31 results on '"Rice BD"'
Search Results
2. Ten-year mortality trends among persons diagnosed with HIV infection in England and Wales in the era of antiretroviral therapy: AIDS remains a silent killer
- Author
-
Simmons, RD, primary, Ciancio, BC, additional, Kall, MM, additional, Rice, BD, additional, and Delpech, VC, additional
- Published
- 2013
- Full Text
- View/download PDF
3. Travel for HIV care in England: a choice or a necessity?
- Author
-
Huntington, S, primary, Chadborn, T, additional, Rice, BD, additional, Brown, AE, additional, and Delpech, VC, additional
- Published
- 2010
- Full Text
- View/download PDF
4. Could male circumcision reduce HIV incidence in the UK?
- Author
-
Rice, BD, primary, Delpech, VC, additional, and Evans, BG, additional
- Published
- 2008
- Full Text
- View/download PDF
5. Loss to follow-up among adults attending human immunodeficiency virus services in England, wales, and northern ireland.
- Author
-
Rice BD, Delpech VC, Chadborn TR, and Elford J
- Published
- 2011
- Full Text
- View/download PDF
6. Neural substrates of cognitive load changes during a motor task in subjects with stroke.
- Author
-
Kimberley J, Lewis SM, Strand C, Rice BD, Hall S, and Slivnik P
- Abstract
Purpose: A critical component to rehabilitation is the degree to which we challenge patients to facilitate learning without providing excessive competition for cognitive resources. The purpose of this study was to examine brain activation and motor performance during changes in cognitive load in a continuous motor task in subjects with stroke (n = 7) and healthy subjects (n = 17).Methods: Subjects participated in a joystick drawing task during functional magnetic resonance imaging. Subjects attempted to continuously draw a square under three conditions of varying cognitive demands.Results: In subjects with stroke, results showed significantly less activation in contralateral primary motor area when the task did not require working memory demands and no change when the condition required online visual feedback processing. Bilaterally, the premotor cortex also demonstrated a significant decrease in activation when the task did not require working memory and then an increase in activation when online visual feedback processing was required. Despite these changes in activation, the accuracy of performance was maintained across the three conditions. Healthy subjects demonstrated no significant differences in activation between conditions.Conclusion: These data suggest that the sensorimotor areas investigated have the greatest demand when the task requires working memory, but that only the bilateral premotor area has increased demands when online visual feedback processing is required. Use of working memory and visual feedback should be carefully considered when designing rehabilitation programs to balance challenging patients with overwhelming their potentially limited cognitive resources. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
7. The changing epidemiology of diagnosed prevalent HIV infections in England: greatest impact on the London environs.
- Author
-
Rice BD, Sinka K, Patel B, Chadborn TR, and Delpech VC
- Abstract
Data from the 1997-2004 Surveys of Prevalent HIV Infections Diagnosed were analysed by three geographical areas of residence and treatment to describe the heterogeneous growth of the HIV epidemic in England and provide projections to 2007. Between 1997 and 2004, the number of diagnosed HIV-infected adults resident in England increased by 163% (14223 to 37459). Within the 'London environs' the increase was 360% (742 to 3411), within the rest of England 219% (4417 to 14088) and within London 120% (9064 to 19960). By 2004, the London environs had the largest proportion of infections acquired through heterosexual sex (and in particular women) and the most recently diagnosed population. Projections indicate over half of diagnosed HIV-infected adults will live outside London by 2007. The epidemiology of diagnosed HIV infection within the London environs is likely to be a predictor of future trends in England overall. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
8. The cyclical cascade of HIV care: Temporal care engagement trends within a population-wide cohort.
- Author
-
Euvrard J, Timmerman V, Keene CM, Phelanyane F, Heekes A, Rice BD, Grimsrud A, Ehrenkranz P, and Boulle A
- Subjects
- Humans, Female, Male, Adult, South Africa epidemiology, Cohort Studies, Middle Aged, Continuity of Patient Care, Anti-HIV Agents therapeutic use, Young Adult, COVID-19 epidemiology, HIV Infections drug therapy, HIV Infections epidemiology
- Abstract
Background: The traditional HIV treatment cascade aims to visualise the journey of each person living with HIV from diagnosis, through initiation on antiretroviral therapy (ART) to treatment success, represented by virological suppression. This representation has been a pivotal tool in highlighting and quantifying sequential gaps along the care continuum. There is longstanding recognition, however, that this may oversimplify the complexity of real-world engagement with HIV services in settings with mature high-burden HIV epidemics. A complementary "cyclical" cascade has been proposed to represent the processes of disengagement at different points on the care continuum, with multiple pathways to re-engagement, although the feasibility of implementing this at scale has been uncertain. This study aimed to populate, refine, and explore the utility of a cyclical representation of the HIV cascade, using routine data from a high-burden HIV setting., Methods and Findings: This observational cohort study leveraged person-level data on all people living with HIV in the Western Cape (WC), South Africa, who accessed public health services in the 2 years prior to 31 December 2023. Programme data from disease registers were complemented by data from pharmacy and laboratory systems. At study closure, 494 370 people were included, constituting 93% of those of those estimated to be living with HIV in the province, of whom 355 104 were on ART. Substantial disengagement from HIV care was evident at every point on the cascade. Early treatment emerged as a period of higher risk of disengagement, but it did not account for the majority of disengagement. Almost all those currently disengaged had prior experience of treatment. While re-engagement was also common, overall treatment coverage had increased slowly over 5 years. The transition to dolutegravir-based regimens was dramatic with good virological outcomes for those in care, notwithstanding a clearly discernible impact of the Coronavirus Disease 2019 (COVID-19) pandemic on viral load (VL) testing. People currently engaged and disengaged in care are similar with respect to age and gender. Those who died or disengaged recently were previously distributed across a range of cascade statuses, and a substantial proportion of those newly initiating and re-initiating treatment were no longer on treatment 6 months later. The main limitation of this study was incomplete evidence of HIV testing, linkage to HIV-specific services, and out-of-facility mortality., Conclusions: Using routine data, it was possible to populate and automate a cyclical cascade of HIV care that continuously captured the nonlinear care journeys of individuals living with HIV. In this generalised mature HIV epidemic, most people are treatment experienced. Disengagement is common and occurs at various points along the cascade, making it challenging to identify high-impact intervention opportunities. While historical HIV cascades remain valuable for target setting and service monitoring, they can be complemented with insights from more detailed cyclical cascades., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Euvrard et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
- Full Text
- View/download PDF
9. Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016.
