A General Model of Sexually Transmitted Disease Epidemiology and Its Implications for Control

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      Reducing rates of bacterial STIs such as gonorrhea and chlamydia is a national priority. A mainstay of STI prevention and control consists of targeting for treatment those individuals who are likely to transmit infection to the largest number of people, that is, core transmitters [28–32]. In this venue-based study in one urban setting, our overall goal was to identify venues or places with core transmitters, which may serve as foci for ongoing STI transmission and may be ideal sites for the targeted control of STIs [33,34].

    • Quantitative assessment of the role of male circumcision in HIV epidemiology at the population level

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      The expansion of circumcision services for HIV prevention could potentially lead to risk compensation, although there is no evidence for this within the RCTs (Auvert et al., 2005; Gray et al., 2007; Mattson et al., 2008) or from a prospective observational study circumcision in Kisumu, Kenya (Agot et al., 2007). In this paper, we use the RCT evidence to estimate the contribution of circumcision to the differential HIV prevalence in sub-Saharan Africa, including the sex differential in HIV prevalence, and to determine the size of the HIV group of sustainable transmission (GST) (Abu-Raddad et al., 2008; Brunham and Plummer, 1990) with and without circumcision. We also estimate the impact of immediate universal circumcision intervention on the number of infections averted and on excess prevalence over a 10 year period and assess the consequences of risk compensation following circumcision expansion.

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