg%26bvm%3Dbv.83829542%2Cd.d2s&gbv = 2&oq = http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dweb%26cd%3D2%26ved%3D0CDUQFjAB%26url%3Dhttp%253A%252F%252Fwww.unaids.org%252Fen%252Fmedia%252Funaids%252Fcontentassets%252Fdocuments%252Fepidemiology%252F2013%252Fgr2013%252FUNAIDS_Global_Report_2013_en.pdf%26ei%3DzG65VKinOcPXatWFgsAP%26usg%3DAFQjCNH9ox1sW4Af9x61I07_wa_Kqz7_mg%26bvm%3Dbv.83829542%2Cd.d2s&gs_l = heirloom-hp.3…337.1569.0.2570.1.1.0.0.0.0.0.0..0.0.msedr…0…1ac.1.34.heirloom-hp..1.0.0.peHgHkvHBYU World AIDS Day Report 2014 | UNAIDS. google.co.za at  http://​www.​google.​co.​za/​search?​client =​ safari&​rls =​ 10_​7_​4&​hl =​ en-ZA&​source =​ hp&​q =​ http%3A%2F%2Fwww.​google.​com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dweb%26cd%3D2%26ved%3D0CDUQFjAB%26url%3Dhttp%253A%252F%252Fwww.​unaids.​org%252Fen%252Fmedia%252Funaids%252Fcontentasset​s%252Fdocuments%252Fepidemiology​%252F2013%252Fgr2013%252FUNAIDS_​Global_​Report_​2013_​en.​pdf%26ei%3DzG65VKinOcPXat​WFgsAP%26usg%3DAFQjCNH9ox1sW4​Af9x61I07_​wa_​Kqz7_​mg%26bvm%3Dbv.​83829542%2Cd.​d2s&​gbv =​ 2&​oq =​ http%3A%2F%2Fwww.​google.​com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dweb%26cd%3D2%26ved%3D0CDUQFjAB%26url%3Dhttp%253A%252F%252Fwww.​unaids.​org%252Fen%252Fmedia%252Funaids%252Fcontentasset​s%252Fdocuments%252Fepidemiology​%252F2013%252Fgr2013%252FUNAIDS_​Global_​Report_​2013_​en.​pdf%26ei%3DzG65VKinOcPXat​WFgsAP%26usg%3DAFQjCNH9ox1sW4​Af9x61I07_​wa_​Kqz7_​mg%26bvm%3Dbv.​83829542%2Cd.​d2s&​gs_​l =​ heirloom-hp.​3…337.​1569.​0.​2570.​1.​1.​0.​0.​0.​0.​0.​0.​.​0.​0.​msedr…0…1ac.​1.​34.​heirloom-hp.​.​1.​0.​0.​peHgHkvHBYU
4.
Zurück zum Zitat Nagelkerke NJD et al. The rise and fall of HIV in high-prevalence countries: a challenge for mathematical modeling. PLoS Comput Biol. 2014;10:e1003459.PubMedPubMedCentralCrossRef Nagelkerke NJD et al. The rise and fall of HIV in high-prevalence countries: a challenge for mathematical modeling. PLoS Comput Biol. 2014;10:e1003459.PubMedPubMedCentralCrossRef
5.
Zurück zum Zitat Chen L et al. Sexual risk factors for HIV infection in early and advanced HIV epidemics in sub-Saharan Africa: systematic overview of 68 epidemiological studies. PLoS One. 2007;2:e1001.PubMedPubMedCentralCrossRef Chen L et al. Sexual risk factors for HIV infection in early and advanced HIV epidemics in sub-Saharan Africa: systematic overview of 68 epidemiological studies. PLoS One. 2007;2:e1001.PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat McKinnon LR et al. High HIV risk in a cohort of male sex workers from Nairobi, Kenya. Sex Transm Infect. 2014;90:237–42.PubMedCrossRef McKinnon LR et al. High HIV risk in a cohort of male sex workers from Nairobi, Kenya. Sex Transm Infect. 2014;90:237–42.PubMedCrossRef
7.
Zurück zum Zitat Sanders EJ, Jaffe H, Musyoki H, Muraguri N, Graham SM. Kenyan MSM: no longer a hidden population. AIDS. 2015;29 Suppl 3:S195–9.PubMedCrossRef Sanders EJ, Jaffe H, Musyoki H, Muraguri N, Graham SM. Kenyan MSM: no longer a hidden population. AIDS. 2015;29 Suppl 3:S195–9.PubMedCrossRef
8.
Zurück zum Zitat Rispel LC, Metcalf CA, Cloete A, Reddy V, Lombard C. HIV prevalence and risk practices among men who have sex with men in two South African cities. J Acquir Immune Defic Syndr. 2011;57:69–76.PubMedCrossRef Rispel LC, Metcalf CA, Cloete A, Reddy V, Lombard C. HIV prevalence and risk practices among men who have sex with men in two South African cities. J Acquir Immune Defic Syndr. 2011;57:69–76.PubMedCrossRef
9.
Zurück zum Zitat Sandfort TGM, Lane T, Dolezal C, Reddy V. Gender expression and risk of HIV infection among Black South African men who have sex with men. AIDS Behav. 2015;19:2270–9.PubMedCrossRef Sandfort TGM, Lane T, Dolezal C, Reddy V. Gender expression and risk of HIV infection among Black South African men who have sex with men. AIDS Behav. 2015;19:2270–9.PubMedCrossRef
10.
Zurück zum Zitat Dunkle KL, Jewkes RK, Murdock DW, Sikweyiya Y, Morrell R. Prevalence of consensual male-male sex and sexual violence, and associations with HIV in South Africa: a population-based cross-sectional study. PLoS Med. 2013;10:e1001472.PubMedPubMedCentralCrossRef Dunkle KL, Jewkes RK, Murdock DW, Sikweyiya Y, Morrell R. Prevalence of consensual male-male sex and sexual violence, and associations with HIV in South Africa: a population-based cross-sectional study. PLoS Med. 2013;10:e1001472.PubMedPubMedCentralCrossRef
11.
Zurück zum Zitat Karim QA et al. Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa. Int J Epidemiol. 2011;40:922–30.PubMedPubMedCentralCrossRef Karim QA et al. Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa. Int J Epidemiol. 2011;40:922–30.PubMedPubMedCentralCrossRef
12.•
Zurück zum Zitat Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell M-L. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;966. This important cohort analysis followed up on the HPTN052 clinical trial results suggesting that ART prevents HIV acquisition. Importantly, these effects were seen in a large population in the context of community treatment programs, suggesting real-world effectiveness of ART as a prevention strategy. Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell M-L. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;966. This important cohort analysis followed up on the HPTN052 clinical trial results suggesting that ART prevents HIV acquisition. Importantly, these effects were seen in a large population in the context of community treatment programs, suggesting real-world effectiveness of ART as a prevention strategy.
13.
Zurück zum Zitat Abdool Karim Q, Sibeko S, Baxter C. Preventing HIV infection in women: a global health imperative. Clin Infect Dis. 2010;50 Suppl 3:S122–9.PubMedCrossRef Abdool Karim Q, Sibeko S, Baxter C. Preventing HIV infection in women: a global health imperative. Clin Infect Dis. 2010;50 Suppl 3:S122–9.PubMedCrossRef
14.
Zurück zum Zitat Kapogiannis BG, Legins KE, Chandan U, Lee S. Evidence-based programming for adolescent HIV prevention and care: operational research to inform best practices. J Acquir Immune Defic Syndr. 2014;66 Suppl 2:S228–35.PubMedCrossRef Kapogiannis BG, Legins KE, Chandan U, Lee S. Evidence-based programming for adolescent HIV prevention and care: operational research to inform best practices. J Acquir Immune Defic Syndr. 2014;66 Suppl 2:S228–35.PubMedCrossRef
15.
Zurück zum Zitat Eaton JW et al. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models. Lancet Glob Health. 2014;2:e23–34.PubMedCrossRef Eaton JW et al. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models. Lancet Glob Health. 2014;2:e23–34.PubMedCrossRef
16.
Zurück zum Zitat Tanser F, de Oliveira T, Maheu-Giroux M, Bärnighausen T. Concentrated HIV subepidemics in generalized epidemic settings. Curr Opin HIV AIDS. 2014;9:115–25.PubMedPubMedCentralCrossRef Tanser F, de Oliveira T, Maheu-Giroux M, Bärnighausen T. Concentrated HIV subepidemics in generalized epidemic settings. Curr Opin HIV AIDS. 2014;9:115–25.PubMedPubMedCentralCrossRef
17.•
Zurück zum Zitat Gerberry DJ, Wagner BG, García-Lerma JG, Heneine W, Blower S. Using geospatial modelling to optimize the rollout of antiretroviral-based pre-exposure HIV interventions in Sub-Saharan Africa. Nat Commun. 2014;5:5454. This paper highlights a major shift in focus of strategies to fight the epidemic in light of antiretroviral-based prevention, and that is finding ways to focus on those most in need and where transmission densities are highest.PubMedPubMedCentralCrossRef Gerberry DJ, Wagner BG, García-Lerma JG, Heneine W, Blower S. Using geospatial modelling to optimize the rollout of antiretroviral-based pre-exposure HIV interventions in Sub-Saharan Africa. Nat Commun. 2014;5:5454. This paper highlights a major shift in focus of strategies to fight the epidemic in light of antiretroviral-based prevention, and that is finding ways to focus on those most in need and where transmission densities are highest.PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Kasedde S, Kapogiannis BG, McClure C, Luo C. Executive summary: opportunities for action and impact to address HIV and AIDS in adolescents. J Acquir Immune Defic Syndr. 2014;66 Suppl 2:S139–43.PubMedCrossRef Kasedde S, Kapogiannis BG, McClure C, Luo C. Executive summary: opportunities for action and impact to address HIV and AIDS in adolescents. J Acquir Immune Defic Syndr. 2014;66 Suppl 2:S139–43.PubMedCrossRef
19.
20.
Zurück zum Zitat Tan JY, Huedo-Medina TB, Warren MR, Carey MP, Johnson BT. A meta-analysis of the efficacy of HIV/AIDS prevention interventions in Asia, 1995–2009. Soc Sci Med. 2012;75:676–87.PubMedPubMedCentralCrossRef Tan JY, Huedo-Medina TB, Warren MR, Carey MP, Johnson BT. A meta-analysis of the efficacy of HIV/AIDS prevention interventions in Asia, 1995–2009. Soc Sci Med. 2012;75:676–87.PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Chandrasekaran P et al. Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative. AIDS. 2008;22 Suppl 5:S1–15.PubMedCrossRef Chandrasekaran P et al. Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative. AIDS. 2008;22 Suppl 5:S1–15.PubMedCrossRef
22.
Zurück zum Zitat Tladi LS. Poverty and HIV/AIDS in South Africa: an empirical contribution. SAHARA J. 2006;3:369–81.PubMedCrossRef Tladi LS. Poverty and HIV/AIDS in South Africa: an empirical contribution. SAHARA J. 2006;3:369–81.PubMedCrossRef
23.