- Author
-
Yin Z, Brown AE, Rice BD, Marrone G, Sönnerborg A, Suligoi B, Sasse A, Van Beckhoven D, Noori T, Regine V, and Delpech VC
- Subjects
- CD4 Lymphocyte Count, Europe epidemiology, Humans, Risk Factors, HIV Infections diagnosis, HIV Infections epidemiology, Transients and Migrants
- Abstract
BackgroundThe assumption that migrants acquire human immunodeficiency virus (HIV) before migration, particularly those from high prevalence areas, is common.AimWe assessed the place of HIV acquisition of migrants diagnosed in four European countries using surveillance data.MethodsUsing CD4+ T-cell count trajectories modelled to account for seroconversion bias, we estimated infection year of newly HIV-diagnosed migrants residing in the United Kingdom (UK), Belgium, Sweden and Italy with a known arrival year and CD4+ T-cell count at diagnosis. Multivariate analyses identified predictors for post-migration acquisition.ResultsBetween 2007 and 2016, migrants constituted 56% of people newly diagnosed with HIV in the UK, 62% in Belgium, 72% in Sweden and 29% in Italy. Of 23,595 migrants included, 60% were born in Africa and 70% acquired HIV heterosexually. An estimated 9,400 migrants (40%; interquartile range (IQR): 34-59) probably acquired HIV post-migration. This proportion was similar by risk group, sex and region of birth. Time since migration was a strong predictor of post-migration HIV acquisition: 91% (IQR: 87-95) among those arriving 10 or more years prior to diagnosis; 30% (IQR: 21-37) among those 1-5 years prior. Younger age at arrival was a predictor: 15-18 years (81%; IQR: 74-86), 19-25 years (53%; IQR: 45-63), 26-35 years (37%; IQR: 30-46) and 36 years and older (25%; IQR: 21-33).ConclusionsMigrants, regardless of origin, sex and exposure to HIV are at risk of acquiring HIV post-migration to Europe. Alongside accessible HIV testing, prevention activities must target migrant communities.
- Published
- 2021
- Full Text
- View/download PDF
10. The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals.
- Author
-
Ehrenkranz P, Rosen S, Boulle A, Eaton JW, Ford N, Fox MP, Grimsrud A, Rice BD, Sikazwe I, and Holmes CB
- Subjects
- Goals, Humans, United Nations, Acquired Immunodeficiency Syndrome therapy, Delivery of Health Care standards, HIV physiology
- Abstract
Peter Ehrenkranz and co-authors present a cyclical cascade of care for people with HIV infection, aiming to facilitate assessment of outcomes., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: PE is an employee of the Bill & Melinda Gates Foundation. SR is a member of PLOS Medicine’s Editorial Board.
- Published
- 2021
- Full Text
- View/download PDF
11. Can HIV recent infection surveillance help us better understand where primary prevention efforts should be targeted? Results of three pilots integrating a recent infection testing algorithm into routine programme activities in Kenya and Zimbabwe.
- Author
-
Rice BD, de Wit M, Welty S, Risher K, Cowan FM, Murphy G, Chabata ST, Waruiru W, Magutshwa S, Motoku J, Kwaro D, Ochieng B, Reniers G, and Rutherford G
- Subjects
- Adult, Counseling, Epidemiological Monitoring, Female, HIV Infections transmission, Health Surveys, Humans, Immunoenzyme Techniques, Infectious Disease Transmission, Vertical prevention & control, Kenya epidemiology, Male, Pregnancy, Pregnancy Complications, Infectious prevention & control, Preventive Health Services, Risk Factors, Sex Workers, Sexual Partners, Viral Load, Young Adult, Zimbabwe, Algorithms, HIV Infections prevention & control, Primary Prevention
- Abstract
Introduction: Surveillance of recent HIV infections in national testing services has the potential to inform primary prevention programming activities. Focusing on procedures required to accurately determine recent infection, and the potential for recent infection surveillance to inform prevention efforts, we present the results of three independent but linked pilots of recency testing., Methods: To distinguish recently acquired HIV infection from long-standing infection, in 2018 we applied a Recent Infection Testing Algorithm that combined a laboratory-based Limiting Antigen Avidity Enzyme Immunoassay with clinical information (viral-load; history of prior HIV diagnosis; antiretroviral therapy-exposure). We explored potential misclassification of test results and analysed the characteristics of participants with recent infection. We applied the algorithm in antenatal clinics providing prevention of mother-to-child transmission services in Siaya County, Kenya, outreach sites serving female sex workers in Zimbabwe, and routine HIV testing and counselling facilities in Nairobi, Kenya. In Nairobi, we also conducted recency testing among partners of HIV-positive participants., Results: In Siaya County, 2.3% (10/426) of HIV-positive pregnant women were classified as recent. A risk factor analysis comparing women testing recent with those testing HIV-negative found women in their first trimester were significantly more likely to test recent than those in their second or third trimester. In Zimbabwe, 10.5% (33/313) of female sex workers testing HIV-positive through the outreach programme were classified recent. A risk factor analysis of women testing recent versus those testing HIV-negative, found no strong evidence of an association with recent infection. In Nairobi, among 532 HIV-positive women and men, 8.6% (46) were classified recent. Among partners of participants, almost a quarter of those who tested HIV-positive were classified as recent (23.8%; 5/21). In all three settings, the inclusion of clinical information helped improve the positive predictive value of recent infection testing by removing cases that were likely misclassified., Conclusions: We successfully identified recently acquired infections among persons testing HIV-positive in routine testing settings and highlight the importance of incorporating additional information to accurately classify recent infection. We identified a number of groups with a significantly higher proportion of recent infection, suggesting recent infection surveillance, when rolled-out nationally, may help in further targeting primary prevention efforts., (© 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.)
