HIV-positive women in Switzerland are mainly relying on male condoms for contraception, investigators report in HIV Medicine. “Male condoms remained the most frequently used contraceptive method, whereas the use of long-acting reversible contraceptives was very uncommon,” note the researchers. “One in six women using contraceptives experienced an unwanted pregnancy, with 42% occurring while using a combined hormonal pill.”
The investigators suggest that HIV clinicians need to do more to encourage effective contraceptive use by women with HIV, especially in the light of growing awareness that people with HIV with undetectable viral load do not transmit HIV. If couples stop using the male condom, women need information about which contraceptive options are suitable for them.
Infection, Genetics and Evolution, Available online 2 June 2016
Human immunodeficiency virus type 1 (HIV-1) was discovered in the early 1980s when the virus had already established a pandemic. For at least three decades the epidemic in the Western World has been dominated by subtype B infections, as part of a sub-epidemic that traveled from Africa through Haiti to United States. However, the pattern of the subsequent spread still remains poorly understood.
Here we analyze a large dataset of globally representative HIV-1 subtype B strains to map their spread around the world over the last 50 years and describe significant spread patterns.
We show that subtype B travelled from North America to Western Europe in different occasions, while Central/Eastern Europe remained isolated for the most part of the early epidemic. Looking with more detail in European countries we see that the United Kingdom, France and Switzerland exchanged viral isolates with non-European countries than with European ones.
The observed pattern is likely to mirror geopolitical landmarks in the post-World War II era, namely the rise and the fall of the Iron Curtain and the European colonialism.
In conclusion, HIV-1 spread through specific migration routes which are consistent with geopolitical factors that affected human activities during the last 50 years, such as migration, tourism and trade. Our findings support the argument that epidemic control policies should be global and incorporate political and socioeconomic factors.