Zurück zum Zitat Kalichman SC et al. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Soc Sci Med. 2006;62:1641–9.PubMedCrossRef Kalichman SC et al. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Soc Sci Med. 2006;62:1641–9.PubMedCrossRef
24.
Zurück zum Zitat Fenton L. Preventing HIV/AIDS through poverty reduction: the only sustainable solution? Lancet. 2004;364:1186–7.PubMedCrossRef Fenton L. Preventing HIV/AIDS through poverty reduction: the only sustainable solution? Lancet. 2004;364:1186–7.PubMedCrossRef
26.
Zurück zum Zitat Shisana O, Rice K, Zungu N, Zuma K. Gender and poverty in South Africa in the era of HIV/AIDS: a quantitative study. J Womens Health (Larchmt). 2010;19:39–46.CrossRef Shisana O, Rice K, Zungu N, Zuma K. Gender and poverty in South Africa in the era of HIV/AIDS: a quantitative study. J Womens Health (Larchmt). 2010;19:39–46.CrossRef
27.
Zurück zum Zitat Mishra V et al. HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. AIDS. 2007;21 Suppl 7:S17–28.PubMedCrossRef Mishra V et al. HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. AIDS. 2007;21 Suppl 7:S17–28.PubMedCrossRef
28.
Zurück zum Zitat Jewkes RK, Levin JB, Penn-Kekana LA. Gender inequalities, intimate partner violence and HIV preventive practices: findings of a South African cross-sectional study. Soc Sci Med. 2003;56:125–34.PubMedCrossRef Jewkes RK, Levin JB, Penn-Kekana LA. Gender inequalities, intimate partner violence and HIV preventive practices: findings of a South African cross-sectional study. Soc Sci Med. 2003;56:125–34.PubMedCrossRef
29.
Zurück zum Zitat Shamu S et al. Prevalence and risk factors for intimate partner violence among Grade 8 learners in urban South Africa: baseline analysis from the Skhokho Supporting Success cluster randomised controlled trial. Int Health. 2016;8:18–26.PubMed Shamu S et al. Prevalence and risk factors for intimate partner violence among Grade 8 learners in urban South Africa: baseline analysis from the Skhokho Supporting Success cluster randomised controlled trial. Int Health. 2016;8:18–26.PubMed
30.
Zurück zum Zitat MacPherson EE, Richards E, Namakhoma I, Theobald S. Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature. Glob Health Action. 2014;7:23717.PubMed MacPherson EE, Richards E, Namakhoma I, Theobald S. Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature. Glob Health Action. 2014;7:23717.PubMed
31.•
Zurück zum Zitat Durevall D, Lindskog A. Intimate partner violence and HIV in ten sub-Saharan African countries: what do the Demographic and Health Surveys tell us? Lancet Glob Health. 2015;3:e34–43. This study used several large national datasets to explore in more detail the associations between intimate partner violence and HIV, providing insight into scenarios where the linkage between these two factors is strongest.PubMedCrossRef Durevall D, Lindskog A. Intimate partner violence and HIV in ten sub-Saharan African countries: what do the Demographic and Health Surveys tell us? Lancet Glob Health. 2015;3:e34–43. This study used several large national datasets to explore in more detail the associations between intimate partner violence and HIV, providing insight into scenarios where the linkage between these two factors is strongest.PubMedCrossRef
32.
Zurück zum Zitat Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci. 2007;8:141–51.PubMedCrossRef Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci. 2007;8:141–51.PubMedCrossRef
33.
Zurück zum Zitat Hargreaves JR et al. Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa. AIDS. 2008;22:403–14.PubMedCrossRef Hargreaves JR et al. Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa. AIDS. 2008;22:403–14.PubMedCrossRef
34.
Zurück zum Zitat Bärnighausen T, Hosegood V, Timaeus IM, Newell M-L. The socioeconomic determinants of HIV incidence: evidence from a longitudinal, population-based study in rural South Africa. AIDS. 2007;21 Suppl 7:S29–38.PubMedPubMedCentralCrossRef Bärnighausen T, Hosegood V, Timaeus IM, Newell M-L. The socioeconomic determinants of HIV incidence: evidence from a longitudinal, population-based study in rural South Africa. AIDS. 2007;21 Suppl 7:S29–38.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Pettifor AE et al. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women. Int J Epidemiol. 2008;37:1266–73.PubMedPubMedCentralCrossRef Pettifor AE et al. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women. Int J Epidemiol. 2008;37:1266–73.PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Stroeken K et al. HIV among out-of-school youth in Eastern and Southern Africa: a review. AIDS Care. 2012;24:186–94.PubMed Stroeken K et al. HIV among out-of-school youth in Eastern and Southern Africa: a review. AIDS Care. 2012;24:186–94.PubMed
37.
Zurück zum Zitat Abdool Karim Q et al. HIV incidence in young girls in KwaZulu-Natal, South Africa—public health imperative for their inclusion in HIV biomedical intervention trials. AIDS Behav. 2012;16:1870–6.PubMedCrossRef Abdool Karim Q et al. HIV incidence in young girls in KwaZulu-Natal, South Africa—public health imperative for their inclusion in HIV biomedical intervention trials. AIDS Behav. 2012;16:1870–6.PubMedCrossRef
38.
Zurück zum Zitat Mugo NR et al. Increased risk of HIV-1 transmission in pregnancy: a prospective study among African HIV-1-serodiscordant couples. AIDS. 2011;25:1887–95.PubMedPubMedCentralCrossRef Mugo NR et al. Increased risk of HIV-1 transmission in pregnancy: a prospective study among African HIV-1-serodiscordant couples. AIDS. 2011;25:1887–95.PubMedPubMedCentralCrossRef
40.
Zurück zum Zitat Baird SJ, Garfein RS, McIntosh CT, Ozler B. Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial. Lancet. 2012;379:1320–9.PubMedCrossRef Baird SJ, Garfein RS, McIntosh CT, Ozler B. Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial. Lancet. 2012;379:1320–9.PubMedCrossRef
41.
Zurück zum Zitat de Walque D et al. Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania. BMJ Open. 2012;2:e000747.PubMedPubMedCentralCrossRef de Walque D et al. Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania. BMJ Open. 2012;2:e000747.PubMedPubMedCentralCrossRef
42.
43.
Zurück zum Zitat Fieno J, Leclerc-Madlala S. The promise and limitations of cash transfer programs for HIV prevention. Afr J AIDS Res. 2014;13:153–60.PubMedCrossRef Fieno J, Leclerc-Madlala S. The promise and limitations of cash transfer programs for HIV prevention. Afr J AIDS Res. 2014;13:153–60.PubMedCrossRef
44.
Zurück zum Zitat Abdool Karim Q et al. Prevalence of HIV, HSV-2 and pregnancy among high school students in rural KwaZulu-Natal. South Africa: a bio-behavioural cross-sectional survey Sex Transm Infect. 2014;90:620–6.PubMed Abdool Karim Q et al. Prevalence of HIV, HSV-2 and pregnancy among high school students in rural KwaZulu-Natal. South Africa: a bio-behavioural cross-sectional survey Sex Transm Infect. 2014;90:620–6.PubMed
45.
Zurück zum Zitat Pettifor A, et al. HPTN 068: A Randomized Control Trial of a Conditional Cash Transfer to Reduce HIV Infection in Young Women in South Africa-Study Design and Baseline Results. AIDS Behav. 2016. doi:10.1007/s10461-015-1270-0 Pettifor A, et al. HPTN 068: A Randomized Control Trial of a Conditional Cash Transfer to Reduce HIV Infection in Young Women in South Africa-Study Design and Baseline Results. AIDS Behav. 2016. doi:10.​1007/​s10461-015-1270-0
46.••
Zurück zum Zitat Abdool Karim Q, Leask K, Kharsany A, Humphries H, Ntombela F, Samsunder N, Baxter C, Frohlich J, van der Elst L, Abdool Karim S. Impact of conditional cash incentives on HSV-2 and HIV prevention in rural South African high school students: results of the CAPRISA 007 cluster randomized controlled trial. (TUAC0101LB). 8th IAS Conference on HIV Pathogenesis, Treatment & Prevention 19–22 July 2015, Vancouver, Canada. J Int AIDS Soc. 2015;18. References [46••] and [47••] explore the possibility of a school-based intervention to prevent HIV transmission, in particular to young women in rural South Africa, by in various ways providing an incentive-based behavioural intervention. Importantly, neither of these studies showed an HIV effect while [46••] showed an HSV2 effect. Understanding these outcomes is critical to the decision of if and how to move forward with this strategy. Abdool Karim Q, Leask K, Kharsany A, Humphries H, Ntombela F, Samsunder N, Baxter C, Frohlich J, van der Elst L, Abdool Karim S. Impact of conditional cash incentives on HSV-2 and HIV prevention in rural South African high school students: results of the CAPRISA 007 cluster randomized controlled trial. (TUAC0101LB). 8th IAS Conference on HIV Pathogenesis, Treatment & Prevention 19–22 July 2015, Vancouver, Canada. J Int AIDS Soc. 2015;18. References [46••] and [47••] explore the possibility of a school-based intervention to prevent HIV transmission, in particular to young women in rural South Africa, by in various ways providing an incentive-based behavioural intervention. Importantly, neither of these studies showed an HIV effect while [46••] showed an HSV2 effect. Understanding these outcomes is critical to the decision of if and how to move forward with this strategy.
47.••