- Published
- 2020
- Full Text
- View/download PDF
12. Outcomes of patients lost to follow-up after antiretroviral therapy initiation in rural north-eastern South Africa.
- Author
-
Ambia J, Kabudula C, Risher K, Xavier Gómez-Olivé F, Rice BD, Etoori D, and Reniers G
- Subjects
- Adult, Anti-HIV Agents therapeutic use, Databases, Factual, Female, HIV Infections drug therapy, Humans, Incidence, Male, Middle Aged, Pregnancy, Proportional Hazards Models, Risk Factors, Rural Population, South Africa epidemiology, Young Adult, HIV Infections mortality, Lost to Follow-Up
- Abstract
Objective: The vital status of patients lost to follow-up often remains unknown in antiretroviral therapy (ART) programmes in sub-Saharan Africa because medical records are no longer updated once the patient disengages from care. Thus, we aimed to assess the outcomes of patients lost to follow-up after ART initiation in north-eastern South Africa., Methods: Using data from a rural area in north-eastern South Africa, we estimated the cumulative incidence of patient outcomes (i) after treatment initiation using clinical records, and (ii) after loss to follow-up (LTFU) using data from clients that have been individually linked to Agincourt Health and Demographic Surveillance System (AHDSS) database. Aside from LTFU, we considered mortality, re-engagement and migration out of the study site. Cox proportional hazards regression was used to identify covariates of these patient outcomes., Results: Between April 2014 and July 2017, 3700 patients initiated ART and contributed a total of 6818 person-years of follow-up time. Three years after ART initiation, clinical record-based estimates of LTFU, mortality and documented transfers were 41.0% (95% CI: 38.5-43.4%), 1.9% (95% CI 1.0-3.2%) and 0.1% (95% CI 0.0-0.9%), respectively. Among those who were LTFU, the cumulative incidence of re-engagement, out-migration and mortality at 3 years were 38.1% (95% CI 33.1-43.0%), 49.4% (95% CI 43.1-55.3%) and 4.7% (95% CI 3.5-6.2%), respectively. Pregnant or breastfeeding women, foreigners and those who initiated ART most recently were at an increased risk of LTFU., Conclusion: LTFU among patients starting ART in north-eastern South Africa is relatively high and has increased in recent years as more asymptomatic patients have initiated treatment. Even though this tendency is of concern in light of the prevention of onwards transmission, we also found that re-engagement in care is common and mortality among persons LTFU relatively low., (© 2019 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
13. Outcomes of Patients Lost to Follow-up in African Antiretroviral Therapy Programs: Individual Patient Data Meta-analysis.
- Author
-
Chammartin F, Zürcher K, Keiser O, Weigel R, Chu K, Kiragga AN, Ardura-Garcia C, Anderegg N, Laurent C, Cornell M, Tweya H, Haas AD, Rice BD, Geng EH, Fox MP, Hargreaves JR, and Egger M
- Subjects
- Africa South of the Sahara epidemiology, Anti-Retroviral Agents therapeutic use, Female, HIV Infections epidemiology, Humans, Incidence, Male, Sex Factors, Treatment Outcome, United Nations, Antiretroviral Therapy, Highly Active, HIV Infections drug therapy, HIV Infections mortality, Lost to Follow-Up
- Abstract
Background: Low retention on combination antiretroviral therapy (cART) has emerged as a threat to the Joint United Nations Programme on human immunodeficiency virus (HIV)/AIDS (UNAIDS) 90-90-90 targets. We examined outcomes of patients who started cART but were subsequently lost to follow-up (LTFU) in African treatment programs., Methods: This was a systematic review and individual patient data meta-analysis of studies that traced patients who were LTFU. Outcomes were analyzed using cumulative incidence functions and proportional hazards models for the competing risks of (i) death, (ii) alive but stopped cART, (iii) silent transfer to other clinics, and (iv) retention on cART., Results: Nine studies contributed data on 7377 patients who started cART and were subsequently LTFU in sub-Saharan Africa. The median CD4 count at the start of cART was 129 cells/μL. At 4 years after the last clinic visit, 21.8% (95% confidence interval [CI], 20.8%-22.7%) were known to have died, 22.6% (95% CI, 21.6%-23.6%) were alive but had stopped cART, 14.8% (95% CI, 14.0%-15.6%) had transferred to another clinic, 9.2% (95% CI, 8.5%-9.8%) were retained on cART, and 31.6% (95% CI, 30.6%-32.7%) could not been found. Mortality was associated with male sex, more advanced disease, and shorter cART duration; stopping cART with less advanced disease andlonger cART duration; and silent transfer with female sex and less advanced disease., Conclusions: Mortality in patients LTFU must be considered for unbiased assessments of program outcomes and UNAIDS targets in sub-Saharan Africa. Immediate start of cART and early tracing of patients LTFU should be priorities.
- Published
- 2018
- Full Text
- View/download PDF
14. The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries.
- Author
-
Mee P, Fearon E, Hassan S, Hensen B, Acharya X, Rice BD, and Hargreaves JR
- Subjects
- Adolescent, Africa, Eastern epidemiology, Africa, Southern epidemiology, Female, Humans, Marriage, Odds Ratio, Young Adult, Educational Status, HIV Seroprevalence, Social Determinants of Health, Student Dropouts statistics & numerical data, Students statistics & numerical data
- Abstract
Introduction: Interventions to keep adolescent girls and young women in school, or support their return to school, are hypothesised to also reduce HIV risk. Such interventions are included in the DREAMS combination package of evidence-based interventions. Although there is evidence of reduced risky sexual behaviours, the impact on HIV incidence is unclear. We used nationally representative surveys to investigate the association between being in school and HIV prevalence., Methods: We analysed Demographic and Health Survey data from nine DREAMS countries in sub-Saharan Africa restricted to young women aged 15-19 (n = 20,429 in total). We used logistic regression to assess cross-sectional associations between being in school and HIV status and present odds ratios adjusted for age, socio-economic status, residence, marital status, educational attainment and birth history (aOR). We investigated whether associations seen differed across countries and by age., Results: HIV prevalence (1.0%-9.8%), being currently in school (50.0%-72.6%) and the strength of association between the two, varied between countries. We found strong evidence that being currently in school was associated with a reduced odds of being HIV positive in Lesotho (aOR: 0.37; 95%CI: 0.17-0.79), Swaziland (aOR: 0.32; 95%CI: 0.17-0.59), and Uganda (aOR: 0.48: 95%CI: 0.29-0.80) and no statistically significant evidence for this in Kenya, Malawi, Mozambique, Tanzania, Zambia or Zimbabwe., Conclusions: Although the relationship is not uniform across countries or over time, these data are supportive of the hypothesis that young women in school are at lower risk of being HIV positive than those who leave school in some sub-Saharan African settings. There is a possibility of reverse causality, with pre-existing HIV infection leading to school drop-out. Further investigation of the contextual factors behind this variation will be important in interpreting the results of HIV prevention interventions promoting retention in school., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2018
