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Journal Article•DOI•

HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention

Rebecca F. Baggaley1, Richard G. White2, Marie-Claude Boily2•
Imperial College London1, University of London2
01 Aug 2010-International Journal of Epidemiology (Oxford University Press)-Vol. 39, Iss: 4, pp 1048-1063
TL;DR: It was demonstrated that it would require unreasonably low numbers of AI HIV exposures per partnership to reconcile the summary per-act and per-partner estimates, suggesting considerable variability in AI infectiousness between and within partnerships over time.
Abstract: Background The human immunodeficiency virus (HIV) infectiousness of anal intercourse (AI) has not been systematically reviewed, despite its role driving HIV epidemics among men who have sex with men (MSM) and its potential contribution to heterosexual spread. We assessed the per-act and per-partner HIV transmission risk from AI exposure for heterosexuals and MSM and its implications for HIV prevention. Methods Systematic review and meta-analysis of the literature on HIV-1 infectiousness through AI was conducted. PubMed was searched to September 2008. A binomial model explored the individual risk of HIV infection with and without highly active antiretroviral therapy (HAART). Results A total of 62 643 titles were searched; four publications reporting per-act and 12 reporting per-partner transmission estimates were included. Overall, random effects model summary estimates were 1.4% [95% confidence interval (CI) 0.2–2.5)] and 40.4% (95% CI 6.0–74.9) for per-act and per-partner unprotected receptive AI (URAI), respectively. There was no significant difference between per-act risks of URAI for heterosexuals and MSM. Per-partner unprotected insertive AI (UIAI) and combined URAI–UIAI risk were 21.7% (95% CI 0.2–43.3) and 39.9% (95% CI 22.5–57.4), respectively, with no available per-act estimates. Per-partner combined URAI–UIAI summary estimates, which adjusted for additional exposures other than AI with a ‘main’ partner [7.9% (95% CI 1.2–14.5)], were lower than crude (unadjusted) estimates [48.1% (95% CI 35.3–60.8)]. Our modelling demonstrated that it would require unreasonably low numbers of AI HIV exposures per partnership to reconcile the summary per-act and per-partner estimates, suggesting considerable variability in AI infectiousness between and within partnerships over time. AI may substantially increase HIV transmission risk even if the infected partner is receiving HAART; however, predictions are highly sensitive to infectiousness assumptions based on viral load. Conclusions Unprotected AI is a high-risk practice for HIV transmission, probably with substantial variation in infectiousness. The significant heterogeneity between infectiousness estimates means that pooled AI HIV transmission probabilities should be used with caution. Recent reported rises in AI among heterosexuals suggest a greater understanding of the role AI plays in heterosexual sex lives may be increasingly important for HIV prevention.

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Journal Article•DOI•
Implementation of unassisted and community-based HIV Self-Testing (HIVST) during the COVID-19 pandemic among Men-who-have-sex-with-Men (MSM) and Transgender Women (TGW): A demonstration study in Metro Manila, Philippines

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09 Mar 2023-PLOS ONE
TL;DR: In this paper , the authors demonstrate the feasibility of an unassisted and community-based HIV self-testing (HIVST) distribution model and evaluate its acceptability among men-having-sex-with-men (MSM) and transgender women (TGW).
Abstract: The study aimed to demonstrate the feasibility of an unassisted and community-based HIV self-testing (HIVST) distribution model and to evaluate its acceptability among men-having-sex-with-men (MSM) and transgender women (TGW).Our demonstration study focused on implementing the HIVST distribution model in Metro Manila, Philippines. Convenience sampling was done with the following inclusion criteria: MSM or TGW, at least 18 years old, and had no previous HIV diagnosis. Individuals taking HIV pre-exposure prophylaxis, on antiretroviral therapy, or female sex at birth were excluded. The implementation of the study was done online using a virtual assistant and a delivery system via courier due to COVID-19-related lockdowns. Feasibility was measured by the number of HIVST kits successfully delivered and utilized and the HIV point prevalence. Moreover, acceptability was evaluated by a 10-item system usability scale (SUS). HIV prevalence was estimated with linkage to care prioritized for reactive participants.Out of 1,690 kits distributed, only 953 (56.4%) participants reported their results. Overall, HIV point prevalence was 9.8%, with 56 (60.2%) reactive participants linked to further testing. Furthermore, 261 (27.4%) of respondents self-reported, and 35 (13.4%) of the reactive participants were first-time testers. The HIVST service had an overall median and interquartile range (IQR) SUS score of 82.5 (IQR: 75.0, 90.0), rendering the HIVST kits very acceptable.Our study suggests the acceptability and feasibility of HIVST among the MSM and TGW in Metro Manila, Philippines, regardless of their age or HIV testing experience. In addition, other platforms of information dissemination and service delivery of HIVST should be explored, including access to online instructional videos and printed materials, which may facilitate easier use and interpretation of results. Furthermore, due to our study's limited number of TGW respondents, a more targeted implementation strategy to reach the TGW population is warranted to increase their access and uptake of HIVST.

