Publications
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Ward H, 2015, WHAT DOES ACCEPt MEAN FOR CHLAMYDIA CONTROL POLICY?, Publisher: BMJ PUBLISHING GROUP, Pages: A17-A17, ISSN: 1368-4973
Rai T, Bruton J, Higgs C, et al., 2015, PATIENT PERSPECTIVES ON THE HIV TREATMENT CASCADE IN THE UNITED KINGDOM, Publisher: BMJ PUBLISHING GROUP, Pages: A230-A231, ISSN: 1368-4973
Wilson JD, Wallace HE, Fisher J, et al., 2015, CLINICIAN-TAKEN EXTRA-GENITAL SAMPLES FOR GONORRHOEA AND CHLAMYDIA IN WOMEN COMPARED WITH SELF-TAKEN SAMPLES ANALYSED SEPARATELY AND SELF-TAKEN POOLED SAMPLES, Publisher: BMJ PUBLISHING GROUP, Pages: A31-A32, ISSN: 1368-4973
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- Citations: 1
McGrath-Lone L, Ward H, Schoenborn C, et al., 2015, The effects of cancer research participation on patient experience: a mixed-methods analysis., European Journal of Cancer Care, Vol: 25, Pages: 1056-1064, ISSN: 1365-2354
Patient-reported benefits of research participation have been described by study participants; however, many studies have small sample sizes or are limited to patient groups with poor prognoses. The purpose of this study was to explore the effects of research participation on patient experience using survey responses from a large, national sample of cancer patients (N = 66 462) and interviews with breast cancer patients attending a London trust. Multivariate logistic regression was used to investigate associations between taking part in research and positive patient experience. Based on our analysis, patients who participated in research were more likely to rate their overall care and treatment as 'very good/excellent' (ORadj :1.64, 95%CI: 1.53-1.76, P < 0.001) and to describe positive patient experiences, such as better access to non-standard care, better interactions with staff and being treated as an individual. However, findings from our interviews indicated that there was no common understanding of what constitutes cancer research and no clear delineation between research participation and standard care, from the patient perspective. Further work to explore how participation positively influences patient experience would be useful to develop strategies to improve care and treatment for all patients regardless of whether or not they choose, or have the opportunity, to take part in research.
Aghaizu A, Murphy G, Tosswill J, et al., 2015, HIV INCIDENCE AMONG PEOPLE WHO ATTEND SEXUAL HEALTH CLINICS IN ENGLAND IN 2012: ESTIMATES USING A BIOMARKER FOR RECENT INFECTION, SEXUALLY TRANSMITTED INFECTIONS, Vol: 91, Pages: A2-A2, ISSN: 1368-4973
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- Citations: 1
Ward H, Davies B, Ronn M, 2015, Chlamydia control in Europe: Qualitative evaluation of the impact of the2009 ECDC guidance document Chlamydia control in Europe, Stockholm, Sweden, Publisher: European Centre for Disease Prevention and Control, TQ-02-15-038-EN-N
In 2011, the European Centre for Disease Prevention and Control (ECDC) commissioned a programme of work to improve knowledge about the impact of chlamydia and chlamydia control in Europe. The aim of this project was to critically review and update the scientific evidence on the epidemiology and natural history of chlamydia and the clinical and cost-effectiveness of screening, update information about chlamydia prevention and control activities in EU/EEA Member States, and review the impact of the 2009 ECDC chlamydia control guidance. This technical report describes the evaluation of the impact of the 2009 guidance document on policymaking in Member States and presents recommendations for a revised version of the guidance. It includes an overview of the responses collected during the 2012 survey on chlamydia control activities in EU/EEA Member States. Different user types – with regard to the guideline document – were identified and described in this report. In addition, a qualitative analysis of the discussions at the March 2014 meeting was conducted. The meeting had brought together experts from Member States who discussed their experiences with the guidance document.This report concludes with evidence-based recommendations for the revision of the 2009 guidance document.