- Full Text
- View/download PDF
15. Monitoring of the HIV Epidemic Using Routinely Collected Data: The Case of the United Kingdom.
- Author
-
Rice BD, Yin Z, Brown AE, Croxford S, Conti S, De Angelis D, and Delpech VC
- Subjects
- Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Delayed Diagnosis, Female, HIV Infections epidemiology, HIV Infections transmission, Humans, Incidence, Male, Mass Screening, United Kingdom epidemiology, AIDS Serodiagnosis statistics & numerical data, Epidemics prevention & control, HIV Infections drug therapy, HIV Infections prevention & control, Heterosexuality, Homosexuality, Male
- Abstract
We report on measures used to monitor the response to the UK HIV epidemic. We present analyses of routine data on HIV testing, diagnosis and care, and of CD4 back-calculation models to estimate country of HIV acquisition and incidence. Over the past decade, HIV and AIDS diagnoses and deaths declined while HIV testing coverage increased. Linkage into care, retention in care, and viral suppression was high with few socio-demographic differences. However, in 2013, incidence among MSM, and undiagnosed infection, also remained high, and more than half of heterosexuals newly diagnosed with HIV (the majority of whom were born-abroad) probably acquired HIV in the UK and were diagnosed late. HIV care following diagnosis is excellent in the UK. Improvements in testing and prevention are required to reduce undiagnosed infection, incidence and late diagnoses. Routinely collected laboratory and clinic data is a low cost, robust and timely mechanism to monitor the public health response to national HIV epidemics.
- Published
- 2017
- Full Text
- View/download PDF
16. Sharp truth: health care workers remain at risk of bloodborne infection.
- Author
-
Rice BD, Tomkins SE, and Ncube FM
- Subjects
- Blood-Borne Pathogens, Body Fluids, Humans, Infectious Disease Transmission, Patient-to-Professional legislation & jurisprudence, Occupational Diseases epidemiology, Protective Devices statistics & numerical data, United Kingdom epidemiology, Infection Control legislation & jurisprudence, Infectious Disease Transmission, Patient-to-Professional prevention & control, Needlestick Injuries prevention & control, Occupational Exposure prevention & control
- Abstract
Background: In 2013, new regulations for the prevention of sharps injuries were introduced in the UK. All health care employers are required to provide the safest possible working environment by preventing or controlling the risk of sharps injuries., Aims: To analyse data on significant occupational sharps injuries among health care workers in England, Wales and Northern Ireland before the introduction of the 2013 regulations and to assess bloodborne virus seroconversions among health care workers sustaining a blood or body fluid exposure., Methods: Analysis of 10 years of information on percutaneous and mucocutaneous exposures to blood or other body fluids from source patients infected with a bloodborne virus, collected in England, Wales and Northern Ireland through routine surveillance of health care workers reported for the period 2002-11., Results: A total of 2947 sharps injuries involving a source patient infected with a bloodborne virus were reported by health care workers. Significant sharps injuries were 67% higher in 2011 compared with 2002. Sharps injuries involving an HIV-, hepatitis B virus- or hepatitis C virus (HCV)-infected source patient increased by 107, 69 and 60%, respectively, between 2002 and 2011. During the study period, 14 health care workers acquired HCV following a sharps injury., Conclusions: Our data show that during a 10-year period prior to the introduction of new regulations in 2013, health care workers were at risk of occupationally acquired bloodborne virus infection. To prevent sharps injuries, health care service employers should adopt safety-engineered devices, institute safe systems of work and promote adherence to standard infection control procedures., (© The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2015
- Full Text
- View/download PDF
17. Universal treatment success among healthcare workers diagnosed with occupationally acquired acute hepatitis C.
- Author
-
Tomkins SE, Rice BD, Roy K, Cullen B, and Ncube FM
- Subjects
- Genotype, Hepacivirus classification, Hepacivirus genetics, Hepacivirus isolation & purification, Humans, Treatment Outcome, United Kingdom, Antiviral Agents therapeutic use, Hepatitis C drug therapy, Occupational Diseases drug therapy
- Abstract
Healthcare workers (HCWs) are at risk of occupationally acquired hepatitis C. In the UK, 17 HCWs were diagnosed with occupationally acquired acute hepatitis C between 2002 and 2011. All 17 cases involved percutaneous injuries from hollowbore needles, 16 known to be contaminated with blood. Of these 17 HCWs, 15 received antiviral therapy and 14 are known to have achieved viral clearance. Treatment success was irrespective of genotype. The successful treatment of HCWs emphasizes the need for UK guidelines on the management of occupationally acquired acute hepatitis C., (Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
18. HIV incidence in men who have sex with men in England and Wales 2001-10: a nationwide population study.
- Author
-
Birrell PJ, Gill ON, Delpech VC, Brown AE, Desai S, Chadborn TR, Rice BD, and De Angelis D
- Subjects
- Adult, CD4-Positive T-Lymphocytes, Drug Administration Schedule, England epidemiology, HIV Infections drug therapy, HIV Infections immunology, HIV Infections transmission, Humans, Incidence, Lymphocyte Count, Male, Mass Screening methods, Middle Aged, Sexual Partners, Wales epidemiology, Anti-HIV Agents administration & dosage, HIV Infections diagnosis, HIV Infections epidemiology, Homosexuality, Male
- Abstract
Background: Control of HIV transmission could be achievable through an expansion of HIV testing of at-risk populations together with ready access and adherence to antiretroviral therapy. To examine whether increases in testing rates and antiretroviral therapy coverage correspond to the control of HIV transmission, we estimated HIV incidence in men who have sex with men (MSM) in England and Wales since 2001., Methods: A CD4-staged back-calculation model of HIV incidence was used to disentangle the competing contributions of time-varying rates of diagnosis and HIV incidence to observed HIV diagnoses. Estimated trends in time to diagnosis, incidence, and undiagnosed infection in MSM were interpreted against a backdrop of increased HIV testing rates and antiretroviral-therapy coverage over the period 2001-10., Findings: The observed 3·7 fold expansion in HIV testing in MSM was mirrored by a decline in the estimated mean time-to-diagnosis interval from 4·0 years (95% credible interval [CrI] 3·8-4·2) in 2001 to 3·2 years (2·6-3·8) by the end of 2010. However, neither HIV incidence (2300-2500 annual infections) nor the number of undiagnosed HIV infections (7370, 95% CrI 6990-7800, in 2001, and 7690, 5460-10 580, in 2010) changed throughout the decade, despite an increase in antiretroviral uptake from 69% in 2001 to 80% in 2010., Interpretation: CD4 cell counts at HIV diagnosis are fundamental to the production of robust estimates of incidence based on HIV diagnosis data. Improved frequency and targeting of HIV testing, as well as the introduction of ART at higher CD4 counts than is currently recommended, could begin a decline in HIV transmission among MSM in England and Wales., Funding: UK Medical Research Council, UK Health Protection Agency., (Copyright © 2013 Elsevier Ltd. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
