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The Unit's research into HIV testing has led to impacts on health policy (WHO and NICE guidelines) and services relating to HIV testing amongst vulnerable populations across Europe, and particularly, Scotland. The policies related to the frequency of HIV testing, increases in sites available for testing, and the scope of interventions to promote testing. These policies have contributed to significant increases in HIV testing, and a reduction in undiagnosed HIV infection, HIV related ill-health and AIDS deaths. For people living with HIV, this has enabled improved quality of life, better health and contributions to society.
Rosengarten's work during the past fourteen years has provided the HIV field with new ways of rethinking otherwise seemingly intractable problems of more effective prevention. Despite over 30 years of biomedical and social research, and policy and programme implementation, the HIV epidemic continues to grow. The efficacies of repurposing potentially toxic and partially effective antiretroviral drugs for prevention in those perceived at risk of infection has thus come under scrutiny. It is in this context that Rosengarten's work has intervened and introduced an alternative approach to prevention that directly scrutinises the social contexts in which people live and work with HIV. Through this approach and her active engagement with clinicians, policy makers, scientists and advocacy groups she has contributed critical insights that have been incorporated into approaches to HIV prevention in practice.
Research carried out by LSHTM into the effects of male circumcision on HIV prevention has led to important policy recommendations by WHO and UNAIDS, the joint UN Programme on HIV/AIDS. The research showed a strongly reduced risk of HIV infection among circumcised men, and modelling studies estimated that male circumcision programmes in 13 priority countries in Africa could avert 4m HIV infections by 2025. Members of the research team serve on key international advisory groups, and these results have been widely used to underpin international policy guidelines.
Interdisciplinary research conducted in the School of International Development (2003-4) demonstrated for the first time high HIV prevalence and AIDS incidence among 0.5 billion people in fishing-dependent communities across the world. Subsequent research analysed the causes and suggested new strategies for development assistance and health service delivery. Dissemination of these insights to stakeholders generated significant post-2008 impacts on national government, international agency and NGO policies and programmes, contributing to improved access to prevention, treatment and care for hundreds of thousands of people. The research improved HIV/AIDS mainstreaming in natural resource sector governance and development programmes via training manuals, toolkits and policy briefs.
This case describes Professor Weait's research into the impact of punitive laws relating to HIV transmission and exposure and against people living with HIV and AIDS (PLHIV). His work has informed the development of policy on criminal liability for HIV transmission and exposure by UNAIDS (the Joint United Nations Programme on HIV/AIDS), the United Nations Development Programme (UNDP), the International Planned Parenthood Federation (IPPF) and the National AIDS Trust (NAT). It has led directly to invitations to contribute at international policy fora as well as civil society and professional medical organisations. His research has been acknowledged judicially; has contributed to the UK Crown Prosecution Services' guidelines on this issue; and involved knowledge transfer to, and consequent capacity enhancement of the activities of various interest and community groups.
This case study focuses on impact that has occurred because of the research of faculty member Lucy Allais in the areas of disease and sexual health. Impact includes:
Research at the University of Glasgow (UoG) has helped faith-based organisations and their non-religious counterparts to develop a better understanding of the effects of Christian beliefs and practices on public health and international development goals. Our research and engagement strategies have benefitted the Catholic Agency for Overseas Development and its partners by educating staff and influencing, in particular, HIV policy. It has also led to greater understanding of religious resistance to the language of development as used in the Joint United Nations Programme on HIV/AIDS and the United Nations Population Fund, encouraging dialogue between UN staff and historically disengaged conservative religious groups.
King's College London (KCL) research has had an major impact on guidelines in the UK, USA, Sweden and worldwide — through the World Health Organization (WHO) — on managing HIV in pregnancy to balance the risk of transmitting HIV from mother-to-child against the toxicities of antiretroviral therapy and the need for Caesarean section. Specifically, KCL research led to guidance on when HIV-infected women should begin antiretroviral treatment and at what viral load they can deliver vaginally to minimise mother-to-child transmission (MTCT). This guidance has led to fewer Caesarean sections (a less acceptable mode of delivery compared to natural vaginal delivery, especially in many ethnic minority groups), a drop in MTCT rates in England and Ireland, and better advice to healthcare practitioners and patients.
Men who have sex with men (MSM) are at highest risk of acquiring HIV in the UK and an estimated one-quarter of HIV-infected MSM have not been diagnosed. The Gay Men's Sexual Health (GMSH) Survey, conducted by University of Glasgow researchers, has provided robust evidence of sexual behaviours as well as prevention and testing activities of MSM in Scotland since 1996. These findings have shaped health policies in Scotland, the UK and Europe and have been used by health practitioners in the conduct of successful NHS sexual health campaigns in Scotland. The campaigns have been credited with increased testing rates and increased awareness of HIV risks demonstrating the effectiveness of direct promotion of sexual health awareness within the gay community.
HIV associated plasmablastic multicentric Castleman's disease (MCD) has emerged as an uncommon disease over the last decade that is a significant cause of mortality in people living with HIV infection. Advances in our understanding of the epidemiology, virology and immunology of this disease led Professor Bower to recognise the potential for using targeted monoclonal antibody therapy. This has dramatically improved the survival of patients with MCD and is now advocated in the national treatment guidelines and is widely adopted in clinical practice globally. Moreover, the use of plasma Kaposi's sarcoma herpesvirus virus levels as a tumour marker for MCD has been developed.