Author
Simon Gregson
Other affiliations: University of Zimbabwe, University of the Witwatersrand, University of Oxford ...read more
Bio: Simon Gregson is an academic researcher from Imperial College London. The author has contributed to research in topics: Population & Acquired immunodeficiency syndrome (AIDS). The author has an hindex of 64, co-authored 237 publications receiving 11927 citations. Previous affiliations of Simon Gregson include University of Zimbabwe & University of the Witwatersrand.
Papers published on a yearly basis
Papers
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TL;DR: The substantial age difference between female and male sexual partners in Manicaland is the major behavioural determinant of the more rapid rise in HIV prevalence in young women than in men.
644 citations
TL;DR: A decline in HIV prevalence in eastern Zimbabwe between 1998 and 2003 was associated with sexual behavior change in four distinct socioeconomic strata and Selective AIDS-induced mortality contributed to the decline.
Abstract: Few sub-Saharan African countries have witnessed declines in HIV prevalence, and only Uganda has compelling evidence for a decline founded on sexual behavior change. We report a decline in HIV prevalence in eastern Zimbabwe between 1998 and 2003 associated with sexual behavior change in four distinct socioeconomic strata. HIV prevalence fell most steeply at young ages-by 23 and 49%, respectively, among men aged 17 to 29 years and women aged 15 to 24 years-and in more educated groups. Sexually experienced men and women reported reductions in casual sex of 49 and 22%, respectively, whereas recent cohorts reported delayed sexual debut. Selective AIDS-induced mortality contributed to the decline in HIV prevalence.
373 citations
TL;DR: The present research presents a novel and scalable approach called “SmartCard™,” developed by a team of scientists and engineers at Imperial College London and the University of California, Berkeley, which aims to provide real-time information about individual patients’ medical needs and provide real time advice on how to care for these patients.
315 citations
TL;DR: HIV-1 prevalence amongst ANC attenders aged 15-24 years can be used to monitor the HIV-1 epidemic in the given setting and shows that sentinel surveillance data need to be age-stratified to give useful information.
Abstract: To monitor the HIV-1 epidemic in western Uganda and the possible impact of interventions age-specific trends in HIV-1 prevalence during 1991-1997 among antenatal clinic (ANC) attenders in Fort Portal where a comprehensive AIDS control program has been implemented since 1991 were analyzed and results compared with outputs from a mathematical model simulating the HIV-1 epidemic in the country. Scenarios with and without behavior change were modelled. Sentinel surveillance data were compared with data from a population-based HIV-1 serosurvey at the study site which was conducted in early 1995. Data from 3271 ANC attenders found greater education and single status to be risk factors for HIV-1 infection. A significant decrease of risk for women with secondary school education over time was observed while the risk for illiterate women remained high. Among the 1045 women aged 15-19 years education and marital status-adjusted HIV-1 prevalence declined steadily from 32.2% to 10.3% over the period. For the 1010 women aged 20-24 years prevalence increased until 1993 from 19.9% to 31.7% then declined thereafter to 21.7% in 1997. These declining trends of HIV-1 prevalence probably reflect a reduced HIV-1 incidence attributable to changes in behavior. No clear trends of HIV-1 prevalence were found in older women.
284 citations
TL;DR: HIV service providers are urged to consider the obstacles that prevent many men from accessing their services and argue for community-based and driven initiatives that facilitate safe and supportive social spaces for men to openly discuss social constructions of masculinity as well as renegotiate more health-enabling masculinities.