Zurück zum Zitat Pettifor A, MacPhail C, Selin A, Gomez-Olivé X, Hughes J, Wagner R, Mabuza W, Mokoena I, Eshleman S, Piwowar-Manning E, Twine R, Julien A, Marcus C, Andrew P, Wang J, Xing Y, McKinstry L, Hamilton E, Agyei Y, Allison S, Sato P, Townley E, Tollman S, Kahn K, HPTN 068 Study Team. HPTN 068 conditional cash transfer to prevent HIV infection among young women in South Africa: results of a randomized controlled tria (TUAC0106LB). 8th IAS Conference on HIV Pathogenesis, Treatment & Prevention 19–22 July 2015, Vancouver, Canada. J Int AIDS Soc. 2015;18. References [46••] and [47••] explore the possibility of a school-based intervention to prevent HIV transmission, in particular to young women in rural South Africa, by in various ways providing an incentive-based behavioural intervention. Importantly, neither of these studies showed an HIV effect while [46••] showed an HSV2 effect. Understanding these outcomes is critical to the decision of if and how to move forward with this strategy. Pettifor A, MacPhail C, Selin A, Gomez-Olivé X, Hughes J, Wagner R, Mabuza W, Mokoena I, Eshleman S, Piwowar-Manning E, Twine R, Julien A, Marcus C, Andrew P, Wang J, Xing Y, McKinstry L, Hamilton E, Agyei Y, Allison S, Sato P, Townley E, Tollman S, Kahn K, HPTN 068 Study Team. HPTN 068 conditional cash transfer to prevent HIV infection among young women in South Africa: results of a randomized controlled tria (TUAC0106LB). 8th IAS Conference on HIV Pathogenesis, Treatment & Prevention 19–22 July 2015, Vancouver, Canada. J Int AIDS Soc. 2015;18. References [46••] and [47••] explore the possibility of a school-based intervention to prevent HIV transmission, in particular to young women in rural South Africa, by in various ways providing an incentive-based behavioural intervention. Importantly, neither of these studies showed an HIV effect while [46••] showed an HSV2 effect. Understanding these outcomes is critical to the decision of if and how to move forward with this strategy.
48.••
Zurück zum Zitat Wagman JA et al. Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort. Lancet Glob Health. 2015;3:e23–33. References [48••], [49••], and [50••] are cluster-randomized studies that all show positive outcomes for interventions to reduce violence including gender-based and intimate partner violence in the context of broader HIV prevention efforts. Wagman JA et al. Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort. Lancet Glob Health. 2015;3:e23–33. References [48••], [49••], and [50••] are cluster-randomized studies that all show positive outcomes for interventions to reduce violence including gender-based and intimate partner violence in the context of broader HIV prevention efforts.
49.••
Zurück zum Zitat Abramsky T et al. Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Med. 2014;12:122. References [48••], [49••], and [50••] are cluster-randomized studies that all show positive outcomes for interventions to reduce violence including gender-based and intimate partner violence in the context of broader HIV prevention efforts. Abramsky T et al. Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Med. 2014;12:122. References [48••], [49••], and [50••] are cluster-randomized studies that all show positive outcomes for interventions to reduce violence including gender-based and intimate partner violence in the context of broader HIV prevention efforts.
50.••
Zurück zum Zitat Devries KM et al. The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda. Lancet Glob Health. 2015;3:e378–86. References [48••], [49••], and [50••] are cluster-randomized studies that all show positive outcomes for interventions to reduce violence including gender-based and intimate partner violence in the context of broader HIV prevention efforts.. Devries KM et al. The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda. Lancet Glob Health. 2015;3:e378–86. References [48••], [49••], and [50••] are cluster-randomized studies that all show positive outcomes for interventions to reduce violence including gender-based and intimate partner violence in the context of broader HIV prevention efforts..
51.
Zurück zum Zitat Green EP, Blattman C, Jamison J, Annan J. Women’s entrepreneurship and intimate partner violence: a cluster randomized trial of microenterprise assistance and partner participation in post-conflict Uganda (SSM-D-14-01580R1). Soc Sci Med. 2015;133:177–88.PubMedCrossRef Green EP, Blattman C, Jamison J, Annan J. Women’s entrepreneurship and intimate partner violence: a cluster randomized trial of microenterprise assistance and partner participation in post-conflict Uganda (SSM-D-14-01580R1). Soc Sci Med. 2015;133:177–88.PubMedCrossRef
52.
Zurück zum Zitat Kajula L et al. Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam. BMC Public Health. 2016;16:113.PubMedPubMedCentralCrossRef Kajula L et al. Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam. BMC Public Health. 2016;16:113.PubMedPubMedCentralCrossRef
53.
Zurück zum Zitat Mathews C et al. Reaching the hard to reach: longitudinal investigation of adolescents’ attendance at an after-school sexual and reproductive health programme in Western Cape, South Africa. BMC Public Health. 2015;15:608.PubMedPubMedCentralCrossRef Mathews C et al. Reaching the hard to reach: longitudinal investigation of adolescents’ attendance at an after-school sexual and reproductive health programme in Western Cape, South Africa. BMC Public Health. 2015;15:608.PubMedPubMedCentralCrossRef
54.
Zurück zum Zitat Quinn TC et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342:921–9.PubMedCrossRef Quinn TC et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342:921–9.PubMedCrossRef
56.
58.
Zurück zum Zitat Donnell D et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375:2092–8.PubMedPubMedCentralCrossRef Donnell D et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375:2092–8.PubMedPubMedCentralCrossRef
59.
Zurück zum Zitat Stöckl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for HIV infection among women in sub-Saharan Africa? A systematic review. Am J Reprod Immunol. 2013;69 Suppl 1:27–40.PubMedCrossRef Stöckl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for HIV infection among women in sub-Saharan Africa? A systematic review. Am J Reprod Immunol. 2013;69 Suppl 1:27–40.PubMedCrossRef
60.
Zurück zum Zitat Pilgrim NA et al. Family structure effects on early sexual debut among adolescent girls in Rakai, Uganda. Vulnerable Child Youth Stud. 2014;9:193–205.PubMedPubMedCentralCrossRef Pilgrim NA et al. Family structure effects on early sexual debut among adolescent girls in Rakai, Uganda. Vulnerable Child Youth Stud. 2014;9:193–205.PubMedPubMedCentralCrossRef
61.
Zurück zum Zitat Seth P, DiClemente RJ, Lovvorn AE. State of the evidence: intimate partner violence and HIV/STI risk among adolescents. Curr HIV Res. 2013;11:528–35.PubMedCrossRef Seth P, DiClemente RJ, Lovvorn AE. State of the evidence: intimate partner violence and HIV/STI risk among adolescents. Curr HIV Res. 2013;11:528–35.PubMedCrossRef
62.
Zurück zum Zitat Maughan-Brown B, Kenyon C, Lurie MN. Partner age differences and concurrency in South Africa: implications for HIV-infection risk among young women. AIDS Behav. 2014;18:2469–76.PubMedPubMedCentralCrossRef Maughan-Brown B, Kenyon C, Lurie MN. Partner age differences and concurrency in South Africa: implications for HIV-infection risk among young women. AIDS Behav. 2014;18:2469–76.PubMedPubMedCentralCrossRef
63.
Zurück zum Zitat Harling G et al. Do age-disparate relationships drive HIV incidence in young women? Evidence from a population cohort in rural KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2014;66:443–51.PubMedPubMedCentralCrossRef Harling G et al. Do age-disparate relationships drive HIV incidence in young women? Evidence from a population cohort in rural KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2014;66:443–51.PubMedPubMedCentralCrossRef
65.
66.
Zurück zum Zitat Helleringer S, Kohler H-P. Sexual network structure and the spread of HIV in Africa: evidence from Likoma Island, Malawi. AIDS. 2007;21:2323–32.PubMedCrossRef Helleringer S, Kohler H-P. Sexual network structure and the spread of HIV in Africa: evidence from Likoma Island, Malawi. AIDS. 2007;21:2323–32.PubMedCrossRef
67.
Zurück zum Zitat Morris M, Kretzschmar M. Concurrent partnerships and the spread of HIV. AIDS. 1997;11:641–8.PubMedCrossRef Morris M, Kretzschmar M. Concurrent partnerships and the spread of HIV. AIDS. 1997;11:641–8.PubMedCrossRef
68.
Zurück zum Zitat Tanser F et al. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study. Lancet. 2011;378:247–55.PubMedPubMedCentralCrossRef Tanser F et al. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study. Lancet. 2011;378:247–55.PubMedPubMedCentralCrossRef
69.
Zurück zum Zitat Wawer MJ et al. Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. J Infect Dis. 2005;191:1403–9.PubMedCrossRef Wawer MJ et al. Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. J Infect Dis. 2005;191:1403–9.PubMedCrossRef
70.
Zurück zum Zitat Brenner B, Wainberg MA, Roger M. Phylogenetic inferences on HIV-1 transmission: implications for the design of prevention and treatment interventions. AIDS. 2013;27:1045–57.PubMedPubMedCentralCrossRef Brenner B, Wainberg MA, Roger M. Phylogenetic inferences on HIV-1 transmission: implications for the design of prevention and treatment interventions. AIDS. 2013;27:1045–57.PubMedPubMedCentralCrossRef
71.•