1 citations

Journal Article•DOI•
Rectal douching among men who have sex with men in six cities in China: a cross-sectional study

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Peiyang Li1, Tanwei Yuan1, Zhenyu Wang1, Ruonan Huang1, Xiaojun Meng2, Kechun Zhang2, Guanghui Wang, Yepeng Zhou, Danyang Luo, Ying Wang3, Yong Cai3, Huachun Zou1, Huachun Zou4 •
Sun Yat-sen University1, Centers for Disease Control and Prevention2, Shanghai Jiao Tong University3, Kirby Institute4
01 Nov 2020-Sexual Health
TL;DR: Rectal douching is common in MSM, some of whom may not realise the potential risks associated with douching, and the co-occurrence of douching and other high-risk behaviours would make MSM more vulnerable to HIV.
Abstract: Background Rectal douching, which is a common practice among men who have sex men (MSM) as a preparation for anal sex, may potentially increase the risk of HIV infection. However, little is known about the practice of rectal douching among Chinese MSM. This study investigated the characteristics of rectal douching and factors associated with rectal douching. Methods: Between January and March 2019, MSM aged ≥18 years in six cities in China were recruited to the study. Participants were asked to complete a self-administered online questionnaire. Chi-squared tests and multivariable logistic regression were used to examine factors associated with rectal douching by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of 485 MSM in this study, 278 (57.3%) practiced rectal douching in the preceding 6 months. The most common reasons for douching before and after anal sex were hygiene/cleanliness (78.6% and 66.1% respectively) and HIV/STI prevention (8.5% and 17.4% respectively). The most used enemas and equipment before and after anal sex were tap water (73.5% and 70.2% respectively) and showerhead hoses (76.1% and 75.2% respectively). Men who engaged in both insertive and receptive anal sex (OR 8.84; 95% CI 4.52–17.30), exclusively receptive anal sex (OR 6.56; 95% CI 3.55–12.13), condom-less anal intercourse (OR 1.64; 95% CI 1.03–2.63) and anal sex after alcohol use (OR 1.54; 95% CI 1.00–2.35) were more likely to perform douching. Conclusion: Rectal douching is common in MSM, some of whom may not realise the potential risks associated with douching. The co-occurrence of douching and other high-risk behaviours would make MSM more vulnerable to HIV. Health education aimed at informing MSM of the potential risks and addressing the high prevalence of douching are urgently needed.

1 citations

Dissertation•DOI•
Mathematical modelling for assessing HIV epidemics and the impact of interventions in Latin America

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Juan F. Vesga
01 Sep 2014

1 citations

Cites background from "HIV transmission risk through anal ..."

  • ...025 Uniform [32] Average time in Early HIV infection stage (years) Ψ 0....

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  • ...This disproportionate concentration of risk is perpetuated by high levels of stigma, marginalization and even penalization, which strengthens segregation and hampers MSM population’s access to prevention campaigns and health services [2, 28, 32-34]....

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  • ...1st line ART ξ 0.23 - - - [37] Average time spent in non-suppressed VL with ART (years) 𝜑 0.5 [38] Relative disease progression reduction caused by ART by stage of disease Φ3 95% - - - [7] Φ4 91% - - - [7] Φ5 72% - - - [7] Condom efficacy on HIV transmission 𝜍 Calibrated 0.8 0.95 Uniform [39, 40] Chapter 2: Estimating the impact of Antiretroviral Treatment in the HIV epidemic of Bogota Equation 40: Linear interpolation, 𝑓(𝑥) = 𝑌𝑎 + (𝑌𝑏 − 𝑌𝑎) 𝑋 − 𝑋𝑎 𝑋𝑏 − 𝑋𝑎 Linear interpolation finds intermediate values from a function underlying the known data points....

