as patients may think? KSSG, St. Gallen, Switzerland
|
|
- Imogen Norman
- 6 years ago
- Views:
Transcription
1 HIV in Semen - Is it as infectious as patients may think? Pietro L Vernazza Pietro L. Vernazza, KSSG, St. Gallen, Switzerland
2
3 Heterosexual Transmission HIV-pos. HIV-neg. Clumeck N, et al, NEJM, 1989;321:1460
4 Is it as infectious as patients may think What do you think? What is your estimate of transmission risk after one single sexual act A) in the absence of treatment B) during fully supressive HAART 100% - 10% - 1% - 1:10 3-1:10 4-1:10 5-1:10 6
5 PHI Transmission couple 22 y/o woman AUG y/o man log 10 /ml or Ejac. HIV-RNA Blood plasma Seminal plasma Seminal cells (DNA) HIV-Ag C.trach.-PCR AZT+3TC+ABC+APV AZM
6 Transmission risk per sex contact Partner studies Anonymous contact 1-9% partner pos. <0.3% per contact 3.1% - 8.2% 9-18% partner pos 0.3% per contact Padian, JAMA 1987 De Vincenzi, NEJM 1994 Mastro, AIDS 1994 Nicolosi, Epidemilogy 1994 Cameron, Lancet 1989
7 Risk after single sexual exposure 422 customers of Kenyan prostitutes 293 HIV-neg, prospectively followed 12% s/c rate in 12 wk period Non circumcision: OR 8.2 (3-23) GUD OR 4.7 (1.3-17) 73 men: only one single contact 8.2% s/c rate (6/73), 43% of uncircumcised Cameron et al, 1989, Lancet ii:403-7
8 Mastro study, Thailand 1115 military conscripts (21y) 6.9% HIV-pos (n=77) Sex with female prostitutes mathematical modelling: risk after single contact: 3.1% ( ) adjusted for random error in self reported frequency of contact: 5.6% ( %) Risk signif. higher in men reporting Hx of STD Mastro et al, 1994, Lancet 343:204-7
9 Sexual Transmission of HIV Risk of transmission enhanced with: Low CD4 counts Symptomatic disease High blood viral load Genital inflammation PHI r =
10 VL and HIV-Transmission-Risk i 30 Rakai (Uganda) 453 HIV-disc. couples 11.6 % TR / year % partners infecte ed < '000- > '000 50'000 HIV-RNA load (cp/ml) Quinn, NEJM, 2000; 342:921-9.
11 HIV-Primary Infection HIV-RNA in blood and semen IV-RNA (log 10 cp p/ml) Blood H r = 0.80 P < Group BL - PHI 3 Early PHI 2 Late PHI Seminal plasma HIV-RNA (log 10 cp/ml) Vernazza, 2000, Quest-Study Group
12 HIV in semen & risk per coital act Chakraborty et al. AIDS 2001,15: 621-7
13 Primary HIV Infection Marked increase of transmission i risk 0.05 isk ct ssion r xual ac nsmis er sex Tra p Weeks after infection Pilcher et al JID 2004; 189:
14 Brenner et al, JID 2007; 195:
15 Summary 1 HIV in genital tract follows blood VL Transmission risk high during PHI Q: What is the effect of treatment
16 HIV in semen under HIV therapy >1 log drop <0.5 log drop Vernazza P. et al, AIDS, 1997;11:
17 HIV V-RNA (lo og 10 cp/ml l) Viral load in blood vs. semen during the course of treatment t t in PHI g 10 c/ejac c) HIV- V-DNA (lo 8 RNA blood 7 RNA seminal fluid DNA seminal cells N=32 N=22 N=22 N=39 Baseline Early Late Acute & Primary HIV Infection CAD
18 HIV in Semen during HAART patient ts (%) with pos s. n seme n HIV dete ection i 100% 80% 60% 40% 20% 6 Pat.2: Pat.1: D4T+SQV+RTV DDI+D4T+HU 6 5 p< semen No Therapy (control) HAART, RNA<400 blood BL Wk 78 n=55 n=114 0% HIV-RNA HIV-DNA Vernazza et al., AIDS, 2000; 14:117-21
19 HIV in Semen during HAART patient ts (%) with pos s. n seme HIV dete ection i 100% nno Therapy (control) HAART, RNA<400 80% p< % p= % 20% n=55 n=114 0% HIV-RNA HIV-DNA Vernazza et al., AIDS, 2000; 14:117-21
20 Zhu et al. Transmitted HIV in semen Zhu et al, 1996, JVirol
21 Cell-free vs. Cell-associated trm Long et al, Nat Med, 2000; 6:71-5
22 HIV diversity develops over time 6 mt time infection
23 HIV diversity in early infection Men: 1 pattern <5% diversity: homogenous oge ous pattern Women: 2 patterns homogenous pattern heterogenous pattern
24 Potential hypotheses Infected by different partners Similar # sex acts / wk Similar fraction with single partner Phylogenetic clustering Differences in immune response 5/6 w already heterogenous before s/c Difference in transmitted virus