Zurück zum Zitat Eaton JW, Hallett TB. Why the proportion of transmission during early-stage HIV infection does not predict the long-term impact of treatment on HIV incidence. Proc Natl Acad Sci U S A. 2014;111:16202–7. This paper deals with an important issue that has caused substantial controversy; HIV transmission during acute infection. Using mathematical models the authors argue that there are several reasons to think this may not be a significant barrier to slowing the epidemic by treatment.PubMedPubMedCentralCrossRef Eaton JW, Hallett TB. Why the proportion of transmission during early-stage HIV infection does not predict the long-term impact of treatment on HIV incidence. Proc Natl Acad Sci U S A. 2014;111:16202–7. This paper deals with an important issue that has caused substantial controversy; HIV transmission during acute infection. Using mathematical models the authors argue that there are several reasons to think this may not be a significant barrier to slowing the epidemic by treatment.PubMedPubMedCentralCrossRef
72.
Zurück zum Zitat Cohen MS, Pilcher CD. Amplified HIV transmission and new approaches to HIV prevention. J Infect Dis. 2005;191:1391–3.PubMedCrossRef Cohen MS, Pilcher CD. Amplified HIV transmission and new approaches to HIV prevention. J Infect Dis. 2005;191:1391–3.PubMedCrossRef
73.
Zurück zum Zitat Lewis F, Hughes GJ, Rambaut A, Pozniak A, Leigh Brown AJ. Episodic sexual transmission of HIV revealed by molecular phylodynamics. PLoS Med. 2008;5:e50.PubMedPubMedCentralCrossRef Lewis F, Hughes GJ, Rambaut A, Pozniak A, Leigh Brown AJ. Episodic sexual transmission of HIV revealed by molecular phylodynamics. PLoS Med. 2008;5:e50.PubMedPubMedCentralCrossRef
76.
Zurück zum Zitat Lai A et al. HIV-1 A1 subtype epidemic in Italy originated from Africa and Eastern Europe and shows a high frequency of transmission chains involving intravenous drug users. PLoS One. 2016;11:e0146097.PubMedPubMedCentralCrossRef Lai A et al. HIV-1 A1 subtype epidemic in Italy originated from Africa and Eastern Europe and shows a high frequency of transmission chains involving intravenous drug users. PLoS One. 2016;11:e0146097.PubMedPubMedCentralCrossRef
77.
Zurück zum Zitat Ratmann O et al. Sources of HIV infection among men having sex with men and implications for prevention. Sci Transl Med. 2016;8:320ra2.PubMedCrossRef Ratmann O et al. Sources of HIV infection among men having sex with men and implications for prevention. Sci Transl Med. 2016;8:320ra2.PubMedCrossRef
78.
Zurück zum Zitat Patel P et al. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28:1509–19.PubMedCrossRef Patel P et al. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28:1509–19.PubMedCrossRef
79.
Zurück zum Zitat Dennis AM et al. Phylogenetic studies of transmission dynamics in generalized HIV epidemics: an essential tool where the burden is greatest? J Acquir Immune Defic Syndr. 2014;67:181–95.PubMedPubMedCentralCrossRef Dennis AM et al. Phylogenetic studies of transmission dynamics in generalized HIV epidemics: an essential tool where the burden is greatest? J Acquir Immune Defic Syndr. 2014;67:181–95.PubMedPubMedCentralCrossRef
80.••
Zurück zum Zitat Kharsany ABM et al. HIV infection in high school students in rural South Africa: role of transmissions among students. AIDS Res Hum Retroviruses. 2014;30:956–65. References [80••] and [81••] are some of the first to study heterosexual HIV transmission networks in Africa using phylogenetics, which has substantial potential to be expanded and gain insight into how to target interventions to where they can have the most impact. Kharsany ABM et al. HIV infection in high school students in rural South Africa: role of transmissions among students. AIDS Res Hum Retroviruses. 2014;30:956–65. References [80••] and [81••] are some of the first to study heterosexual HIV transmission networks in Africa using phylogenetics, which has substantial potential to be expanded and gain insight into how to target interventions to where they can have the most impact.
81.••
Zurück zum Zitat Grabowski MK et al. The role of viral introductions in sustaining community-based HIV epidemics in rural Uganda: evidence from spatial clustering, phylogenetics, and egocentric transmission models. PLoS Med. 2014;11:e1001610. References [80••] and [81••] are some of the first to study heterosexual HIV transmission networks in Africa using phylogenetics, which has substantial potential to be expanded and gain insight into how to target interventions to where they can have the most impact. Grabowski MK et al. The role of viral introductions in sustaining community-based HIV epidemics in rural Uganda: evidence from spatial clustering, phylogenetics, and egocentric transmission models. PLoS Med. 2014;11:e1001610. References [80••] and [81••] are some of the first to study heterosexual HIV transmission networks in Africa using phylogenetics, which has substantial potential to be expanded and gain insight into how to target interventions to where they can have the most impact.
82.
Zurück zum Zitat Scott-Sheldon LAJ, Walstrom P, Harrison A, Kalichman SC, Carey MP. Sexual risk reduction interventions for HIV prevention among South African youth: a meta-analytic review. Curr HIV Res. 2013;11:549–58.PubMedPubMedCentralCrossRef Scott-Sheldon LAJ, Walstrom P, Harrison A, Kalichman SC, Carey MP. Sexual risk reduction interventions for HIV prevention among South African youth: a meta-analytic review. Curr HIV Res. 2013;11:549–58.PubMedPubMedCentralCrossRef
83.
Zurück zum Zitat Protogerou C, Johnson BT. Factors underlying the success of behavioral HIV-prevention interventions for adolescents: a meta-review. AIDS Behav. 2014;18:1847–63.PubMedCrossRef Protogerou C, Johnson BT. Factors underlying the success of behavioral HIV-prevention interventions for adolescents: a meta-review. AIDS Behav. 2014;18:1847–63.PubMedCrossRef
84.
Zurück zum Zitat Jewkes R et al. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ. 2008;337:a506.PubMedPubMedCentralCrossRef Jewkes R et al. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ. 2008;337:a506.PubMedPubMedCentralCrossRef
86.
Zurück zum Zitat Boily M-C et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis. 2009;9:118–29.PubMedPubMedCentralCrossRef Boily M-C et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis. 2009;9:118–29.PubMedPubMedCentralCrossRef
87.
Zurück zum Zitat Powers KA, Poole C, Pettifor AE, Cohen MS. Rethinking the heterosexual infectivity of HIV-1: a systematic review and meta-analysis. Lancet Infect Dis. 2008;8:553–63.PubMedPubMedCentralCrossRef Powers KA, Poole C, Pettifor AE, Cohen MS. Rethinking the heterosexual infectivity of HIV-1: a systematic review and meta-analysis. Lancet Infect Dis. 2008;8:553–63.PubMedPubMedCentralCrossRef
88.•
Zurück zum Zitat Abu-Raddad LJ et al. Have the explosive HIV epidemics in sub-Saharan Africa been driven by higher community viral load? AIDS. 2013;27:981–9. This reference along with reference [93] suggest that clade C infections do not have higher viral loads nor are they more transmissible than other clades. These are both important issues that have been proposed to fuel the more substantial epidemics in Southern Africa, and these two large, well-designed analyses fail to find evidence to support this idea. Abu-Raddad LJ et al. Have the explosive HIV epidemics in sub-Saharan Africa been driven by higher community viral load? AIDS. 2013;27:981–9. This reference along with reference [93] suggest that clade C infections do not have higher viral loads nor are they more transmissible than other clades. These are both important issues that have been proposed to fuel the more substantial epidemics in Southern Africa, and these two large, well-designed analyses fail to find evidence to support this idea.
89.
Zurück zum Zitat Van Harmelen JH et al. A predominantly HIV type 1 subtype C-restricted epidemic in South African urban populations. AIDS Res Hum Retroviruses. 1999;15:395–8.PubMedCrossRef Van Harmelen JH et al. A predominantly HIV type 1 subtype C-restricted epidemic in South African urban populations. AIDS Res Hum Retroviruses. 1999;15:395–8.PubMedCrossRef
91.
Zurück zum Zitat Kiwanuka N et al. Effect of human immunodeficiency virus Type 1 (HIV-1) subtype on disease progression in persons from Rakai, Uganda, with incident HIV-1 infection. J Infect Dis. 2008;197:707–13.PubMedCrossRef Kiwanuka N et al. Effect of human immunodeficiency virus Type 1 (HIV-1) subtype on disease progression in persons from Rakai, Uganda, with incident HIV-1 infection. J Infect Dis. 2008;197:707–13.PubMedCrossRef
92.
Zurück zum Zitat Baeten JM et al. HIV-1 subtype D infection is associated with faster disease progression than subtype A in spite of similar plasma HIV-1 loads. J Infect Dis. 2007;195:1177–80.PubMedCrossRef Baeten JM et al. HIV-1 subtype D infection is associated with faster disease progression than subtype A in spite of similar plasma HIV-1 loads. J Infect Dis. 2007;195:1177–80.PubMedCrossRef
93.
Zurück zum Zitat Kahle E et al. HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission: a multinational study among HIV-1 serodiscordant couples. AIDS. 2014;28:235–43.PubMedPubMedCentralCrossRef Kahle E et al. HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission: a multinational study among HIV-1 serodiscordant couples. AIDS. 2014;28:235–43.PubMedPubMedCentralCrossRef
94.
Zurück zum Zitat McKinnon LR, Kaul R. Quality and quantity: mucosal CD4+ T cells and HIV susceptibility. Curr Opin HIV AIDS. 2012;7:195–202.PubMedCrossRef McKinnon LR, Kaul R. Quality and quantity: mucosal CD4+ T cells and HIV susceptibility. Curr Opin HIV AIDS. 2012;7:195–202.PubMedCrossRef
95.
