UK role 4 military infection services: past, present and future.

NATO describes 'Role 4' military medical services as those provided for the definitive care of patients who cannot be treated within a theatre of operations and these are usually located in a military force's country of origin and may include the involvement of civilian medical services. The UK Defence Medical Services have a proud history of developing and providing clinical services in infectious diseases and tropical medicine, sexual health and HIV medicine, and medical microbiology and virology. These UK Role 4 Military Infection Services have adapted well to recent overseas deployments, but new challenges will arise due to current military cutbacks and a greater diversity of contingency operations in the future. Further evidence-based development of these services will require leadership by military clinicians and improved communication and support for 'reach-back' services.

Sexual health and HIV in the Army.

Sexual acquisition of infections has always been an important part of military history and although disease patterns have changed over time, the problem has not gone away. This article will look at how to recognise infection, the general principles of management, where to access guidance and how to get specialised help within the complexities of the military environment.

Darunavir concentrations exceed the protein-corrected EC50 for wild-type HIV in the semen of HIV-1-infected men.

Variable antiretroviral drug penetration into the genital tract may contribute to the differential evolution of HIV-1 and the emergence of drug resistance. We compared concentrations of darunavir in 34 time-matched blood plasma and seminal plasma samples from 18 HIV-1 positive men. Darunavir in seminal plasma were approximately 10-20% of that achieved in blood at matched time points postdrug ingestion. All seminal plasma darunavir were above the protein-corrected EC50 values for wild-type HIV-1.