Impact of TI Programmes Intervention under National AIDS Control Programme among Female Sex Workers in India: Evidence from Integrated Biological and Behavioural Survey, 2014-15

Background: A better understanding of the impact of Targeted Interventions (TI) services on Female Sex Worker (FSW) behaviours can help in informing and strengthening future TI efforts under National AIDS Control Programme (NACP). Methods: National Integrated Biological and Behavioural Survey (IBBS) 2014-15 has been analysed in the paper. Descriptive statistics and logistic regression analysis were used to understand factors affecting condom use. Propensity score matching (PSM) was done to understand the impact of the TI services on condom use at the last act and consistent condom use in the last three months among FSWs. Results: Younger FSWs aged 15 - 25 years were 1.4 times (95% CI: 1.04 - 1.77) more likely to use consistent condoms in the last three months compared to older over 45 years after controlling for other socio-economic and programme variables. The matched samples estimate ATET i.e. the average treatment effect on treated for consistent condom use in the last three months shows that a 6.0% (CI: 4.7 - 7.3) increase in consistent condom use in the last three months in the FSWs who received information on STI/HIV from peer educator and outreach worker. There is also a 6.0% (4.7 - 7.2) increase in condom use in the last act for FSWs who received the referral services at STI clinics, HIV testing, and detox centres. Conclusions: It is evident that the TI programme has a positive impact on behavior change among FSWs which can prove beneficial to curtail the spread of HIV to the partners and onward transmission to the general population.

Molecular network-based intervention brings us closer to ending the HIV pandemic

Precise identification of HIV transmission among populations is a key step in public health responses.However,the HIV transmission network is usually difficult to determine.HIV molecular networks can be determined by phylogenetic approach,genetic distance-based approach,and a combination of both approaches.These approaches are increasingly used to identify transmission networks among populations,reconstruct the history of HIV spread,monitor the dynamics of HIV transmission,guide targeted intervention on key subpopulations,and assess the effects of interventions.Simulation and retrospective studies have demonstrated that these molecular network-based interventions are more cost-effective than random or traditional interventions.However,we still need to address several challenges to improve the practice of molecular network-guided targeting interventions to finally end the HIV epidemic.The data remain limited or difficult to obtain,and more automatic real-time tools are required.In addition,molecular and social networks must be combined,and technical parameters and ethnic issues warrant further studies.

Epidemic cycle induced by intervention in a susceptibility-structured population

Epidemics of infectious diseases have been known to recur in time.Diseases like influenza,despite intervention efforts through vaccination and targeted social distancing,continue to persist intermittently in the population.I have undertaken an analysis of a stochastic epidemic model with the hypothesis that intervention drives epidemic cycles.Intervention indeed is found to induce cycles of epidemic activity.Above a minimum intervention rate,however,activity dies out in finite time.The susceptibility structure of a community could be easily infused into the design of existing surveillance protocols.By tracking that structure,early detection of an impending outbreak is enhanced.

Practice and Prospect:HIV-1 Molecular NetworkBased Studies in China

Identification of human immunodeficiency virus(HIV)transmission networks is a critical step in the public health response;however,it is challenging to achieve this through traditional epidemiological surveys alone.The molecular network approach can provide more accurate information for understanding HIV outbreaks and bring targeted interventions into reality.Based on the current global development of the concept of the molecular network,Chinese scientists have in recent years explored the applications of molecular networks for understanding the HIV-1 transmission trends,for identifying the population acquiring priority interventions,and for evaluating the targeted intervention effectiveness.In this review,we focus on research progress by Chinese scientists in the field of molecular networks and put forward some suggestions for future research of molecular networks.

干预主义下的因果选择及一种多世界干预标准

在有氧气的情况下划亮一根火柴,直觉上会选择划火柴而不是有氧气作为的火柴燃烧的原因。但原始的干预主义的结构方程架构蕴涵两者都是原因,放弃了因果选择,因而是有缺陷的。一些哲学家认为可以在原结构方程架构中加入干预的合适标靶标准,进行因果选择。本文提出了一个新反例,它表明合适标靶标准是错误的。在此基础上,本文给出了一个不必假设所谓的合适标靶的因果选择标准,即多世界干预。该标准不涉及道德上善恶及责任归属问题,也不需主观地设想每个可能世界的正常性的排序,因而是一种客观的、自然主义的因果选择标准。