25 Hypothesis Sex. Trsm of HIV = rare event 1 hit One single hit could be Free virus HIV-infected cell Multiple strains Cell-associated
26 HIV-diversity, STDs and DNA 156 female sex workers, Kenya 89 heterogenous, 67 homogenous viral strain Sagar, AIDS, 2004;18:615-9
27 QUEST: HIV-RNA in semen during tx HIV- RNA (log 10 cp/m ml) Plasma RNA 7 Semen RNA # Days on Therapy
28 QUEST: HIV-DNA in semen during tx g 10 /Ejac c.) HIV- -DNA (lo Plasma RNA Viral DNA / ejaculate # Days on Therapy
29 Malawi urethritis project: HIV-RNA in semen log 10 HIV- V-1 RNA co opies/ml BL Wk2 BL Wk1 Wk2 BL Wk1 Wk2 BL Wk1 Wk2 Dermatology Urethritis GC NGU Cohen et al, Lancet 1997; 349:
30 HIV-Infectiousness I over time PHI STDs Infectiousness (arbritrary scale) Weeks Months / Years
31 Urethritis during HAART (n=24) Plasma HIV-RNA Semen HIV-RNA 2 / 20 positive 20 (low level) / 4 positive (high level) Sadiq et al, AIDS 2002;16:219-25
32 HAART: Latent t HIV in seminal cells 28 men 60 Supressive HAART 50 PBMC and SC Viral growth 2-LTR-circular DNA itive % pos Viral Cx PBMC 2-LTR-circ DNA Seminal Cells Nunnari G. et al, AIDS, 2002; 16:39-45
33 Decline in infectivity* w. HAART HIV incidence in SF-MSM during Infectivity* * per-partnership probability of trx from HIV+ partner from HIV+ partner - 60% Porco et al, AIDS 2004, 18:81 88
34 Literature Review Case reports of trsm under HAART
35 Artificial Insemination in HIV- discordant d couples(kssg) Experiences until Couples counselled 72 Inseminations started 43 (60%) Total Inseminations 145 Insem/couple: Median 3 (1-16) Pregnancies 17 12% of all Cycles 40% of all couples
36 HIV und Kinderwunsch Retrospective analysis Semprini: 500 couples contacted t after counselling Half of couples had conceived natrually 1 woman was HIV-infected Is our intervention missing it s target? Vernazza et al, AIDS , S
37 HIV-discordant couples in Insemination Program HIV-RNA in semen Are we reducing a zero Risk? 68 Chakraborty et al. AIDS 2001,15: 621-7
38 HAART und Transmissionsrisiko Biologische Daten: Risiko reduziert HAART: Ø Transmission dokumentiert Epid. Studien Fallserien z.b. Barroso, JAIDS
39 License to Love Counselling of HIV-d/c couples 1. Information of both partner about transmission risks 2. Rule out asymptomatic STDs 3. Maintain i fully suppressive HAART 4. Timing of unprotected intercourse (LH-urine test) 5. HIV-Pre-Exposure Prophylaxis (TDF)
40 License to Love Pregnancy-rates rates in first 21 couples 100% 25 80% Couples Preg.Rate 20 Pregna ancy Rate (c cumm.) 60% 40% 20% Num mber of cou uples 0% >10 Number of Cycles
HIV/STDs and Excretion of HIV in Genital Secretions - Implications for sexual transmission. Pietro L. Vernazza, KSSG, St. Gallen, Switzerland
HIV/STDs and Excretion of HIV in Genital Secretions - Implications for sexual transmission Pietro L. Vernazza, KSSG, St. Gallen, Switzerland Where it all began... Vogt M, Lancet, 8. March 86 Schultz
More informationSexual transmission of HIV: a heterogeneous event
Sexual transmission of HIV: a heterogeneous event Deutsch-Österreichischer AIDS Kongress Wien 1.-4. June 2005 Pietro L. Vernazza, Infectious Diseases, KSSG St. Gallen, Switzerland Heterosexual Transmission
More informationFertility Desires/Management of Serodiscordant HIV + Couples
Fertility Desires/Management of Serodiscordant HIV + Couples William R. Short, MD, MPH Assistant Professor of Medicine Division Of Infectious Diseases Jefferson Medical College of Thomas Jefferson University
More informationImportance of Viral Suppression to Reduce HIV Transmission: Recent Evidence
Importance of Viral Suppression to Reduce HIV Transmission: Recent Evidence Toye Brewer, MD Co-Director, Fogarty International Training Program University of Miami Miller School of Medicine Viral suppression
More informationHIV: Pregnancy in Serodiscordant Couple. Dr Chow TS ID Clinic HPP