Zurück zum Zitat Montague C et al. Implementation of adolescent-friendly voluntary medical male circumcision using a school based recruitment program in rural KwaZulu-Natal, South Africa. PLoS One. 2014;9:e96468.PubMedPubMedCentralCrossRef Montague C et al. Implementation of adolescent-friendly voluntary medical male circumcision using a school based recruitment program in rural KwaZulu-Natal, South Africa. PLoS One. 2014;9:e96468.PubMedPubMedCentralCrossRef
96.
Zurück zum Zitat Moses S et al. Geographical patterns of male circumcision practices in Africa: association with HIV seroprevalence. Int J Epidemiol. 1990;19:693–7.PubMedCrossRef Moses S et al. Geographical patterns of male circumcision practices in Africa: association with HIV seroprevalence. Int J Epidemiol. 1990;19:693–7.PubMedCrossRef
97.
Zurück zum Zitat Bailey RC et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56.PubMedCrossRef Bailey RC et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56.PubMedCrossRef
98.
Zurück zum Zitat Gray RH et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369:657–66.PubMedCrossRef Gray RH et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369:657–66.PubMedCrossRef
99.
Zurück zum Zitat Auvert B et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2:e298.PubMedPubMedCentralCrossRef Auvert B et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2:e298.PubMedPubMedCentralCrossRef
100.
Zurück zum Zitat Hayes R, Watson-Jones D, Celum C, van de Wijgert J, Wasserheit J. Treatment of sexually transmitted infections for HIV prevention: end of the road or new beginning? AIDS. 2010;24 Suppl 4:S15–26.PubMedCrossRef Hayes R, Watson-Jones D, Celum C, van de Wijgert J, Wasserheit J. Treatment of sexually transmitted infections for HIV prevention: end of the road or new beginning? AIDS. 2010;24 Suppl 4:S15–26.PubMedCrossRef
101.
Zurück zum Zitat Freeman EE et al. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS. 2006;20:73–83.PubMedCrossRef Freeman EE et al. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS. 2006;20:73–83.PubMedCrossRef
102.
Zurück zum Zitat Houlihan CF et al. Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. AIDS. 2012;26:2211–22.PubMedCrossRef Houlihan CF et al. Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. AIDS. 2012;26:2211–22.PubMedCrossRef
103.
Zurück zum Zitat Atashili J, Poole C, Ndumbe PM, Adimora AA, Smith JS. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. 2008;22:1493–501.PubMedPubMedCentralCrossRef Atashili J, Poole C, Ndumbe PM, Adimora AA, Smith JS. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. 2008;22:1493–501.PubMedPubMedCentralCrossRef
104.•
Zurück zum Zitat Ralph LJ, McCoy SI, Shiu K, Padian NS. Hormonal contraceptive use and women’s risk of HIV acquisition: a meta-analysis of observational studies. Lancet Infect Dis. 2015. doi:10.1016/S1473-3099(14)71052-7. See also: Hormonal Contraception and the Risk of HIV Acquisition: An Individual Participant Data Meta-analysis. Charles S. Morrison1*, Pai-Lien Chen2, Cynthia Kwok2, Jared M. Baeten3, Joelle Brown4, Angela M. Crook5, Lut Van Damme6, Sinead Delany-Moretlwe7, Suzanna C. Francis8, Barbara A. Friedland9, Richard J. Hayes8, Renee Heffron3, Saidi Kapiga8, Quarraisha Abdool Karim10, Stephanie Karpoff11, Rupert Kaul12, R. Scott McClelland3, Sheena McCormack4, Nuala McGrath13, Landon Myer14, Helen Rees7, Ariane van der Straten15, Deborah Watson-Jones16, Janneke H. H. M. van de Wijgert17, Randy Stalter1, Nicola Low18. These 2 references represent the more recent meta-analyses that have tried to answer the controversial question of whether DMPA use increases HIV risk. Both papers found an approximate 50% increase in risk, which is having major policy considerations on a global level on how to balance the risk of HIV with that of unwanted pregnancy in much of the African region. Ralph LJ, McCoy SI, Shiu K, Padian NS. Hormonal contraceptive use and women’s risk of HIV acquisition: a meta-analysis of observational studies. Lancet Infect Dis. 2015. doi:10.​1016/​S1473-3099(14)71052-7. See also: Hormonal Contraception and the Risk of HIV Acquisition: An Individual Participant Data Meta-analysis. Charles S. Morrison1*, Pai-Lien Chen2, Cynthia Kwok2, Jared M. Baeten3, Joelle Brown4, Angela M. Crook5, Lut Van Damme6, Sinead Delany-Moretlwe7, Suzanna C. Francis8, Barbara A. Friedland9, Richard J. Hayes8, Renee Heffron3, Saidi Kapiga8, Quarraisha Abdool Karim10, Stephanie Karpoff11, Rupert Kaul12, R. Scott McClelland3, Sheena McCormack4, Nuala McGrath13, Landon Myer14, Helen Rees7, Ariane van der Straten15, Deborah Watson-Jones16, Janneke H. H. M. van de Wijgert17, Randy Stalter1, Nicola Low18. These 2 references represent the more recent meta-analyses that have tried to answer the controversial question of whether DMPA use increases HIV risk. Both papers found an approximate 50% increase in risk, which is having major policy considerations on a global level on how to balance the risk of HIV with that of unwanted pregnancy in much of the African region.
105.
Zurück zum Zitat Murphy K, Irvin SC, Herold BC. Research gaps in defining the biological link between HIV risk and hormonal contraception. Am J Reprod Immunol. 2014;72:228–35.PubMedPubMedCentralCrossRef Murphy K, Irvin SC, Herold BC. Research gaps in defining the biological link between HIV risk and hormonal contraception. Am J Reprod Immunol. 2014;72:228–35.PubMedPubMedCentralCrossRef
106.
Zurück zum Zitat Low N et al. Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis. PLoS Med. 2011;8:e1000416.PubMedPubMedCentralCrossRef Low N et al. Intravaginal practices, bacterial vaginosis, and HIV infection in women: individual participant data meta-analysis. PLoS Med. 2011;8:e1000416.PubMedPubMedCentralCrossRef
107.
Zurück zum Zitat Hilber AM, Chersich MF, van de Wijgert JHHM, Rees H, Temmerman M. Vaginal practices, microbicides and HIV: what do we need to know? Sex Transm Infect. 2007;83:505–8.PubMedPubMedCentralCrossRef Hilber AM, Chersich MF, van de Wijgert JHHM, Rees H, Temmerman M. Vaginal practices, microbicides and HIV: what do we need to know? Sex Transm Infect. 2007;83:505–8.PubMedPubMedCentralCrossRef
108.
Zurück zum Zitat Yi TJ, Shannon B, Prodger J, McKinnon L, Kaul R. Genital immunology and HIV susceptibility in young women. Am J Reprod Immunol. 2013;69 Suppl 1:74–9.PubMedCrossRef Yi TJ, Shannon B, Prodger J, McKinnon L, Kaul R. Genital immunology and HIV susceptibility in young women. Am J Reprod Immunol. 2013;69 Suppl 1:74–9.PubMedCrossRef
109.
Zurück zum Zitat Mlisana K et al. Symptomatic vaginal discharge is a poor predictor of sexually transmitted infections and genital tract inflammation in high-risk women in South Africa. J Infect Dis. 2012;206:6–14.PubMedPubMedCentralCrossRef Mlisana K et al. Symptomatic vaginal discharge is a poor predictor of sexually transmitted infections and genital tract inflammation in high-risk women in South Africa. J Infect Dis. 2012;206:6–14.PubMedPubMedCentralCrossRef
110.
Zurück zum Zitat Levinson P et al. Levels of innate immune factors in genital fluids: association of alpha defensins and LL-37 with genital infections and increased HIV acquisition. AIDS. 2009;23:309–17.PubMedCrossRef Levinson P et al. Levels of innate immune factors in genital fluids: association of alpha defensins and LL-37 with genital infections and increased HIV acquisition. AIDS. 2009;23:309–17.PubMedCrossRef
111.
Zurück zum Zitat Morrison C et al. Cervical inflammation and immunity associated with hormonal contraception, pregnancy, and HIV-1 seroconversion. J Acquir Immune Defic Syndr. 2014;66:109–17.PubMed Morrison C et al. Cervical inflammation and immunity associated with hormonal contraception, pregnancy, and HIV-1 seroconversion. J Acquir Immune Defic Syndr. 2014;66:109–17.PubMed
112.
Zurück zum Zitat Hwang LY, Scott ME, Ma Y, Moscicki A-B. Higher levels of cervicovaginal inflammatory and regulatory cytokines and chemokines in healthy young women with immature cervical epithelium. J Reprod Immunol. 2011;88:66–71.PubMedPubMedCentralCrossRef Hwang LY, Scott ME, Ma Y, Moscicki A-B. Higher levels of cervicovaginal inflammatory and regulatory cytokines and chemokines in healthy young women with immature cervical epithelium. J Reprod Immunol. 2011;88:66–71.PubMedPubMedCentralCrossRef
113.••
Zurück zum Zitat Masson L, et al. Genital inflammation and the risk of HIV acquisition in women. Clin. Infect. Dis. 2015. doi:10.1093/cid/civ298. This represents the definitive paper on inflammation and HIV, showing that increased levels of pro-inflammatory cytokines in the female reproductive tract increased the risk of HIV acquisition. Importantly, many of these cytokines are found at higher levels in young women. This paper has had a broad influence on the field and has led to many follow-up efforts to better understand these data Masson L, et al. Genital inflammation and the risk of HIV acquisition in women. Clin. Infect. Dis. 2015. doi:10.​1093/​cid/​civ298. This represents the definitive paper on inflammation and HIV, showing that increased levels of pro-inflammatory cytokines in the female reproductive tract increased the risk of HIV acquisition. Importantly, many of these cytokines are found at higher levels in young women. This paper has had a broad influence on the field and has led to many follow-up efforts to better understand these data
114.
