Dr Ajith Karawita, President of the Sri Lanka College of Venereologists. World Hepatitis Day was organized by the Sri Lanka College of Venereologists on world hepatitis day on 28 July 2015 at BMICH
Spread the Awareness about #Hepatitis with us on this World Hepatitis Day!
#28July #WorldHepatitisDay
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Dr Ajith Karawita, President of the Sri Lanka College of Venereologists. World Hepatitis Day was organized by the Sri Lanka College of Venereologists on world hepatitis day on 28 July 2015 at BMICH
Spread the Awareness about #Hepatitis with us on this World Hepatitis Day!
#28July #WorldHepatitisDay
*Free Shipping on all US Orders - Coupon Code "FS99"
www.OffshoreCheapMeds.co
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
Presentation made by Zsuzsanna Jakab, WHO Regional Director for Europe, at the meeting "Health in Action reforming the Greek National Health System to Improve Citizens’ Health", on 5 March 2014, Athens, Greece.
L'infection par le VIH n'est pas une infection contagieuse, c'est-à-dire qu'à la différence de la grippe (par exemple), elle ne se transmet pas d'une personne à une autre dans un quotidien de vie ou de travail. Cette information est importante, car de nombreuses personnes rejettent encore les personnes séropositives dans le milieu professionnel en raison de peurs infondées et de risques qui n'existent pas. En revanche, l'infection par le VIH est une infection transmissible dans des situations précises.
Hepatitis is generally refer to inflammation of liver, it is resulted from infectious causes (such as viral, bacterial and fungal causes ) or noninfectious ( such as alcohol drugs, autoimmune diseases and metabolic diseases) , in this research , I’m going to focus on viral hepatitis because it is the most common cause of acute hepatitis in USA ( 50% of cases ).
The commonness and important viruses that cause viral hepatitis are (A,B,C,D,E) types, approximately 4.4 million Americans are currently living with chronic hepatitis B and C.
Presentation from the European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE), published by the European Centre for Disease Prevention and Control (ECDC)
Professor Quarraisha Abdool Karim will take you on a journey showing how knowledge and science have made an incredible impact on battling the HIV virus on the African content. Through empowering women to help fight this deadly disease, Professor Karim’s work has managed to translate scientific research and knowledge into people-centred solutions and prevention programmes to reduce the factors making young people so vulnerable to HIV infection. Be inspired by this story and prepared to embrace your own challenges to transform them into positive actions.
Trevor Hawkins, M.D., M.P.H. of the Univeristy of New Mexico and Southwest CARE Center, presents "Top Ten HIV Clinical Controversies 2014" at AIDS Clinical Rounds
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
Presentation made by Zsuzsanna Jakab, WHO Regional Director for Europe, at the meeting "Health in Action reforming the Greek National Health System to Improve Citizens’ Health", on 5 March 2014, Athens, Greece.
L'infection par le VIH n'est pas une infection contagieuse, c'est-à-dire qu'à la différence de la grippe (par exemple), elle ne se transmet pas d'une personne à une autre dans un quotidien de vie ou de travail. Cette information est importante, car de nombreuses personnes rejettent encore les personnes séropositives dans le milieu professionnel en raison de peurs infondées et de risques qui n'existent pas. En revanche, l'infection par le VIH est une infection transmissible dans des situations précises.
Hepatitis is generally refer to inflammation of liver, it is resulted from infectious causes (such as viral, bacterial and fungal causes ) or noninfectious ( such as alcohol drugs, autoimmune diseases and metabolic diseases) , in this research , I’m going to focus on viral hepatitis because it is the most common cause of acute hepatitis in USA ( 50% of cases ).
The commonness and important viruses that cause viral hepatitis are (A,B,C,D,E) types, approximately 4.4 million Americans are currently living with chronic hepatitis B and C.
Presentation from the European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE), published by the European Centre for Disease Prevention and Control (ECDC)
Professor Quarraisha Abdool Karim will take you on a journey showing how knowledge and science have made an incredible impact on battling the HIV virus on the African content. Through empowering women to help fight this deadly disease, Professor Karim’s work has managed to translate scientific research and knowledge into people-centred solutions and prevention programmes to reduce the factors making young people so vulnerable to HIV infection. Be inspired by this story and prepared to embrace your own challenges to transform them into positive actions.
