Highlights from this issue ========================== * Jackie A Cassell * Partner notification * health services research * chlamydia * epidemiology We begin a new series this month, setting out Programme Science as an approach to optimising for differing epidemics the mix of interventions for HIV prevention. Aral and Blanchard1 provide an overview of the methods and ambitions of Programme Science, and an introduction to a planned series they will guest edit. Readers will be aware of growing international concerns about the spread of antimicrobial resistant strains of gonocci. Chan *et al*2 demonstrate a paradox that presents real challenges for future control strategies. Where there is antimicrobial resistance, treatment strategies that focus on the ‘core group’ result in maximal dissemination of resistant strains, even though this strategy is the most effective in the absence of resistance. Incidence of HIV among MSM (men who have sex with men) continues to be a major concern in many parts of the world. This month, McDonald *et al*3 report trends in Scotland, demonstrating a marked reduction in incidence among intravenous drug users yet stable and high incidence in MSM. HIV testing is one of the keys to effective prevention for MSM. Li *et al*4 report low HIV testing rates, particularly among married MSM and migrants within China. They emphasise the need for free and anonymous testing. Research into healthcare structures that can support HIV testing continues, amidst varying regulatory frameworks across the world. Belza *et al*,5 in a study from Spain, compare the performance and acceptability of self-taken blood testing at a street based HIV testing centre. They conclude that this provides a potentially valuable option for testing without the need for nurses or doctors. Should chlamydia screening be selectively targeted? This is the question addressed by van den Broek *et al*6 in the rural component of a web based screening study in the Netherlands. Exclusion of individuals on the basis of a risk score enabled high positivity in the tested population, without reducing participation in the next round. This is an important study with wide-ranging policy implications. This month's edition includes also a comparison of swabs and urine for the diagnosis of *Trichomonas vaginalis*7; an exploration of the correlates of condom breakage in a population of sex workers with high rates of condom use8, analysis of the effectiveness of doxycycline in otosyphilis9 and unprotected sex in HIV positive Chinese MSM.10 ## Footnotes * Provenance and peer review Not commissioned; internally peer reviewed. ## References 1. Aral SO, Blanchard JF. The Program Science initiative: improving the planning, implementation and evaluation of HIV/STI prevention programs. Sex Transm Infect 2012;88:157–9. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8xNTciO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 2. Chan CH, McCabe CJ, Fisman DN. Core groups, antimicrobial resistance and rebound in gonorrhoea in North America. Sex Transm Infect 2012;88:200–4. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8yMDAiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 3. McDonald SA, Hutchinson SJ, Wallace LA, et al. Trends in the incidence of HIV in Scotland, 1988-2009. Sex Transm Infect 2012;88:194–9. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8xOTQiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 4. Li X, Lu H, Raymond HF, et al. Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China. Sex Transm Infect 2012;88:187–93. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8xODciO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 5. Belza MJ, Rosales-Statkus ME, Hoyos J, et al. Supervised blood-based self-sample collection and rapid test performance: a valuable alternative to the use of saliva by HIV testing programmes with no medical or nursing staff. Sex Transm Infect 2012;88:218–21. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8yMTgiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 6. van den Broek IVF, Brouwers EEHG, Götz HM, et al. Systematic selection of screening participants by risk score in a chlamydia screening programme is feasible and effective. Sex Transm Infect 2012;88:205–11. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8yMDUiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 7. Jang D, Gilchrist J, Portillo E, et al. Comparison of dacron and nylon-flocked self-collected vaginal swabs and urine for the detection of *Trichomonas vaginalis* using analyte-specific reagents in a transcription-mediated amplification assay. Sex Transm Infect 2012;88:160–2. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8xNjAiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 8. Bradley J, Rajaram SP, Moses S, et al. Why do condoms break? A study of female sex workers in Bangalore, south India. Sex Transm Infect 2012;88:163–70. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8xNjMiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 9. Chotmongkol V, Sawanyawisuth K, Yimtae K, et al. Doxycycline treatment of otosyphilis with hearing loss. Sex Transm Infect 2012;88:177–8. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8xNzciO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 10. He Q, Peng W-J, Zhang J-Q, et al. Prevalence of unprotected anal intercourse and unprotected vaginal intercourse among HIV-positive men who have sex with men in China: a meta-analysis. Sex Transm Infect 2012;88:229–33. [Abstract/FREE Full Text](http://sti.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoic2V4dHJhbnMiO3M6NToicmVzaWQiO3M6ODoiODgvMy8yMjkiO3M6NDoiYXRvbSI7czoyMzoiL3NleHRyYW5zLzg4LzMvMTUzLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==)