Could implementation of Australia's National Gay Men's Syphilis Action Plan have an indirect effect on the HIV epidemic?

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 144 ◽  
Author(s):  
Alexander Hoare ◽  
Richard T. Gray ◽  
David P. Wilson
Keyword(s):  
Public Health ◽  
Gay Men ◽  
Indirect Effect ◽  
Hiv Transmission ◽  
Action Plan ◽  
Hiv Infections ◽  
Hiv Interventions ◽  
Sexually Transmissible Infections ◽  
Epidemiological Impact ◽  
Public Health Strategies

Objectives The number of incident infections of syphilis and HIV have increased over the past decade across Australia, particularly among gay men. In other industrialised settings, syphilis epidemics have also resurged coincidentally with increases in HIV diagnoses. Sexually transmissible infections (STI) are a biologically plausible cofactor for increasing HIV transmission. We pose the question: could strategies purely targeting syphilis also have an indirect impact on HIV incidence? Methods: We developed an agent-based computer model that simulates the transmission and disease progression of HIV and syphilis among a population of sexually active gay men, calibrated to reflect the epidemics in Victoria, Australia. The model was informed by detailed behavioural data from a variety of sources and was used to investigate the potential epidemiological impact of different public health interventions. Results: Assuming that syphilis could act as a biological cofactor for HIV transmission, from no effect to increasing risk by five-fold, our model indicates that if Australia’s syphilis action plan is effectively implemented then the number of HIV infections could decrease by up to 48% over the next decade in the absence of any specific HIV interventions. Conclusion: It is plausible that effective implementation of interventions targeting syphilis epidemics can have an indirect effect of mitigating the spread of HIV. The possible effects of STI should be considered in the design, implementation and evaluation of public health strategies and programs.

Modelling the epidemiological impact of scaling up HIV testing and antiretroviral treatment in China

Sexual Health ◽  
2012 ◽  
Vol 9 (3) ◽  
pp. 261 ◽  
Author(s):  
Lei Zhang ◽  
Richard T. Gray ◽  
David P. Wilson
Keyword(s):  
Hiv Testing ◽  
Action Plan ◽  
Scale Up ◽  
Hiv Infections ◽  
Fold Increase ◽  
Treatment Rate ◽  
Hiv Epidemic ◽  
Epidemiological Impact ◽  
Public Health Strategies ◽  
Roll Out

Background The HIV epidemic in China has been increasing. In response, a 5-year action plan in China has prioritised the scale-up of HIV testing and treatment. Methods: We use a mathematical model to reproduce HIV epidemic trends in China and to forecast epidemic trends according to current conditions or increases in the rate of HIV testing or roll-out of antiretroviral therapy. Results: We show that the epidemic in China could be expected to experience a 2.5-fold expansion over the next 5 years such that ~1.8 million people will be infected with HIV in China by 2015. However, increasing testing and treatment rates can have substantial epidemiological benefits. For example, a four-fold increase in testing rates may avert more than 42 000 HIV infections and 11 000 deaths over the next 5years. A 10-fold increase in the treatment rate could decrease the number of HIV-related deaths by 58% and the number of new infections by one-quarter by 2015. Conclusions: Increasing HIV testing and treatment are important public health strategies for prevention.

Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men

Sexual Health ◽  
2009 ◽  
Vol 6 (1) ◽  
pp. 19 ◽  
Author(s):  
David P. Wilson ◽  
Alexander Hoare ◽  
David G. Regan ◽  
Matthew G. Law
Keyword(s):  
Hiv Testing ◽  
Early Treatment ◽  
Hiv Transmission ◽  
Public Health Intervention ◽  
Population Level ◽  
Hiv Infections ◽  
Long Term Effects ◽  
Wide Range ◽  
Epidemiological Impact ◽  
Sex With Men

