World AIDS Day web collection now live

01 Jan 2017

This collection from the RSTMH Journals includes original research articles, commentaries, a systematic review and an editorial, covering factors affecting retention in care among ART patients, effects of targeting education and treatment strategies to vulnerable population groups, and barriers to accessing appropriate patient care. It is worth considering the context of these papers.

Perhaps only pandemic influenza has come close in history to the devastating global impact of HIV/AIDS.  HIV infection is mediated by human behaviour; HIV-infected persons suffer considerable stigma and discrimination in most venues, and are in need of huge health resources to stay healthy and to reduce infectiousness to others. Happily, the global community, particularly the United States, has made major strides in funding a substantive programmatic response to the HIV pandemic.  According to the UNAIDS 2016 fact sheet, 2015 estimates suggest that US$ 19 billion were invested in the HIV response in low- and middle- income countries (LMICs) with 57% of this total coming from domestic budgets. Even as incidence has declined, prevalence has risen with more persons living with HIV.  Hence, UNAIDS projects that US$ 26.2 billion will be required in 2020 and US$ 23.9 billion required in 2030.  It seems improbable that the current funding climate in the US, UK and other donor nations will commit to higher sums, but the need will exist nonetheless.

Hence, we need prevention NOW to turn off the flow of new cases into the overflowing clinical settings offering antiretroviral therapy. We also need efficiencies, respectful clinical care and quality improvements in our clinical care settings.  Discovery in the vaccine, cure and diagnostic arenas can offer more tools for the future.  Implementation science is essential for interventions that work, but are not adequately deployed, from male circumcision to the ‘continuum of HIV care’. In the collection of articles from the RSTMH journals, one will see opinion and data that help clarify both challenges and prospective solutions.  We must not succumb to ‘AIDS fatigue’ any more than experts in disease control and prevention of malaria, tuberculosis, or a myriad of historical or emerging infectious threats can afford to declare premature victory.

This World AIDS Day 2016, let us think how we can merge synergistic agendas, getting away from ‘siloed’, single disease responses.  Can our HIV infrastructures in rural Africa be deployed more effectively to meet community needs in control of TB, parasitic diseases, or other chronic diseases?  Might such deployment bring stronger government and local community support?  Can the drumbeat announcing the ascendancy of non-communicable diseases in LMICs be combined with reality-based awareness that existing infectious disease threats remain? The temptation to continue business-as-usual in our vertical disease control campaigns invites inefficiencies and competition between legitimate health needs; we can integrate for efficiency to make a maximum footprint on health of LMICs.

Simply click on the titles below to read the full-text FREE online until 31 January 2017. Beyond this date, these articles will only be accessible to RSTMH members. To find out more about joining RSTMH, please click here.

Quick links to papers

Biomedical technologies for the prevention of sexually transmitted infections and HIV for adolescent girls and young women by Manjulaa Narasimhan, Sten H. Vermund and Gina Ogilvie

Emerging themes for sensitivity training modules of African healthcare workers attending to men who have sex with men: a systematic review by Maartje Dijkstra, Elise M. van der Elst, Murugi Micheni, Evanson Gichuru, Helgar Musyoki, Zoe Duby, Joep M.A. Lange, Susan M. Graham and Eduard J. Sanders

Marriage, like income and education, fails to provide shelter for women against HIV infection in sub-Saharan Africa: widowhood and divorce increase the risk by Edward S. Cooper

Balancing the need to rapidly scale-up and improve clinical outcomes in antiretroviral programmes in developing countries: lessons from an Indian programmatic cohort study by Peter Bock, Nulda Beyers and Sarah Fidler

Survival probability and predictors of mortality and retention in care among patients enrolled for first-line antiretroviral therapy, Andhra Pradesh, India, 2008–2011 by Ramesh Reddy Allam, Manoj V. Murhekar, Tarun Bhatnagar, Chengappa K Uthappa, Nalini Chava, B. B. Rewari, S. Venkatesh and Sanjay Mehendale

Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa by Eric Y. Tenkorang

Implementation and evaluation of a curriculum to teach reproductive health to adolescents in northern Madagascar by Amanda Klinger and Ramin Asgary

Age-targeted HIV treatment and primary prevention as a ‘ring fence’ to efficiently interrupt the age patterns of transmission in generalized epidemic settings in South Africa by Anna Bershteyn, Daniel J. Klein and Philip A. Eckhoff

Client satisfaction: correlates and implications for improving HIV/AIDS treatment and care services in southern Ethiopia by Bereket Yakob and Busisiwe Purity Ncama

Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men by Muktar H. Aliyu, Meridith Blevins, Karen M. Megazzini, Deidra D. Parrish, Carolyn M. Audet, Naomi Chan, Chisom Odoh, Usman I. Gebi, Mukhtar Y. Muhammad, Bryan E. Shepherd, C. William Wester and Sten H. Vermund

Dissonances between medical expectations and patients' choice raise questions about present policy by Nathan Hodson

Targeting HIV services to male migrant workers in southern Africa would not reverse generalized HIV epidemics in their home communities: a mathematical modeling analysis by Daniel J. Klein, Philip A. Eckhoff and Anna Bershteyn

Call for papers

The RSTMH journals, Transactions of the Royal Society of Tropical Medicine & Hygiene and International Health, are looking for submissions of original research papers and reviews in all areas of HIV research, and are particularly interested in studies relating to:

  • Access to ARTs
  • ART treatment outcomes
  • Treatment adherence
  • Disease resistance
  • Stigma and mental health issues associated with living with HIV/AIDS
  • Management of patients with comorbid conditions

To submit a paper and to view our author instructions visit: www.editorialmanager.com/trstmh (Transactions of the Royal Society of Tropical Medicine & Hygiene) or www.editorialmanager.com/inthealth (International Health).