An important goal of research in immunology is to understand the flaws in the human immune system, such that their impacts can be effectively mitigated. Previous work documented flaws in the mechanisms by which the immune system tempers its responses to pathogens in order to avoid harming the host. As explained here, these tempering mechanisms also govern the phenomenon of the original antigenic sin, whereby an encounter with a new pathogen strain preferentially recalls less potent immune responses directed against an older, moderately different strain.
: In the context of an implementation research project, aiming at better aligning targeted services with the general health services, we conducted cross-sectional surveys among a representative sample of female sex workers (FSWs) in four cities. We explored, through structured face-to-face interviews, where FSWs procure commodities and services for sexual and reproductive health. We compared service utilization across the four cities and assessed if it was significantly different.
Abstract: Twenty years ago, in 1997, I wrote the following piece reflecting on the Mothusimpilo project, an early attempt to understand and help to manage the epidemic of HIV in South Africa. I thought it might be interesting for you to look back on where we have come from.
Two months ago Lander Willem and I organized the first edition of the short course “Individual-based modelling in epidemiology: A practical introduction”. The feedback at the end of the course was overwhelmingly positive, which left us feeling empowered and encouraged to not leave it at this first edition. Participants of the next edition should expect an even more hands-on course, with more time to acquire skills in developing, exploring and fitting individual-based models.
As epidemiologists we constantly think about indicators and metrics. Given the well-known limitations of simplifying complex dependencies to one-dimensional indicators, isn’t it surprising that many academics have bought into the practice of measuring the quality and impact of their work by a handful of metrics? While books have been written about the need for more and better indicators of impact and excellence in academia, surprisingly little attention is given to the challenge and value of being engaged and excelling in non-academic activities. Some ideas around this are presented in this editorial.
As a PhD student in Ecology and Evolutionary Biology, I have spent more than half of the past four years of my dissertation work in Madagascar, where I study the transmission dynamics of zoonotic viruses which jump the species barrier from bat reservoirs to human hosts. I combine field, laboratory, and modeling methods, with each technique offering unique insights into the larger truth.
This study attempted to evaluate several HIV treatment monitoring strategies based on the 2013 and 2016 WHO Guidelines by developing a mathematical model that mimics the natural history of people on ART in South Africa. The results indicate that, from both a public health and an economic perspective, the replacement of HIV monitoring from the current CD4 count testing to only viral load (VL) testing, is not supported. The best economic results were achieved in the hybrid strategies combining CD4 and VL tests. More cost modelling studies are required to evaluate the cost-benefit of the 2016 WHO Guidelines.
Recent advances in ART have improved the success of treating infected individuals and have provided valuable tools to prevent infection. Early ART also offers one of the most practicable components in attempting to achieve functional cures, but diagnosing and treating HIV early remains a challenge.
This study clearly shows the diversity of sex workers (SWs) and their varying HIV treatment needs in the workplace and at home. Standard treatment guidelines could therefore fall short of their intention to reduce vulnerability to poor health outcomes if a non-differentiated approach to care is followed. Trained staff who are sensitised to the local medical, emotional and legal needs of SWs are able to create user friendly services that encourage these vulnerable women to utilise services.
Interventions to curb age-disparate relationships (ADR) are ongoing in spite of conflicting evidence that ADR are a risk factor for HIV transmission. There is a real need to explore the prevalence of ADR and understand what they mean for HIV transmission. We must first understand and describe these relationships; second, establish a causal relationship with HIV. We recently published a paper that explores those objectives in a population of 1,922 adult men and women living in Likoma Island, Malawi.