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  • ...Table 1: Parameters and calibration information Calibration Range Prior Distribution Symbol Value Low High Source Demographic and Initial Model Conditions Total Population 15 to 49 years at time 0 (1970) N0 906000 - - - [20] Population growth rate Υ(t) See below - - - [20] Background mortality rate μ 1/65 years - - - [20] Rate of ceasing sexual activity σ 1/34 years - - - [20] Proportion of Female population f 0.52 - - - [20] Fraction of Sexually Active Women 1- Ω1 0.842 - - - [20] Fraction of FSW in female population Ω4 calibrated 0.005 0.02 Uniform [12] Fraction FSW out to Low Risk Group postSW 0.5 Assumption FSW turnover rate γ Calibrated 1 20 Triangle [21] Fraction of female in High Activity category Ω3 0.0298 - - - [10] Fraction of female Low Activity category Ω2 1-( Ω1+ Ω3+ Ω4) - - - Assumption Fraction male High Activity category Ω7 Calibrated 0.09 0.14 Uniform [10, 22] Fraction of male in MSM category Ω8 Calibrated 0.021 0.067 Uniform [14] Fraction of MSM in Bisexual activity category Ω9 Calibrated 0.11 0.43 Uniform [14] Fraction of male in CFSW in category Ω10 Calibrated 0.05 0.15 Uniform [23] Fraction of male in Low Activity category Ω6 1-( Ω5+ Ω7+ Ω8 Ω9+ Ω10) - - - Assumption Year of Start of the epidemic 1975 - - Assumption Chapter 2: Estimating the impact of Antiretroviral Treatment in the HIV epidemic of Bogota Seed (HIV prevalence at time 0) seed - 0.0001 0.0025 Uniform Assumption Behaviour parameters Proportion testing for HIV per year (Hk(t)) 𝐻𝑚𝑠𝑚(2006) Calibrated 0.122 0.177 Uniform [24] 𝐻𝑚𝑠𝑚(2010) Calibrated 0.197 0.305 Uniform [14] 𝐻𝑓𝑠𝑤(2007) Calibrated 0.421 0.506 Uniform [25] 𝐻𝑓𝑠𝑤(2012) Calibrated 0.463 0.537 Uniform [21] 𝐻𝑚𝑒𝑛(2007) Calibrated 0.049 0.065 Uniform [26] 𝐻𝑤𝑜𝑚𝑒𝑛(2005) Calibrated 0.040 0.045 Uniform [27] 𝐻𝑤𝑜𝑚𝑒𝑛(2005) Calibrated 0.086 0.098 Uniform [28] HIV testing cofactor according to CD4 count (Fs) F1 (CD4 >500) Calibrated 0.01 1 Uniform Assumption F2 (CD4 350-500 Calibrated 0.01 1 Uniform Assumption F3(CD4 200-349) Calibrated 0.01 1 Uniform Assumption F4(CD4 50-199) Calibrated 1 3 Uniform Assumption Proportion of sex acts protected with condom per year by risk group(νk(t)) νall( 1984) Calibrated 0.010 0.100 Uniform Assumption νmsm(2006) Calibrated 0.590 0.667 Uniform [24] νmsm(2010) Calibrated 0.530 0.650 Uniform [14] νfsw(2007) Calibrated 0.739 0.811 Uniform [25] νfsw(2012) Calibrated 0.956 0.982 Uniform [21] νhetero(1995) Calibrated 0.072 0.101 Uniform [29] νlow(2000) Calibrated 0.104 0.136 Uniform [30] νhigh(2000) Calibrated 0.020 0.24 Uniform [30] νlow(2005) Calibrated 0.121 0.148 Uniform [27] νhigh(2005) Calibrated 0.200 0.415 Uniform [27] νlow(2010) Calibrated 0.146 0.170 Uniform [28] νhigh(2010) Calibrated 0.260 0.444 Uniform [28] Year of Condom use increase (Behaviour change) condyear80 Calibrated 1984 1994 Uniform Assumption Partner Change Rate by risk group per year (ck) clow_women 0.9522 - - - [10] chigh-women Calibrated 2 4 Uniform [10] clow_men 1 - - - [10] chigh_men Calibrated 2 4 Uniform [10] cfsw 638 159 1117 Triangle [21] cbi 10 2 45 Triangle [14] cmsm 10 2 45 Triangle [14] ccfsw - 2 30 Uniform Assumption Average number acts per partnership by risk grouper year (αk) αlow 53 - - - [31] αhigh 2 - - - Assumption αfsw 1 - - - Assumption αmsm 4 - - - [14] Assortativeness coefficient e - 0 1 Uniform Assumption Natural History of Disease Per-Act Female to Male HIV transmission probability βf Calibrated 0.00114 0.009 Uniform [9] Per-Act Male to female HIV transmission probability βm Calibrated 0.0008 0.002 Uniform [9] Per-Act MSM HIV transmission probability (combined)* βmsm Calibrated 0.002 0.025 Uniform [32] Average time in Early HIV infection stage (years) Ψ 0.25 - - - [8] Progression rates through CD4 stages (years) Ρ1, Ρ2, Ρ3, Ρ4 2.4 - - - [7] Progression rate to death when CD4 50 cell/mL (years) δ 0.75 - - - [8] Relative Infectiousness during Early HIV Infection L0,1 calibrated 4.47 18.18 Uniform [9] Interventions Recruitment rate into ART by stage of disease per year Cs(t) C5(2001) calibrated 0.56 5,98 Uniform (30) C4(2001) Calibrated 0.23 3,96 Uniform (30) C3(2001) Calibrated 0,23 2,53 Uniform (30) C2(2001) Calibrated 0,19 1 Uniform (30) C1(2001) Calibrated 0,16 1,02 Uniform (30) C5(2009) Calibrated 2.97 11,7 Uniform (30) C4(2009) Calibrated 1,99 11,7 Uniform (30) C3(2009) Calibrated 1 2,99 Uniform (30) C2(2009) Calibrated 0,52 2,96 Uniform (30) C1(2009) Calibrated 0,43 2,96 Uniform (30) Annual retention rate into ART r Calibrated 0.4 0.9 Uniform [33] Year of ART start - 1997 - - - [34] HIV transmission proportional reduction due to ART La,s For a=2,5 Calibrated 0.73 0.99 Uniform [35] HIV transmission proportional reduction non-suppressed ART L a,s For a=1,4 0.5 - - - Assumption Annual rate of failure on 1st line ART 𝜗 Calibrated 0.05 0.25 Uniform [36] Annual rate of failure on 2nd?...

