HIV Prevention Research and Reports

Following are links to the Kaiser Daily HIV/AIDS Report or other sources, and summaries from the CDC HIV/STD/TB Prevention News Update.

March-April 2008 Titles and Briefly

Treating Genital Herpes Does Not Reduce Risk of HIV, Study Says http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=50960

"Injecting Alone Among Young Adult IDUs in Five US Cities: Evidence of Low Rates of Injection Risk Behavior"
Drug and Alcohol Dependence Vol. 91; Supplement 1: P. S48-S55, (11..2007) Illicit drug injection usually takes place in private or semi-public settings where at least two injectors are present. In a large sample of injecting drug users (IDUs) ages 15-30 in five US cities, the study authors describe those who reported consistently injecting by themselves in a recent period. CDC Summary

See February Archives

Summaries

AFRICA:
"Do Unsafe Tetanus Toxoid Injections Play a Significant Role in the Transmission of HIV/AIDS? Evidence from Seven African Countries"
Sexually Transmitted Infection Vol. 84; No. 2: P. 122-125, (04.08.2008) D. de Walque
Sexual transmission is generally considered to be the main factor driving the HIV/AIDS epidemic in Africa. However, some recent studies have asserted that iatrogenic transmission should be considered as an important infection route. Specifically, receipt of tetanus toxoid injections during pregnancy has been reported to be associated with HIV infection in Kenya. In the current study, the researchers set out to “assess the robustness of this association among women in nationally representative HIV surveys in seven African countries.”

Using individual-level data from women who gave birth in the preceding five years, the researchers analyzed the association between prophylactic tetanus toxoid injections during pregnancy and HIV infection. The data were taken from the nationally representative Demographic and Health Surveys, which included HIV testing in Burkina Faso 2003 (N=2,424), Cameroon 2004 (N=2,600), Ethiopia 2005 (N=2,886), Ghana 2003 (N=2,560), Kenya 2003 (N=1,617), Lesotho 2004 (N=1,278) and Senegal 2005 (N=2,126).

After the researchers adjusted odds ratios (OR) for five-year age groups and for ethnic, urban and regional indicators, the association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was never statistically significant in any of the seven countries. An association was found in Cameroon between previous tetanus toxoid injection and HIV infection, but this became weaker after adjusting for urban location and ethnic group (OR 1.53, 95 percent CI, 0.91 to 2.57).

“Although the risk of HIV infection through unsafe injections and health care should not be ignored and should be reduced, it does not seem that there is, at present and in the seven countries studied, strong evidence supporting the claim that unsafe tetanus toxoid injections are a major factor driving the HIV epidemic,” the authors concluded.

UNITED STATES:
"Older Sexual Partners During Adolescence: Links to Reproductive Health Outcomes in Young Adulthood"
Persp Sexual & Reprod Health Vol. 40; No. 1: P. 17-26, (03..2008) Suzanne Ryan; Kerry Franzetta; Jennifer S. Manlove; Erin Schelar
"Sex at a young age with an older partner has been linked to poor reproductive health outcomes during adolescence,” the authors wrote. However, little research has been done on the influence of such relationships on reproductive health outcomes during the transition to young adulthood.

In the current study, the researchers used logistic regression and contrast analyses of three waves of data from the National Longitudinal Study of Adolescent Health to examine whether individuals who had sex before age 16 with a partner at least three years older were at increased risk of becoming teenage or unmarried parents or of infection with an STD by early adulthood.

The data showed that 10 percent of females and 2 percent of males reported early sex with an older partner. Analysis of the data found these females were more likely to acquire an STD as young adults than were those girls whose riskiest relationship was before age 16 with a partner of similar age (odds ratio, 2.1) or at age 16 or later with a similar-aged or older partner (2.4 and 2.6, respectively). The data showed that for males, sex before age 16, regardless of the age of the partner, was associated with an elevated STD risk (odds ratio, 1.9); however, controlling for relationship history characteristics attenuated this association.

The potential risks of sex with older partners should be made clear to adolescents, particularly to young adolescents, the authors concluded. “In particular, program providers should be alerted that females who engage in early sexual activity with older partners are at especially high risk of experiencing adverse reproductive health consequences,” they wrote.

"Injecting Alone Among Young Adult IDUs in Five US Cities: Evidence of Low Rates of Injection Risk Behavior"
Drug and Alcohol Dependence Vol. 91; Supplement 1: P. S48-S55, (11..2007) Holly Hagan; Jennifer V. Campbell; Hanne Thiede; Steffanie A. Strathdee; Lawrence Ouellet; Mary Latka; Sharon Hudson; Richard S. Garfein; for the DUIT Study Team
Illicit drug injection usually takes place in private or semi-public settings where at least two injectors are present. In a large sample of injecting drug users (IDUs) ages 15-30 in five US cities, the study authors describe those who reported consistently injecting by themselves in a recent period.

Of the 3,199 eligible subjects, 85 percent were male; median age was 24; and median number of years injecting was four. To understand the relationship between injecting alone and injection risk behavior, the 15 percent (n=467) who reported consistently injecting by themselves in the previous three months were compared to other IDUs. Subjects who reported injecting alone were substantially less likely to report injection with a syringe (AOR=0.16, 95 percent CI 0.1-0.2) or other drug preparation equipment (AOR=0.17, 95 percent CI 0.13-0.2) previously used by another injector.

As markedly low rates of injection risk behavior were observed in IDUs who reported injecting alone, this practice may facilitate safe injection by allowing the individual greater control over the injection setting, the authors said. However, the risks of this practice include accidental overdose with severe consequences.

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