Trevor Hawkins, M.D., M.P.H. of the Univeristy of New Mexico and Southwest CARE Center, presents "Top Ten HIV Clinical Controversies 2014" at AIDS Clinical Rounds
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Valerie Delpech, Public Health Engand
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
NIH AIDS Executive Committee (NAEC) FY 2019 Ending the HIV Epidemic (EHE) in ...HopkinsCFAR
The NIH Office of AIDS Research (OAR) is pleased to release the NIH AIDS Executive Committee (NAEC) FY 2019 Ending the HIV Epidemic (EHE) in the U.S. Report.
NIMH funding on PrEP use Among Adolescent Girls and Young Women in sub-Sahara...HopkinsCFAR
Dr. Susannah Allison. Dr. Allison is a Program Officer at the National Institute of Mental Health within the Division of AIDS Research. She oversees a portfolio of research focused on the prevention of HIV infection among infants, children, and adolescents as well as research to enhance health outcomes among youth living with HIV. She is also the training director for the division. Prior to working at NIMH, Dr. Allison worked with children and families infected and affected by HIV in Baltimore, Miami, and Washington, DC. She completed her doctorate at George Washington University where she received her Ph.D. in Clinical Child Psychology with an emphasis in child health psychology.
High Sensitivity HIV Testing and Translational Science around PrEPHopkinsCFAR
Joanne Stekler, MD MPH
Associate Professor, Department of Medicine
University of Washington
Inter-Center for AIDS ResearchAntiretroviralsfor Prevention Working Group
November 13, 2017
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
Achieving HIV epidemic control - the importance of HIV prevention in women
1. CAPRISA hosts a MRC
HIV-TB Pathogenesis and
Treatment Research Unit
CAPRISA hosts a DST-
NRF Centre of Excellence
in HIV Prevention
CAPRISA is the UNAIDS
Collaborating Centre for
HIV Research and Policy
Achieving HIV epidemic control –
the importance of HIV prevention in
women
CFAR Biannual meeting, Durban 2016
Quarraisha Abdool Karim, PhD
Associate Scientific Director: CAPRISA
Member: UNAIDS Scientific Expert Panel
Professor in Clinical Epidemiology, Columbia University
Adjunct Professor in Public Health, University of KwaZulu-Natal
2. Overview
• Is epidemic control achievable?
• Can treatment alone end the AIDS epidemic?
• What is combination prevention?
• The evolving HIV epidemic:
o Where are new infections occurring?
o Where and what are the challenges for epidemic control?
• Conclusion
3. What is Epidemic Control?
• Reduction of disease incidence, prevalence,
morbidity or mortality to a locally acceptable level
as a result of deliberate intervention measures
• Point where HIV no longer represents a public
health threat and is no longer among the leading
causes of country’s disease burden
• Mathematically defined as the point at which the
reproductive rate of infection (R0) is below 1
4. Can treatment alone end the AIDS epidemic?
The case of Botswana
Despite being very close to the
UNAIDS targets of 90-90-90,
Botswana still has unacceptably
high community HIV incidence
rates. … at 3.1%.
5. What is combination prevention?
“Prevention packages that… combine
various arrays of evidence-based
strategies… tailored to the needs of
diverse subgroups and… targeted to
achieve high coverage… for a measurable
reduction in population-level HIV
transmission”
Source: Kurth et al, Current HIV/AIDS Reports 2011
6. Note: PMTCT, Screening transfusions, Harm reduction, Universal precautions, etc. have not been included – this is on sexual transmission
Behavioural
Intervention
- Abstinence
- Be Faithful
HIV Counselling
and Testing
Coates T, Lancet 2000
Sweat M, Lancet 2011
Male Condoms
Female Condoms
Treatment of
STIs
Grosskurth H, Lancet 2000
Male
circumcision
Auvert B, PloS Med 2005
Gray R, Lancet 2007
Bailey R, Lancet 2007
Treatment for
prevention
Cohen M, NEJM, 2011
Donnell D, Lancet 2010
Tanser, Science 2013
Grant R, NEJM 2010 (MSM)
Baeten J , NEJM 2012 (Couples)
Thigpen L, NEJM 2012 (Heterosexuals)
Choopanya K, Lancet 2013 (IDU)
Oral pre-exposure
prophylaxis
Post Exposure
prophylaxis (PEP)
Scheckter M, 2002
Tools for
preventing sexual
transmission of HIV
HIV
PREVENTION
7. About 6,000
new HIV
infections
each day
The world has made impressive
progress in the HIV response, but the
spread of HIV has yet to be controlled!