HIV: Pregnancy in Serodiscordant Couple Dr Chow TS ID Clinic HPP Sexual Reproductive Health and Rights The recognition of the sexual and reproductive health and rights (SRHR) of all individuals and couples
More informationOutline. HIV and Other Sexually Transmitted Infections. Gonorrhea Epidemiology. Epidemiology 11/2/2012
HIV and Other Sexually Transmitted Infections Tanya Kowalczyk Mullins, MD, MS Division of Adolescent Medicine Cincinnati Children s Hospital Medical Center Outline Epidemiology of select STIs and HIV STIs
More informationThe Synergy between HIV and other STIs
Training Course in Sexual and Reproductive Health Research 2017 Module: Sexually transmitted infections, HIV/AIDS The Synergy between HIV and other STIs Alberto Matteelli Brescia University Sexual Transmission
More informationHIV TRANSMISSION AND PREVENTION KENNETH H. MAYER, M.D. BROWN UNIVERSITY/MIRIAM HOSPITAL FENWAY COMMUNITY HEALTH 5/31/07
HIV TRANSMISSION AND PREVENTION KENNETH H. MAYER, M.D. BROWN UNIVERSITY/MIRIAM HOSPITAL FENWAY COMMUNITY HEALTH 5/31/07 Estimates of Per-Contact Risk of HIV Infection HIV TRANSMISSION SIGNIFICANT, LOW
More informationDr Yvonne Gilleece Brighton and Sussex University Hospitals NHS Trust
17 TH ANNUAL CONFERENCE OF THE BRITISH HIV ASSOCIATION (BHIVA) Dr Yvonne Gilleece Brighton and Sussex University Hospitals NHS Trust 6-8 April 2011, Bournemouth International Centre Pre exposure prophylaxis
More informationART for HIV Prevention:
ART for HIV Prevention: KENNETH H. MAYER, M.D. Brown University/The Fenway Institute August 22, 2009 APPROACHES TO PREVENT HIV TRANSMISSION DECREASE SOURCE OF INFECTION Barrier Protection Treat STI Antiretroviral
More informationHIV Reproductive Health: Conception Options in the Era of PrEP
HIV Reproductive Health: Conception Options in the Era of PrEP Meg Sullivan, MD Director, HIV Clinical Programs, Section of Infectious Diseases Boston Medical Center Boston University School of Medicine
More informationSexually Transmitted Infection Treatment and HIV Prevention
Sexually Transmitted Infection Treatment and HIV Prevention Toye Brewer, MD Co-Director, Fogarty International Training Program University of Miami Miller School of Medicine STI Treatment and HIV Prevention.
More informationHIV & Condomless Sex - What is the Risk? Why Not? Alan J. Taege, MD Assistant Professor of Medicine Department of Infectious Disease Cleveland Clinic
HIV & Condomless Sex - What is the Risk? Why Not? Alan J. Taege, MD Assistant Professor of Medicine Department of Infectious Disease Cleveland Clinic Yes No What s Going on Out There? Condomless Sex among
More informationART FOR HIV PREVENTION: PANACEA OR PANDORA S BOX? KENNETH H. MAYER, M.D.
ART FOR HIV PREVENTION: PANACEA OR PANDORA S BOX? KENNETH H. MAYER, M.D. HIV TRANSMISSION SIGNIFICANT, LOW PROBABILITY EVENT (
More information(Part 2): Epidemiology and Infectivity
PHI and Transmission Risk (Part 2): Epidemiology and Infectivity Christopher D. Pilcher, md Research Assistant Professor of Medicine, University of North Carolina, Chapel Hill Chapel Hill, North Carolina
More informationGenital Herpes in the STD Clinic
Genital Herpes in the STD Clinic Christine Johnston, MD, MPH Last Updated: 5/23/2016 uwptc@uw.edu uwptc.org 206-685-9850 Importance of HSV HSV is the leading cause of GUD - HSV is very common HSV-2: 16%
More informationSEXUAL TRANSMISSION. SEXUAL TRANSMISSION under ART: Biological Considerations
SEXUAL TRANSMISSION under ART: Biological Considerations Dr Steve Taylor, MB ChB, FRCP, PhD Consultant Physician, HIV/GU Medicine, Lead Consultant HIV Services, Directorate of Sexual Medicine and HIV Birmingham
More informationGuidelines on safer conception in fertile HIV infected individuals
Guidelines on safer conception in fertile HIV infected individuals couples Vivian Black Co-authors: L-G Bekker, H Rees, S Black, D Cooper, S Mall, C Mnyami, F Conradie, I Mahabeer, L Gilbert, S Schwartz,
