81 results found
Martin NK, Devine A, Eaton JW, et al., 2014, Modeling the impact of early antiretroviral therapy for adults coinfected with HIV and hepatitis B or C in South Africa, AIDS, Vol: 28, Pages: S35-S46, ISSN: 0269-9370
Eaton JW, Menzies NA, Stover J, et al., 2014, Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models, LANCET GLOBAL HEALTH, Vol: 2, Pages: E23-E34, ISSN: 2214-109X
van de Vijver DAMC, Nichols BE, Abbas UL, et al., 2013, Preexposure prophylaxis will have a limited impact on HIV-1 drug resistance in sub-Saharan Africa: a comparison of mathematical models, AIDS, Vol: 27, Pages: 2943-2951, ISSN: 0269-9370
McGrath N, Eaton JW, Bärnighausen TW, et al., 2013, Sexual behaviour in a rural high HIV prevalence South African community: time trends in the antiretroviral treatment era, AIDS, Vol: 27, Pages: 2461-2470, ISSN: 1473-5571
OBJECTIVES: Data from generalized epidemic settings have consistently found that patients on antiretroviral therapy (ART) reduce sexual risk behaviours, but how sexual behaviour changes in the general population in response to ART availability, including amongst HIV-uninfected and undiagnosed adults, has not been characterized in these settings. DESIGN: General population open cohort. METHODS: We report trends in sexual behaviour indicators for men aged 17-54 years and women aged 17-49 years in rural KwaZulu-Natal province, based on annual sexual behaviour surveys during ART scale-up from 2005 to 2011. Estimates are adjusted for survey nonparticipation and nonresponse to individual survey items using inverse probability weighting and multiple imputation. Trends are presented by HIV status, knowledge of status, age and marital status. RESULTS: Reports of condom use at last sex with a regular partner increased by 2.6% points per year [95% confidence interval (CI) 1.5%, 3.7%] for men and 4.1% per year (3.0%, 5.3%) for women. Condom use at last sex with a casual partner was high and did not change significantly over the period for both sexes. There were statistically significant declines in the percentage reporting multiple partnerships in the last year and the point prevalence of concurrency. Trends within subgroups were generally consistent with overall estimates. CONCLUSION: We find no evidence of increased sexual risk-taking following ART availability and protective changes in some behaviours, suggesting that general trends in sexual behaviour are not counter-acting preventive effects of HIV treatment. Continued monitoring of population-level sexual behaviour indicators will be essential to interpret the success of combination-prevention programmes.
Eaton JW, Garnett GP, Takavarasha FR, et al., 2013, Increasing Adolescent HIV Prevalence in Eastern Zimbabwe - Evidence of Long-Term Survivors of Mother-to-Child Transmission?, PLOS One, Vol: 8, ISSN: 1932-6203
Recent data from the Manicaland HIV/STD Prevention Project, a general-population open HIV cohort study, suggested thatbetween 2004 and 2007 HIV prevalence amongst males aged 15–17 years in eastern Zimbabwe increased from 1.20% to2.23%, and in females remained unchanged at 2.23% to 2.39%, while prevalence continued to decline in the rest of theadult population. We assess whether the more likely source of the increase in adolescent HIV prevalence is recent sexual HIVacquisition, or the aging of long-term survivors of perinatal HIV acquisition that occurred during the early growth of theepidemic. Using data collected between August 2006 and November 2008, we investigated associations betweenadolescent HIV and (1) maternal orphanhood and maternal HIV status, (2) reported sexual behaviour, and (3) reportingrecurring sickness or chronic illness, suggesting infected adolescents might be in a late stage of HIV infection. HIV-infectedadolescent males were more likely to be maternal orphans (RR = 2.97, p,0.001) and both HIV-infected adolescent males andfemales were more likely to be maternal orphans or have an HIV-infected mother (male RR = 1.83, p,0.001; female RR = 16.6,p,0.001). None of 22 HIV-infected adolescent males and only three of 23 HIV-infected females reported ever having hadsex. HIV-infected adolescents were 60% more likely to report illness than HIV-infected young adults. Taken together, allthree hypotheses suggest that recent increases in adolescent HIV prevalence in eastern Zimbabwe are more likelyattributable to long-term survival of mother-to-child transmission rather than increases in risky sexual behaviour. HIVprevalence in adolescents and young adults cannot be used as a surrogate for recent HIV incidence, and health systemsshould prepare for increasing numbers of long-term infected adolescents.
