Shifting the HIV Paradigm from Care to Cure: Proceedings from the Caribbean Expert Summit in Barbados, August 2017.

The CCAS EXPERT SUMMIT convened an array of international experts in Barbados on August 27-31, 2017 under the theme "From Care to Cure-Shifting the HIV Paradigm." The Caribbean Cytometry & Analytical Society (CCAS) partnered with the Joint United Nations Programme on HIV/AIDS (UNAIDS) to deliver a program that reviewed the advances in antiretroviral therapy and the public health benefits accruing from treatment as prevention. Particular emphasis was placed on reexamining stigma and discrimination through a critical appraisal of whether public health messaging and advocacy had kept pace with the advances in medicine. Persistent fear of HIV driving discriminatory behavior was widely reported in different regions and sectors, including the healthcare profession itself; continued fear of the disease was starkly misaligned with the successes of new medical treatments and progress toward the UNAIDS 90-90-90 targets. The summit therefore adopted the mantra "Test-Treat-Defeat" to help engage with the public in a spirit of optimism aimed at creating a more conducive environment for persons to be tested and treated and, thereby, help reduce HIV disease and stigma at the individual and community levels.

Attitudes and decision making about neonatal male circumcision in a Hispanic population in New York City.

OBJECTIVE: To understand attitudes and decision making regarding neonatal male circumcision. METHODS: Parents (n = 150) with a son 3 years old were interviewed regarding demographics, communication with a medical provider, attitudes, and process by which the neonatal circumcision decision was made. RESULTS: Thirty-three percent of sons were circumcised. In univariate analyses, choosing male circumcision was associated with parents being interviewed in English, the father being circumcised, positive attitudes, being informed of the advantages of circumcision, making a decision before birth, and being offered a choice. In the final model, parents who came from a culture and family that believed in circumcision and who believed that it was not too risky were more likely to circumcise their sons. CONCLUSIONS: Decisions regarding circumcision appear to be influenced by values, risk perceptions, and medical providers. Future research should address ways of ensuring that families have the opportunity to make an informed decision.

The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five countries.

BACKGROUND: Asymptomatic Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) infections pose diagnostic and control problems in developing countries. METHODS: Participants in China, India, Peru, Russia, and Zimbabwe were screened for C. trachomatis and N. gonorrhoeae infections and symptoms. RESULTS: A total of 18,014 participants were evaluated at baseline, 15,054 at 12 months, and 14,243 at 24 months. The incidence of chlamydia in men was 2.0 per 100 person years both from baseline to 12 months and from 12 to 24 months, and in women, 4.6 from baseline to 12 months and 3.6 from 12 to 24 months; a range of 31.2% to 100% reported no symptoms across the 5 countries. The incidence of gonorrhea in men was 0.3 per 100 person years both from baseline to 12 months and from 12 to 24 months, and in women, 1.4 from baseline to 12 months and 1.1 from 12 to 24 months; a range of 66.7% to 100% reported no symptoms. Being female, aged 18 to 24 years, and having more than 1 partner were associated with both the infections. In addition, being divorced, separated, or widowed was associated with gonorrhea. Being male, having 6+ years of education, and reporting only 1 partner were associated with having no symptoms among those infected with chlamydia. No variables correlated with asymptomatic gonorrhea among those infected. CONCLUSION: A high prevalence and incidence of asymptomatic sexually transmitted infections was identified among men and women in a wide variety of settings. More effective programs are needed to identify and treat chlamydia and gonorrhea infections, especially among women, young adults, those with multiple partners, those repeatedly infected, and particularly those at risk without symptoms. The risk of transmission from persons with no symptoms requires further study.

Diagnóstico de infección por VIH / HIV infection diagnosis

Se revisan los diferentes métodos y técnicas de diagnóstico de infección por Virus de la Inmunodeficiencia Humana (VIH) junto a los últimos avances y perspectivas futuras

Perspectivas de la epidemia del SIDA: La experiencia en los Estados Unidos / Perspectives on the AIDS epidemic: The experience within the United States

As of 13 June 1988 a cumulative total of 64 896 AIDS cases and 36 480 AIDS related deaths had been reported to the United States Centers for Disease Control (CDC). Of the 63 880 adults afflicted, 63 percent were homosexual or bisexual men; 19 percent were intravenous drug users; 7 percent were homosexual men who were also I.V. drug users; 4 percent were heterosexuals in sexual contact with people suffering from AIDS or at risk or AIDS; or heterosexual transmission of HIV is common; 3 percent were blood transfusion recipients; 1 percent were homophiliacs, and 3 percent were people for whom risk factor information was incomplete. Most of the children with AIDS (77 percent) were born to a parent who had or was at risk for AIDS, 13 percent were blood transfusion recipients, 6 percent were hemophiliacs, and 4 percent were children for whom risk factor information was incomplete. Most of the children with AIDS (77 percent) were born to a parent who had or was at risk for AIDS, 13 percent were blood transfusion recipients, 6 percent were hemophiliacs, and 4 percent were children for whom risk factor information was incomplete. Blacks and hispanics accounted for disproportionate shares of the cases. Regarding infection with the HIV agent, available data are more limited. Various studies have indicated that the average incubation period between the time of infection and the development of symptoms is

Perspectivas de la epidemia del SIDA: La experiencia en los Estados Unidos / Perspectives on the AIDS epidemic: The experience within the United States

As of 13 June 1988 a cumulative total of 64 896 AIDS cases and 36 480 AIDS related deaths had been reported to the United States Centers for Disease Control (CDC). Of the 63 880 adults afflicted, 63 percent were homosexual or bisexual men; 19 percent were intravenous drug users; 7 percent were homosexual men who were also I.V. drug users; 4 percent were heterosexuals in sexual contact with people suffering from AIDS or at risk or AIDS; or heterosexual transmission of HIV is common; 3 percent were blood transfusion recipients; 1 percent were homophiliacs, and 3 percent were people for whom risk factor information was incomplete. Most of the children with AIDS (77 percent) were born to a parent who had or was at risk for AIDS, 13 percent were blood transfusion recipients, 6 percent were hemophiliacs, and 4 percent were children for whom risk factor information was incomplete. Most of the children with AIDS (77 percent) were born to a parent who had or was at risk for AIDS, 13 percent were blood transfusion recipients, 6 percent were hemophiliacs, and 4 percent were children for whom risk factor information was incomplete. Blacks and hispanics accounted for disproportionate shares of the cases. Regarding infection with the HIV agent, available data are more limited. Various studies have indicated that the average incubation period between the time of infection and the development of symptoms is