More informationCUMULATIVE PERINATAL HIV EXPOSURE, AUSTRALIA. Date
CUMULATIVE PERINATAL HIV EXPOSURE, AUSTRALIA 350 300 250 Number 200 150 100 50 0 1/01/1997 1/01/1998 1/01/1999 1/01/2000 31/12/2000 31/12/2001 31/12/2002 Date July 2004 Reported number of perinatally exposed
More informationProfessor Thomas Quinn Johns Hopkins Center for Global Health, Maryland, USA
17 TH ANNUAL CONFERENCE OF THE BRITISH HIV ASSOCIATION (BHIVA) Professor Thomas Quinn Johns Hopkins Center for Global Health, Maryland, USA 6-8 April 2011, Bournemouth International Centre 17 TH ANNUAL
More informationPRE-EXPOSURE PROPHYLAXIS FOR HIV: EVIDENCE AND GENDER CONSIDERATIONS. Jean R. Anderson M.D. Director, Johns Hopkins HIV Women s Health Program
PRE-EXPOSURE PROPHYLAXIS FOR HIV: EVIDENCE AND GENDER CONSIDERATIONS Jean R. Anderson M.D. Director, Johns Hopkins HIV Women s Health Program Disclosures None Objectives Review the evidence regarding the
More informationA Sex-informed Framework for HIV Prevention. Robert M. Grant, M.D., M.P.H. Betty Jean and Hiro Ogawa Endowed Investigator
A Sex-informed Framework for HIV Prevention Robert M. Grant, M.D., M.P.H. Betty Jean and Hiro Ogawa Endowed Investigator Disclosures Gilead Sciences donated study medication to US NIH for trials that I
More informationSo you want to have a baby? Pre-conception counselling for the HIV affected couple. Dr Louise Gilbert 23 November 2011
So you want to have a baby? Pre-conception counselling for the HIV affected couple Dr Louise Gilbert 23 November 2011 Meet Miss LM A 30 yr old lady HIV positive, well, on ART for the past 5 years Latest
More informationSo you have HIV and you want to have a baby?
So you have HIV and you want to have a baby? Judy Levison, MD, MPH Associate Professor Department of Obstetrics and Gynecology Baylor College of Medicine Objectives Describe methods of safe conception
More informationQ and A - the PARTNER Study: new results from PARTNER 2
Q and A - the PARTNER Study: new results from PARTNER 2 1. Study results What is the PARTNER Study? The PARTNER study is an international two-phase study that looked at whether HIV transmission occurs
More informationBiomedical Prevention Update Thomas C. Quinn, M.D.
Biomedical Prevention Update Thomas C. Quinn, M.D. Associate Director of International Research National Institute of Allergy and Infectious Diseases Director, Johns Hopkins Center for Global Health Global
More informationAnswers to those burning questions -
Answers to those burning questions - Ann Avery MD Infectious Diseases Physician-MetroHealth Medical Center Assistant Professor- Case Western Reserve University SOM Medical Director -Cleveland Department
More informationAntivirals and Vaccines: What s old and new in HSV-2 treatment
Antivirals and Vaccines: What s old and new in HSV-2 treatment Christine Johnston, MD, MPH Last Updated: January 19, 2018 uwptc@uw.edu uwptc.org 206-685-9850 Importance of HSV: Why pursue a vaccine? Prevention
More informationFertility Therapy for Women & their Partners Affected by HIV. J. Preston Parry, MD, MPH
Fertility Therapy for Women & their Partners Affected by HIV J. Preston Parry, MD, MPH Objectives To recognize historical barriers to care for women and their partners affected by HIV To understand evidence
More informationHIV : Test and Treat?
HIV : Test and Treat? 14 th HIV Resistance Meeting 22.9.10 Why now? Test and Treat What does it mean? Could it work-what is the evidence? What are the challenges? 1 Universal ART Access 2008 UNAIDS 33
More informationFertility Management in HIV. INTEREST Workshop, 16 Dakar May 2013 Vivian Black, Director Clinical Programmes Wits Reproductive Health & HIV Institute
Fertility Management in HIV INTEREST Workshop, 16 Dakar May 2013 Vivian Black, Director Clinical Programmes Wits Reproductive Health & HIV Institute What to consider Does HIV affect fertility success?