19. A new method to assign country of HIV infection among heterosexuals born abroad and diagnosed with HIV.
- Author
-
Rice BD, Elford J, Yin Z, and Delpech VC
- Subjects
- Adolescent, Adult, CD4 Lymphocyte Count, Female, HIV Seropositivity ethnology, HIV Seropositivity transmission, Health Surveys, Humans, Male, Middle Aged, United Kingdom epidemiology, Young Adult, Black People statistics & numerical data, Emigrants and Immigrants statistics & numerical data, HIV Seropositivity epidemiology, HIV-1, Heterosexuality statistics & numerical data, Population Surveillance
- Abstract
Objective: To apply a new method to ascertain likely place of HIV infection among persons born abroad and diagnosed with HIV in the United Kingdom (UK)., Design: Analyses of heterosexual adults born abroad, diagnosed with HIV in the UK between 2004 and 2010, and reported to the national HIV diagnoses database., Methods: Year of infection was ascertained by applying an estimated rate of CD4 cell count decline between an individual's CD4 cell count at diagnosis and estimates of CD4-cell count at infection. A person was classified as having probably acquired HIV while living in the UK if estimated year of infection was later than reported year of arrival in the UK., Results: Of 10 612 heterosexual adults born abroad included in the analyses, 85% (9065) were of black-African ethnicity. We estimate that 33% (26-39%) of persons acquired HIV while living in the UK. This percentage increased from 24% (16-39%) in 2004 to 46% (31-50%) in 2010 (P < 0.01). The estimate of 33% is three times higher than national estimates of HIV acquired in the UK based on clinic reports (11%) (P < 0.01)., Conclusion: : Assigning place of HIV infection using routinely available clinical and demographic data and estimated rates of CD4 cell decline is feasible. We report a high and increasing proportion of persons born abroad who appear to have acquired their HIV infection while living in the UK. These findings highlight the need for continued targeted HIV prevention efforts, particularly among black-African communities.
- Published
- 2012
- Full Text
- View/download PDF
20. Invasive pneumococcal disease among HIV-positive individuals, 2000-2009.
- Author
-
Yin Z, Rice BD, Waight P, Miller E, George R, Brown AE, Smith RD, Slack M, and Delpech VC
- Subjects
- AIDS-Related Opportunistic Infections drug therapy, AIDS-Related Opportunistic Infections immunology, Adolescent, Adult, CD4 Lymphocyte Count, Case-Control Studies, England epidemiology, Female, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections immunology, Humans, Incidence, Male, Medical Record Linkage, Pneumococcal Infections drug therapy, Pneumococcal Infections immunology, Pneumococcal Infections microbiology, Risk Factors, Serotyping, Time Factors, Wales epidemiology, Young Adult, AIDS-Related Opportunistic Infections epidemiology, AIDS-Related Opportunistic Infections microbiology, HIV Infections complications, Pneumococcal Infections epidemiology, Pneumococcal Vaccines administration & dosage, Pneumococcal Vaccines immunology, Streptococcus pneumoniae immunology, Streptococcus pneumoniae pathogenicity
- Abstract
Objectives: To examine invasive pneumococcal disease (IPD) incidence, the impact of the 7-valent pneumococcal conjugate vaccines (PCV7s) programme on the distribution of Streptococcus pneumoniae serotypes and risk factors for IPD among HIV-positive adults., Methods: We analysed adults (aged ≥15 years) reported to the HIV and IPD national datasets in England and Wales (2000-2009). Through data-linkage, changes in IPD incidence and serotype distribution were examined. Risk factors for IPD among HIV-positive adults were assessed using a case-control study., Results: Among 63,109 HIV-positive adults, 951 were co-infected with IPD. The average annual incidence of IPD was 245 episodes per 100,000 HIV-positive adults and 246 of 100,000 among those aged 15-44 years. Incidence was higher among those not on antiretroviral therapy (ART) (281 of 100,000) and those with severe immunosuppression (563 of 100,000). Among 9283 adults aged 15-44 at IPD diagnosis, 2.4% were living with undiagnosed HIV. The proportion of IPD episodes in HIV-positive adults with serotypes covered by PCV7 was 23% in 2009, a 54% proportional reduction compared with pre-PCV7 (2000-2006); the reduction in adults of unknown HIV status was 70%. The proportion of IPD episodes among HIV-positive adults caused by serotypes covered by PCV13 was 61%. Significant risk factors for IPD in multivariate analysis included older aged (≥65 years), a lower nadir CD4 cell count and no previous ART., Conclusion: An HIV test should be offered and recommended to adults aged 15-44 years without other obvious IPD risk factors. Our study provides an evidence base to policy makers regarding the use of the new PCV13 in HIV-positive adults.
- Published
- 2012
- Full Text
- View/download PDF
21. Travel for HIV care in England: a choice or a necessity?
- Author
-
Huntington S, Chadborn T, Rice BD, Brown AE, and Delpech VC
- Subjects
- Adolescent, Adult, Choice Behavior, Confidence Intervals, England epidemiology, Female, HIV Infections therapy, Health Services Accessibility economics, Humans, Male, Socioeconomic Factors, Travel economics, Young Adult, HIV Infections epidemiology, Health Services Accessibility statistics & numerical data, Travel statistics & numerical data
- Abstract
Objectives: The aims of the study were (1) to measure the distance required to travel, and the distance actually travelled, to HIV services by HIV-infected adults, and (2) to calculate the proportion of patients who travelled beyond local services and identify socio-demographic and clinical predictors of use of non-local services., Methods: The straight-line distance between a patient's residence and HIV services was determined for HIV-infected patients in England in 2007. 'Local services' were defined as the closest HIV service to a patient's residence and other services within an additional 5 km radius. Multivariable logistic regression was used to identify socio-demographic and clinical predictors of accessing non-local services., Results: In 2007, nearly 57 000 adults with diagnosed HIV infection accessed HIV services in England; 42% lived in the most deprived areas. Overall, 81% of patients lived within 5 km of a service, and 8.7% used their closest HIV service. The median distance to the closest HIV service was 2.5 km [interquartile range (IQR) 1.5-4.2 km] and the median actual distance travelled was 4.8 km (IQR 2.5-9.7 km). A quarter of patients used a 'non-local' service. Patients living in the least deprived areas were twice as likely to use non-local services as those living in the most deprived areas [adjusted odds ratio (AOR) 2.16; 95% confidence interval (CI) 1.98-2.37]. Other predictors for accessing non-local services included living in an urban area (AOR 0.77; 95% CI 0.69-0.85) and being diagnosed more than 12 months (AOR 1.48; 95% CI 1.38-1.59)., Conclusion: In England, 81% of HIV-infected patients live within 5 km of HIV services and a quarter of HIV-infected adults travel to non-local HIV services. Those living in deprived areas are less likely to travel to non-local services., (© 2010 British HIV Association.)
