; Wald A, During initial infection, viral DNA travels by axon to the spinal cord sensory ganglion where it persists for life.8 Reactivation of HSV causes migration back through the axon, its branches, or contralateral axons to the skin and mucosa.11, A visible outbreak consists of single or clustered vesicles on the genitalia (Figures 1 and 212), perineum, buttocks, upper thighs, or perianal areas that ulcerate before resolving. Warren T, Welcome To Herpes Dating Website Meet HSV Singles, Herpes Singles, Positive Singles, STD Singles . All rights Reserved. Each factor increases OR of shedding HSV-2: Hormonal contraception increases OR to 1.5, Group B streptococcus increases OR to 2.3, Increases risk of transmitting HSV-1 from latent or active infection at oral site to genital site of uninfected partner, Presence of other sexually transmitted diseases. Clinical characteristics of hypertrophic herpes simplex genitalis and treatment outcomes of imiquimod: a retrospective observational study. Turner KM, In: Morse SA, Ballard RC, Holmes KK, Moreland AA, eds. Phipps W, Eppes C. Schillinger JA, The patient should be provided a supply of medication or a prescription for the medication to initiate treatment immediately with symptoms. Lebrun-Vignes B, Clin Infect Dis. Patients should be educated on the atypical and subtle signs of herpes outbreaks because it improves recognition. Antiviral Res. Leeyaphan C, Magaret AS, There is a window of two weeks to six months after HSV exposure to formation of detectable antibody, so repeat serologic testing may be needed to confirm recent acquisition. Type-specific serologic testing should be offered to partners of patients with HSV infection to determine the risk of HSV acquisition. Let us take a look at why this amazing dating site boom as HSV singles makes the New Year’s resolution. 41. Dunphy K. et al. Tata S, Tan DH, This review updates a previous article on this topic by Beauman, http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/genital-herpes-screening, http://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm, Diet and Physical Activity for Cardiovascular Disease Prevention, Diagnosis and Management of Ovarian Cancer. Halpern-Felsher BL, 4th ed. Genital herpes: a review. Adapted from Centers for Disease Control and Prevention. 98. Three nucleoside analogues, which work by inhibiting viral DNA, are approved and well tolerated: acyclovir, famciclovir (Famvir), and valacyclovir (Valtrex). Reprints are not available from the author. Suppressive therapy reduces symptom severity, duration, and recurrence in patients with genital herpes. Gilbert LK, Kinghorn GR, 4. Ashley-Morrow R. 2007;196(1):43.e1–e6. Gupta R, Corey L, Efficacy of topical acyclovir cream in first and recurrent episodes of genital herpes. Gottlieb SL, et al. Johnston C, Morrow RA, Moreland A, Wald A. Xu F, HSVG : Herpes simplex virus (HSV) types 1 and 2 are members of the Herpesviridae family and produce infections that may range from mild stomatitis to disseminated and fatal disease. Diese Webseite wurde mit Jimdo erstellt! Serological testing for herpes simplex virus (HSV)-1 and HSV-2 infection. Generic price listed first; brand price listed in parentheses. ELISA = enzyme-linked immunosorbent assay; HSV = herpes simplex virus. 32. [2] … et al. You can link to this same page with the following url formats: https://rgb.to/97,98,101 https://rgb.to/hex/616265 https://rgb.to/616265 Read the about section for other useful url shortcuts. Synergistic copathogens—HIV-1 and HSV-2 [published correction appears in. Gillespie G, Xu F, Don't miss a single issue. Treatment of primary and subsequent outbreaks with nucleoside analogues is well tolerated and reduces duration, severity, and frequency of recurrences. Leeyaphan C, Dating with HSV is possible Today! Abudalu M, Shaik NS, Corey L, 2002;78(3):160–165. Gallina K, 2015;10(5):e0128615]. Tyring S, et al. The Solana HSV 1+2/VZV Assay is a multiplex in vitro diagnostic test for the detection and differentiation of Herpes simplex virus type 1 (HSV-1), Herpes simplex virus type 2 (HSV-2), and Varicella-zoster virus (VZV) nucleic acids isolated and purified from cutaneous or mucocutaneous swab specimens obtained from symptomatic patients.. Partners in Prevention HSV/HIV Transmission Study Team. A visible outbreak consists of single or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal areas that ulcerate before resolving. 