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Journal Article•DOI•
Mot de présentation : drogues et minorités sexuelles

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Martin Blais, Dominic Beaulieu Prévost, Joseph Josy Lévy
01 Jan 2018
TL;DR: While significant differences in socio-demographic and sexual history were observed for selfidentification, substance use varied less by self-identification than by sex of partners, for both women and men.
Abstract: Objective To analyze the differences in the use of alcohol and illicit drugs according to sexual orientation among men and women. Methods L’Enquête Presse Gays et Lesbiennes 2011 is a self-administered cross-sectional survey of volunteers responding to a questionnaire available on gay and lesbian websites. Respondents aged 18 years or over, living in France, who have had sexual intercourse in their lifetime were selected for this analysis. Alcohol consumption is measured by the frequency of use in the last twelve months, the number of drinks each day and the consumption of six or more drinks on the same occasion. Use of cannabis, ecstasy or cocaine is measured by consumption once or more in the last twelve months. Sexual orientation is measured by two indicators: self-identification and sex of partners. Self-identification as «bisexual» or «gay / lesbian» is reported by 2 675 women and 8 725 men, sex of partners during lifetime for 2 747 women and 9 001 men and sex of the partners in the last twelve months for 2 871 women and 8 974 men. Results While significant differences in socio-demographic and sexual history were observed for selfidentification, substance use varied less by self-identification than by sex of partners, for both women and men. Respondents who had partners of both sexes reported higher levels of alcohol and drug use. Elements of lifestyle, psychological distress and discrimination did not explain observed differences in substance use by sex of partners. Conclusion Understanding what underlies these differences in consumption remains a major public health concern.

1 citations

Hagfræðilegt mat á nálaskiptiþjónustu sem forvörn gegn útbreiðslu HIV meðal sprautufíkla á Íslandi

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Elías Sæbjörn Eyþórsson
01 Jun 2012

1 citations

References
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Journal Article•DOI•
Measuring inconsistency in meta-analyses

