Model-based evaluation of single-round mass treatment of sexually transmitted diseases for HIV control in a rural African population

Korenromp, Eline L.; Vliet, C. van; Grosskurth, Heiner; Gavyole, Awena; Ploeg, C.P.B. van der; Fransen, L; Hayes, Richard; Habbema, J. Dik F.

doi:10.1097/00002030-200003310-00013

Cited by 81 publications

(51 citation statements)

References 60 publications

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“…In a study done in a rural African population, mass treatment combined with improved treatment services has been found to lead to a rapid and sustained fall in HIV incidence. 23 Alternatively, regular clinical and laboratory screening for different STIs may be tried. In the Abidijan study, 24 a South African mining community study, 25 and the Mwanza trial 26 it was observed that there was significant reduction of HIV incidence and other STIs among female SWs who received a comprehensive intervention of health education, condom distribution, and periodic screening and treatment.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of sexually transmitted infections and performance of STI syndromes against aetiological diagnosis, in female sex workers of red light area in Surat, India

Desai

Kosambiya²,

Thakor³

et al. 2003

Sexually Transmitted Infections

100

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Section: Discussionmentioning

confidence: 99%

Prevalence of sexually transmitted infections and performance of STI syndromes against aetiological diagnosis, in female sex workers of red light area in Surat, India

Desai

Kosambiya²,

Thakor³

et al. 2003

Sexually Transmitted Infections

100

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“…For example, Korenromp and colleagues 37 assumed that genital ulcers from syphilis or chancroid in either partner enhance HIV transmission by a factor of 100, implying an HIV transmission risk from a single coital act of 30% from men to women and 8% from women to men. These rates are at odds with most empiric studies.…”

Section: Unexplained High Implicit Rates Of Heterosexual Transmissionmentioning

confidence: 99%

HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

et al. 2002

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An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behaviour. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%–40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic. More research is warranted to clarify risks for HIV transmission through health care.

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“…However, presumptive treatment of STIs in the general population as well as in specific subgroups is currently being tested in Africa, through theoretical modeling 19 as well as through community trials (such as that in Rakai, Uganda 20 ) and operations research 21 in mining communities. This strategy may yet prove to be of value in situations where the prevalence of HIV and other STIs is high and where mass treatment is possible.…”

mentioning

confidence: 99%

Integration of STI Prevention and Management with Family Planning and Antenatal Care in Sub-Saharan Africa: What More Do We Need to Know?

Askew¹,

Maggwa²

2002

International Family Planning Perspectives

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The way in which reproductive health services are offered, or at least how policies recommend they should be offered, has been undergoing considerable revision over the past few years. In most cases, these revisions focus on reorganizing the way in which services are configured, and the configurations receiving the most attention are those that integrate STI and HIV prevention, detection and management with family planning and antenatal care. There are several reasons for this in the Sub-Saharan region. 1 Reproductive tract infections (RTIs), particularly those that are sexually transmitted (STIs), continue to be a serious public health problem in Sub-Saharan Africa, with the World Health Organization (WHO) estimating that 12% of 15-49-year-olds have a curable STI. 2 Not only are the prevention and management of STIs important public health concerns in themselves, but the presence of some STIs enhances the sexual transmission of HIV, and STI management has been shown to be effective in reducing HIV transmission. Moreover, the Programme of Action of the 1994 International Conference on Population and Development (ICPD) emphasized reorienting health care systems to enable women to obtain comprehensive and quality reproductive health services. Finally, configuring services jointly rather than separately has perceived financial benefits for health systems.The clients of public-sector programs providing maternal and child health care and family planning services are almost exclusively women using family planning, pregnant women and women with newborn babies-women who usually are married and are considered at low risk for STIs. Data from a variety of sources 3 indicate that in some populations, 2-7% of pregnant women and of women using family planning have a cervical gonorrheal, chlamydial or syphilis infection. Moreover, trichomoniasis-a sexually transmitted vaginal infection-has been diagnosed in 4-34% of such women. (Non-sexually transmitted vaginal infections such as candidiasis and bacterial vaginosis are also common among these women-8-38%-but present less serious consequences to the woman and her fetus or newborn.) Finally, 25-30% of pregnant women in several parts of the region are infected with HIV. 4 These data indicate that many women served by maternal and child health and family planning programs should no longer be considered at low risk, and that efforts to reach them through these programs are justifiable on a public health basis. This article will focus on public programs, which are the primary source of family planning and antenatal services in Sub-Saharan Africa. A study in Uganda has shown that men are twice as likely as women to bring an HIV infection into a marriage, 5 emphasizing that the risk of HIV and other STIs among married women, who make up the majority of maternal and child health and family planning program clients in this

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Model-based evaluation of single-round mass treatment of sexually transmitted diseases for HIV control in a rural African population

Abstract: In populations in which STD control can reduce HIV incidence, mass treatment may, in the short run, have an impact comparable to sustained syndromic treatment. Mass treatment combined with sustained syndromic treatment may be particularly effective.

Cited by 81 publications

References 60 publications

Prevalence of sexually transmitted infections and performance of STI syndromes against aetiological diagnosis, in female sex workers of red light area in Surat, India

Prevalence of sexually transmitted infections and performance of STI syndromes against aetiological diagnosis, in female sex workers of red light area in Surat, India

HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

Integration of STI Prevention and Management with Family Planning and Antenatal Care in Sub-Saharan Africa: What More Do We Need to Know?

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