2008;35(6):599–606. Primary infections may cause malaise, fever, or localized adenopathy. J Am Acad Dermatol. Herpes Singles HSV Singles is dedicated to serving the needs of positive herpes singles looking for real relationships and dates. Hughes J, Hughes J, 2006;296(8):964–973. The treatment of herpes simplex infections: an evidence-based review. Overlapping reactivations of herpes simplex virus type 2 in the genital and perianal mucosa. Looker KJ, 2005;72(8):1529. Although HSV-1 and HSV-2 are indistinguishable visually, they exhibit differences in behavior that may affect management. Just create a free profile, and browse members near you. March 2005. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/genital-herpes-screening. N Engl J Med. JAMA. Considering the increased incidence of new genital HSV-1 infections and changing sexual practices, clinicians should counsel patients who test positive for HSV-1 antibody that they may be able to transmit HSV to uninfected partners through oral or genital sex, and that they remain at risk of acquiring HSV-2 infection.8,24. Primary and secondary genital HSV-1 infections tend to be milder than HSV-2 infections. Cherpes TL, Grundlegend ist das HSL-Farbmodell eine Abwandlung des HSV-Farbmodell und lässt sich in andere Farbmodelle umrechnen (RGB, HEX, CMYK, HSL). Seroprevalence of herpes simplex virus types 1 and 2 in pregnant women in the united states. Freeman EE, Celum C, Genital herpes. Omisore F. Xu F, Die Negativserie von jetzt schon 4 hintereinander verlorenen Heimspielen konnte mit dieser Einstellung nie und nimmer abgewendet werden. Huang ML, Kottiri BJ, Polymerase chain reaction assay is the preferred method of confirming HSV infection in patients with active lesions. Arch Intern Med. Saracino M, Krantz E, Sex Transm Dis. Centers for Disease Control and Prevention (CDC). ... 97 to 100. Kostenlose Lieferung für viele Artikel! 2011;305(14):1441–1449. Bodsworth N, Centers for Disease Control and Prevention. Clinical characteristics of hypertrophic herpes simplex genitalis and treatment outcomes of imiquimod: a retrospective observational study. Brodell RT. 20. Kottiri BJ, Graber JM, 1. 1999;26(4):221–225. Vickerman P, Brodell RT. Search dates: June 2015 through March 2016. note: This review updates a previous article on this topic by Beauman.12. HSV, a DNA virus, is named from its protein coat as HSV-1 or HSV-2. Send a … Partners in Prevention HSV/HIV Transmission Study Team. For information about the SORT evidence rating system, go to, HSV = herpes simplex virus; OR = odds ratio, Reprinted with permission from Beauman JG. Gardella C. / Vol. 5. et al. Mujugira A, The wide variability in clinical expression may have greater significance to the individual's symptomatic course than the viral type.8, Asymptomatic viral shedding is common, occurring on 10% to 20% of all days and more often during the first year of infection, but continuing over the extended years studied.14–16 The frequency of subclinical infection and asymptomatic shedding facilitates HSV transmission. 2009;20(1):e1–e7. 16. 42. Sex Transm Dis. Today, there are millions of singles around the world with herpes and HSV. Do you have HSV and be single? Serological testing for herpes simplex virus (HSV)-1 and HSV-2 infection. Mujugira A, Corey L. Click the labels to copy the value onto the clipboard. et al. Cylindrical-coordinate representations (also known as HSL) of color #fbd808 hue: 0.14 , saturation: 0.97 and the lightness value of fbd808 is 0.51.. Recurrent herpes simplex virus erosions on the labia minora. Sex Transm Infect. *—Requires initiation of medication with prodrome preceding outbreak or within one day of lesion onset. Scoular A. It is caused by herpes simplex virus (HSV) and characterized by lifelong infection and periodic reactivation. 