Prioritising Infectious Disease Mapping.

BACKGROUND: Increasing volumes of data and computational capacity afford unprecedented opportunities to scale up infectious disease (ID) mapping for public health uses. Whilst a large number of IDs show global spatial variation, comprehensive knowledge of these geographic patterns is poor. Here we use an objective method to prioritise mapping efforts to begin to address the large deficit in global disease maps currently available. METHODOLOGY/PRINCIPAL FINDINGS: Automation of ID mapping requires bespoke methodological adjustments tailored to the epidemiological characteristics of different types of diseases. Diseases were therefore grouped into 33 clusters based upon taxonomic divisions and shared epidemiological characteristics. Disability-adjusted life years, derived from the Global Burden of Disease 2013 study, were used as a globally consistent metric of disease burden. A review of global health stakeholders, existing literature and national health priorities was undertaken to assess relative interest in the diseases. The clusters were ranked by combining both metrics, which identified 44 diseases of main concern within 15 principle clusters. Whilst malaria, HIV and tuberculosis were the highest priority due to their considerable burden, the high priority clusters were dominated by neglected tropical diseases and vector-borne parasites. CONCLUSIONS/SIGNIFICANCE: A quantitative, easily-updated and flexible framework for prioritising diseases is presented here. The study identifies a possible future strategy for those diseases where significant knowledge gaps remain, as well as recognising those where global mapping programs have already made significant progress. For many conditions, potential shared epidemiological information has yet to be exploited.

Effect of an online video-based intervention to increase HIV testing in men who have sex with men in Peru.

BACKGROUND: Although many men who have sex with men (MSM) in Peru are unaware of their HIV status, they are frequent users of the Internet, and can be approached by that medium for promotion of HIV testing. METHODS: We conducted an online randomized controlled trial to compare the effect of HIV-testing motivational videos versus standard public health text, both offered through a gay website. The videos were customized for two audiences based on self-identification: either gay or non-gay men. The outcomes evaluated were 'intention to get tested' and 'HIV testing at the clinic.' FINDINGS: In the non-gay identified group, 97 men were randomly assigned to the video-based intervention and 90 to the text-based intervention. Non-gay identified participants randomized to the video-based intervention were more likely to report their intention of getting tested for HIV within the next 30 days (62.5% vs. 15.4%, Relative Risk (RR): 2.77, 95% Confidence Interval (CI): 1.42-5.39). After a mean of 125.5 days of observation (range 42-209 days), 11 participants randomized to the video and none of the participants randomized to text attended our clinic requesting HIV testing (p = 0.001). In the gay-identified group, 142 men were randomized to the video-based intervention and 130 to the text-based intervention. Gay-identified participants randomized to the video were more likely to report intentions of getting an HIV test within 30 days, although not significantly (50% vs. 21.6%, RR: 1.54, 95% CI: 0.74-3.20). At the end of follow up, 8 participants who watched the video and 10 who read the text visited our clinic for HIV testing (Hazard Ratio: 1.07, 95% CI: 0.40-2.85). CONCLUSION: This study provides some evidence of the efficacy of a video-based online intervention in improving HIV testing among non-gay-identified MSM in Peru. This intervention may be adopted by institutions with websites oriented to motivate HIV testing among similar MSM populations. TRIAL REGISTRATION: Clinicaltrials.gov NCT00751192.

Riesgos y beneficios del uso de Internet entre personas viviendo con VIH/SIDA en Lima, Perú / Risks and benefits of Internet use among people living with HIV/AIDS in Lima, Peru

Objetivo: Evaluar el uso de Internet para buscar parejas sexuales e información sobre VIH/SIDA o infecciones de transmisión sexual (ITS) entre personas viviendo con VIH/SIDA (PVVS). Materiales y métodos: Entrevistamos a las PVVS que acudieron consecutivamente a Vía Libre en Lima Perú entre mayo y junio de 2004. Resultados: De las 100 PVVS (46 hombres que tienen sexo con hombres [HSH], 18 hombres heterosexuales y 36 mujeres), 59 por ciento reportó el uso de Internet en los últimos 12 meses. De ellos, la mayoría (73 por ciento) accedió a Internet en un lugar público; 16 (27,1 por ciento) reportaron haber buscado parejas sexuales en línea y cinco (8,5 por ciento) reportaron haber tenido sexo con una pareja que conocieron por Internet. Todas las PVVS que buscaron sexo en Internet fueron hombres, siendo el porcentaje de HSH significativamente mayor que la de heterosexuales (94 por ciento frente a 6 por ciento; p=0,032). Los cinco que reportaron haber tenido sexo con una pareja que conocieron en línea fueron HSH. De los que accedieron a Internet en el último año, 76 por ciento (45/59) lo hizo para buscar información sobre VIH/SIDA y 39 por ciento (23/59) para buscar información sobre otras ITS. Conclusiones: Entre las PVVS encuestadas, más de la mitad reportó acceso a Internet. La mayoría lo hizo para buscar información sobre VIH/SIDA y más de la cuarta parte - casi exclusivamente HSH - lo hizo para buscar parejas sexuales. Estos hallazgos sugieren que Internet es una herramienta conveniente para brindar mensajes de prevención en línea sobre VIH/ITS a HSH de alto riesgo.

Objective: To evaluate use of the Internet for seeking sex partners and information on HIV and/or sexually transmitted infections (STIs) among people living with HIV/AIDS (PLWHA). Materials and methods: We interviewed consecutive PLWHA attending at Vía Libre, in Lima, Peru, between May and June 2004. Results: Of 100 PLWHA, (46 men who had sex with men [MSM], 18 heterosexual men and 36 women), 59 per cent reported using the Internet in the last 12 months. Of these, the majority (73 per cent) accessed the Internet at a public place; 16 (27,1 per cent) reported having gone online to search for sexual partners; and five (8,5 per cent) reported having had sex with a partner found over the Internet. All sex seekers were men, of them a greater percentage were MSM rather than heterosexual (94 per cent vs. 6 per cent, p= 0,032). All five respondents who reported having had sex with a partner found online were MSM. Of those who accessed the Internet in the past year, 76 per cent (47/59) had used it to find information on HIV/AIDS, and 39 per cent (23/59) had used it to seek information on other STIs. Conclusions: Among PLWHA interviewed more than half reported Internet access. More than a quarter -almost exclusively MSM- had used it to search for sex partners, however, the majority had used the Internet to look for information about HIV/AIDS. These findings suggest that the Internet offers a convenient tool to engage high-risk MSM in online HIV/STI prevention.