Redmond SM, Alexander-Kisslig K, Woodhall SC, et al., 2015, Genital Chlamydia Prevalence in Europe and Non-European High Income Countries: Systematic Review and Meta-Analysis, PLOS One, Vol: 10, ISSN: 1932-6203
Armano M, Audley H, Auger G, et al., 2015, Disentangling the magnetic force noise contribution in LISA Pathfinder, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
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- Citations: 4
Armano M, Audley H, Auger G, et al., 2015, Bayesian statistics for the calibration of the LISA Pathfinder experiment, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
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- Citations: 2
Armano M, Audley H, Auger G, et al., 2015, The LISA Pathfinder Mission, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
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- Citations: 30
Gibert F, Nofrarias M, Armano M, et al., 2015, In-flight thermal experiments for LISA Pathfinder: Simulating temperature noise at the Inertial Sensors, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
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- Citations: 2
Armano M, Audley H, Auger G, et al., 2015, Free-flight experiments in LISA Pathfinder, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
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- Citations: 4
Armano M, Audley H, Auger G, et al., 2015, A Strategy to Characterize the LISA-Pathfinder Cold Gas Thruster System, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
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- Citations: 3
Armano M, Audley H, Auger G, et al., 2015, A noise simulator for eLISA: Migrating LISA Pathfinder knowledge to the eLISA mission, 10th International LISA Symposium, Publisher: IOP PUBLISHING LTD, ISSN: 1742-6588
Davies B, 2014, The association between Chlamydia trachomatis and pelvic inflammatory disease: findings from observational studies
Aral SO, Ward H, 2014, Behavioral Convergence: Implications for Mathematical Models of Sexually Transmitted Infection Transmission, JOURNAL OF INFECTIOUS DISEASES, Vol: 210, Pages: S600-S604, ISSN: 0022-1899
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- Citations: 5
Rai T, Lambert HS, Borquez AB, et al., 2014, Circular Labor Migration and HIV in India: Exploring Heterogeneity in Bridge Populations Connecting Areas of High and Low HIV Infection Prevalence, Journal of Infectious Diseases, Vol: 210, Pages: S556-S561, ISSN: 1537-6613
BACKGROUND:The emerging human immunodeficiency virus (HIV) epidemics in rural areas of India are hypothesized to be linked to circular migrants who are introducing HIV from destination areas were the prevalence of HIV infection is higher. We explore the heterogeneity in potential roles of circular migrants in driving an HIV epidemic in a rural area in north India and examine the characteristics of the "sustaining bridge population", which comprises individuals at risk of HIV acquisition at destination and of HIV transmission into networks at origin capable of sustaining an epidemic.METHODS:Results of a behavioral survey of 639 male migrants from Azamgarh district, India, were analyzed using χ(2) tests and logistic regression.RESULTS:We estimated the size of various subgroups defined by specific sexual behaviors across different locations and over time. Only 20% fit our definition of a sustaining bridge population, with the majority making no apparent contribution to geographical connectedness between high- and low-prevalence areas. However, we found evidence of sexual contacts at origin that could potentially sustain an epidemic once HIV is introduced. Variables associated with sustaining bridge population membership were self-perceived HIV risk, current migrant status, and age.CONCLUSIONS:Circular migrants represent a heterogeneous population in terms of their role as a bridge group. Self-perception of heightened risk could be exploited in designing prevention programs.
Gomez GB, Ward H, Garnett GP, 2014, Risk Pathways for Gonorrhea Acquisition in Sex Workers: Can We Distinguish Confounding From an Exposure Effect Using A Priori Hypotheses?, Journal of Infectious Diseases, Vol: 210, Pages: S579-S585, ISSN: 1537-6613
The population distribution of sexually transmitted infections (STIs) varies broadly across settings. Althoughthere have been many studies aiming to define subgroups at risk of infection that should be a target for preventioninterventions by identifying risk factors, questions remain about how these risk factors interact, how theireffects jointly influence the risk of acquisition, and their differential importance across populations. Theoreticalframeworks describing the interrelationships among risk determinants are useful in directing both the designand analysis of research studies and interventions. In this article, we developed such a framework from a reviewlooking at determinants of risk for STI acquisition, using gonorrhea as an index infection. We also propose ananalysis strategy to interpret the associations found to be significant in uniform analyses of observational data.The framework and the hierarchical analysis strategy are of particular relevance in the understanding of riskformation and might prove useful in identifying determinants that are part of the causal pathway and thereforeamenable to prevention strategies across populations.
Rönn M, White PJ, Hughes G, et al., 2014, Developing a Conceptual Framework of Seroadaptive Behaviors in HIV-Diagnosed Men Who Have Sex With Men, Journal of Infectious Diseases, Vol: 210, Pages: S586-S593, ISSN: 1537-6613
Background. Seroadaptive behaviors are strategies employed by men who have sex with men (MSM) to reduce the transmission risk for human immunodeficiency virus (HIV). It has been suggested that they contribute to the increasing diagnoses of sexually transmitted infections in HIV-diagnosed MSM. To understand the context in which the reemerging sexually transmitted infections appear, we developed a social epidemiological model incorporating the multiple factors influencing seroadaptive behaviors. Methods. A literature review of seroadaptive behaviors in HIV-diagnosed MSM was conducted. The literature was synthesized using a social epidemiological perspective. Results. Seroadaptive behaviors are adopted by MSM in high-income countries and are a way for HIV-diagnosed men to manage and enjoy their sexual lives. Influences are apparent at structural, community, interpersonal, and intrapersonal levels. There is little evidence of whether and when the behavior forms part of a premeditated strategy; it seems dependent on the social context and on time since HIV diagnosis. Social rules of HIV disclosure and perception of risk depend on the setting where partners are encountered. Conclusions. Seroadaptive behaviors are strongly context dependent and can reduce or increase transmission risk for different infectious diseases. Further data collection and mathematical modeling can help us explore the specific conditions in more detail.