More informationPrevention of Perinatal HIV Transmission
Prevention of Perinatal HIV Transmission Emily Adhikari, MD Division of Maternal-Fetal Medicine Obstetrics and Gynecology University of Texas Southwestern Medical Center February 20, 2018 None Understand
More informationGonorrhea Cook County Department of Public Health
Gonorrhea What is it? Infection with the bacterium Neisseria gonorrhoeae (GC) causes gonorrheal infections, the second most commonly reported communicable disease in both Cook County Department of Public
More informationReport Back from CROI 2010
Report Back from CROI 2010 Conference on Retroviruses and Opportunistic Infections Edwin Charlebois, MPH PhD Associate Professor of Medicine Department of Medicine University of California, San Francisco
More informationEffect of antiviral treatment on the shedding of HIV-1 in semen
Effect of antiviral treatment on the shedding of HIV-1 in semen Pietro L. Vernazza*, Bruce L. Gilliam, Markus Flepp, John R. Dyer, Andreas C. Frank*, Susan A. Fiscus, Myron S. Cohen and Joseph J. Eron
More informationHIV Clinical Update- HIV prevention
HIV Clinical Update- HIV prevention 18 th Australian and New Zealand Conference on Haemophilia and Rare Bleeding Disorders, Melbourne October 13 th 2017 Edwina Wright Disclosures None in the past 12 months
More informationPre exposure Prophylaxis (PrEP): Stepping Up HIV Prevention
Pre exposure Prophylaxis (PrEP): Stepping Up HIV Prevention Dawn K. Smith, MD, MS, MPH Centers for Disease Control and Prevention The findings and conclusions in this presentation have not been formally
More informationHIV in Women: A Global View of the HIV Epidemic
Training Course in Reproductive Health / Sexual Health Research Geneva 2006 HIV in Women: A Global View of the HIV Epidemic George Schmid, M.D., M.Sc. Department of HIV/AIDS World Health Organization Geneva,
More informationPre-exposure Prophylaxis for HIV Prevention
Mountain West AIDS Education and Training Center Pre-exposure Prophylaxis for HIV Prevention Concerns about PrEP: Sexual Behavior and STIs Joanne Stekler, MD MPH May 19, 2016 This presentation is intended
More informationAn Analysis of Genital Tract Derived HIV from Heterosexual Transmission Pairs. Debrah Boeras Emory University October 14, 2008
An Analysis of Genital Tract Derived HIV from Heterosexual Transmission Pairs Debrah Boeras Emory University October 14, 2008 Background A majority of HIV-1 infections occur through heterosexual exposure
More informationHIV in Women: A Global View of the HIV Epidemic
HIV in Women: A Global View of the HIV Epidemic George Schmid, M.D., M.Sc. Department of HIV/AIDS World Health Organization Geneva, Switzerland Schmidg@who.int Training Course in Sexual and Reproductive
More informationThe Pregnancy Journey...
The Pregnancy Journey... when you are living with HIV Authors: Angelina Namiba, Jo Manchester and Lucy Osman If you, or your partner, is HIV positive and you want to get pregnant, or you are pregnant or
More informationFemale-to-Male Infectivity of HIV-1 among Circumcised and Uncircumcised Kenyan Men
MAJOR ARTICLE Female-to-Male Infectivity of HIV-1 among Circumcised and Uncircumcised Kenyan Men Jared M. Baeten, 1,a Barbra A. Richardson, 2,4 Ludo Lavreys, 1 Joel P. Rakwar, 5 Kishorchandra Mandaliya,
More informationWomen and Viral Load. Together, we can change the course of the HIV epidemic one woman at a time.
Women and Viral Load Together, we can change the course of the HIV epidemic one woman at a time. #onewomanatatime #thewellproject What Is Viral Load? Viral load is the amount of HIV (number of viruses
More informationNon-occupational HIV Post Exposure Prophylaxis (npep)
Mountain West AIDS Education and Training Center Non-occupational HIV Post Exposure Prophylaxis (npep) Robert Harrington, M.D. This presentation is intended for educational use only, and does not in any
More informationHIV Prevention. Recent Advances and Implications for the Caribbean
HIV Prevention Recent Advances and Implications for the Caribbean Chris Behrens, MD CCAS/CHART Conference Barbados, August 2010 Cases 200 180 160 140 120 100 80 60 40 20 0 Year HIV Cases AIDS Cases HIV
More informationQuantification of HIV in semen: correlation with antiviral treatment and immune status
Quantification of HIV in semen: correlation with antiviral treatment and immune status Pietro L. Vernazza*, Bruce L. Gilliam, John Dyer, Susan A. Fiscus, Joseph J. Eron, Andreas C. Frank and Myron S. Cohen
More informationRoy M. Gulick, MD, MPH Chief, Division of Infectious Diseases Professor of Medicine Weill Medical College of Cornell University New York City
PrEP 2013 Roy M. Gulick, MD, MPH Chief, Division of Infectious Diseases Professor of Medicine Weill Medical College of Cornell University New York City Slide #2 U.S.: New HIV Infections Per Year ~50,000
More informationPRECONCEPTION COUNSELING
PRECONCEPTION COUNSELING A Counseling Guide for Healthcare Providers Preconception Care & Counseling 1 Introduction Pregnancy planning and preconception care are important in order to: 1. Ensure maternal
More informationHIV Prevention in US Women
HIV Prevention in US Women Sally L. Hodder M.D. Sally L. Hodder MD Professor of Medicine December 1, 2010 24, 2010 Overview Epidemiology of HIV in US women HIV testing Antiretroviral i treatment as HIV
More informationDisclosure. Learning Objectives. Epidemiology. Transmission. Risk of Transmission PRE-EXPOSURE PROPHYLAXIS (PREP) FOR HIV PREVENTION 50,000.