Zurück zum Zitat Venkatesh KK, Cu-Uvin S. Assessing the relationship between cervical ectopy and HIV susceptibility: implications for HIV prevention in women. Am J Reprod Immunol. 2013;69 Suppl 1:68–73.PubMedCrossRef Venkatesh KK, Cu-Uvin S. Assessing the relationship between cervical ectopy and HIV susceptibility: implications for HIV prevention in women. Am J Reprod Immunol. 2013;69 Suppl 1:68–73.PubMedCrossRef
115.
Zurück zum Zitat McLaren PJ et al. Association study of common genetic variants and HIV-1 acquisition in 6,300 infected cases and 7,200 controls. PLoS Pathog. 2013;9:e1003515.PubMedPubMedCentralCrossRef McLaren PJ et al. Association study of common genetic variants and HIV-1 acquisition in 6,300 infected cases and 7,200 controls. PLoS Pathog. 2013;9:e1003515.PubMedPubMedCentralCrossRef
116.•
Zurück zum Zitat Masson L, et al. Defining genital tract cytokine signatures of sexually transmitted infections and bacterial vaginosis in women at high risk of HIV infection: a cross-sectional study. Sex Transm Infect. 2014. doi:10.1136/sextrans-2014-051601. References [116•], [117•], and [118•] address the issue of altered microflora as a source of inflammation, finding similar signatures of bacterial-immune associations. While the causes of mucosal inflammation remain poorly defined, the common condition of abnormal flora appears a major contributor that is in need of better interventions. Masson L, et al. Defining genital tract cytokine signatures of sexually transmitted infections and bacterial vaginosis in women at high risk of HIV infection: a cross-sectional study. Sex Transm Infect. 2014. doi:10.​1136/​sextrans-2014-051601. References [116•], [117•], and [118•] address the issue of altered microflora as a source of inflammation, finding similar signatures of bacterial-immune associations. While the causes of mucosal inflammation remain poorly defined, the common condition of abnormal flora appears a major contributor that is in need of better interventions.
117.•
Zurück zum Zitat Anahtar MN et al. Cervicovaginal bacteria are a major modulator of host inflammatory responses in the female genital tract. Immunity. 2015;42:965–76. References [116•], [117•], and [118•] address the issue of altered microflora as a source of inflammation, finding similar signatures of bacterial-immune associations. While the causes of mucosal inflammation remain poorly defined, the common condition of abnormal flora appears a major contributor that is in need of better interventions. Anahtar MN et al. Cervicovaginal bacteria are a major modulator of host inflammatory responses in the female genital tract. Immunity. 2015;42:965–76. References [116•], [117•], and [118•] address the issue of altered microflora as a source of inflammation, finding similar signatures of bacterial-immune associations. While the causes of mucosal inflammation remain poorly defined, the common condition of abnormal flora appears a major contributor that is in need of better interventions.
118.•
Zurück zum Zitat Kyongo JK et al. Cross-sectional analysis of selected genital tract immunological markers and molecular vaginal microbiota in sub-Saharan African women, with relevance to HIV risk and prevention. Clin Vaccine Immunol. 2015;22:526–38. References [116•], [117•], and [118•] address the issue of altered microflora as a source of inflammation, finding similar signatures of bacterial-immune associations. While the causes of mucosal inflammation remain poorly defined, the common condition of abnormal flora appears a major contributor that is in need of better interventions.. Kyongo JK et al. Cross-sectional analysis of selected genital tract immunological markers and molecular vaginal microbiota in sub-Saharan African women, with relevance to HIV risk and prevention. Clin Vaccine Immunol. 2015;22:526–38. References [116•], [117•], and [118•] address the issue of altered microflora as a source of inflammation, finding similar signatures of bacterial-immune associations. While the causes of mucosal inflammation remain poorly defined, the common condition of abnormal flora appears a major contributor that is in need of better interventions..
119.
Zurück zum Zitat Rebbapragada A et al. Negative mucosal synergy between Herpes simplex type 2 and HIV in the female genital tract. AIDS. 2007;21:589–98.PubMedCrossRef Rebbapragada A et al. Negative mucosal synergy between Herpes simplex type 2 and HIV in the female genital tract. AIDS. 2007;21:589–98.PubMedCrossRef
120.
Zurück zum Zitat Zhu J et al. Persistence of HIV-1 receptor-positive cells after HSV-2 reactivation is a potential mechanism for increased HIV-1 acquisition. Nat Med. 2009;15:886–92.PubMedPubMedCentralCrossRef Zhu J et al. Persistence of HIV-1 receptor-positive cells after HSV-2 reactivation is a potential mechanism for increased HIV-1 acquisition. Nat Med. 2009;15:886–92.PubMedPubMedCentralCrossRef
121.
Zurück zum Zitat Marsden V et al. Herpes simplex virus type 2-infected dendritic cells produce TNF-α, which enhances CCR5 expression and stimulates HIV production from adjacent infected cells. J Immunol. 2015;194:4438–45.PubMedCrossRef Marsden V et al. Herpes simplex virus type 2-infected dendritic cells produce TNF-α, which enhances CCR5 expression and stimulates HIV production from adjacent infected cells. J Immunol. 2015;194:4438–45.PubMedCrossRef
122.
Zurück zum Zitat Goode D et al. HSV-2-driven increase in the expression of α4β7 correlates with increased susceptibility to vaginal SHIV(SF162P3) infection. PLoS Pathog. 2014;10:e1004567.PubMedPubMedCentralCrossRef Goode D et al. HSV-2-driven increase in the expression of α4β7 correlates with increased susceptibility to vaginal SHIV(SF162P3) infection. PLoS Pathog. 2014;10:e1004567.PubMedPubMedCentralCrossRef
123.
Zurück zum Zitat Shannon B et al. Impact of asymptomatic herpes simplex virus type 2 infection on mucosal homing and immune cell subsets in the blood and female genital tract. J Immunol. 2014;192:5074–82.PubMedCrossRef Shannon B et al. Impact of asymptomatic herpes simplex virus type 2 infection on mucosal homing and immune cell subsets in the blood and female genital tract. J Immunol. 2014;192:5074–82.PubMedCrossRef
124.
Zurück zum Zitat Rollenhagen C, Lathrop MJ, Macura SL, Doncel GF, Asin SN. Herpes simplex virus type-2 stimulates HIV-1 replication in cervical tissues: implications for HIV-1 transmission and efficacy of anti-HIV-1 microbicides. Mucosal Immunol. 2014;7:1165–74.PubMedPubMedCentralCrossRef Rollenhagen C, Lathrop MJ, Macura SL, Doncel GF, Asin SN. Herpes simplex virus type-2 stimulates HIV-1 replication in cervical tissues: implications for HIV-1 transmission and efficacy of anti-HIV-1 microbicides. Mucosal Immunol. 2014;7:1165–74.PubMedPubMedCentralCrossRef
125.
Zurück zum Zitat Antonovics J et al. Biology and evolution of sexual transmission. Ann N Y Acad Sci. 2011;1230:12–24.PubMedCrossRef Antonovics J et al. Biology and evolution of sexual transmission. Ann N Y Acad Sci. 2011;1230:12–24.PubMedCrossRef
126.
127.
Zurück zum Zitat Veldhuijzen NJ, Snijders PJ, Reiss P, Meijer CJ, van de Wijgert JH. Factors affecting transmission of mucosal human papillomavirus. Lancet Infect Dis. 2010;10:862–74.PubMedCrossRef Veldhuijzen NJ, Snijders PJ, Reiss P, Meijer CJ, van de Wijgert JH. Factors affecting transmission of mucosal human papillomavirus. Lancet Infect Dis. 2010;10:862–74.PubMedCrossRef
128.
129.
Zurück zum Zitat Wira CR, Rodriguez-Garcia M, Patel MV. The role of sex hormones in immune protection of the female reproductive tract. Nat Rev Immunol. 2015;15:217–30.PubMedPubMedCentralCrossRef Wira CR, Rodriguez-Garcia M, Patel MV. The role of sex hormones in immune protection of the female reproductive tract. Nat Rev Immunol. 2015;15:217–30.PubMedPubMedCentralCrossRef
131.
Zurück zum Zitat Morris MR et al. Relationship of menstrual cycle and vaginal infection in female rhesus macaques challenged with repeated, low doses of SIVmac251. J Med Primatol. 2015;44:301–5.PubMedCrossRef Morris MR et al. Relationship of menstrual cycle and vaginal infection in female rhesus macaques challenged with repeated, low doses of SIVmac251. J Med Primatol. 2015;44:301–5.PubMedCrossRef
132.
Zurück zum Zitat Cortez V, Odem-Davis K, Lehman DA, Mabuka J, Overbaugh J. Quotidian changes of genital tract cytokines in human immunodeficiency virus-1-infected women during the menstrual cycle. Open Forum Infect Dis. 2014;1:ofu002.PubMedPubMedCentralCrossRef Cortez V, Odem-Davis K, Lehman DA, Mabuka J, Overbaugh J. Quotidian changes of genital tract cytokines in human immunodeficiency virus-1-infected women during the menstrual cycle. Open Forum Infect Dis. 2014;1:ofu002.PubMedPubMedCentralCrossRef
133.
Zurück zum Zitat Birse K et al. Molecular signatures of immune activation and epithelial barrier remodeling are enhanced during the luteal phase of the menstrual cycle: implications for HIV susceptibility. J Virol. 2015;89:8793–805.PubMedPubMedCentralCrossRef Birse K et al. Molecular signatures of immune activation and epithelial barrier remodeling are enhanced during the luteal phase of the menstrual cycle: implications for HIV susceptibility. J Virol. 2015;89:8793–805.PubMedPubMedCentralCrossRef
134.
Zurück zum Zitat Byrne EH, et al. Association between injectable progestin-only contraceptives and HIV acquisition and HIV target cell frequency in the female genital tract in South African women: a prospective cohort study. Lancet Infect Dis. 2015. doi:10.1016/S1473-3099(15)00429-6 Byrne EH, et al. Association between injectable progestin-only contraceptives and HIV acquisition and HIV target cell frequency in the female genital tract in South African women: a prospective cohort study. Lancet Infect Dis. 2015. doi:10.​1016/​S1473-3099(15)00429-6
