Cellulose sulfate did not prevent HIV infection and may have increased the risk of HIV acquisition. (ClinicalTrials.gov number, NCT00153777; and Current Controlled Trials number, ISRCTN95638385.)
Infectivity estimates for infected blood transfusions are larger than for other modes of HIV transmission. Few studies on transmission risk per contaminated injection were found. However, transmission risk per needlestick injury, where needles are more likely to be rinsed or disinfected between recipients (especially for medical injections), may be representative of non-intravenous medical injections and lower than the risk from intravenous injections, which are likely to be deeper and to involve more fluids. Further work is needed to better estimate transmission probability related to contaminated injections and its likely contribution to overall HIV transmission.
Objectives: To identify the contribution of Mycoplasma genitalium to the aetiology of cervicitis in subSaharan Africa and its relative importance in the overall burden of sexually transmitted infections among female sex workers (FSW). Methods: The study population consisted of FSW recruited in Ghana and Bénin during the initial visit of a randomised controlled trial. A questionnaire was administered, a pelvic examination carried out, and cervical samples obtained for detection of M genitalium, Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Clinical signs potentially indicating cervicitis were cervical discharge, pus on the cervical swab, bleeding after sampling, and inflammatory cervix. Results: Among 826 FSW, 26.3% were infected with M genitalium. N gonorrhoeae was strongly and independently associated with each of the four signs of cervicitis (adjusted odds ratios (AOR): 4.1 to 6.0). The AOR for C trachomatis were intermediate (1.3-4.1) and the AOR for M genitalium were lower (between 1.6 and 1.8) but statistically significant (p(0.05) for each sign. Conclusions: M genitalium is weakly associated with signs of cervicitis in west African FSW but is highly prevalent.
The aim of this study was to evaluate the efficacy of a theory-based intervention to increase the use of a new syringe for each injection among injection drug users (IDUs). Users of two needle exchange programs (NEPs) were involved. At both sites, participants were assigned at random to either the experimental or the control group. Once a week for four weeks, users reported to the NEPs where they logged onto a computer and received an audiovisual message. A total of 260 IDUs were recruited. At baseline, 52.3% of participants reported that they had not always used new syringes in the previous week. The results indicate that it is possible for IDUs to adopt safer injection practices. One month after the intervention began, participants in the experimental group were using fewer dirty syringes compared to the control group (RR: 0.47 CI(95%) 0.28-0.79; P = .004). This short-term effect was no longer present 3 months later.
Evaluation is a major challenge in the field of health promotion and health education. Since the degree to which a project is planned often guarantees its potential success, the evaluation process should make it possible to answer different questions related to stages of project implementation. The goal of this study was to develop a planning tool to help health professionals and community workers judge the potential success of health education interventions based on the extent to which they are planned and to test the tool in real intervention evaluations. Educational interventions examined in this study were targeted primarily at the promotion and adoption of behaviour reducing the risk of human immunodeficiency virus (HIV) transmission. The conceptual framework of "intervention mapping" served as the basis for developing the tool. Experts were consulted to identify criteria that would make it possible to evaluate the extent to which different stages of the model were accomplished. The tool was tested for reliability. Data from 123 projects were then collected and analyzed. The process for the development of the tool made it possible to identify 40 planning criteria, broken down into the 19 tasks of intervention mapping model. Reliability test results were highly satisfactory. The overall average score for project planning was 12.7 out of 40. The degree to which different stages were planned varied considerably. For example, only 15% of projects had developed their objective matrices properly, whereas 80% were assured proper support for their implementation. Thirty-nine percent of the projects were satisfactorily available for evaluation. This exercise made it possible to construct an interesting tool for identifying strengths and weaknesses of intervention planning. Various promoters might find this tool useful for increasing the potential success of their initiatives.
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