Background: We address the research questions: (i) what proportion of new HIV infections is transmitted from people who are (a) undiagnosed, (b) in primary HIV infection (PHI), (c) on antiretroviral therapy?; and (ii) what is the expected epidemiological impact of (a) increasing the proportion of newly acquired HIV infections receiving early treatment, and (b) increasing HIV testing rates? Methods: We used a mathematical model to simulate HIV transmission in the population of men who have sex with men (MSM) in Australia. We calibrated the model using established biological and clinical data and a wide range of Australian MSM epidemiological and behavioural data sources. Results: We estimate that ~19% of all new HIV infections are transmitted from the ~3% of Australian HIV-infected MSM who are in PHI; ~31% of new HIV infections are estimated to be transmitted from the ~9% of MSM with undiagnosed HIV. We estimate that the average number of infections caused per HIV-infected MSM through the duration of PHI is ~0.14–0.28. Conclusions: The epidemiological impact of increasing treatment in PHI would be modest due to insufficient detection of newly-infected individuals. In contrast, increases in HIV testing rates could have substantial epidemiological consequences. The benefit of testing will also increase over time. Promoting increases in the coverage and frequency of testing for HIV could be a highly-effective public health intervention, but the population-level impact of interventions based on promoting early treatment of patients diagnosed in PHI is likely to be small. Treating PHI requires further evaluation of its long-term effects on HIV-infected individuals.

Treatment for prevention of HIV transmission in a localised epidemic: the case for South Australia

Sexual Health ◽  
2011 ◽  
Vol 8 (3) ◽  
pp. 280 ◽  
Author(s):  
Kelly-Jean Heymer ◽  
David P. Wilson
Keyword(s):  
Hiv Transmission ◽  
South Australia ◽  
Hiv Infections ◽  
Small Population ◽  
Transmission Model ◽  
Minimal Impact ◽  
Gay Community ◽  
Epidemiological Impact ◽  
Sex With Men ◽  
Novel Model

Background Discussion is currently taking place among international HIV/AIDS groups around increasing HIV testing and initiating earlier use of antiretroviral therapy (ART) among people diagnosed with HIV as a method to reduce the spread of HIV. In this study, we explore the expected epidemiological impact of this strategy in a small population in which HIV transmission is predominantly confined to men who have sex with men (MSM). Methods: A deterministic mathematical transmission model was constructed to investigate the impacts of strategies that increase testing and treatment rates, and their likely potential to mitigate HIV epidemics among MSM. Our novel model distinguishes men in the population who are more easily accessible to prevention campaigns through engagement with the gay community from men who are not. This model is applied to the population of MSM in South Australia. Results: Our model-based findings suggest that increasing testing rates alone will have minimal impact on reducing the expected number of infections compared to current conditions. However, in combination with increases in treatment coverage, this strategy could lead to a 59–68% reduction in the number of HIV infections over the next 5 years. Targeting men who are socially engaged with the gay community would result in the majority of potential reductions in incidence, with only minor improvements possible by reaching all other MSM. Conclusions: Investing in strategies that will achieve higher coverage and earlier initiation of treatment to reduce infectiousness of HIV-infected individuals could be an effective strategy for reducing incidence in a population of MSM.

scholarly journals Challenges in evaluating the use of viral sequence data to identify HIV transmission networks for public health

2020 ◽  
Vol 12 (s1) ◽  
Author(s):  
Rami Kantor ◽  
John P. Fulton ◽  
Jon Steingrimsson ◽  
Vladimir Novitsky ◽  
Mark Howison ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Hiv Transmission ◽  
Sequence Data ◽  
The United States ◽  
Viral Sequence ◽  
Transmission Networks ◽  
New Methods ◽  
Hiv Epidemic ◽  
The World

AbstractGreat efforts are devoted to end the HIV epidemic as it continues to have profound public health consequences in the United States and throughout the world, and new interventions and strategies are continuously needed. The use of HIV sequence data to infer transmission networks holds much promise to direct public heath interventions where they are most needed. As these new methods are being implemented, evaluating their benefits is essential. In this paper, we recognize challenges associated with such evaluation, and make the case that overcoming these challenges is key to the use of HIV sequence data in routine public health actions to disrupt HIV transmission networks.

scholarly journals 31.C. Workshop: Development and implementation of action plans on health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
Action Plan ◽  
Knowledge Society ◽  
Implementation Strategies ◽  
Social Consequences ◽  
Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

scholarly journals Understanding the Spatial-Related Abstraction of Public Health Impact Goals and Measures: Illustrated by the Example of the Austrian Action Plan on Women’s Health

