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Treating curable sexually transmitted infections to prevent HIV in Africa; still an effective control strategy?

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dc.contributor.author White, R. G. en_US
dc.contributor.author Orroth, K. K. en_US
dc.contributor.author Glynn, J. R. en_US
dc.contributor.author Freeman, E. E. en_US
dc.contributor.author Bakker, R. en_US
dc.contributor.author Habbema, J. D. F. en_US
dc.contributor.author Terris-Prestholt, F. en_US
dc.contributor.author Kumaranayake, L. en_US
dc.contributor.author Buvé, A. en_US
dc.contributor.author Hayes, R. J. en_US
dc.date.accessioned 2008-04-03T07:56:47Z
dc.date.available 2008-04-03T07:56:47Z
dc.date.issued 2008
dc.identifier.issn 1525-4135
dc.identifier.doi http://dx.doi.org/10.1097/QAI.0b013e318160d56a
dc.identifier.other ITG-M9A en_US
dc.identifier.other MICRO en_US
dc.identifier.other U-HIVSTD en_US
dc.identifier.other JIF en_US
dc.identifier.other UPD1 en_US
dc.identifier.other DOI en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.uri http://hdl.handle.net/10390/2218
dc.description Not the final published version en_US
dc.description.abstract BACKGROUND: Evidence regarding the effectiveness of sexually transmitted infection (STI) treatment for HIV prevention in Africa is equivocal, leading some policy makers to question whether it should continue to be promoted for HIV control. We explore whether treating curable STIs remains a cost-effective HIV control strategy in Africa. METHODS: The model STDSIM was fitted to the characteristics of 4 populations in East and West Africa. Over the simulated HIV epidemics, the population-attributable fractions (PAFs) of incident HIV attributable to STIs, the impact of syndromic STI management on HIV incidence, and the cost per HIV infection averted were evaluated and compared with an estimate of lifetime HIV treatment costs (US $3500). RESULTS: Throughout the HIV epidemics in all cities, the total PAF for. all STIs remained high, with > or = 50% of HIV transmission attributed to STIs. The PAF for herpes simplex virus type 2 increased during the epidemics, whereas the PAF for curable STIs and the relative impact of syndromic management decreased. The models showed that the absolute impact of syndromic management remains high in generalized epidemics, and it remained cost-saving in 3 of the 4 populations in which the cost per HIV infection averted ranged between US $321 and $1665. CONCLUSION: Curable STI interventions may remain cost-saving in populations with generalized HIV epidemics, particularly in populations with high-risk behaviors or low male circumcision rates. en_US
dc.language English en_US
dc.publisher Lippincott, Williams & Wilkins en_US
dc.subject Viral diseases en_US
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject Primary prevention en_US
dc.subject Control strategies en_US
dc.subject Sexually transmitted diseases en_US
dc.subject STD en_US
dc.subject Case management en_US
dc.subject Syndromic management en_US
dc.subject Cost-effectiveness en_US
dc.subject Risk populations en_US
dc.subject Africa, East en_US
dc.subject Africa, West en_US
dc.title Treating curable sexually transmitted infections to prevent HIV in Africa; still an effective control strategy? en_US
dc.type Article en_US
dc.citation.issue 3 en_US
dc.citation.jtitle Journal of Acquired Immune Deficiency Syndromes en_US
dc.citation.volume 47 en_US
dc.citation.pages 346-353 en_US
dc.publisher.place Philadelphia en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/18176323
dc.citation.jabbreviation J Acquir Immun Defic Syndr en_US


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