Hallett TB, Eaton JW, 2013, A Side Door Into Care Cascade for HIV-Infected Patients?, JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol: 63, Pages: S228-S232, ISSN: 1525-4135
Robertson L, Mushati P, Eaton JW, et al., 2013, Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial, LANCET, Vol: 381, Pages: 1283-1292, ISSN: 0140-6736
Robertson L, Mushati P, Eaton JW, et al., 2012, Household-based cash transfer targeting strategies in Zimbabwe: Are we reaching the most vulnerable children?, SOCIAL SCIENCE & MEDICINE, Vol: 75, Pages: 2503-2508, ISSN: 0277-9536
Eaton JW, Hallett TB, Epstein H, 2012, What Might be the Impact of Sexual Partnership "Concurrency'' Behavior Change Communication Campaigns?, SEXUALLY TRANSMITTED DISEASES, Vol: 39, Pages: 899-899, ISSN: 0148-5717
Case KK, Ghys PD, Gouws E, et al., 2012, Understanding the modes of transmission model of new HIV infection and its use in prevention planning, BULLETIN OF THE WORLD HEALTH ORGANIZATION, Vol: 90, Pages: 831-838, ISSN: 0042-9686
Delva W, Eaton JW, Meng F, et al., 2012, HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes, PLOS Medicine, Vol: 9, ISSN: 1549-1277
Until now, decisions about how to allocate ART have largely been based on maximising the therapeutic benefit of ART for patients. Since the results of the HPTN 052 study showed efficacy of antiretroviral therapy (ART) in preventing HIV transmission, there has been increased interest in the benefits of ART not only as treatment, but also in prevention. Resources for expanding ART in the short term may be limited, so the question is how to generate the most prevention benefit from realistic potential increases in the availability of ART. Although not a formal systematic review, here we review different ways in which access to ART could be expanded by prioritising access to particular groups based on clinical or behavioural factors. For each group we consider (i) the clinical and epidemiological benefits, (ii) the potential feasibility, acceptability, and equity, and (iii) the affordability and cost-effectiveness of prioritising ART access for that group. In re-evaluating the allocation of ART in light of the new data about ART preventing transmission, the goal should be to create policies that maximise epidemiological and clinical benefit while still being feasible, affordable, acceptable, and equitable.
HIV Modelling Consortium Treatment as Prevention Editorial Writing Group, 2012, HIV treatment as prevention: models, data, and questions--towards evidence-based decision-making., PLOS Medicine, Vol: 9, ISSN: 1549-1277
Antiretroviral therapy (ART) for those infected with HIV can prevent onward transmission of infection, but biological efficacy alone is not enough to guide policy decisions about the role of ART in reducing HIV incidence. Epidemiology, economics, demography, statistics, biology, and mathematical modelling will be central in framing key decisions in the optimal use of ART. PLoS Medicine, with the HIV Modelling Consortium, has commissioned a set of articles that examine different aspects of HIV treatment as prevention with a forward-looking research agenda. Interlocking themes across these articles are discussed in this introduction. We hope that this article, and others in the collection, will provide a foundation upon which greater collaborations between disciplines will be formed, and will afford deeper insights into the key factors involved, to help strengthen the support for evidence-based decision-making in HIV prevention.