Disclosure PRE-EXPOSURE PROPHYLAXIS (PREP) FOR HIV PREVENTION I have no financial interest in and/or affiliation with any external organizations in relation to this CE program. DaleMarie Vaughan, PharmD
More informationPrEP and Behavioral Strategies for HIV Prevention. Douglas Krakower, MD January 30, 2014
PrEP and Behavioral Strategies for HIV Prevention Douglas Krakower, MD January 30, 2014 Potential Competing Interests Dr. Krakower: investigator-initiated research regarding HIV prevention National Institutes
More informationHPV Transmission. Rachel Winer, PhD, MPH Department of Epidemiology University of Washington
HPV Transmission Rachel Winer, PhD, MPH Department of Epidemiology University of Washington rlw@u.washington.edu Disclosure Information I have no financial relationships to disclose. Human Papillomavirus
More informationThe Global State of HIV/AIDS. Presented By: Siobhan K. Young, MPH PhD Candidate at UNC Chapel Hill
The Global State of HIV/AIDS Presented By: Siobhan K. Young, MPH PhD Candidate at UNC Chapel Hill siobhany@email.unc.edu Outline HIV/AIDS 101 Origin of AIDS State of the Epidemic HIV/AIDS in Sub-Saharan
More information3 rd International Workshop on Women and HIV January 14 th, 2013
3 rd International Workshop on Women and HIV January 14 th, 2013 Systematic review of HIV transmission between heterosexual serodiscordant couples where the HIV-positive partner is fully suppressed on
More informationo Changes since 1999 policy statement and 2005 update
Circumcision A Review of AAP Task Force Recommendations from August of 2012 Objectives Review AAP recommendations on circumcision o Changes since 1999 policy statement and 2005 update Be able to discuss
More informationSexually Transmitted Infections. Kim Dawson October 2010
Sexually Transmitted Infections Kim Dawson October 2010 Objectives: You will learn about: Sexually Transmitted Infections (STI s). How they are transferred. High risk behavior. The most common STI s. How
More informationHerpes virus co-factors in HIV infection
Herpes virus co-factors in HIV infection Dr Jane Deayton Barts and the London Queen Mary School of Medicine Introduction Herpes viruses very common and often coexist with HIV Establish life-long latent
More informationPre-Exposure Prophylaxis: The New Frontier of Prophylaxis Against HIV Infection
Pre-Exposure Prophylaxis: The New Frontier of Prophylaxis Against HIV Infection William F. Ryan Community Health Network PrEP Network Coordinator: Trevor Hedberg, MPH, CPH Supervising Health Educator:
More informationPresentation Overview
Effectiveness of female condoms in the prevention of pregnancy and sexually transmitted infections Bidia Deperthes Technical Advisor Condom Programming United Nations Population Fund Theresa Hatzell Hoke
More informationPEP and PREP. Dr David Hawkins Chelsea and Westminster Hospital
PEP and PREP Dr David Hawkins Chelsea and Westminster Hospital Opportunities for biomedical interventions YEARS HOURS 72 HOURS YEARS Prior to exposure Exposure (pre-coital/ coital) Exposure (pre-coital/
More informationPlanned Vaccine Trials to Follow-up on RV 144. Merlin Robb, MD Deputy Director for Clinical Research MHRP
Planned Vaccine Trials to Follow-up on RV 144 Merlin Robb, MD Deputy Director for Clinical Research MHRP Planned studies are mutually reinforcing and will amplify public health impact and regional relevance
More informationAll HIV+ Women on Antiretroviral Therapy Should Breastfeed in Both Low and High Resource Settings VOTE NO!!
All HIV+ Women on Antiretroviral Therapy Should Breastfeed in Both Low and High Resource Settings VOTE NO!! Lynne Mofenson MD Elizabeth Glaser Pediatric AIDS Foundation My Esteemed Opponent Will Likely
More informationHPV Epidemiology and Natural History
HPV Epidemiology and Natural History Rachel Winer, PhD, MPH Associate Professor Department of Epidemiology University of Washington School of Public Health rlw@uw.edu Human Papillomavirus (HPV) DNA virus
More informationHIV Lecture. Anucha Apisarnthanarak, MD Division of Infectious Diseases Thammasart University Hospital
HIV Lecture Anucha Apisarnthanarak, MD Division of Infectious Diseases Thammasart University Hospital End-2001 global estimates for children and adults People living with HIV/AIDS New HIV infections in
More informationRon Gray, MBBS, MFCM, MSc Johns Hopkins University. STIs in an International Setting
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationTo increase listener s awareness of the reality of discordance
Communication Objective: The Reality of Discordance I To increase listener s awareness of the reality of discordance Suggested Guests: AIC Branch Manager Medical Dr/DHO Key Content: What is discordance?
