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One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.
The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for five key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines. Particularly for key populations, social, legal, structural and other contextual factors both increase vulnerability to HIV, viral hepatitis and STIs and obstruct access to health and other essential services. These guidelines highlight the critical importance of addressing structural barriers in all settings as a priority. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching these key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services to these groups.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
These consolidated guidelines are aimed at supporting the generation of responsive person-centred data from routine national health management information systems across the HIV cascade, from prevention, testing and treatment to longer-term health care. They build upon the 2017 Consolidated guidelines on person-centred HIV patient monitoring and case surveillance, which describe information that should be collected in primary HIV patient monitoring tools, and the 2020 Consolidated HIV strategic information guidelines, which cover aggregate indicators for managing and monitoring programmes. The purpose of this guideline consolidation is to provide the recommended data elements, indicators and guidance on data systems and their use across the spectrum of health sector HIV services in one place. This document focuses on strengthening the analysis and use of routine data at each stage of the cascade and emphasizes?/addresses? person-centred HIV prevention, testing and treatment, integration of HIV-related infections, the use of routine surveillance data to measure impact, and the development and use of digital health data systems and their governance. It also identifies the gaps and limitations in these data, and the need for strengthening the use of data in all HIV-related strategic information, including population-based surveys, modelling, community-led monitoring and other sources.
A global economic analysis of HIV infection amongst sex workers, finding that evidence based and rights affirming interventions are not implemented to the level that their efficacy warrants, and that doing so at scale would be cost effective and deliver significant returns on investment.
This guide identifies interventions in prevention, testing, treatment, care, clinical management and support services for the HIV and related co-morbidities for which there is evidence that community health workers can provide safe and effective care in HIV. It also provides policy recommendations on how to design, implement and optimize CHW programmes as part of broader health workforce and service delivery strategies that are acceptable to communities and can be sustained. Finally, it outlines key knowledge gaps that should be addressed through further research.
As the HIV epidemic moves into its fourth decade, it is clear that the global response has failed to adequately address the needs of a wide range of vulnerable populations and groups. Chief among these are gay, bisexual and other men who have sex with men, and transgender persons, who globally face the disproportional burden of HIV infection. This volume rethinks HIV prevention and health promotion for sexual and gender minorities – in both the industrialised societies of the West, as well as in the developing nations of the Global South. The chapters it contains offer a critical analysis of past and present HIV research employing categories to designate gay and other men who have sex with men, transgender persons, and/or other persons and communities with diverse gender and sexual identities. Contributors question the politics of many of the existing classifications and categories in HIV research and argue for a more sophisticated analysis of gender and sexual diversity in order to tackle the social and political barriers that impede the design of successful HIV prevention and health promotion approaches. This book was originally published as a special issue of Global Public Health.
"These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv