eLetters

61 e-Letters

published between 2007 and 2010

  • Anal sex need not be highly prevalent to affect HIV incidence among heterosexual populations
    Richard T Gray

    The results published by Kalichman et. al. on anal intercourse (AI) practices among heterosexuals in South Africa [1] and the associated editorial by Boily et. al. [2] are important contributions to our understanding of HIV transmission. While a small proportion of men (14%) and women (10%) report engaging in heterosexual AI [1], this mode of exposure could be important to overall HIV transmission rates because the ris...

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  • The financial burden of HPV on the NHS was underestimated leading to wrong choice of vaccine.
    Colm P O'Mahony

    Sir: The editorial by Sheldon R Morris1 concludes that the rationale for a vaccine that includes HPV 6 and 11 is compelling. The British Association for Sexual Health & HIV also thought the evidence was compelling and said so in a press release2. The choice of Cervarix over Gardasil was indeed a sad day for Sexual Health in the UK3. The key to the decision in the UK was the perceived cost to the NHS of genital...

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  • The challenge of detecting gonorrhoea (GC) – we can, we should, we already do more.
    Mrinalini Mahto

    Dear Editor,

    In a recent leading article Alexander (1) citing in particular recent work with men who have sex with men (MSM) in the USA (2), has suggested that when examining extra-genital specimens from high risk patient groups, GC culture should be replaced by GC nucleic acid amplification tests (NAATs). We agree with this conclusion but believe that the higher sensitivity of GC NAATs should be promoted to allow imp...

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  • A surgical perspective
    Emma L Marsdin

    Dear Editor,

    Although lymphogranuloma venereum (LGV) as a cause of severe proctitis is well known amongst genitourinary and gastroenterological specialists, it remains absent from a common list of causes of rectal bleeding amongst General Practitioners and Surgeons. An example is a case of a homosexual man who presented as a 2 week rule urgent referral to the Colorectal clinic with painless rectal bleeding and went on...

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  • LGV doesn’t spread in the overall Chlamydia trachomatis-infected population in France
    Bertille de Barbeyrac

    Dear Editor,

    Helen Ward (3) ask the question about the extent of the Lymphogranuloma venereum (LGV) in the wider population than that of men who have sex with men (MSM). A rospective sentinel survey set up in France following the European alert in January 2004 tried to answer this question. From April 2002 to December 2008, rectal samples from MSM were collected by the French National Reference Centre for Chlamydia infec...

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  • no mention of "on costs"?
    Colm O'Mahony

    Dear Editor,

    From this paper we get a good idea on the medical and nursing costs for managing warts but a major cost for the NHS is the building, furnishings, equipment, phones, all other satffing i.e secretaries, reception, managers, finance, personnel etc. This is estimated at about 20% to 25% and should have been mentioned. Some detail about what drugs were used would have been good. In my clinic we treat 800 new...

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  • The quality of sero-surveillance in low and middle income countries
    Jacqueline P Duncan

    Dear Editor,

    Lyerla et al (August 2008 issue) conclude that there is a general overall weakness in the surveillance system of most low and middle income countries in their article on the quality of sero-surveillance. This may well be the case. However, the paper has some important inaccuracies and some of their assertions can be challenged. Their assessment that Jamaica has a poorly functioning surveillance syste...

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  • Reply regarding confidentiality and the human touch
    Emma J Lim

    Dear Editor,

    With regard to your concerns about losing the human touch and confidentiality issues with your patients, our full text article explains the following:

    1. All patients are given a preference on how they would like us to communicate results to them, by phone, text or letter. We found the majority preferred text message as the patients believed it led to the highest degree of confidentiality and ens...

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  • Genomicizing Behavioral HIV Prevention: Next Steps
    Rhonda Rosenberg

    Dear Editor,

    The study reported by Brown et al 1. underscores the urgent need for targeted testing and supportive strategies of opt-out testing and post-exposure prophylaxis. We agree with the editorial review by Steckler & Golden 2., recommending more aggressive analysis of why testing is accepted/rejected or offered/not pursued by providers; however, we would add a further strategy for the field to consider. Wh...

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  • Confidentiality concerns
    Susan H Dubb

    Dear Editor,

    Although the concern to contact patients as soon as possible after the diagnosis is made to initiate treatment and prevent further spread is of great importance, I'm concerned about the possibility of patient confidentiality, and the loss of the human touch.

    More and more we are becoming dependant on the latest pieces of technology to transmit information, rather than direct interaction with th...

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