27. Requires initiation of medication with prodrome preceding outbreak or within one day of lesion onset. Bradley H, Clinical specificity of AHSV for HSV-1 and 2 detection was 97.8% (95% CI: 96.3-98.8) and 94.5% (95% CI: 92.2-96.1), respectively, compared to culture; and 99.5% (95% CI: 98.5-99.9) and 99.5% (95% CI: 98.3-99.7), respectively, compared to culture with discordant resolution. The patient should be provided a supply of medication or a prescription for the medication to initiate treatment immediately with symptoms, Estimated retail price of treatment based on information obtained at, Estimated retail price of one month's treatment based on information obtained at, Valacyclovir, 500 mg once per day, may be less effective than other valacyclovir or acyclovir regimens in persons with very frequent episodes (i.e., more than 10 episodes per year), Address correspondence to Mary Jo Groves, MD, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy., Dayton, OH 45435. Eppes C. Accessed March 1, 2016. Engelberg R, Fiddian AP. Pediatrics. et al. Left out but not forgotten: should closer attention be paid to coinfection with herpes simplex virus type 1 and HIV? Polymerase chain reaction for detection of herpes simplex virus (HSV) DNA on mucosal surfaces: comparison with HSV isolation in cell culture. 2003;163(1):76–80. et al. 2014;209(3):325–333. Polymerase chain reaction for diagnosis of genital herpes in a genitourinary medicine clinic. et al. *—Treatment can be extended if healing is incomplete after 10 days. Tronstein E, Sternberg MR, 2011;203(2):180–187. Genital herpes. 2007;356(8):854–856. et al. 4th ed. Table 3 lists the differential diagnosis.24,25 Because HSV-1 and HSV-2 infections are indistinguishable visually, suspected infection should be confirmed by type-specific testing to guide management.1,24 In the presence of active lesions, polymerase chain reaction assay is the preferred test, with sensitivity and specificity greater than 95%.24,26,27, Serologic testing may be useful if there is a history of suggestive symptoms but no lesions are present or polymerase chain reaction assay results are negative, or when the patient's partner is infected.24  Western blot is the diagnostic standard, although glycoprotein G tests are comparable (Table 4).28 Older immunoglobulin G and M antibody tests are not reliable and should not be used.28. J Infect Dis. Clin Infect Dis. Satterwhite CL, Type your color in the box in the left, it doesn't matter the format and how you space the values.You can also try with a keyword. Cornell JL, Sternberg MR, 2015 sexually transmitted diseases treatment guidelines: genital HSV infections. 14. It is caused by herpes simplex virus (HSV) and characterized by lifelong infection and periodic reactivation. There may be a prodrome of hours to days consisting of pain, tingling, itching, or burning at the site of exposure. Join the herpes community for FREE and meet singles with STDs soon! / Journals Natural history of genital herpes simplex virus type 1 infection. Dunphy K. Xu F, 33. Kaul R, Patients should be informed of the high incidence of asymptomatic viral shedding and the likelihood of transmitting HSV in the absence of an active outbreak. 36. In patients with HSV who are HIV-negative, treatment reduces transmission of HSV to uninfected partners. HSV = herpes simplex virus; OR = odds ratio. 21. et al. 2015 sexually transmitted diseases treatment guidelines: genital HSV infections. Satterwhite CL, Bernstein DI, Celum C, Lancet. et al. Clin Infect Dis. Genital tract shedding of herpes simplex virus type 2 in women: effects of hormonal contraception, bacterial vaginosis, and vaginal group B. Tata S, March 2005. Genital herpes: a review. Saracino M, Herpes. ; Choose a single article, issue, or full-access subscription. et al. Persistent genital herpes simplex virus-2 shedding years following the first clinical episode. 2008;168(11):1137–1144. http://betze-schnipsel.blogspot.de/das aktuelle Sportstudio - Spielbericht Task Force on Herpes Simplex Virus Resistance. Clin Infect Dis. et al. 2010;59(15):456–459. 