Category: sexual behaviour

Sex workers collective show long-term health gains of self-empowerment

A parallel AIDS conference in Kolkota, India gave the rights an update on the success of the VAMP sex-workers colective – now in its 15th year reports, reports Andera Cornwall the Guardian.

They have shown an impressive ability to minimise risk of HIV and other sexually transmitted infections in sex workers.

Founded in 1997, Vamp now has more than 5,000 members. Weekly meetings bring the collective together to tackle a wide range of issues faced by members. Health work and advocacy for sex rights’ human rights are interwoven with Vamp’s everyday work in the densely populated alleyways in the red-light districts of Sangli and other towns in the region.

Vamp’s mission is to change society. Rather than treating sex workers as victims to be rescued or rehabilitated, it demonstrates the power of collective action as a force for women’s empowerment, mobilising sex workers to improve their working conditions, and claim rights and recognition. And they’re yielding results.

The report showed how self-empowerment and education can achieve high rates of safe sex in women at high risk of sexually transmitted infections and HIV. It is yet another reminder to that the most effective way to protect this vulnerable population is to help then self-organise and self-protect rather than to criminalise prostitution.

The latter, as many studies have shown, merely drives women into the hands of criminal gangs, or leads to risk-taking sexual practices and high rates of self-harm.

Development of a questionnaire to measure patients’ satisfaction with HIV Clinics

A STIRF funded project (STIRF-012) has been completed successfully. Professor Jonathan Ross, Consultant in HIV medicine at University Hospital Birmingham and Lucy Land, Reader in Nursing at Birmingham City University have developed a questionnaire that will give patients attending an HIV clinic the opportunity to feedback their experiences of care.

A systematic review of the medical literature provided background information on what factors were important to patients attending a HIV clinic. Current users of the service were then involved in verifying this information and added their views about the issues that were important to them. For example being afforded respect, dignity and autonomy, together with an expectation of expert medical care were considered essential to a good service.

A draft questionnaire was constructed to include questions around these issues as well as others that were relevant and important to patients with HIV. This draft was tested with a group of patients and refined further. The final questionnaire was piloted on 100 clinic patients and showed that the feedback from the questionnaire could provide an accurate reflection of patients’ experiences. In the future, an annual survey using this questionnaire will be conducted and the data will be used to measure the quality of care and inform improvements in HIV clinic services.

The research had been submitted for publication

Dramatic drop in health spending according to OECD

Growth in health spending slowed or fell in real terms in 2010 in almost all OECD countries, reversing a long-term trend of rapid increases, according to OECD Health Data 2012.

In real terms average health spending has declined by over 6% compared to the start of the millenium.

Overall health spending grew by nearly 5% per year in real terms in OECD countries over the period 2000-2009, but this was followed by zero growth in 2010. Preliminary figures for a limited number of countries suggest little or no growth in 2011. The halt in total health spending in 2010 was driven by a fall of 0.5% in public spending for health, following an increase of over 5% per year in 2008 and 2009.

While government health spending tended to be maintained at the start of the economic crisis, cuts in spending really began to take effect in 2010. This was particularly the case in the European countries hardest hit by the recession.

UK gonorrhoea rates increase by 25%

Although overall rates of sexually transmitted infections rose by 2%, there has been an increase of 25% in new infections by gonorrhoea reported to the UK Health Protection Agency (HPA) – the second increase in two years running. Gonorrhoea rates increased from 16,835 to 20,965.

Other significant increases in sexually transmitted infections were in infectious syphilis (10%; 2,650 to 2,915) and genital herpes (5%; 29,794 to 31,154).

In contrast there was only a 1% rise in genital warts, perhaps reflecting the effectiveness of the vaccination programme. Diagnoses of genital warts cases in women aged 15-19 actually fell by 14% (11,251 to 9,700).

The greatest increase in sexually transmitted infections was in men who have sex with men and in heterosexual men and women aged 15-24. The high rates of infection reported in girls aged 15-19 is particularly worrying.

According to Professor Cathy Ison, director of sexually transmitted bacterial reference laboratory, the appearance of resistant strains for which no single antibiotic is effective is particularly worrying. This opens the prospect of having to use combination therapy in the future.

Research on effective behavioural change therefore remains a top priority.

Invitation to apply for research funds

We have entered a new round of invitation to apply for research funds. We are particularly interested in providing initial funding in projects that may allow young researchers to obtain preliminary results as a prelude to acquire further funds from larger funding bodies.