- Published
- 2011
- Full Text
- View/download PDF
22. Insights into the rise in HIV infections, 2001 to 2008: a Bayesian synthesis of prevalence evidence.
- Author
-
Presanis AM, Gill ON, Chadborn TR, Hill C, Hope V, Logan L, Rice BD, Delpech VC, Ades AE, and De Angelis D
- Subjects
- Adolescent, Adult, Bayes Theorem, England epidemiology, Female, HIV Infections transmission, Humans, Male, Middle Aged, Population Surveillance, Prevalence, Risk Factors, Wales epidemiology, Young Adult, Disease Outbreaks statistics & numerical data, HIV Infections epidemiology
- Abstract
Objective: To estimate trends in prevalence of HIV infection, undiagnosed and total, among adults aged 15-44 years in England and Wales since 2001., Design: Multiple surveillance systems and survey data are available to inform different aspects of the HIV epidemic in England and Wales. To coherently and consistently combine this information to estimate trends in HIV prevalence, we apply a multiparameter evidence synthesis in a Bayesian statistical framework., Methods: The study population is stratified by exposure group and region of residence. We synthesize data from behavioural and community surveys, unlinked anonymous seroprevalence surveys, and an annual survey of individuals with diagnosed HIV infection. Prevalence estimates are given with 95% credible intervals., Results: The estimated number of prevalent HIV infections in 15-44-year-olds has increased from 32,400 (29,600-35,900) in 2001 to 54,500 (50,500-59,100) in 2008, corresponding to an estimated prevalence of 1.5 per 1000 (1.4-1.7) rising to 2.4 per 1000 (2.3-2.6) in 2008. A rise in prevalence of diagnosed infection contributes substantially to the increase. There is no evidence of a statistically significant decrease in the prevalence of undiagnosed infection. The proportion of infections that are diagnosed has therefore also increased., Conclusion: Although the increase in the proportion of infections that are diagnosed is encouraging, the rise in HIV prevalence and lack of evidence of a decrease in prevalence of undiagnosed infection suggest that diagnosis rates are not high enough to reduce the pool of individuals unaware of their infection and that new infections must be occurring.
- Published
- 2010
- Full Text
- View/download PDF
23. HIV transmission and high rates of late diagnoses among adults aged 50 years and over.
- Author
-
Smith RD, Delpech VC, Brown AE, and Rice BD
- Subjects
- Adolescent, Adult, Age Distribution, Algorithms, CD4 Lymphocyte Count methods, England epidemiology, Female, HIV Infections mortality, HIV Infections transmission, Humans, Male, Middle Aged, Northern Ireland epidemiology, Population Surveillance, Risk Factors, Sentinel Surveillance, Sex Distribution, Time Factors, Wales epidemiology, Young Adult, Delayed Diagnosis statistics & numerical data, HIV Infections diagnosis, Sexual Behavior statistics & numerical data
- Abstract
Objectives: Describe the epidemiology and impact of late diagnosis among older adults living with HIV and estimate age at infection., Methods: Comparative national analyses between individuals diagnosed when aged 50 years and over with individuals diagnosed prior to 50 years. Age at infection was estimated using CD4 cell count at diagnosis., Results: A total of 8255 older adults accessed HIV care in England, Wales and Northern Ireland in 2007, a 3.5-fold increase compared to 2000; with one in 10 individuals newly diagnosed in 2007. When compared with younger adults at diagnosis, older adults were significantly more likely to be men (74 vs. 58%; P < 0.001), infected through sex between men (40 vs. 34%; P < 0.001) and of white ethnicity (60 vs. 38%; P < 0.001). Older heterosexual adults were more likely to be infected within the UK (16 vs. 12%; P < 0.001), with evidence of travel abroad among white heterosexual men. Almost half (48%) of older adults were late presenters vs. a third (33%) of younger adults. Older late presenters were 14 times more likely to die within a year of diagnosis compared with older adults who were not diagnosed late (14 vs. 1%; P < 0.001) and had 2.4 times the risk of dying than younger late presenters. We estimate that nearly half (48%) of older adults diagnosed between 2000 and 2007 acquired their infection at age 50 and over., Conclusion: Our study provides evidence of HIV transmission, high rates of late presentation and an increased risk of short-term mortality among older adults. These findings highlight the need for increased targeted prevention efforts and strategies to increase HIV testing among older adults at risk of HIV.
- Published
- 2010
- Full Text
- View/download PDF
24. HIV infection and suicide in the era of HAART in England, Wales and Northern Ireland.
- Author
-
Rice BD, Smith RD, and Delpech VC
- Subjects
- Adolescent, Adult, Aged, Antiretroviral Therapy, Highly Active, Cause of Death, England epidemiology, Female, Humans, Male, Middle Aged, Northern Ireland epidemiology, Wales epidemiology, Young Adult, HIV Infections mortality, Suicide statistics & numerical data
- Published
- 2010
- Full Text
- View/download PDF
25. The impact in the UK of the Central and Eastern European HIV epidemics.
- Author
-
Delpech VC, Yin Z, Abernethy J, Hill C, Logan L, Chadborn TR, and Rice BD
- Subjects
- Adult, Europe, Eastern, Female, Homosexuality, Male, Humans, Incidence, Male, Prevalence, Risk Factors, Substance Abuse, Intravenous, United Kingdom epidemiology, Emigrants and Immigrants, HIV Infections epidemiology
- Abstract
Despite increasing migration, the impact of HIV epidemics from Central and Eastern Europe (C&EE) on the UK HIV epidemic remains small. C&EE-born adults comprised 1.2% of adults newly diagnosed with HIV in the UK between 2000 and 2007. Most C&EE-born women probably acquired their infection heterosexually in C&EE. In contrast, 59% of C&EE-born men reported sex with men, half of whom probably acquired their infection in the UK. Previously undiagnosed HIV prevalence in C&EE-born sexual-health-clinic attendees was low (2007, 0.5%) as was overall HIV prevalence in C&EE-born women giving birth in England (2007, <0.1%). The high proportion of men who have sex with men (MSM) suggests under-reporting of this group in C&EE HIV statistics and/or migration of MSM to the UK. In addition to reducing HIV transmission in injecting drug users, preventative efforts aimed at C&EE-born MSM both within their country of origin and the UK are required.
