Search

The article presents a study which examines the effect of aciclovir on the progression of HIV-1 disease in people dually infected with HIV-1 and herpes simplex virus type 2 via a randomised placebo-controlled trial. It states that 3,381 heterosexual people who were infected by the said diseases were randomly assigned in a 1:1 ratio to aciclovir 400 mg orally or placebo twice daily in the trial with 14 sites in southern and east Africa. They were followed up for up to 12 months and the effect of aciclovir was defined by a primary endpoint of first occurrence of CD4 cell counts fewer than 200 cells per μL. It suggests that the use of aciclovir reduced the risk of HIV-1 disease progression by 16%, wherein 284 participants for aciclovir and 324 for placebo reached the primary endpoint.

Background Gender-based violence and gender inequality are increasingly cited as important determinants of women's HIV risk; yet empirical research on possible connections remains limited. No study on women has yet assessed gender-based violence as a risk factor for HIV after adjustment for women's own high-risk behaviours, although these are known to be associated with experience of violence. Methods We did a cross-sectional study of 1366 women presenting for antenatal care at four health centres in Soweto, South Africa, who accepted routine antenatal HIV testing. Private face-to-face interviews were done in local languages and included assessement of sociodemographic characteristics, experience of gender-based violence, the South African adaptation of the Sexual Relationship Power Scale (SRPS), and risk behaviours including multiple, concurrent, and casual male partners, and transactional sex. Findings After adjustment for age and current relationship status and women's risk behaviour, intimate partner violence odds ratio 1.48, 95% CI 1.15--1.89) and high levels of male control in a woman's current relationship as measured by the SRPS (1.52, 1.13--2.04) were associated with HIV seropositivity. Child sexual assault, forced first intercourse, and adult sexual assault by non-partners were not associated with HIV serostatus. Interpretation Women with violent or controlling male partners are at increased risk of HIV infection. We postulate that abusive men are more likely to have HIV and impose risky sexual practices on partners. Research on connections between social constructions of masculinity, intimate partner violence, male dominance in relationships, and HIV risk behaviours in men, as well as effective interventions, are urgently needed. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor in response to the article "Cotrimoxazole as prophylaxis against opportunistic infections in HIV-infected Zambian children (CHAP): a double-blind randomised placebo-controlled trial," by C. Chintu, G.J. Bhat, A.S. Walker, et al., in the November 20, 2004 issue.