More informationPopulation attributable fraction of genital inflammation and ulceration in HIV risk among discordant couples, Zambia,
Population attributable fraction of genital inflammation and ulceration in HIV risk among discordant couples, Zambia, 1994-2012 10 th International Workshop on HIV Transmission Kristin M. Wall, PhD kmwall@emory.edu
More informationKEY ELEMENTS FOR SUCCESSFUL INTERVENTION (1)
KEY ELEMENTS FOR SUCCESSFUL INTERVENTION (1) Mobilization of political will and commitment Good surveillance Learn and adapt from past experiences Unified national planning Rapid implementation KEY ELEMENTS
More informationPrEP for Women: HIV Prevention in Family Planning Settings
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention PrEP for Women: HIV Prevention in Family Planning Settings Dawn K. Smith, MD, MS, MPH Division of HIV/AIDS Prevention dsmith1@cdc.gov
More informationHIV - Preventing New Infections: New Options, Readjusted Approaches
HIV - Preventing New Infections: New Options, Readjusted Approaches Ronald P. Hattis, MD, MPH Beyond AIDS Foundation Presented at Loma Linda University December 6, 2013 1 Thesis (Summary) As of 2013-14,
More informationContraception & HIV Still searching for answers after >2 decades
Contraception & HIV Still searching for answers after >2 decades R Scott McClelland, MD, MPH University of Washington Inter CFAR Symposium on HIV Research in Women September 20 th 2012 Overview Global
More informationProviding Hope in the midst of Despair: A Person Centered Response to the AIDS Epidemic : Ethical Principles Moving Forward
Providing Hope in the midst of Despair: A Person Centered Response to the AIDS Epidemic : Ethical Principles Moving Forward Timothy P. Flanigan, MD Professor of Medicine Division of Infectious Diseases
More informationHIV Prevention and Reproductive Choices
HIV Prevention and Reproductive Choices Renee Heffron, PhD MPH University of Washington Virology Education International Workshop on HIV & Women Boston, 20-21 February 2016 Reproductive choices & pregnancy
More informationBreast-Milk Infectivity in Human Immunodeficiency Virus Type 1 Infected Mothers
MAJOR ARTICLE Breast-Milk Infectivity in Human Immunodeficiency Virus Type 1 Infected Mothers Barbra A. Richardson, 1,3 Grace C. John-Stewart, 2 James P. Hughes, 1 Ruth Nduati, 5 Dorothy Mbori-Ngacha,
More informationInfertility Treatment and HIV
Infertility Treatment and HIV Infertility Treatment by IVF Or Intra-cytoplasmic Sperm Injections (ICSC) In Chronic HIV-1 Sero- discordant Couples (Poster 670) Retrospective study of outcome of IVF or ICSC
More informationPrEP Integration into Primary Care
PrEP Integration into Primary Care Linking HIV/AIDS prevention to primary care K A M L A S A N A S I - B H O L A, M D SC Primary Healthcare Association's 23rd Annual Clinical Network Retreat Sunday, June
More informationART and Prevention: What do we know?
ART and Prevention: What do we know? Biomedical Issues Trip Gulick, MD, MPH Chief, Division of Infectious Diseases Professor of Medicine Weill Cornell Medical College New York City ART for Prevention:
More informationART and Transmission. Martin Fisher. Brighton and Sussex University Hospitals, UK
ART and Transmission Martin Fisher Brighton and Sussex University Hospitals, UK 11th Advanced HIV Course Aix-en-Provence 2013 New HIV diagnoses by exposure group: United Kingdom, 2002 2011 1 Predicted
More informationPre-Exposure Prophylaxis (PrEP) A Biomedical Intervention Prevention with Negatives Antiretroviral Prevention
Pre-Exposure Prophylaxis (PrEP) A Biomedical Intervention Prevention with Negatives Antiretroviral Prevention New and Emerging Biomedical HIV Prevention Interventions Vaccines Vaginal microbicides Pre-exposure
More informationThe Science behind Preexposure Prophylaxis (PrEP) Yunus Moosa Department of Infectious Diseases UKZN
The Science behind Preexposure Prophylaxis (PrEP) Yunus Moosa Department of Infectious Diseases UKZN 1 Ongoing HIV transmission despite expanding access to ART SA 18 16 14 12 10 8 6 4 2 0 Treatment exposure
More information5. Over the last ten years, the proportion of HIV-infected persons who are women has: a. Increased b. Decreased c. Remained about the same 1
Epidemiology 227 April 24, 2009 MID-TERM EXAMINATION Select the best answer for the multiple choice questions. There are 60 questions and 9 pages on the examination. Each question will count one point.