- Published
- 2009
- Full Text
- View/download PDF
26. Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa.
- Author
-
Rice BD, Bätzing-Feigenbaum J, Hosegood V, Tanser F, Hill C, Barnighausen T, Herbst K, Welz T, and Newell ML
- Subjects
- AIDS Serodiagnosis, Adolescent, Adult, Cluster Analysis, Female, HIV Infections diagnosis, Humans, Middle Aged, Pregnancy, Pregnancy Complications, Infectious diagnosis, Prenatal Care statistics & numerical data, Prevalence, Selection Bias, South Africa epidemiology, Contraception statistics & numerical data, Family Planning Services statistics & numerical data, HIV Infections epidemiology, Pregnancy Complications, Infectious epidemiology, Rural Health statistics & numerical data, Sentinel Surveillance
- Abstract
Background: To present and compare population-based and antenatal-care (ANC) sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations, and with evidence of possible biases inherent to both surveillance systems, we explore differences between the two systems. There is particular emphasis on unrepresentative selection of ANC clinics and unrepresentative testing in the population., Methods: HIV sero-prevalence amongst blood samples collected from women consenting to test during the 2005 annual longitudinal population-based serological survey was compared to anonymous unlinked HIV sero-prevalence amongst women attending antenatal care (ANC) first visits in six clinics (January to May 2005). Both surveillance systems were conducted as part of the Africa Centre Demographic Information System., Results: Population-based HIV prevalence estimates for all women (25.2%) and pregnant women (23.7%) were significantly lower than that for ANC attendees (37.7%). A large proportion of women attending urban or peri-urban clinics would be predicted to be resident within rural areas. Although overall estimates remained significantly different, presenting and standardising estimates by age and location (clinic for ANC-based estimates and individual-residence for population-based estimates) made some group-specific estimates from the two surveillance systems more predictive of one another., Conclusion: It is likely that where ANC coverage and contraceptive use is widespread and fertility is low, population-based surveillance under-estimates HIV prevalence due to unrepresentative testing by age, residence and also probably by HIV status, and that ANC sentinel surveillance over-estimates prevalence due to selection bias in terms of age of sexual debut and contraceptive use. The results presented highlight the importance of accounting for unrepresentative testing, particularly by individual residence and age, through system design and statistical analyses.
- Published
- 2007
- Full Text
- View/download PDF
27. Monitoring the effectiveness of HIV and STI prevention initiatives in England, Wales, and Northern Ireland: where are we now?
- Author
-
Brown AE, Tomkins SE, Logan LE, Lamontagne DS, Munro HL, Hope VD, Righarts A, Blackham JE, Rice BD, Chadborn TR, Tookey PA, Parry JV, Delpech V, Gill ON, and Fenton KA
- Subjects
- Adult, Anti-HIV Agents therapeutic use, CD4 Lymphocyte Count, Female, HIV Infections prevention & control, Hepatitis B Vaccines, Homosexuality, Male, Humans, Male, Mass Screening, Patient Acceptance of Health Care, Prenatal Diagnosis, Risk-Taking, Sexually Transmitted Diseases epidemiology, Substance Abuse, Intravenous epidemiology, Treatment Outcome, United Kingdom epidemiology, Waiting Lists, Sexually Transmitted Diseases prevention & control
- Abstract
Primary and secondary prevention are essential components of the response to HIV and sexually transmitted infections (STIs). We present findings from nationally implemented HIV/STI prevention interventions. In 2003, of those attending STI clinics at least 64% of men who have sex with men (MSM) and 55% of heterosexuals accepted a confidential HIV test; 88% of all HIV infections in women giving birth in England were diagnosed before delivery; 85% of MSM eligible for hepatitis B vaccination received a first dose of vaccine at their first STI clinic attendance; 74% of STI clinic attendees for emergency appointments, and 20% of those for routine appointments were seen within 48 hours of initiating an appointment; the National Chlamydia Screening Programme in England found a positivity of 10% and 13% among young asymptomatic women and men, respectively. Prevention initiatives have seen recent successes in limiting further HIV/STI transmission. However, more work is required if current levels of transmission are to be reduced.
- Published
- 2006
- Full Text
- View/download PDF
28. The changing epidemiology of prevalent diagnosed HIV infections in England, Wales, and Northern Ireland, 1997 to 2003.
- Author
-
Rice BD, Payne LJ, Sinka K, Patel B, Evans BG, and Delpech V
- Subjects
- Adolescent, Adult, Age Factors, Aged, Anti-HIV Agents therapeutic use, Female, HIV Infections therapy, HIV Infections transmission, Heterosexuality, Humans, Male, Middle Aged, Prevalence, Residence Characteristics, Sex Factors, United Kingdom epidemiology, HIV Infections epidemiology
- Abstract
Objectives: To present the current epidemiology of prevalent diagnosed HIV infections in England, Wales, and Northern Ireland (E, W, & NI) and describe trends over time., Methods: Descriptive analyses of the annual national Survey of Prevalent HIV Infections Diagnosed (SOPHID) for the period 1997 to 2003., Results: In 2003, 34 251 adults (15 years of age or over) were seen for HIV related care in E, W, & NI, representing a 17% increase in the prevalence of diagnosed HIV infections compared with 2002 and a 132% increase compared with 1997. Between 1997 and 2003, as a proportion of total prevalent cases, adults who acquired their infection through heterosexual sex increased from 26% to 49%; black African adults increased from 15% to 35% and diagnosed adults resident in London fell from 62% to 55% of the total. The male to female ratio declined from 5:1 to 2:1. The proportion of adults receiving combination antiretroviral therapy increased from 53% in 1998 to 64% in 2003., Conclusion: There has been a large increase in the number of adults with diagnosed HIV infection seen for care in E, W, & NI since 1997. Changes in the epidemiology of prevalent diagnosed HIV were seen by sex, route of infection, ethnicity, level of antiretroviral therapy, and areas of residence and treatment. In 2003, for the first time, prevalent diagnosed infections acquired through heterosexual sex over-took those acquired through sex between men. These increases have serious implications for the planning and financing of HIV services in the United Kingdom.
