A measure of betweenness centrality based on random walks

This report updates and combines earlier versions of guidelines for the prevention and treatment of opportunistic infections (OIs) in HIV-infected adults (i.e., persons aged >/=18 years) and adolescents (i.e., persons aged 13--17 years), last published in 2002 and 2004, respectively. It has been prepared by the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA). The guidelines are intended for use by clinicians and other health-care providers, HIV-infected patients, and policy makers in the United States. These guidelines address several OIs that occur in the United States and five OIs that might be acquired during international travel. Topic areas covered for each OI include epidemiology, clinical manifestations, diagnosis, prevention of exposure; prevention of disease by chemoprophylaxis and vaccination; discontinuation of primary prophylaxis after immune reconstitution; treatment of disease; monitoring for adverse effects during treatment; management of treatment failure; prevention of disease recurrence; discontinuation of secondary prophylaxis after immune reconstitution; and special considerations during pregnancy. These guidelines were developed by a panel of specialists from the United States government and academic institutions. For each OI, a small group of specialists with content-matter expertise reviewed the literature for new information since the guidelines were last published; they then proposed revised recommendations at a meeting held at NIH in June 2007. After these presentations and discussion, the revised guidelines were further reviewed by the co-editors; by the Office of AIDS Research, NIH; by specialists at CDC; and by HIVMA of IDSA before final approval and publication. The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of evidence supporting the recommendation, so that readers can ascertain how best to apply the recommendations in their practice environments. Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for the prevention and treatment of OIs, especially those OIs for which no specific therapy exists; 2) information regarding the diagnosis and management of immune reconstitution inflammatory syndromes; 3) information regarding the use of interferon-gamma release assays for the diagnosis of latent Mycobacterium tuberculosis (TB) infection; 4) updated information concerning drug interactions that affect the use of rifamycin drugs for prevention and treatment of TB; 5) the addition of a section on hepatitis B virus infection; and 6) the addition of malaria to the list of OIs that might be acquired during international travel. This report includes eleven tables pertinent to the prevention and treatment of OIs, a figure that pertains to the diagnois of tuberculosis, a figure that describes immunization recommendations, and an appendix that summarizes recommendations for prevention of exposure to opportunistic pathogens.

Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00056-2.pdf

Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial.

This meta-analysis tested the major theoretical assumptions about behavior change by examining the outcomes and mediating mechanisms of different preventive strategies in a sample of 354 HIV-prevention interventions and 99 control groups, spanning the past 17 years. There were 2 main conclusions from this extensive review. First, the most effective interventions were those that contained attitudinal arguments, educational information, behavioral skills arguments, and behavioral skills training, whereas the least effective ones were those that attempted to induce fear of HIV. Second, the impact of the interventions and the different strategies behind them was contingent on the gender, age, ethnicity, risk group, and past condom use of the target audience in ways that illuminate the direction of future preventive efforts.

/pdf/a-test-of-major-assumptions-about-behavior-change-a-58nhe5pof8.pdf

A Test of Major Assumptions About Behavior Change: A Comprehensive Look at the Effects of Passive and Active HIV-Prevention Interventions Since the Beginning of the Epidemic

HIV-positive persons who do not maintain consistently high levels of adherence to often complex and toxic highly active antiretroviral therapy (HAART) regimens may experience therapeutic failure and deterioration of health status and may develop multidrug-resistant HIV that can be transmitted to uninfected others The current analysis conceptualizes social and psychological determinants of adherence to HAART among HIV-positive individuals The authors propose an information-motivation-behavioral skills (IMB) model of HAART adherence that assumes that adherence-related information, motivation, and behavioral skills are fundamental determinants of adherence to HAART According to the model, adherence-related information and motivation work through adherence-related behavioral skills to affect adherence to HAART Empirical support for the IMB model of adherence is presented, and its application in adherence-promotion intervention efforts is discussed

An information-motivation-behavioral skills model of adherence to antiretroviral therapy

See also Editorial by Catchpole

Rates of sexually transmitted diseases are increasing, particularly in people aged between 15 and 25. How best to tackle this increase is unresolved, although several tests have recently been developed that are providing new opportunities for screening, early detection, and prevention of sexually transmitted infections and their complications, particularly for Chlamydia trachomatis , herpes simplex virus, and human papillomavirus. Already these tests are being used in research studies, but their introduction into clinical practice raises complex issues. This articles describes the tests that are now available for the major sexually transmitted infections and discusses the important issues they raise in the management of those diseases.

We selected topics for inclusion by reviewing specialist journals and conference abstracts from 1998 to 2000. We chose areas that were the subject of most research reports and that are having a direct impact on patient care. We performed a search of Medline for the same period, based on keywords related to these topics. Earlier references were among those quoted in the publications retrieved by the systematic search. We have not considered advances in HIV disease and its management.

In the United Kingdom most cases of sexually transmitted infections are treated at genitourinary medicine clinics. Surveillance data from these clinics show that their workload is steadily increasing (fig 1). There has been a noticeable increase in the number of cases of bacterial infections, particularly chlamydia and gonorrhoea since 1995.1

Chlamydia trachomatis is the most commonly diagnosed bacterial sexually transmitted infection in the developed world and a leading cause of pelvic inflammatory disease.2 In 1999, 56 855 patients with uncomplicated chlamydial infection were seen at UK clinics dealing with genitourinary medicine, an increase of 61% since 1996.1 Given the potential for morbidity from ectopic pregnancy and tubal infertility …

/pdf/recent-advances-sexually-transmitted-infections-3twg8nj73d.pdf

Recent advances: Sexually transmitted infections

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-842X.2001.tb00312.x

Opting off the New South Wales Pap Test Register in a sexual health setting

Sexual health education for male sex workers.

Original article Sexually transmitted infections and risk behaviours in women who have sex with women

in female CSWs (0.4%, p=0.0001), but less than in non-CSW homosexual men (23.9%, p<0.0001). Genital warts occurred significantly more frequently in male CSWs than in comparison groups. Prevalence of other STIs was similar in all groups. Male CSWs saw significantly fewer clients per week than female CSWs and male and female CSWs used condoms with almost all clients. Male CSWs reported significantly more non-work sexual partners than female CSWs and non-CSW homosexual men and were significantly more likely to have unprotected penetrative sex with their non-work partners than non-CSW homosexual men. Injecting drug use was significantly more frequent in male CSWs than in both comparison groups. Conclusions: Although male CSWs use condoms with clients, they are more likely to practise unsafe sex with non-work partners (especially women) and inject drugs than female CSWs and non-CSW homosexual men. Some men with HIV are working within the commercial sex industry. Targeted health education to encourage safer drug use and safer sex outside work is needed. (Sex Transm Inf 2000;76:294‐298)

Adrian Mindel

Papers

Recent advances: Sexually transmitted infections

Opting off the New South Wales Pap Test Register in a sexual health setting

Sexual health education for male sex workers.

Original article Sexually transmitted infections and risk behaviours in women who have sex with women

Original article HIV, sexually transmitted infections, and risk behaviours in male commercial sex workers in Sydney