More informationRESEARCH. Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study
Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study Jorge Del Romero, clinical researcher, 1 Jesús Castilla, consultant medical epidemiologist,
More informationIt is a good idea for anyone having sex to get tested regularly and treated for STIs if necessary.
FACTSHEET Sexually Transmitted Infections and HIV Transmission This is one of a series of fact sheets about the biology of HIV transmission. The fact sheets review specific biological factors that make
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest
More informationWhere Epidemiology Meets Biology: Primary HIV Infection and Sexual Transmission
Where Epidemiology Meets Biology: Primary HIV Infection and Sexual Transmission Jim Koopman, md, mph Professor of Epidemiology, Center for the Study of Complex Systems Department of Epidemiology, University
More informationThe Latest on HIV Testing. Dominika Seidman, MD MAS
The Latest on HIV Testing Dominika Seidman, MD MAS Disclosures none 2 Learning objectives At the conclusion of this session, participants should be able to Define the window periods for various HIV tests
More informationObstetric Complications in HIV-Infected Women. Jeanne S. Sheffield, MD Maternal-Fetal Medicine UT Southwestern Medical School
Obstetric Complications in HIV-Infected Women Jeanne S. Sheffield, MD Maternal-Fetal Medicine UT Southwestern Medical School Obstetric Complications and HIV Obstetric complications are not increased in
More informationObjectives. Outline. Section 1: Interaction between HIV and pregnancy. Effects of HIV on Pregnancy. Section 2: Mother-to-Child-Transmission (MTCT)
Objectives Prevention of Mother-to-Child Transmission (PMTCT) Teen Club Community Partners Training Programme By the end of the session participants will be able to: 1. Identify factors affecting the transmission
More informationPrEP: Pre Exposure Prophylaxis
PrEP: Pre Exposure Prophylaxis Lyn Stevens, NP, MS, ACRN Deputy Director Office of the Medical Director NYS Department of Health, AIDS Institute Faculty Disclosure Lyn Stevens No relationships to disclose
More informationTreating Infertility
Treating Infertility WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 About 10% of couples in the United States are infertile. Infertility is a condition in which a woman has not been able
More informationTerapia come prevenzione e ruolo del community viral load (CVR) Andrea Antinori INMI L. Spallanzani IRCCS, Roma
Terapia come prevenzione e ruolo del community viral load (CVR) Andrea Antinori INMI L. Spallanzani IRCCS, Roma Transmission Rate per 100 Person-Yrs ART for HIV Prevention: The Hypothesis The quantity
More informationQuantifying sexual exposure to HIV within an HIV-serodiscordant relationship: development of an algorithm
Quantifying sexual exposure to HIV within an HIV-serodiscordant relationship: development of an algorithm Julie Fox a, Peter J. White b,c, Jonathan Weber d, Geoff P. Garnett c, Helen Ward e and Sarah Fidler
More informationAttendees will be able to:
A. Kay Kalousek, DO, MS, FACOFP kaysdroid@gmail.com April 21, 2017 Attendees will be able to: List strategies for prevention of HIV infection Explain the pharmacology of TDF/FTC related to PrEP Assess
More informationBiomedical Prevention in HIV
Biomedical Prevention in HIV CHART - CCAS-CDC 3 RD Joint Meeting Montego Bay, Jamaica August 21-26,2011 Presented by Tina Hylton-Kong, ERTU-CHART Some Slides from Impact of ART on HIV Transmission Wafaa
More informationPrEP efficacy the evidence
PrEP efficacy the evidence Dr Michael Brady Consultant, HIV and Sexual Health King s College Hospital, London Medical Director Terrence Higgins Trust PrEP Pre-exposure prophylaxis Tenofovir and emtricitabine
More informationZIKA Jordan H. Perlow MD Banner University Medical Center Division of Maternal Fetal Medicine Phoenix Perinatal Asoociates
ZIKA Jordan H. Perlow MD Banner University Medical Center Division of Maternal Fetal Medicine Phoenix Perinatal Asoociates Disclosures I have no relevant financial relationships to disclose or conflicts
More informationModule 2: Integration of HIV Rapid Testing in HIV Prevention and Treatment Programs
Module 2: Integration of HIV Rapid Testing in HIV Prevention and Treatment Programs Purpose Pre-requisite Modules Module Time Learning Objectives To provide the participants with the basic concepts of
More informationPrEP in the Real World: Clinical Case Studies
PrEP in the Real World: Clinical Case Studies Kevin L. Ard, MD, MPH April 30, 2015 Massachusetts General Hospital, National LGBT Health Education Center Continuing Medical Education Disclosure Program
More informationAnswering basic questions about HIV
Answering basic questions about HIV Sixth Edition This booklet is for you if you have basic questions about HIV such as what it is, how it is transmitted and how it affects the body. If you have HIV and
More information