2021 ◽  
Vol 13 (2) ◽  
pp. 773
Author(s):  
Tatjana Fischer
Keyword(s):  
Public Health ◽  
Women’S Health ◽  
Women's Health ◽  
Spatial Planning ◽  
Action Plan ◽  
Qualitative Interviews ◽  
Health Impact ◽  
Political Awareness ◽  
Policy Paper ◽  
High Degree

The influence of spatial aspects on people’s health is internationally proven by a wealth of empirical findings. Nevertheless, questions concerning public health still tend to be negotiated among social and health scientists. This was different in the elaboration of the Austrian Action Plan on Women’s Health (AAPWH). On the example of the target group of older women, it is shown whether and to what extent the inclusion of the spatial planning perspective in the discussion of impact goals and measures is reflected in the respective inter-ministerial policy paper. The retrospective analysis on the basis of a document analysis of the AAPWH and qualitative interviews with public health experts who were also invited to join, or rather were part of, the expert group, brings to light the following key reasons for the high degree of spatial-related abstraction of the content of this strategic health policy paper: the requirement for general formulations, the lack of public and political awareness for the different living situations in different spatial archetypes, and the lack of external perception of spatial planning as a key discipline with regard to the creation of equivalent living conditions. Nonetheless, this research has promoted the external perception of spatial planning as a relevant discipline in public health issues in Austria. Furthermore, first thematic starting points for an in-depth interdisciplinary dialogue were identified.

scholarly journals Addressing lead exposure in children in Georgia: challenges and successes of a multi-agency response

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Ruadze ◽  
I Khonelidze ◽  
L Sturua ◽  
P Lauriola ◽  
H Crabbe ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Concentration ◽  
Tracking System ◽  
Action Plan ◽  
Blood Lead ◽  
Relevant Information ◽  
State Intervention ◽  
Intervention Programme ◽  
Public Health Action ◽  
Pb Exposure

Abstract The national response for reducing lead (Pb) exposure in Georgia is coordinated by the National Centre for Disease Control and Public Health (NCDC&PH) and implemented as a multi-agency (CDC, UNICEF, WHO, University of Emory) response. Given concerns about the extent of Pb exposure, in 2018 Multiple Indicator Cluster Surveys (MICS) of representative samples of children have been conducted to study several demographic and health aspects, including a study of the prevalence of blood Pb levels among 2 to 7 years old children (n = 1578). This survey was conducted in collaboration with the Italian Instituto Superiore di Sanita' (ISS), UNICEF and NCDC. The laboratory analyses were conducted at ISS in Italy. Initial results showed that in 41% of all children, blood Pb concentration was ≥ 5 µg/dl, a challenge which motivated public agencies to establish an initial public health action plan to assess environmental samples (paint, dust, water, soil, selected food items such as spices and imported sweets) in families where Pb concentrations were ≥ 10 µg/dL. A State intervention programme, monitoring Pb blood concentration among MICS children and their family members, provided relevant information on exposed households and led to a reduction of Pb blood concentration across the most exposed households. In collaboration with Public Health England, NCDC has conducted a small Pb isotope ratio study aimed at identifying the most relevant sources of Pb exposure contributing to elevated blood Pb in MICS children. It is expected that these data will support the design of more detailed public health interventions to reduce exposure to key sources of Pb, thus leading to further reduction of Pb-induced health effects in Georgia. In addition, this experience will clarify elements of an ongoing monitoring of environmental factors such as an Environmental Public Health Tracking system, to support national capacity to manage the risks to public health. Key messages Environmental health response requires extensive research and multi-agency approach. If State implements adequate intervention it is possible to reduce blood lead (Pb) level.

scholarly journals Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Care ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Persons Who Inject Drugs ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

scholarly journals An evaluation of the Victorian Salt Reduction Partnership’s advocacy strategy for policy change

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Emalie Rosewarne ◽  
Michael Moore ◽  
Wai-Kwan Chislett ◽  
Alexandra Jones ◽  
Kathy Trieu ◽  
...  
Keyword(s):  
Public Health ◽  
Policy Change ◽  
Action Plan ◽  
Evaluation Framework ◽  
Decision Makers ◽  
Health Advocacy ◽  
Salt Reduction ◽  
Public Health Advocacy ◽  
The Creation ◽  
The Impact

Abstract Background Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy strategy in achieving policy change. Methods Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. Results A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. Conclusions The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.

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