In 2015, worldwide there were:
1.2 million HIV deaths
37 million living with HIV
2 million new infections
Source: UNAIDS Global Report 2016
8. About 6,000
new HIV
infections
each day
Source: UNAIDS Global Report 2015
2 out of 3 new
HIV infections
are in sub-
Saharan Africa
1 out of 3 new
HIV infections
are in youth
(15-24yr)
Global HIV epidemic at a glance
9. Rank Country
% of people with
HIV in the world
1 South Africa 18%
2 Nigeria 9%
3 India 6%
4 Kenya 5%
5 Mozambique 4%
6 Uganda 4%
7 Tanzania 4%
8 Zimbabwe 4%
9 USA 4%
10 Malawi 3%
Remaining
countries 39%
South Africa
Nigeria
India
Kenya
Mozambique
Uganda
Tanzania
Zimbabwe
USA
Zambia
Remaining countries
With <1% of the world’s population, South
Africa has 18% of the HIV infections
61%
Zambia
Source: UNAIDS Global Report 2014
33%
Top 10
countries:
People living
with HIV
35 countries account for 90% of new
HIV infections globally
11. The South African HIV Epidemic:
A diversity of epidemics at a district level
12. HIV in South Africa:
Disproportionate burden of HIV in young women
South Africa
HIV in 15–24 year
men and women
(2008–2011)
Young women have
up to 8 times more
HIV than men
AIDS 1992, 6:1535-1539
1990
13. Worsening of the HIV epidemic in
young women in South Africa from
1990 to 2005HIVprevalence(%)
Source: Abdool Karim SS, Churchyard G, Abdool Karim Q, Lawn S. Lancet 2009
1990
2005
Abdool Karim Q et al. AIDS 1992
Shisana O et al. HSRC Press 2005
< 9 10-14 15-19 20-24 25-29 30-39 40-49 > 49
14. HSRC Survey: 2012
0
5
10
15
20
25
30
35
40
0-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+
HIVPrevalence(%)
Age group (years)
Females
Adapted from Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu
N, et al. South African National HIV Prevalence, Incidence and
Behaviour Survey, 2012. Cape Town, HSRC Press. 2014.
15. 0
10
20
30
40
50
60
70
80
01 02 03 04 05 06 07 08 09 10 11 12 13 14
HIVprevalence(%)
Survey year
Pregnant women in Vulindlela
National HIV prevalence in pregnant women
In KwaZulu-Natal, HIV prevalence
declining too slowly in young women
Moving average HIV prevalence
in pregnant women in Vulindlela
Source: Kharsany ABM et al , JAIDS 2015
01 02 03 04 05 06 07 08 09 10 11 12 13
32 35 41 43 37 38 34 41 37 40 35 40 44
25 27 28 30 30 29 29 29 29 30 30 30 30
Year
HIV
prevalence (%)
National HIV
prevalence (%)
Age
Group
(Years)
HIV Prevalence
(N=4818)
≤16 11.5%
17-18 21.3%
19-20 30.4%
21-22 39.4%
23-24 49.5%
>25 51.9%
Overall HIV prevalence
in rural Vulindlela
(2001-2013)
16. Highest Priority: Reducing HIV in young girls
HIV in rural South Africa (Grade 9/10)
Age Group
(years)
HIV Prevalence (2010)
% (95% Confidence Interval)
Male (n=1252)
≤15 1.0 (0.0 - 2.2)
16-17 1.1 (0.2 - 2.0)
18-19 1.5 (0 - 3.7)
≥20 1.8 (0 - 3.9)
Female (n= 1423)
2.6 (1.2 - 4.0)
6.1 (2.6 - 9.6)
13.6 (9.0 - 18.1)
24.7 (6.3 - 43.1)
17. Age Group
(years)
HIV Prevalence
% (95% Confidence Interval)
Male (n=1252) Female (n= 1423)
≤15 1.0
16-17 1.1
18-19 1.5
≥20 1.8
HIV & HSV-2 prevalence in students by age
HSV-2 Prevalence
≤15 0.7
16-17 2.0
18-19 6.6
≥20 3.5
2.6
6.1
13.6
24.7
3.5
9.3
30.2
43.3
18. Risk factors for HIV acquisition in
female high school students
Risk factor Adjusted OR p-value
Age <18 years
2.67
(1.67-4.27)
<0.001
HSV-2 seropositive
4.35
(2.61-7.24)
<0.001
Experience of pregnancy
1.66
(1.10-2.51)
0.016
Experience of >1 adult
deaths in household
1.97
(1.13-3.44)
0.016
SOCIAL as well as BIOLOGICAL
vulnerability to infection
Abdool Karim Q, Kharsany ABM, Leask K, Ntombela F, Humphries H, Frohlich JA, Samsunder N,
Grobler A, Dellar R, Abdool Karim SS. Sexually Transmitted Infections 2014;
19. HSV-2 infection increases HIV risk in
CAPRISA 004 women
HSV-2 incident infections
HSV-2 positive
n=58
HSV-2 Negative
n=164
# HIV infections 11 13
HIV incidence / 100 person-yrs 12.3 5.3
HR for HIV risk in incident HSV-2: 2.4 (CI: 1.1-5.4), p = 0.03
Prevalent HPV infection increases
HIV risk
*Multivariate model fitted to HIV incidence adjusting for Study arm, Self-reported condom use, Age, Baseline
HSV-2 status, Self-reported sex acts in the last month, and Age at sexual debut.