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Julian P T Higgins1, Simon G. Thompson1, Jonathan J Deeks, Douglas G. Altman•
University of Cambridge1
04 Sep 2003-BMJ
TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Abstract: Cochrane Reviews have recently started including the quantity I 2 to help readers assess the consistency of the results of studies in meta-analyses. What does this new quantity mean, and why is assessment of heterogeneity so important to clinical practice? Systematic reviews and meta-analyses can provide convincing and reliable evidence relevant to many aspects of medicine and health care.1 Their value is especially clear when the results of the studies they include show clinically important effects of similar magnitude. However, the conclusions are less clear when the included studies have differing results. In an attempt to establish whether studies are consistent, reports of meta-analyses commonly present a statistical test of heterogeneity. The test seeks to determine whether there are genuine differences underlying the results of the studies (heterogeneity), or whether the variation in findings is compatible with chance alone (homogeneity). However, the test is susceptible to the number of trials included in the meta-analysis. We have developed a new quantity, I 2, which we believe gives a better measure of the consistency between trials in a meta-analysis. Assessment of the consistency of effects across studies is an essential part of meta-analysis. Unless we know how consistent the results of studies are, we cannot determine the generalisability of the findings of the meta-analysis. Indeed, several hierarchical systems for grading evidence state that the results of studies must be consistent or homogeneous to obtain the highest grading.2–4 Tests for heterogeneity are commonly used to decide on methods for combining studies and for concluding consistency or inconsistency of findings.5 6 But what does the test achieve in practice, and how should the resulting P values be interpreted? A test for heterogeneity examines the null hypothesis that all studies are evaluating the same effect. The usual test statistic …

45,105 citations

Journal Article•DOI•
Meta-analysis of observational studies in epidemiology - A proposal for reporting

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Donna F. Stroup1, Jesse A. Berlin2, Sally C. Morton3, Ingram Olkin4, G. D. Williamson1, Drummond Rennie5, Drummond Rennie6, David Moher, Betsy Jane Becker7, Theresa Ann Sipe8, Stephen B. Thacker1 •
Centers for Disease Control and Prevention1, University of Pennsylvania2, RAND Corporation3, Stanford University4, University of California, San Francisco5, American Medical Association6, Michigan State University7, Georgia State University8
19 Apr 2000-JAMA
TL;DR: A checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion should improve the usefulness ofMeta-an analyses for authors, reviewers, editors, readers, and decision makers.
Abstract: ObjectiveBecause of the pressure for timely, informed decisions in public health and clinical practice and the explosion of information in the scientific literature, research results must be synthesized. Meta-analyses are increasingly used to address this problem, and they often evaluate observational studies. A workshop was held in Atlanta, Ga, in April 1997, to examine the reporting of meta-analyses of observational studies and to make recommendations to aid authors, reviewers, editors, and readers.ParticipantsTwenty-seven participants were selected by a steering committee, based on expertise in clinical practice, trials, statistics, epidemiology, social sciences, and biomedical editing. Deliberations of the workshop were open to other interested scientists. Funding for this activity was provided by the Centers for Disease Control and Prevention.EvidenceWe conducted a systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies using MEDLINE, Educational Research Information Center (ERIC), PsycLIT, and the Current Index to Statistics. We also examined reference lists of the 32 studies retrieved and contacted experts in the field. Participants were assigned to small-group discussions on the subjects of bias, searching and abstracting, heterogeneity, study categorization, and statistical methods.Consensus ProcessFrom the material presented at the workshop, the authors developed a checklist summarizing recommendations for reporting meta-analyses of observational studies. The checklist and supporting evidence were circulated to all conference attendees and additional experts. All suggestions for revisions were addressed.ConclusionsThe proposed checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion. Use of the checklist should improve the usefulness of meta-analyses for authors, reviewers, editors, readers, and decision makers. An evaluation plan is suggested and research areas are explored.

17,663 citations

Journal Article•DOI•
The combination of estimates from different experiments.

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William G. Cochran1•
Johns Hopkins University1
01 Mar 1954-Biometrics
TL;DR: The problem of making a combined estimate has been discussed previously by Cochran and Yates and Cochran (1937) for agricultural experiments, and by Bliss (1952) for bioassays in different laboratories as discussed by the authors.
Abstract: When we are trying to make the best estimate of some quantity A that is available from the research conducted to date, the problem of combining results from different experiments is encountered. The problem is often troublesome, particularly if the individual estimates were made by different workers using different procedures. This paper discusses one of the simpler aspects of the problem, in which there is sufficient uniformity of experimental methods so that the ith experiment provides an estimate xi of u, and an estimate si of the standard error of xi . The experiments may be, for example, determinations of a physical or astronomical constant by different scientists, or bioassays carried out in different laboratories, or agricultural field experiments laid out in different parts of a region. The quantity xi may be a simple mean of the observations, as in a physical determination, or the difference between the means of two treatments, as in a comparative experiment, or a median lethal dose, or a regression coefficient. The problem of making a combined estimate has been discussed previously by Cochran (1937) and Yates and Cochran (1938) for agricultural experiments, and by Bliss (1952) for bioassays in different laboratories. The last two papers give recommendations for the practical worker. My purposes in treating the subject again are to discuss it in more general terms, to take account of some recent theoretical research, and, I hope, to bring the practical recommendations to the attention of some biologists who are not acquainted with the previous papers. The basic issue with which this paper deals is as follows. The simplest method of combining estimates made in a number of different experiments is to take the arithmetic mean of the estimates. If, however, the experiments vary in size, or appear to be of different precision, the investigator may wonder whether some kind of weighted meani would be more precise. This paper gives recommendations about the kinds of weighted mean that are appropriate, the situations in which they