135.
Zurück zum Zitat Mitchell CM et al. Long-term effect of depot medroxyprogesterone acetate on vaginal microbiota, epithelial thickness and HIV target cells. J Infect Dis. 2014;210:651–5.PubMedPubMedCentralCrossRef Mitchell CM et al. Long-term effect of depot medroxyprogesterone acetate on vaginal microbiota, epithelial thickness and HIV target cells. J Infect Dis. 2014;210:651–5.PubMedPubMedCentralCrossRef
136.
Zurück zum Zitat Francis SC et al. Immune activation in the female genital tract: expression profiles of soluble proteins in women at high risk for HIV infection. PLoS One. 2016;11:e0143109.PubMedPubMedCentralCrossRef Francis SC et al. Immune activation in the female genital tract: expression profiles of soluble proteins in women at high risk for HIV infection. PLoS One. 2016;11:e0143109.PubMedPubMedCentralCrossRef
137.
Zurück zum Zitat Deese J, et al. Injectable Progestin-Only Contraception is Associated With Increased Levels of Pro-Inflammatory Cytokines in the Female Genital Tract. Am J Reprod Immunol. 2015. doi:10.1111/aji.12415 Deese J, et al. Injectable Progestin-Only Contraception is Associated With Increased Levels of Pro-Inflammatory Cytokines in the Female Genital Tract. Am J Reprod Immunol. 2015. doi:10.​1111/​aji.​12415
138.
Zurück zum Zitat Ngcapu S et al. Lower concentrations of chemotactic cytokines and soluble innate factors in the lower female genital tract associated with the use of injectable hormonal contraceptive. J Reprod Immunol. 2015;110:14–21.PubMedCrossRef Ngcapu S et al. Lower concentrations of chemotactic cytokines and soluble innate factors in the lower female genital tract associated with the use of injectable hormonal contraceptive. J Reprod Immunol. 2015;110:14–21.PubMedCrossRef
139.
140.•
Zurück zum Zitat Arnold KB, et al. Increased levels of inflammatory cytokines in the female reproductive tract are associated with altered expression of proteases, mucosal barrier proteins, and an influx of HIV-susceptible target cells. Mucosal Immunol. 2015. doi:10.1038/mi.2015.51. This paper used proteomic techniques to describe linkages between the mucosal barrier, HIV target cells, and inflammatory cytokines in the female reproductive tract. These data raise many hypotheses regarding mechanisms of how these processes might be linked to increase the odds of HIV transmission during exposure. Arnold KB, et al. Increased levels of inflammatory cytokines in the female reproductive tract are associated with altered expression of proteases, mucosal barrier proteins, and an influx of HIV-susceptible target cells. Mucosal Immunol. 2015. doi:10.​1038/​mi.​2015.​51. This paper used proteomic techniques to describe linkages between the mucosal barrier, HIV target cells, and inflammatory cytokines in the female reproductive tract. These data raise many hypotheses regarding mechanisms of how these processes might be linked to increase the odds of HIV transmission during exposure.
141.•
Zurück zum Zitat Noguchi LM et al. Risk of HIV-1 acquisition among women who use diff erent types of injectable progestin contraception in South Africa: a prospective cohort study. Lancet HIV. 2015;2:e279–87. This is the first large study able to address the differences in HIV risk posed by DMPA and NET-EN, a similar but distinct form of contraception. Interestingly, HSV2 serostatus had a big impact on the difference between these two forms of contraception, suggesting that this virus might play some role in exacerbating DMPA’s mucosal impact.PubMedCrossRef Noguchi LM et al. Risk of HIV-1 acquisition among women who use diff erent types of injectable progestin contraception in South Africa: a prospective cohort study. Lancet HIV. 2015;2:e279–87. This is the first large study able to address the differences in HIV risk posed by DMPA and NET-EN, a similar but distinct form of contraception. Interestingly, HSV2 serostatus had a big impact on the difference between these two forms of contraception, suggesting that this virus might play some role in exacerbating DMPA’s mucosal impact.PubMedCrossRef
142.
Zurück zum Zitat Grabowski MK et al. Use of injectable hormonal contraception and women’s risk of herpes simplex virus type 2 acquisition: a prospective study of couples in Rakai, Uganda. Lancet Glob Health. 2015;3:e478–86.PubMedCrossRef Grabowski MK et al. Use of injectable hormonal contraception and women’s risk of herpes simplex virus type 2 acquisition: a prospective study of couples in Rakai, Uganda. Lancet Glob Health. 2015;3:e478–86.PubMedCrossRef
143.
Zurück zum Zitat Kaul R et al. Prevalent herpes simplex virus type 2 infection is associated with altered vaginal flora and an increased susceptibility to multiple sexually transmitted infections. J Infect Dis. 2007;196:1692–7.PubMedCrossRef Kaul R et al. Prevalent herpes simplex virus type 2 infection is associated with altered vaginal flora and an increased susceptibility to multiple sexually transmitted infections. J Infect Dis. 2007;196:1692–7.PubMedCrossRef
144.
Zurück zum Zitat Roxby AC et al. Changes in vaginal microbiota and immune mediators in HIV-1-seronegative Kenyan Women initiating depot medroxyprogesterone acetate. J Acquir Immune Defic Syndr. 2016;71:359–66.PubMedCrossRef Roxby AC et al. Changes in vaginal microbiota and immune mediators in HIV-1-seronegative Kenyan Women initiating depot medroxyprogesterone acetate. J Acquir Immune Defic Syndr. 2016;71:359–66.PubMedCrossRef
145.•
Zurück zum Zitat Fichorova RN et al. The Contribution of Cervicovaginal Infections to the Immunomodulatory Effects of Hormonal Contraception. MBio. 2015;6:e00221–15. This very large cohort analysis demonstrates how mucosal associations can be dependent on other co-factors present in the same women. Importantly the sample size provided power to investigate these in greater detail than was previously available.PubMedPubMedCentralCrossRef Fichorova RN et al. The Contribution of Cervicovaginal Infections to the Immunomodulatory Effects of Hormonal Contraception. MBio. 2015;6:e00221–15. This very large cohort analysis demonstrates how mucosal associations can be dependent on other co-factors present in the same women. Importantly the sample size provided power to investigate these in greater detail than was previously available.PubMedPubMedCentralCrossRef
146.
Zurück zum Zitat Eaton JW et al. Recent HIV prevalence trends among pregnant women and all women in sub-Saharan Africa: implications for HIV estimates. AIDS. 2014;28 Suppl 4:S507–14.PubMedPubMedCentralCrossRef Eaton JW et al. Recent HIV prevalence trends among pregnant women and all women in sub-Saharan Africa: implications for HIV estimates. AIDS. 2014;28 Suppl 4:S507–14.PubMedPubMedCentralCrossRef
147.
Zurück zum Zitat Santelli JS et al. Trends in HIV acquisition, risk factors and prevention policies among youth in Uganda, 1999–2011. AIDS. 2015;29:211–9.PubMedCrossRef Santelli JS et al. Trends in HIV acquisition, risk factors and prevention policies among youth in Uganda, 1999–2011. AIDS. 2015;29:211–9.PubMedCrossRef
148.
149.
Zurück zum Zitat Stover J et al. How can we get close to zero? The potential contribution of biomedical prevention and the investment framework towards an effective response to HIV. PLoS One. 2014;9:e111956.PubMedPubMedCentralCrossRef Stover J et al. How can we get close to zero? The potential contribution of biomedical prevention and the investment framework towards an effective response to HIV. PLoS One. 2014;9:e111956.PubMedPubMedCentralCrossRef
150.
Zurück zum Zitat Karim SSA, Karim QA. Antiretroviral prophylaxis: a defining moment in HIV control. Lancet. 2011;378:e23–5.PubMedCrossRef Karim SSA, Karim QA. Antiretroviral prophylaxis: a defining moment in HIV control. Lancet. 2011;378:e23–5.PubMedCrossRef
151.•
Zurück zum Zitat Baeten JM, et al. Use of a vaginal ring containing dapivirine for HIV-1 prevention in women. N Engl J Med 2016. doi:10.1056/NEJMoa1506110. While this very recent paper provides more good news for the HIV prevention field, it is once again worrying that adherence may be an important barrier, especially for young women, in order for interventions such as dapivurine ring to realize their full potential. Baeten JM, et al. Use of a vaginal ring containing dapivirine for HIV-1 prevention in women. N Engl J Med 2016. doi:10.​1056/​NEJMoa1506110. While this very recent paper provides more good news for the HIV prevention field, it is once again worrying that adherence may be an important barrier, especially for young women, in order for interventions such as dapivurine ring to realize their full potential.
152.
Zurück zum Zitat Kapogiannis BG, Handelsman E, Ruiz MS, Lee S. Introduction: paving the way for biomedical HIV prevention interventions in youth. J Acquir Immune Defic Syndr. 2010;54 Suppl 1:S1–4.PubMedCrossRef Kapogiannis BG, Handelsman E, Ruiz MS, Lee S. Introduction: paving the way for biomedical HIV prevention interventions in youth. J Acquir Immune Defic Syndr. 2010;54 Suppl 1:S1–4.PubMedCrossRef
Metadaten
Titel
Factors Driving the HIV Epidemic in Southern Africa
verfasst von
Lyle R. McKinnon
Quarraisha Abdool Karim
Publikationsdatum
02.05.2016
Verlag
Springer US
Erschienen in
Current HIV/AIDS Reports / Ausgabe 3/2016
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-016-0314-z

