Simon Gregson

..We investigated the latter hypothesis using data from a field study in rural Manicaland, Zimbabwe...

..Here, we analyse the determinants of HIV incidence in this period of decline and estimate the population-level impact of identified risk factors...

..Longitudinal data are needed to disentangle the cyclical effects of poverty and HIV as well as to separate historical patterns from contemporary trends of infection...

..Sexually experienced men and women reported reductions in casual sex of 49 and 22%, respectively, whereas recent cohorts reported delayed sexual debut. Selective AIDS-induced mortality contributed to the decline in HIV prevalence...

..Data collected since the late 1980s show that there was a mismatch between the observed growth in the HIV epidemic and assumptions made about viral transmission...

..This finding can be explained by their having a greater lifetime number of sexual partners than those whose first sexual experience occurs later...

..To compare nationally representative trends in self-reported uptake of HIV testing and receipt of results in selected countries prior to treatment scale-up...

..Changes in socio-demographic characteristics and reported sexual behaviour are investigated...

..This study suggests that, among women, particularly those who are infected, behavioural risk reduction does occur following VCT...

..We assessed the contributions of rising mortality, falling HIV incidence and sexual behaviour change to the decline in HIV prevalence...

..We measured the psychosocial effect of orphanhood in a sub-Saharan African population and evaluated a new framework for understanding the causes and consequences of psychosocial distress among orphans and other vulnerable children...

..The authors conducted an assessment of the role of beer halls in the HIV epidemic of rural Zimbabwe as part of the ongoing identification of risky places for the targeting of prevention activities...

..To estimate HIV incidence in the general population in countries where there have been two recent household-based HIV prevalence surveys (the Dominican Republic, Mali, Niger, Tanzania, and Zambia)...

..ANC estimate adjustment procedures that control for contraceptive use and age at first sex are needed...

..Increased male participation in antenatal care and uptake of couple voluntary counselling and testing (VCT) for HIV could reduce horizontal and vertical HIV transmission in sub-Saharan Africa...

..This suggests that orphaned adolescent women are an important target group for HIV prevention and that efforts should be made to integrate prevention messages into existing support programmes for orphans and vulnerable children...

..GOAL The goal of this report was to describe and evaluate an informal, confidential, low-technology method-Informal Confidential Voting Interviews (ICVIs)-for collecting sexual behavior data in less developed settings...

..It was clear that community sensitization programmes coupled with improvement of the health facility environment to be receptive to men are essential for increasing male attendance of ANC...

..The extent to which these could be attributed to the direct impact of the epidemic on both infected and uninfected women, as opposed to pre-existing differences in their fertility, merits further study...

..The wealth index approach was the most efficient at reaching children with poor outcomes whilst socio-demographic targeting reached more vulnerable children but was less efficient...

..Household viability is threatened by sustained crisis-level mortality in widely disseminated HIV epidemics. This article describes the impact of adult deaths on households in small towns, estates, and villages in eastern Zimbabwe...

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..Some, but not all, observational studies have suggested an increase in the risk of HIV acquisition for women using injectable hormonal contraception (IHC)...

..This finding, considered alongside the timing and location of HIV prevention activities, will give insight into the decline of HIV prevalence in Zimbabwe...

..Despite the 15 million children orphaned by AIDS, and fears of sexual vulnerability, little is known about the link between orphanhood and HIV risk...

..Large differences in the spread of HIV have been observed within sub-Saharan Africa...

..During this period, adult mortality in men was stable, whereas female mortality increased to levels similar to those of men. We examine the trends in mortality from 2003 to 2005...

..To examine the determinants of uptake of voluntary counselling and testing (VCT) services, to assess changes in sexual risk behaviour following VCT, and to compare HIV incidence amongst testers and non-testers...

..HIV-1 control in sub-Saharan Africa requires cost-effective and sustainable programmes that promote behaviour change and reduce cofactor sexually transmitted infections (STIs) at the population and individual levels...

..One suggested solution has been a proximate determinants framework, in which risk factors are grouped into "underlying", "proximate" and "biological" determinants...

..However, our findings suggest that promotion of and organisational development and training among community groups could well be an effective HIV control strategy...

..These findings may be related to the mature stage of the HIV epidemic and the social and living conditions of migrants in Zimbabwean cities...

..To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV...

..A reliable tool that is independent of HIV status is needed for measuring the frequency of AIDS deaths and ultimately the impact of antiretroviral therapy on mortality...

..CONCLUSION: Rural-urban migration does not appear to be responsible for maintaining the high HIV prevalence in rural Zimbabwe, but rates of HIV infection may be affected by rural-rural migration...

..Miscarriage appears to be a less important factor than elsewhere possibly because syphilis is rare...

..It has recently been argued that unsafe medical injections are a major transmission route of HIV infection in the generalised epidemics of sub-Saharan Africa...

..These findings indicate that programmes should assist maternal orphans and support women's efforts by reinforcing the roles of extended families and local communities, and by facilitating greater self-sufficiency...

..08, 95 % CI 2.95-12.53). Although a causal relationship cannot be assumed, detection and treatment of trichomoniasis may be important in strategies to reduce HIV transmission through sexually transmitted infection control...

..To quantify and describe orphan incidence in Manicaland, eastern Zimbabwe...

..We investigated the potential influence of alternative patient management and ART initiation strategies on the impact of ART programmes in sub-Saharan Africa...

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..Repeated cross-sectional measures of HIV prevalence are now becoming available for general populations in many countries, and we aim to develop and validate methods that use these data to estimate HIV incidence...