Davies B, Ward H, Leung S, et al., 2014, Heterogeneity in Risk of Pelvic Inflammatory Diseases After Chlamydia Infection: A Population-Based Study in Manitoba, Canada, Journal of Infectious Diseases, Vol: 210, Pages: S549-S555, ISSN: 1537-6613
Background. The association between chlamydia infection and pelvic inflammatory disease (PID) is a key parameterfor models evaluating the impact of chlamydia control programs. We quantified this association using aretrospective population-based cohort.Methods. We used administrative health data sets to construct a retrospective population-based cohort ofwomen and girls aged 12–24 years who were resident in Manitoba, Canada, between 1992 and 1996. We performedsurvival analysis on a subcohort of individuals who were tested for chlamydia to estimate the risk of PID diagnosed ina primary care, outpatient, or inpatient setting after ≥1 positive chlamydia test.Results. A total of 73 883 individuals contributed 625 621 person years of follow-up. Those with a diagnosis ofchlamydia had an increased risk of PID over their reproductive lifetime compared with those who tested negative(adjusted hazard ratio [AHR], 1.55; 95% confidence interval [CI], 1.43–1.70). This risk increased with each subsequentinfection: the AHR was 1.17 for first reinfection (95% CI, 1.06–1.30) and 1.35 for the second (95% CI,1.04–1.75). The increased risk of PID from reinfection was highest in younger individuals (AHR, 4.55 (95% CI,3.59–5.78) in individuals aged 12–15 years at the time of their second reinfection, compared with individualsolder than 30 years).Conclusions. There is heterogeneity in the risk of PID after a chlamydia infection. Describing the progression toPID in mathematical models as an average rate may be an oversimplification; more accurate estimates of the costeffectivenessof screening may be obtained by using an individual-based measure of risk. Health inequalities may bereduced by targeting health promotion interventions at sexually active girls younger than 16 years and those with ahistory of chlamydia.
White PJ, Fox J, Weber J, et al., 2014, How Many HIV Infections May Be Averted by Targeting Primary Infection in Men Who Have Sex With Men? Quantification of Changes in Transmission-Risk Behavior, Using an Individual-Based Model, Journal of Infectious Diseases, Vol: 210, Pages: S594-S599, ISSN: 1537-6613
In the United Kingdom, human immunodeficiency virus (HIV) transmission among men who have sex with men(MSM) is not under control, despite readily available treatment, highlighting the need to design a cost-effectivecombination prevention package. MSM report significantly reduced transmission risk behavior following HIVdiagnosis. To assess the effectiveness of HIV diagnosis in averting transmission during highly infectious primaryHIV infection (PHI), we developed a stochastic individual-based model to calculate the number of HIVtransmissionevents expected to occur from a cohort of recently infected MSM with and those without the behaviorchanges reported after diagnosis. The model incorporates different types of sex acts, incorporates condom use,and distinguishes between regular and casual sex partners. The impact on transmission in the 3 months afterinfection depends on PHI duration and testing frequency. If PHI lasts for 3 months and testing is performedmonthly, then behavior changes after diagnosis would have reduced estimated transmission events by 49%–52%,from 31–45 to 15–23 events; a shorter duration of PHI and/or a lower testing frequency reduces the number ofinfections averted. Diagnosing HIV during PHI can markedly reduce transmission by changing transmissionriskbehavior. Because of the high infectivity but short duration of PHI, even short-term behavior change cansignificantly reduce transmission. Our quantification of the number of infections averted is an essential componentof assessment of the cost-effectiveness of strategies to increase detection and diagnoses of PHI.
