Recent papers of interest, week 31

Some recent catch-up reading that’s caught my eye; all HIV stuff it turns out, and as a bonus, all freely accessible:

• How important are viral introductions vs. local transmission for sustaining an epidemic in rural Uganda?  In Rakai, it seems, pretty important.  I really liked how the authors triangulate spatial, phylogenetic and mathematical modelling approaches to build a solid narrative. And the topic seems really important in the context of targeting key subpopulations within generalized epidemics – something that is rising up the prevention agenda, apparently/hopefully. The primary author also has some recent work (presented at CROI this year) on which partner brings HIV into stable couples; an area in desperate need of good data.

• Unconditional cash to caregivers of children affects age of sexual debut, but not other risk behaviours, in Kenya. This study starts to get at which behaviours are, and are not, driven by economic factors – as opposed to cultural or other norms.  I would have liked to have seen data on marriage age too, but since that doesn’t typically happen while the child is within the home, perhaps that’s too distant an outcome.

• A serious effort to build a sexual network focused prevention intervention.  Early days, but proving the feasibility of such innovative interventions is reassuring for those of us following along behind.

• A review of some heterogeneities in infection dynamics that provoked some thoughts, although not about modelling, which is the nominal reason for the piece.  Notably, the authors highlight that there may well be heterogeneity in susceptibility, which will practically act to fragment sexual transmission networks as less-susceptibles act more like recovered individuals.  And that alloimmunity to a partner’s expressed antigens may mean that infection risk from an ongoing partner recently infected may be less than expected, while that from a new partner with a chronic infection may be higher than expected (due to no acquired alloimmunity). I must admit this is my first introduction to alloimmunity – it looks like there’s a whole world of research out there on this, with some interesting paradoxical results. Happy reading.

Potentially interesting papers: Week 50 2011

This week I have three possibilities to tantalize you with, one of which I am immediately set against, but feel I should read.

1. This piece in AIDS Care worries me for two surface reasons.  First, the abstract suggests that it is a quantitative analysis of DHS data being published in AIDS Care, a journal I usually turn to for depth and richness, not number crunching.  But I would never write something off based only on this.  Of more concern is the line “Contrary to the public health literature, women of high SES were also vulnerable to HIV risk”.  I am pretty there is a large literature highlighting this relationship already, which leads me to question the level of background research conducted.

2. A reminder that prevention interventions are acutely context-dependent.

3. I find it strange/disturbing how infrequently we consider the disease context of a community in measuring risk factors for HIV across large areas.  This paper from Zimbabwe, via UNC Chapel Hill, is a nice reminder of the importance of cross-level interactions.

Disclaimer. These posts are based on my reading of titles and abstracts, and all papers may be of much greater/lesser interest/quality than I have concluded based on reading 200 words or fewer.