4,335 citations

Journal Article•DOI•
Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1

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Thomas C. Quinn, Maria J. Wawer1, Nelson K. Sewankambo2, David Serwadda2, Chuanjun Li3, Fred Wabwire-Mangen2, Mary Meehan1, Tom Lutalo2, Ronald H. Gray3 •
Columbia University1, Makerere University2, Johns Hopkins University3
30 Mar 2000-The New England Journal of Medicine
TL;DR: The viral load is the chief predictor of the risk of heterosexual transmission of HIV-1, and transmission is rare among persons with levels of less than 1500 copies of HIV -1 RNA per milliliter.
Abstract: Background and Methods We examined the influence of viral load in relation to other risk factors for the heterosexual transmission of human immunodeficiency virus type 1 (HIV-1). In a community-based study of 15,127 persons in a rural district of Uganda, we identified 415 couples in which one partner was HIV-1–positive and one was initially HIV-1–negative and followed them prospectively for up to 30 months. The incidence of HIV-1 infection per 100 person-years among the initially seronegative partners was examined in relation to behavioral and biologic variables. Results The male partner was HIV-1–positive in 228 couples, and the female partner was HIV-1–positive in 187 couples. Ninety of the 415 initially HIV-1–negative partners seroconverted (incidence, 11.8 per 100 person-years). The rate of male-to-female transmission was not significantly different from the rate of female-to-male transmission (12.0 per 100 person-years vs. 11.6 per 100 person-years). The incidence of seroconversion was highest among ...

2,897 citations

Journal Article•DOI•
Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model

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Reuben Granich, Charles F. Gilks, Christopher Dye, Kevin M. De Cock, Brian G. Williams 
03 Jan 2009-The Lancet
TL;DR: A theoretical strategy of universal voluntary HIV testing and immediate treatment with ART, combined with present prevention approaches, could have a major effect on severe generalised HIV/AIDS epidemics.

1,948 citations

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10 Aug 2011-The New England Journal of Medicine
Myron S. Cohen, Ying Q. Chen, Marybeth McCauley, Theresa Gamble, Mina C. Hosseinipour, Nagalingeswaran Kumarasamy, James Hakim, Johnstone Kumwenda, Beatriz Grinsztejn, José Henrique Pilotto, Sheela Godbole, Sanjay Mehendale, Suwat Chariyalertsak, Breno Santos, Kenneth H. Mayer, Irving F. Hoffman, Susan H. Eshleman, Estelle Piwowar-Manning, Lei Wang, Joseph Makhema, Lisa A. Mills, Guy de Bruyn, Ian Sanne, Joseph J. Eron, Joel E. Gallant, Diane V. Havlir, Susan Swindells, Heather J. Ribaudo, Vanessa Elharrar, David N. Burns, Taha E. Taha, Karin Nielsen-Saines, David D. Celentano, Myron Essex, Thomas R. Fleming 
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Robert M. Grant, Javier R. Lama, Peter L. Anderson, Vanessa McMahan, Albert Y. Liu, Lorena Vargas, Pedro Goicochea, Martin Casapia, Juan Vicente Guanira-Carranza, Maria Esther Ramirez-Cardich, Orlando Montoya-Herrera, Telmo Fernandez, Valdilea G. Veloso, Susan Buchbinder, Suwat Chariyalertsak, Mauro Schechter, Linda-Gail Bekker, Kenneth H. Mayer, Esper G. Kallas, K. Rivet Amico, Kathleen Mulligan, Lane R. Bushman, Robert J. Hance, Carmela Ganoza, Patricia Defechereux, Brian S. Postle, Furong Wang, J. Jeff McConnell, Jia-Hua Zheng, Jeanny Lee, James F. Rooney, Howard S. Jaffe, Ana Martinez, David N. Burns, David V. Glidden 
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30 Mar 2000-The New England Journal of Medicine
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Respondent-driven sampling : A new approach to the study of hidden populations

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01 May 1997-Social Problems
Douglas D. Heckathorn