Abstract: Background: A growing number of studies highlight men’s disinclination to make use of HIV services. This suggests there are factors that prevent men from engaging with health services and an urgent need to unpack the forms of sociality that determine men’s acceptance or rejection of HIV services. Methods: Drawing on the perspectives of 53 antiretroviral drug users and 25 healthcare providers, we examine qualitatively how local constructions of masculinity in rural Zimbabwe impact on men’s use of HIV services. Results: Informants reported a clear and hegemonic notion of masculinity that required men to be and act in control, to have know-how, be strong, resilient, disease free, highly sexual and economically productive. However, such traits were in direct conflict with the ‘good patient’ persona who is expected to accept being HIV positive, take instructions from nurses and engage in health-enabling behaviours such as attending regular hospital visits and refraining from alcohol and unprotected extra-marital sex. This conflict between local understandings of manhood and biopolitical representations of ‘a good patient’ can provide a possible explanation to why so many men do not make use of HIV services in Zimbabwe. However, once men had been counselled and had the opportunity to reflect upon the impact of ART on their productivity and social value, it was possible for some to construct new and more ART-friendly versions of masculinity. Conclusion: We urge HIV service providers to consider the obstacles that prevent many men from accessing their services and argue for community-based and driven initiatives that facilitate safe and supportive social spaces for men to openly discuss social constructions of masculinity as well as renegotiate more health-enabling masculinities.
283 citations
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TL;DR: This update of the CONSORT statement improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition, such as selective outcome reporting bias.
Abstract: Overwhelming evidence shows the quality of reporting of randomised controlled trials (RCTs) is not optimal. Without transparent reporting, readers cannot judge the reliability and validity of trial findings nor extract information for systematic reviews. Recent methodological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects. Such systematic error is seriously damaging to RCTs, which are considered the gold standard for evaluating interventions because of their ability to minimise or avoid bias. A group of scientists and editors developed the CONSORT (Consolidated Standards of Reporting Trials) statement to improve the quality of reporting of RCTs. It was first published in 1996 and updated in 2001. The statement consists of a checklist and flow diagram that authors can use for reporting an RCT. Many leading medical journals and major international editorial groups have endorsed the CONSORT statement. The statement facilitates critical appraisal and interpretation of RCTs. During the 2001 CONSORT revision, it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports. A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement. After an expert meeting in January 2007, the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement. This update improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition, such as selective outcome reporting bias. This explanatory and elaboration document-intended to enhance the use, understanding, and dissemination of the CONSORT statement-has also been extensively revised. It presents the meaning and rationale for each new and updated checklist item providing examples of good reporting and, where possible, references to relevant empirical studies. Several examples of flow diagrams are included. The CONSORT 2010 Statement, this revised explanatory and elaboration document, and the associated website (www.consort-statement.org) should be helpful resources to improve reporting of randomised trials.
5,957 citations
TL;DR: As an example of how the current "war on terrorism" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says "permanently marked" the generation that lived through it and had a "terrific effect on American public life over the last half-century."
Abstract: The present historical moment may seem a particularly inopportune time to review Bowling Alone, Robert Putnam's latest exploration of civic decline in America. After all, the outpouring of volunteerism, solidarity, patriotism, and self-sacrifice displayed by Americans in the wake of the September 11 terrorist attacks appears to fly in the face of Putnam's central argument: that \"social capital\" -defined as \"social networks and the norms of reciprocity and trustworthiness that arise from them\" (p. 19)'has declined to dangerously low levels in America over the last three decades. However, Putnam is not fazed in the least by the recent effusion of solidarity. Quite the contrary, he sees in it the potential to \"reverse what has been a 30to 40-year steady decline in most measures of connectedness or community.\"' As an example of how the current \"war on terrorism\" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says \"permanently marked\" the generation that lived through it and had a \"terrific effect on American public life over the last half-century.\" 3 If Americans can follow this example and channel their current civic
5,309 citations
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) as discussed by the authors was used to estimate the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015.
5,050 citations
TL;DR: The Global Burden of Disease 2015 Study provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015, finding several countries in sub-Saharan Africa had very large gains in life expectancy, rebounding from an era of exceedingly high loss of life due to HIV/AIDS.
4,804 citations
TL;DR: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide, and more than a quarter of deaths were attributable to indirect causes.
3,976 citations