Boily M-C, Masse B, Alsallaq R, et al., 2012, HIV Treatment as Prevention: Considerations in the Design, Conduct, and Analysis of Cluster Randomized Controlled Trials of Combination HIV Prevention, PLOS Medicine, Vol: 9, ISSN: 1549-1277
Eaton JW, Johnson LF, Salomon JA, et al., 2012, HIV Treatment as Prevention: Systematic Comparison of Mathematical Models of the Potential Impact of Antiretroviral Therapy on HIV Incidence in South Africa, PLOS MEDICINE, Vol: 9, ISSN: 1549-1277
Crea TM, Lombe M, Robertson LA, et al., 2012, Asset ownership among households caring for orphans and vulnerable children in rural Zimbabwe: The influence of ownership on children's health and social vulnerabilities, AIDS Care, Vol: 25, Pages: 126-132, ISSN: 0954-0121
The high prevalence of human immunodeficiency virus/acquired immune deficiency syndrome in sub-Saharan Africa has resulted in a dramatic increase in orphans and vulnerable children (OVC) over the past decade. These children typically rely on extended family networks for support, but the magnitude of the crisis has resulted in traditional familial networks becoming overwhelmed and more economically and socially vulnerable. Previous research consistently demonstrates the positive influence of household asset ownership on children's well-being. Using data from impoverished households caring for OVC in rural Manicaland Province, Zimbabwe, this study explores the influence of household asset ownership on OVC health vulnerability (HV) and social vulnerability (SV). Findings indicate that asset ownership is associated with significantly lower SV, in terms of school attendance and birth registration. Yet, assets do not emerge as a direct influence of OVC HV as measured by disease and chronic illness, although having a chronically ill adult in the household increases HV. These findings suggest that asset ownership, specifically a combination of fixed and movable assets, may offset the influence of other risk factors for children's SV.
Eaton JW, McGrath N, Newell M-L, 2012, Unpacking the recommended indicator for concurrent sexual partnerships, AIDS, Vol: 26, Pages: 1037-1039, ISSN: 0269-9370
Eaton JW, Hallett TB, Garnett GP, 2011, Concurrent Sexual Partnerships and Primary HIV Infection: A Critical Interaction, AIDS AND BEHAVIOR, Vol: 15, Pages: 687-692, ISSN: 1090-7165
UNAIDS Reference Group on Estimates Modelling and Projections Working Group on Measuring Concurrent Sexual Partnerships, 2010, HIV: consensus indicators are needed for concurrency., Lancet, Vol: 375, Pages: 621-622
Reniers G, Eaton J, 2009, Refusal bias in HIV prevalence estimates from nationally representative seroprevalence surveys, AIDS, Vol: 23, Pages: 621-629, ISSN: 0269-9370
Watson OJ, FitzJohn R, Eaton JW, rdhs: an R package to interact with The Demographic and Health Surveys (DHS) Program datasets, Publisher: F1000 ( Faculty of 1000 Ltd)
<ns4:p>Since 1985, the Demographic and Health Surveys (DHS) Program has conducted more than 400 surveys in over 90 countries. These surveys provide decision markers with key measures of population demographics, health and nutrition, which allow informed policy evaluation to be made. Though standard health indicators are routinely published in survey final reports, much of the value of DHS is derived from the ability to download and analyse standardised microdata datasets for subgroup analysis, pooled multi-country analysis, and extended research studies. We have developed an open-source freely available R package ‘rdhs’ to facilitate management and processing of DHS survey data. The package provides a suite of tools to (1) access standard survey indicators through the DHS Program API, (2) identify all survey datasets that include a particular topic or indicator relevant to a particular analysis, (3) directly download survey datasets from the DHS website, (4) load datasets and data dictionaries into R, and (5) extract variables and pool harmonised datasets for multi-survey analysis. We detail the core functionality of ‘rdhs’ by demonstrating how the package can be used to firstly compare trends in the prevalence of anaemia among women between countries before conducting secondary analysis to assess for the relationship between education and anemia.</ns4:p>
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