- Published
- 2005
- Full Text
- View/download PDF
29. No time to wait: how many HIV-infected homosexual men are diagnosed late and consequently die? (England and Wales, 1993-2002).
- Author
-
Chadborn TR, Baster K, Delpech VC, Sabin CA, Sinka K, Rice BD, and Evans BG
- Subjects
- Adolescent, Adult, Age Distribution, Antiretroviral Therapy, Highly Active methods, CD4 Lymphocyte Count, England epidemiology, HIV Infections diagnosis, HIV Infections epidemiology, Humans, Incidence, Male, Middle Aged, Population Surveillance methods, Risk Factors, Sensitivity and Specificity, Time Factors, Wales epidemiology, HIV Infections mortality, Homosexuality, Male
- Abstract
Objectives: To present national trends of the estimated number and proportion of late HIV diagnoses and short-term mortality following diagnosis among men who have had sex with men (MSM). To determine separately risk factors for late diagnosis and short-term mortality., Methods: Analysis of national HIV/AIDS case reports of new diagnoses linked to CD4 cell counts from the CD4 Surveillance Scheme. Inverse probability weighting adjusted for individuals with no CD4 cell count at diagnosis. Outcomes were late diagnosis (CD4 cell count <200 x 10(6) cells/l at diagnosis) and short-term mortality (death within 1 year of diagnosis)., Results: Of 14,158 new diagnoses, 31% were estimated as late diagnoses. Despite a decreasing trend (P trend <0.01) an estimated 430 (25%) MSM were still diagnosed late in 2001. Late diagnosis disproportionately affected individuals diagnosed outside London, of non-white ethnicity, and of older age. There were 710 (5.0% of 14 158) deaths within a year of HIV diagnosis. Estimated short-term mortality was 14% for MSM diagnosed late and 1% for other MSM (adjusted odds ratio, 10.8; 95% confidence interval, 7.7-15.9). Short-term mortality declined concurrently with availability of highly active antiretroviral therapy and was independently associated with age and diagnosis outside London but not ethnicity., Conclusions: The continued late diagnosis of one in four MSM means these individuals lose the option to start therapy early, miss opportunities to prevent further transmission and are approximately 10 times more likely to die within a year of diagnosis. Early diagnosis of all MSM in 2001 could have reduced short-term mortality by 84% and all mortality in that year by 22%.
- Published
- 2005
- Full Text
- View/download PDF
30. Recent trends in diagnoses of HIV and other sexually transmitted infections in England and Wales among men who have sex with men.
- Author
-
Macdonald N, Dougan S, McGarrigle CA, Baster K, Rice BD, Evans BG, and Fenton KA
- Subjects
- Adolescent, Adult, Age Distribution, Chi-Square Distribution, Confidence Intervals, England epidemiology, HIV Infections diagnosis, HIV Infections epidemiology, Health Surveys, Humans, Incidence, Male, Prevalence, Sexually Transmitted Diseases epidemiology, Wales epidemiology, Homosexuality, Male statistics & numerical data, Sexually Transmitted Diseases diagnosis
- Abstract
Objectives: To examine trends in rates of diagnoses of HIV and other sexually transmitted infections (STIs) in men who have sex with men (MSM) in England and Wales between 1997 and 2002., Methods: Estimates of the MSM population living in England and Wales, London and the rest of England and Wales were applied to surveillance data, providing rates of diagnoses of HIV and STIs and age group specific rates for HIV and uncomplicated gonorrhoea., Results: Between 1997 and 2002, rates of diagnoses of HIV and acute STIs in MSM increased substantially. Rates in London were higher than elsewhere. Rises in acute STIs were similar throughout England and Wales, except for uncomplicated gonorrhoea and infectious syphilis, with greater increases outside London. Rates of gonorrhoea diagnoses doubled between 1999 and 2001 (661/100,000, 1271/100,000, p<0.001) in England and Wales followed by a slight decline to 1210/100,000 (p=0.03) in 2002-primarily the result of a decline in diagnoses among men aged 25-34 (1340/100,000, 1128/100,000, p<0.001) and 35-44 (924/100,000, 863/100,000, p=0.03) in London. HIV was the third most common STI diagnosed in MSM in England and Wales and the second in London, with the highest rate (1286/100,000) found among men aged 35-44 in London in 2002., Conclusions: Rates of diagnosis of HIV and other STIs have increased substantially among MSM in England and Wales. Increases show heterogeneity by infection, geography, and age over time. Rates in London were twice those seen elsewhere, with greatest changes over time. The observed changes reflect concomitant increases in high risk behaviour documented in behavioural surveillance survey programmes.
- Published
- 2004
- Full Text
- View/download PDF
31. Prevalent diagnosed HIV in England, Wales and Northern Ireland: adjusted totals 1996 to 2001 and extrapolations to 2004.
- Author
-
Rice BD, McHenry A, Sinka K, Payne LJ, Baster K, Patel B, and Evans BG
- Subjects
- Binomial Distribution, Disease Transmission, Infectious, England epidemiology, Female, HIV Infections transmission, Health Surveys, Heterosexuality, Homosexuality, Humans, London epidemiology, Male, Northern Ireland epidemiology, Prevalence, Regression Analysis, Wales epidemiology, HIV Infections epidemiology
- Abstract
Objective: To predict trends in diagnosed HIV prevalence by extrapolation to 2004 using data from the annual surveys of individuals receiving HIV-related care in England, Wales and Northern Ireland from 1996 to 2001., Methods: Data from the annual surveys of prevalent HIV infections diagnosed (SOPHID) were adjusted for under-reporting and non-attendance and separately extrapolated for infections acquired homosexually, heterosexually and by other routes. The data were extrapolated using negative binomial and linear regression models based on the 1996 to 2001 annual surveys., Results: The negative binomial model predicted an increase of 56% in diagnosed HIV prevalence in England, Wales and Northern Ireland between 2001 and 2004. The linear model predicted an increase of 25% for the same time period. The predicted increases are mostly driven by the large rise in the number of new diagnoses, in particular in individuals infected heterosexually., Conclusion: Increases in HIV prevalence in England, Wales and Northern Ireland have diverged from a linear trend. Negative binomial modelling of the data predicts that large rises in prevalence will continue during the early 2000s.
- Published
- 2004
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.