2005;72(8):1527–1534. J Infect Dis. Turner EB, et al. 29. In persons with HIV and HSV-2 infections, suppressive therapy does not reduce the transmission of HSV-2 to at-risk partners. This content is owned by the AAFP. Celum C, A dating community for singles that have hsv. Centers for Disease Control and Prevention. Phipps W, tip! Corey L, Asymptomatic shedding of transmissible virus is common. Convert it to JSON format and generate color schemes for your design. Consistent use of male latex condoms reduces the risk of HSV transmission. Single-day, patient-initiated famciclovir therapy versus 3-day valacyclovir regimen for recurrent genital herpes: a randomized, double-blind, comparative trial. Drug resistance with long-term nucleoside analogue use is rare in immunocompetent persons.39 Topical acyclovir has minimal benefit for local symptom reduction, and does not improve episode duration, recurrence, or transmission rates.24,40, There are no approved vaccines for the treatment or prevention of genital herpes. See the CME Quiz Questions. Krantz E, Hook EW III, 3. Gardella C. 34. Type-specific laboratory confirmation of HSV is recommended in patients with clinical disease to guide counseling and management. STEFAN BÖGER HAMBURGER SV HSV 97/98 Autogrammkarte n original signiert Originalangebot aufrufen. Using the evidence base on genital herpes: optimising the use of diagnostic tests and information provision. Freeman EE, Generic price listed first; brand price listed in parentheses. Barton IG, Johnston C, Patient-initiated episodic treatment in those with known genital herpes is safe and effective, and avoids delay in initiating treatment.38 Chronic suppression is valuable for patients with frequent recurrences and for protecting at-risk partners. 2014;41(4):601–614. Johnston C, Nucleoside analogues are equally effective in treating first and subsequent episodes of HSV infection, in reducing the frequency and severity of recurrence, and in decreasing viral shedding.24,33–35 However, shedding is not completely eliminated with any treatment regimen, nor does treatment eliminate latent virus or affect transmission risk or symptoms once the medication is discontinued.24 Oral regimens32  recommended in the 2015 CDC guidelines are provided in Tables 6, 7, and 8.24. Kropp RY, Genital Herpes: A Review. Why do you need to start dating? Antiviral prophylaxis with acyclovir is recommended from 36 weeks' gestation until delivery in women with a history of genital herpes to minimize active recurrence at the time of delivery.42 All three nucleoside analogues are U.S. Food and Drug Administration category B for breastfeeding and pregnancy. The treatment of herpes simplex infections: an evidence-based review. Because HSV-2 is almost always genitally acquired, the presence of HSV-2 antibody implies anogenital disease, even if there is no history of symptoms.24 However, the site of HSV-1 infection cannot be identified by positive HSV-1 serology results alone.5,24 HSV-1 antibody is present in 54% of the U.S. population, primarily acquired orolabially in childhood,5 and it is often asymptomatic whether orolabial or genital. Halpern-Felsher BL, Gottlieb SL, JAMA. Task Force on Herpes Simplex Virus Resistance. It is unclear how to counsel patients with a positive serologic test result but no history of genital herpes symptoms.29 Therefore, the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention (CDC) recommend against serologic screening for genital herpes.24,30 Type-specific serologic testing should be offered to partners of patients with HSV infection to determine the risk of acquisition15,24,29  (Table 5 31). Acyclovir-resistant genital herpes among persons attending sexually transmitted disease and human immunodeficiency virus clinics. 2015 sexually transmitted diseases treatment guidelines: genital HSV infections. During pregnancy, antiviral prophylaxis with acyclovir is recommended from 36 weeks of gestation until delivery in women with a history of genital herpes. Patients should be counseled to inform current sex partners about genital herpes and to inform future partners before initiating a sexual relationship. In HIV-negative persons with HSV infection, suppressive therapy and sexual abstinence during apparent outbreak and prodrome reduce the risk of HSV transmission. Wald A, This clinical content conforms to AAFP criteria for continuing medical education (CME). In HIV-negative patients, it is also effective in reducing transmission to at-risk partners. 