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Prepared by Anne Buv é Belgium Sabina Bindra-Barnes India Saidi Kapiga Tanzania Jorge Sanchèz Peru David Wilson Australia

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The CAPRISA 004 Trial of vaginal microbicide: 1% Tenofovir gel in HIV negative ladies in South Africa Proof of idea trial, twofold visually impaired, fake treatment controlled Coital ward inclusion of gel

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The CAPRISA 004 trial

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The CAPRISA 004 trial No wellbeing issues, no resistance recognized Excited, yet not prepared for take off One trial in one populace Adherence: would we be able to improve?

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Young individuals Trends in HIV and practices in youngsters 15-24 yrs (TuAC0204) 21 nations with summed up scourges (Africa and the Caribbean) 2000 – 2008: noteworthy diminishment of 25% in HIV pervasiveness in 10 nations connection with conduct change in 8

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Incentivising conduct change? Malawi: Zomba money exchange program (SUSA22) Cash exchanges to schoolgirls and young ladies who had as of late dropped out of school to remain in (or come back to) class After 1 year, among school young ladies Significantly bring down commonness of HIV and HSV-2 in the mediation bunch than the control gather (however no gauge information) Effect because of tutoring or higher wage?

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Intravenous medication clients RDS study in 8 urban areas in Russia (2008-2010) HIV: 2.6 % - 64.3% (>50% in 3 urban areas) HCV pervasiveness: 49% - 90% Non-IDU sexual accomplices: 32% - 70% MOAC0202 Zanzibar (2007): first RDS study among IDU in Africa HIV: 16% ,related with high hazard sexual conduct MOAC0401

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Needle and syringe programs NSPs in Australia ( MOAC0403) In the previous 10 years, for each 1$ put resources into NSPs 0.2 days of handicap balanced life spared > 4$ returned in social insurance cost investment funds

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Needle and syringe programs NSPs in Estonia ( MOAC0402) 2003 – 2009: quantities of needles circulated from 18,000 to >770,000 2005-2009: HIV frequency among new injectors (begin infusing < 5 yrs prior) 18/100 pyrs to 7.5/100 pyrs Strong proof on cost-adequacy yet arrangements and laws piece execution (Lancet arrangement).

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MSM Survey in Kampala (Uganda) – RDS HIV: 14% Recruitment troublesome in view of police activities Opening session:" Human rights infringement are a boundary to knowing your scourge" (TUAC0305)

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MSM South Africa and Senegal: troublesome access to anticipation and care administrations (WEPDC101 & WEPDC102) Lack of comprehension of hazard practices by specialist organizations - dangerous practices with female accomplices.

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Commercial sex laborers Avahan : program focusing on sex specialists in 6 states in India – overall biggest SW program Karnataka: benchmark overview and follow-up review Longer span of program introduction related with expanded condom utilize Significant decrease in HIV: 19.6% to 16.4%

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Male circumcision: where are we? Kenya: quick scale up was achievable and safe – assignment moving Kisumu (Kenya): populace based review Increase in predominance of MC No proof of sexual hazard remuneration. (THAC0103 & THAC0101)

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Mother-to-kid transmission Coverage of PMTCT in Eastern and Southern Africa: 58% (THSY09) The Antiretroviral Pregnancy Registry: Overall pervasiveness of birth deformities for any ART presentation amid pregnancy: 2.7 for each 100 live births (session WEAX01)

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Treatment as counteractive action Biological believability Mathematical models Empirical proof Individual level: conflicting couples Risk of transmission low however not 0 Population level: natural examinations, e.g. English Columbia, Denmark (MOAC0103)

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Treatment as aversion Issues ( WESY0705) Transmission amid intense disease: what amount? Transmission of safe strains Sustainability of viral concealment: to what extent?

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Combination counteractive action "The vital, concurrent utilization of various classes of anticipation exercises (biomedical, behavioral, social/auxiliary) that work on different levels (singular, relationship, group, societal), to react to the particular needs of specific gatherings of people and methods of HIV transmission, and to make productive utilization of assets through organizing, association and engagement of influenced groups".

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Combination aversion Challenging to assess RCTs troublesome, may not be suited Use of assortment of techniques and information sources Make pathway to affect express