Weitere Artikel der Ausgabe 3/2016

Current HIV/AIDS Reports 3/2016 Zur Ausgabe

The Science of Prevention (JD Stekler and J Baeten, Section Editors)

PrEP as Peri-conception HIV Prevention for Women and Men

Complications of Antiretroviral Therapy (G McComsey, Section Editor)

Non-infectious Pulmonary Diseases and HIV

Complications of Antiretroviral Therapy (G McComsey, Section Editor)

Chronic Kidney Disease and Antiretroviral Therapy in HIV-Positive Individuals: Recent Developments

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

CKD bei Diabetes: Neuheiten und Zukunftsaussichten

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Jeder Mensch mit Diabetes muss auf eine chronische Nierenerkrankung gescreent werden – diese neue Empfehlung spricht die KDIGO aus. Die Therapie erfolgt individuell und je nach Szenario mit verschiedenen Substanzklassen. Künftig kommt wahrscheinlich, neben RAS-Hemmung, SGLT2-Inhibition und nsMRA, eine vierte Therapiesäule hinzu.

Riesenzellarteriitis: 15% der Patienten sind von okkulter Form betroffen

16.05.2024 Riesenzellarteriitis Nachrichten

In einer retrospektiven Untersuchung haben Forschende aus Belgien und den Niederlanden die okkulte Form der Riesenzellarteriitis genauer unter die Lupe genommen. In puncto Therapie und Rezidivraten stellten sie keinen sehr großen Unterschied zu Erkrankten mit kranialen Symptomen fest.

SGLT2-Inhibitoren und GLP-1-Rezeptoragonisten im Schlagabtausch

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Wer hat die Nase vorn – SGLT2-Inhibitoren oder GLP-1-Rezeptoragonisten? Diese Frage diskutierten zwei Experten in einer Session auf dem diesjährigen Diabetes-Kongress.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.