2 It is thought to represent less than 1% of all ALF cases and less than 2% of all viral causes of ALF. 94 to 97… Barton IG, Hollier LM, 2009;15(3):57–61. Am J Obstet Gynecol. Virginia’s School Quality Profiles provide information about student achievement, college and career readiness, program completion, school safety, teacher quality and other topics of interest to parents and the general public for all Virginia public schools. Tschann JM. 96-97 b04 : 97-98 b04 : 00-01 s04 : 00-01 hsv : 04-05 fcb : 09-10 wob : 10-11 freib : 11-12 bvb : 18-19 fcb : 21; 72-73 wsv : 73-74 fck : 73-74 s04 : 76-77 bo : 77-78 fck : 78-79 s04 : 79-80 hsv : 79-80 1.fc : 81-82 fcb : 82-83 vfb : 82-83 f95 : 85-86 vfb : 90-91 fcb : 96-97 1.fc : 97-98 fck : … Epithelial damage at the portal of entry leads to eruption of vesicles that open, ulcerate, and reepithelialize during an outbreak that lasts about two weeks. Corey L, Subsequent outbreaks, caused by reactivation of latent virus, are usually milder. 1983;3(5–6):291–301. Corey L. An update on short-course episodic and prevention therapies for herpes genitalis. A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Magaret A, Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012 [published correction appears in PLoS One. Carman WF. Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012 [published correction appears in. Herpes simplex virus infection during pregnancy. Commercial. Elective cesarean delivery should be performed in laboring patients with active lesions to reduce the risk of neonatal herpes. Der Sieg des Aufsteigers ging somit völlig in Ordnung. J Med Ethics. et al. Tan DH, Am Fam Physician. Koltun W, Gottlieb SL, et al. Sexually Transmitted Diseases. Patients with recurrent genital symptoms or atypical symptoms and negative herpes simplex virus polymerase chain reaction assay or culture, Patients with a clinical diagnosis of genital herpes but no laboratory confirmation, Patients who report having a partner with genital herpes, Patients presenting for a sexually transmitted disease evaluation (especially those with multiple sex partners), Persons with human immunodeficiency virus infection, Men who have sex with men who are at increased risk of human immunodeficiency virus acquisition, Interpretation of serology results is critical to accurately counsel patients. Grundlegend ist das HSL-Farbmodell eine Abwandlung des HSV-Farbmodell und lässt sich in andere Farbmodelle umrechnen (RGB, HEX, CMYK, HSL). Asymptomatic partners of patients with HSV infection should be counseled on HSV and offered type-specific serologic testing. 18. Common questions about herpes: analysis of chat-room transcripts. 2002;78(1):21–25. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. Obstet Gynecol Clin North Am. Hollier LM, 23. / 2016 Jun 1;93(11):928-934. Am Fam Physician. Diamond C, Copied to clipboard! Patients with HSV-2 have a higher risk of acquiring human immunodeficiency virus (HIV) infection. Common questions about herpes: analysis of chat-room transcripts. 2015;33:165–170. Infection with HSV increases the risk of acquiring HIV infection. *—Estimated retail price of one month's treatment based on information obtained at http://www.goodrx.com (accessed February 10, 2016). et al. Genital herpes: a review, ELISA = enzyme-linked immunosorbent assay; HSV = herpes simplex virus, Adapted with permission from Wald A, Ashley-Morrow R. Serological testing for herpes simplex virus (HSV)-1 and HSV-2 infection, Treatment can be extended if healing is incomplete after 10 days, Estimated retail price for 10 days of treatment based on information obtained at. Seroprevalence of herpes simplex virus types 1 and 2—United States, 1999–2010. Newman LM. Stephenson-Famy A, Gallina K, Copyright © 2016 by the American Academy of Family Physicians. Genital herpes: Oral antiviral treatments. afpserv@aafp.org for copyright questions and/or permission requests. Genital herpes: a review. 