eLetters

195 e-Letters

  • Reactivated syphilis - Author's response
    Hugh Young
    Dear Editor

    Mr McElborough considers it unfortunate that reference labs may have developed their algorithms in the case of conventional syphilis diagnosis and these do little to help with HIV coinfected patients. Guidelines for serological diagnosis in coexisting HIV infection, neurosyphilis and congenital infection are currently under preparation by the (Public Health Laboratory Service) PHLS Syphilis Forum and will...

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  • Dangers of generalising
    Linda Semple
    Dear Editor,

    Whilst it is comforting that some research is finally being carried out in depth on the risk of STIs amongst women who have sex with women (WSW), any conclusions drawn from this study for WSW in general need to be handled with a great deal of caution when one looks at the make-up of the subjects and controls.

    For example, over twice as many of the WSW as the control group were current sex workers;...

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  • Reactivated syphilis
    Denis J McElborough
    Dear Editor,

    In our area the high HIV prevalence has made the interpretation of syphilis tests paticularly problematic. Coinfected patients do appear to reactivate their treponemal infection or possibly reinfection with a different "strain" in the presence of profound immunosuppression. As with some other agents IgM can persist for several years with peaks and troughs! Non-treponemal tests are uniformly negative whilst...

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  • WSW status needs further definition
    Rudiger Pittrof

    Dear Editor

    Fether at al present a very interesting case control study on STIs in women who have sex with women (WSW). This was not a community based sample and thus prone to selection bias. In order to appreciate the results in full it would help to know how cases and controls were identified and how controls were selected.

    As bisexual or homosexual orientation may be difficult to disclose even in a sympat...

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  • AIDS and globalisation
    Mike Griffiths
    Dear Editor

    I commend Shamanesh et al for their searching and informed account of the impact of globalisation on the world AIDS problem. Revisiting Alma Ata 1978: the existence of gross inequalities between advantaged and disadvantaged peoples is "politically, socially and economically" unacceptable. 22 years on, are we closer to the ideal of "health for all" or further away. When will we learn?

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