We invite applications from researchers in the East and West Midland, the North East and North West Regions on projects relating to sexually transmitted diseases and HIV. All projects will be initially screened by the Scientific Committee of STIRF and those considered suitable will be sent for peer review by experts in the field. We encourage applications for

The following fields of research will be considerd in relation to STIs and HIV

  • Epidemiology of HIV and other sexually transmitted diseases
  • Health care delivery including views of clients
  • Issues relating to deprived or marginalised communities.
  • Pathophysiology of diseases and syndromes
  • Inter-relationship between diseases
  • Treatment modalities
  • Complications of treatment and co-morbidities

Applications should not exceed £50,000 in the first year. Depending on satisfactory reports a further £25,000 may be available for the second year. Joint funding with other grant giving bodies will be considered.

Further information and guidance on how to apply can be found on

How to Apply for Research funds

 

Current vaccines cover only a minority of human papillomavirus (HPV) subtypes associated with cancer and genital warts

Effective vaccination exists for two sexually transmittable viruses, human papilloma virus (HPV) and hepatitis B virus (HBV). Other viruses have proved more problematic. A recent study in the New England Journal of Medicine showed, yet again, that a vaccine for herpes virus remains elusive. The same is true for hepatitis C and even more for HIV.

Thus identifying at risk groups for HPV and HBV is essential for targeting vaccination strategies. Particularly as persistent infection with high-risk sexually transmitted HPVs (HR-HPV) can lead to development of cervical and other cancers, while low-risk types (low-risk HPV) may cause genital warts. In a recent publication by Ann Johnson and colleagues at University College London they explored the epidemiology of different HPV types in men and women in the UK and their association with demographic and behavioural variables.

Data collected for the British National Survey of Sexual Attitudes and Lifestyles, a cross-sectional survey undertaken in 1999–2001 were analysed. Half of all sexually experienced male and female respondents aged 18–44 years were invited to provide a urine sample. They tested 3123 stored urine samples for HPV DNA.

HPV infection, was prevalent in this population, detected in 29% of samples from women and 17% from men. Significantly 13 high risk HPV subtypes were detected in 16% of women and 10% of men. HPV subtypes, HPV types 16/18, which for part of the two available vaccines in the market, were found in only 5% of women and 3% of men. Types 6/11 which are responsible for most cases of genital warts were isolated in in 5% of women and 2%  of men. In multivariate analysis, HR-HPV was associated with new partner numbers, in women with younger age, single status and partner concurrency, and in men with number of partners without using condom(s) and age at first intercourse.

They concluded that HPV DNA was detectable in urine of a high proportion of the sexually active British population. In both genders, HR-HPV was strongly associated with risky sexual behaviour. The minority of HPV infections were of vaccine types that are currently used in the two available vaccines. These cover HPV 16/18 and 6/11 only.

The authors pointed out t is important to monitor HPV prevalence and type distribution following the introduction of vaccination as vaccination itself may alter the prvalence of the difefrent sun

Sexual behaviour as well as HPV types 6 and 11 are associated with genital warts

A recent study by GM Anic et al from  the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., have found that human papillomavirus types 6 and 11, as well as recent sexual behavior, are strongly associated with the incidence of genital condyloma (wart) infection.

The strongest associations were found for infections with HPV types 6 and 11. The risk for condyloma also increased with an increasing number of female sexual partners but decreased with age. Sexual behaviors in the previous 3 months were also associated with a high risk for condyloma: a high number of male anal sex partners, more frequent vaginal intercourse and infrequent condom use. Also influencing the incidence of condyloma was ever having a sexually transmitted infection and ever having a partner with condyloma.

Since subclinical infection with HPV is more common than condylomas, this latter finding suggests that patients with visible genital warts are more likely to transmit condylomata to their sexual partner. This finding confirms an old study by the veteran British venerologist JD Oriel in 1971.

Factors strongly associated with condyloma were incident infection with human papillomavirus (HPV) types 6 and 11 (hazard ratio [HR], 12.42 [95% confidence interval {CI}, 3.78–40.77]), age (HR, 0.43 [95% CI, .26–.77]; 45–70 vs 18–30 years), high lifetime number of female partners (HR, 5.69 [95% CI, 1.80–17.97]; ≥21 vs 0 partners), and number of male partners (HR, 4.53 [95% CI, 1.68–12.20]; ≥3 vs 0 partners). The results suggest that HPV types 6 and 11 and recent sexual behavior are strongly associated with incident condyloma.

“The strong association between recent sexual history and incident condyloma after accounting for HPV infection suggests that prevention efforts targeting behavioral modification may be effective at reducing condyloma incidence among men who have not received the HPV vaccine,” the researchers wrote.