2008;371(9630):2109–2119. Elective cesarean delivery should be performed in laboring patients with active lesions to decrease the risk of HSV transmission.42. Bodsworth N, Generic price listed first; brand price listed in parentheses. Sex Transm Infect. Cornell JL, Genital herpes is a common sexually transmitted disease, affecting more than 400 million persons worldwide. Infection with herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2) is extremely frequent in the human population, as well as recurrent reactivations due to lifelong infection. ; This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. 11(June 1, 2016) 17. Acyclovir-resistant genital herpes among persons attending sexually transmitted disease and human immunodeficiency virus clinics. Clin Infect Dis. 6. 39. The Best & Largest STD Dating Site & App for People Living With Herpes (HSV-1, HSV-2), HPV, HIV/AIDS & other STDs.      Print. Don't be alone anymore. Now, Positivesingles.com is the world’s largest and most trusted online dating site for people with HSV-1 and HSV-2. MARY JO GROVES, MD, Wright State University Boonshoft School of Medicine, Dayton, Ohio. 37. Markowitz LE, Cernik C, Arch Intern Med. / afp Magaret AS, ; et al. Koltun W, Manager Age: 46 Years Appointed: Jul 6, 2020 Contract expires: Jun 30, 2022 Genital herpes: Oral antiviral treatments. †—Valacyclovir, 500 mg once per day, may be less effective than other valacyclovir or acyclovir regimens in persons with very frequent episodes (i.e., more than 10 episodes per year). 8. Oral versus vaginal sex among adolescents: perceptions, attitudes, and behavior. Bernstein DI, Johnston C, Morrow RA, Moreland A, Wald A. BMJ Clin Evid. Reyes M, Daily acyclovir to decrease herpes simplex virus type 2 (HSV-2) transmission from HSV-2/HIV-1 coinfected persons: a randomized controlled trial. 24. STEFAN BÖGER HAMBURGER SV HSV 97/98 Autogrammkarte n original signiert: Artikelzustand: Gebraucht. Seroprevalence of herpes simplex virus type 2 and characteristics associated with undiagnosed infection: New York City, 2004. 2007;57(2):238–246. Cernik C, PLoS One. Genital herpes. 2 versch. Copyright © 2020 American Academy of Family Physicians. Diamond C, Schillinger JA, et al. Walsmley S. Herpes. Tyring S, Kropp RY, Burke CA, Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Until recently, genital herpes was more likely to be caused by HSV-2. 9. Scoular A. U.S. Preventive Services Task Force. 2015 sexually transmitted diseases treatment guidelines: genital HSV infections. Wald A. Carman WF. Seroprevalence of herpes simplex virus type 2 among persons aged 14–49 years—United States, 2005–2008.      Print. To see the full article, log in or purchase access. In: Holmes KK, Sparling PF, Stamm WE, et al. A meta-analysis to assess the efficacy of oral antiviral treatment to prevent genital herpes outbreaks. 31. Regimens are identical for HSV-1 and HSV-2. Author disclosure: No relevant financial affiliations. Centers for Disease Control and Prevention. 2015;10(1):e114989. Walsmley S. Thema: Presseartikel, Beiträge: 2150, Datum letzter Beitrag: 25.03.2021 - 08:53 Uhr 22. Corey L, Wald A. Wald A. The 1997–98 Bundesliga was the 35th season of the Bundesliga, Germany's premier football league. Episodic and suppressive treatment of herpes is aimed at reducing the severity, duration, and recurrence of symptoms, and at preventing transmission to uninfected partners.24,32 Suppressive treatment may be intermittent or continuous. The cobas® HSV 1 and 2 Test on the cobas® 4800 system is an automated FDA-cleared test for the direct detection and differentiation of Herpes simplex virus 1 and 2 (HSV-1 and HSV-2) DNA in clinician-collected external anogenital lesion specimens from symptomatic male and female patients. et al. et al. Polymerase chain reaction for diagnosis of genital herpes in a genitourinary medicine clinic. Bellamy AR, Adapted with permission from Wald A, Ashley-Morrow R. Serological testing for herpes simplex virus (HSV)-1 and HSV-2 infection. Seroprevalence of herpes simplex virus type 2 and characteristics associated with undiagnosed infection: New York City, 2004. Can J Infect Dis Med Microbiol. Atlas of Sexually Transmitted Diseases and AIDS. Effect of aciclovir on HIV-1 acquisition in herpes simplex virus 2 seropositive women and men who have sex with men: a randomised, double-blind, placebo-controlled trial. Immediate, unlimited access to all AFP content.