Ward H, Gregson S, Watts C, et al., 2014, Translational Epidemiology: Developing and Applying Theoretical Frameworks to Improve the Control of HIV and Other Sexually Transmitted Infections, JOURNAL OF INFECTIOUS DISEASES, Vol: 210, Pages: S547-S548, ISSN: 0022-1899
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- Citations: 2
Elmes J, Nhongo K, Ward H, et al., 2014, The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe, JOURNAL OF INFECTIOUS DISEASES, Vol: 210, Pages: S569-S578, ISSN: 0022-1899
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- Citations: 36
Sesana A, Weber WJ, Killow CJ, et al., 2014, Space-based detectors, GENERAL RELATIVITY AND GRAVITATION, Vol: 46, ISSN: 0001-7701
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- Citations: 4
Trenchard L, McGrath-Lone L, Ward H, 2014, Ethnic variation in patients' ratings of communication: analysis of National Cancer Patient Experience Survey data, European Public Health Science Conference, Publisher: ELSEVIER SCIENCE INC, Pages: 79-79, ISSN: 0140-6736
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- Citations: 1
Chandrasekaran L, Davies B, Eaton JW, et al., 2014, Evaluation of diagnosed incidence rate as a measure of performance: an ecological study of England's national chlamydia screening programme, European Public Health Science Conference
Kim S-H, Gerver SM, Fidler S, et al., 2014, Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis, AIDS, Vol: 28, Pages: 1945-1956, ISSN: 0269-9370
Objective: Adolescent and young adult (AYA) populations (12–24 years) representover 40% of new HIV infections globally. Adolescence is sometimes characterized byhigh-risk sexual behaviour and a lack of engagement with healthcare services that canaffect adherence to antiretroviral therapy (ART). Despite adherence to ART beingcritical in controlling viral replication, maintaining health and reducing onward viraltransmission, there are limited data on ART adherence amongst AYA globally. Weundertook a systematic review and meta-analysis of published studies reportingadherence to ART for AYA living with HIV.Design and methods: Searches included Embase, Medline and PsychINFO databasesup to 14 August 2013. Eligible studies defined adequate adherence as at least 85% onself-report or undetectable blood plasma virus levels. A random effects meta-analysiswas performed and heterogeneity examined using meta-regression.Results: We identified 50 eligible articles reporting data from 53 countries and 10 725patients. Using a pooled analysis of all eligible studies, 62.3% [95% confidence interval(CI) 57.1–67.6; I2 : 97.2%] of the AYA population were adherent to therapy. The lowestaverage ART adherence was in North America [53% (95% CI 46–59; I2 : 91%)], Europe[62% (95% CI 51–73; I2 : 97%)] and South America [63% (95% CI 47–77; I2 : 85%]and, with higher levels in Africa [84% (95% CI 79–89; I2 : 93%)] and Asia [84% (95% CI77–91; I2 : 0%].Conclusion: Review of published literature from Africa and Asia indicate more than70% of HIV-positive AYA populations receiving ART are adherent to therapy and lowerrates of adherence were shown in Europe and North America at 50–60%. The globaldiscrepancy is probably multifactorial reflecting differences between focused andgeneralised epidemics, access to healthcare and funding.
Elmahdi R, Ward H, Cooke G, et al., 2014, HIV TESTING Implementation of HIV testing is patchy in the UK, BMJ-BRITISH MEDICAL JOURNAL, Vol: 349, ISSN: 1756-1833
Crawford MJ, Sanatinia R, Barrett B, et al., 2014, The clinical and cost-effectiveness of brief advice for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial, Sexually Transmitted Infections, Vol: 91, Pages: 37-43, ISSN: 1472-3263
Objectives To examine the clinical and costeffectivenessof brief advice for excessive alcoholconsumption among people who attend sexual healthclinics.Methods Two-arm, parallel group, assessor blind,pragmatic, randomised controlled trial. 802 people aged19 years or over who attended one of three sexualhealth clinics and were drinking excessively wererandomised to either brief advice or control treatment.Brief advice consisted of feedback on alcohol and health,written information and an offer of an appointment withan Alcohol Health Worker. Control participants receiveda leaflet on health and lifestyle. The primary outcomewas mean weekly alcohol consumption during theprevious 90 days measured 6 months afterrandomisation. The main secondary outcome wasunprotected sex during this period.Results Among the 402 randomised to brief advice,397 (99%) received it. The adjusted mean difference inalcohol consumption at 6 months was −2.33 units perweek (95% CI −4.69 to 0.03, p=0.053) among thosein the active compared to the control arm of the trial.Unprotected sex was reported by 154 (53%) of thosewho received brief advice, and 178 (59%) controls(adjusted OR=0.89, 95% CI 0.63 to 1.25, p=0.496).There were no significant differences in costs betweenstudy groups at 6 months.Conclusions Introduction of universal screening andbrief advice for excessive alcohol use among peopleattending sexual health clinics does not result inclinically important reductions in alcohol consumption orprovide a cost-effective use of resources.
Mc Grath-Lone L, Marsh K, Hughes G, et al., 2014, The sexual health of female sex workers compared with other women in England: analysis of cross-sectional data from genitourinary medicine clinics, SEXUALLY TRANSMITTED INFECTIONS, Vol: 90, Pages: 344-350, ISSN: 1368-4973
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- Citations: 39
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