Prevalent HPV Women-years (n/N) HIV Incidence rate (95% CI)
HPV- 330.5 (8/204) 2.4 (1.1 - 4.8)
HPV+ 880.3 (59/575) 6.7 (5.1 - 8.6)
HR for prevalent HPV: 2.8 (CI: 1.3 – 5.9), p=0.007
20. New WHO policy on ARVs to
prevent the spread of HIV by sex
(Pre-exposure prophylaxis - PrEP):
New WHO PrEP
guidelines
“..the use of daily oral
pre-exposure prophylaxis
is recommended as an
additional prevention
choice for people at
substantial risk of HIV
infection as part of
combination prevention
approaches..”
20
PrEP recommended as global standard for all at high risk
Daily Truvada
21. Summary
• Diversity of epidemics
• Responses have to be shaped by knowledge of
epidemic, drivers of epidemic & target populations
• Need to define optimal combinations of known
interventions appropriate for target population and
epidemic
• More than a health issue - social mobilization is
effective
• Treatment scale up and PrEP are creating new
opportunities for prevention – increase male
engagement; 3 zeroes
• HIV prevention is complex challenge - no quick fix, no
magic bullets, no one size fits all
• Major gap is HIV prevention technologies for young
women – daily Truvada is a start.
• M&E and keep track of new knowledge
22. Conclusion
Impressive progress in scientific research, political
commitment & implementation globally:
created a favourable HIV trajectory
but, young women in SSA still have high HIV rates
SSA is important and critical in impacting the global
There are many challenges but it should not deter us!
We won’t stop HIV in young women tomorrow….
…. but socialand biomedical innovation has to
be part of our long-term vision
23. CAPRISA hosts a MRC
HIV-TB Pathogenesis and
Treatment Research Unit
CAPRISA is the UNAIDS
Collaborating Centre for
HIV Research and Policy
CAPRISA hosts a DST-
NRF Centre of Excellence
in HIV Prevention
CAPRISA Partner
Institutions:
Acknowledgements
CAPRISA is funded by:
DAIDS, NIAID, National Institutes of Health
US Agency for International Development (USAID)
President’s Emergency fund for AIDS Relief (PEPFAR)
US Centers for Disease Control and Prevention (CDC)
South African Department of Science and Technology
(DST)
National Research Foundation (NRF)
Fogarty International Center, NIH
Gilead Sciences (tenofovir API)
MACAIDS Fund (via Tides Foundation)
Medical Research Council (MRC)
CONRAD
• CAPRISA hosts a DST-NRF Centre of Excellence in HIV
Prevention (jointly with the University of KwaZulu-Natal)
24.
25. Who is infecting who?
Africa Centre identified phylogenetically linked HIV
transmission networks in Hlabisa
High HIV incidence men
mean age 27 years (range
23-35 years)
High HIV risk women
Mean age 18 years
(range 16-23 years)
High HIV prevalence women
Mean age 26 years
(range 24-29 years)
Very young women
acquire HIV from
men, on average,
8 years older
Men and women > 24
years usually acquire
HIV from similarly
aged partners
When teen women
reach mid-20s they
continue the cycleSource: Dellar R, et al. Manuscript in preparation
26. Source: Cremin I. et al. AIDS 2013
Status quo
+ 100% ART at CD4 200
+ Circumcision
+ Early ART + structural
+ PrEP + behavioral
Is HIV epidemic control achievable?
Yes, HIV epidemic control is achievable!
27. CAPRISA hosts a MRC
HIV-TB Pathogenesis and
Treatment Research Unit
CAPRISA hosts a DST-
NRF Centre of Excellence
in HIV Prevention
CAPRISA is the UNAIDS
Collaborating Centre for
HIV Research and Policy
HSRC 2012 Survey: HIV Incidence rates
Adapted from Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African National HIV Prevalence,
Incidence and Behaviour Survey, 2012. Cape Town, HSRC Press. 2014.
