Digital Commons Network^™

Hiv Dna Reservoir Increases Risk For Cognitive Disorders In Cart-Nave Patients, Robert H. Paul, Victor G. Valcour, Jintanat Ananworanich, Melissa Agsalda

Robert Paul

Objectives Cognitive impairment remains frequent in HIV, despite combination antiretroviral therapy (cART). Leading theories implicate peripheral monocyte HIV DNA reservoirs as a mechanism for spread of the virus to the brain. These reservoirs remain present despite cART. The objective of this study was to determine if the level of HIV DNA in CD14+ enriched monocytes predicted cognitive impairment and brain injury. Methods We enrolled 61 cART-naïve HIV-infected Thais in a prospective study and measured HIV DNA in CD14+ enriched monocyte samples in a blinded fashion. We determined HAND diagnoses by consensus panel and all participants underwent magnetic resonance spectroscopy (MRS) …

Using Survival Analysis To Identify Risk Factors For Treatment Interruption Among New And Retreatment Tuberculosis Patients In Kenya, Enos O. Masini, Omar Mansour, Clare E. Speer, Vittorio Addona, Christy L. Hanson, Joseph K. Sitienei, Hillary K. Kipruto, Martin Muhingo Githiomi, Brenda Nyambura Mungai

Vittorio Addona

" Despite high tuberculosis (TB) treatment success rate, treatment adherence is one of the major obstacles to tuberculosis control in Kenya. Our objective was to identify patient-related factors that were associated with time to TB treatment interruption and the geographic distribution of the risk of treatment interruption by county. Data of new and retreatment patients registered in TIBU, a Kenyan national case-based electronic data recording system, between 2013 and 2014 was obtained. Kaplan-Meier curves and log rank tests were used to assess the adherence patterns. Mixed-effects Cox proportional hazards modeling was used for multivariate analysis. Records from 90,170 patients were …

Impact Of Specialty Pharmacy On Hiv-Positive Clinical Outcomes, Bhumi Gandhi-Patel, Clark Kebodeaux, Daron Smith, Noah Tennyson, Kellye Holtgrave, Nicole Gattas

Clark Kebodeaux

The Impact Of Hiv-Related Stigma On Older And Younger Adults Living With Hiv Disease: Does Age Matter?, Charles A. Emlet, David J. Brennan, Sarah Brennenstuhl, Sergio Rueda, Trevor A. Hart, Sean B. Rourke

Charles Emlet

Risk And Protective Factors Associated With Health-Related Quality Of Life Among Older Gay And Bisexual Men Living With Hiv Disease, Charles A. Emlet, Karen I. Fredriksen-Goldsen

Charles Emlet

No abstract provided.

Experiences Of Community And Parental Violence Among Hiv Positive Young Racial/Ethnic Minority Men Who Have Have With Men, Sheldon D. Fields

Sheldon D. Fields

Adolescents and young adults (ages 13–24) in the USA are frequently exposed to violence in their community and home. While studies have examined the prevalence and impact of violence exposure among adolescents, there is a lack of data focusing specifically on adolescent men of color who have sex with men. Eight demonstration sites funded through a Special Projects of National Significance (SPNS) Initiative recruited 363 HIV-positive racial/ethnic minority young men who have sex with men (YMSM) for a longitudinal study between 2006 and 2009. Over two-thirds of participants (83.8%) had witnessed community violence, 55.1% in the prior three months. Witnessing …

Sociodemographic Profile Of Older Adults With Hiv/Aids: Gender And Sexual Orientation Differences, David J. Brennan, Charles A. Emlet, Sarah Brennenstuhl, Sergio Rueda

Charles Emlet

Hiv Testing Practices Among Black Primary Care Physicians In The United States, Eric Y. Wong, Wilbert C. Jordan, David J. Malebranche, Lori L. Delaitsch, Rebecca Abravanel, Alisha Bermudez, Bryan P. Baugh

David J Malebranche

Background: The Centers for Disease Control and Prevention recommends routine HIV testing in all healthcaresettings, but it is unclear how consistently physicians adopt the recommendation. Making the most of each interaction between black physicians and their patients is extremely important to address the HIV health disparities that disproportionately afflict the black community. The goal of this survey-based study was to evaluate the perceptions and practices of black, primary care physicians regarding HIV testing.

Methods: A physician survey was administered at the 2010 National Medical Association Annual Convention, via online physician panels, and by email. Physician eligibility criteria: black race; practicing …

“Rugged Vaginas” And “Vulnerable Rectums”: The Sexual Identity, Epidemiology, And Law Of The Global Hiv Epidemic, Aziza Ahmed

Aziza Ahmed

AIDS remains amongst the leading causes of death globally. Identity is the primary mode of understanding HIV and organizing in response to the HIV epidemic. In this Article, I examine how epidemiology and human rights activism co-produce ideas of identity and risk. I call this the “identity/risk narrative”: the commonsense understanding about an identity group’s HIV risk. For example, epidemiology offers the biological narrative of risk: anal sex and the weak rectal lining make men who have sex with men more vulnerable to HIV;while the fragility of a woman’s vaginal wall provides a biological foundation for women’s vulnerability. These biological …

Alcohol Intoxication And Self-Reported Risky Sexual Behaviour Intentions With Highly Attractive Strangers In Naturalistic Settings, Michael Lyvers, Emma Cholakians, Megan Puorro, Shanti Sundram

Mike Lyvers

Objective: The present investigation examined the relationship between alcohol intoxication and risky sex intentions in naturalistic settings.

Methods: Heterosexual young adults (n = 72) were approached at a campus pub and at campus parties. Blood alcohol concentration (BAC) was measured by a breath test and ranged from 0 to 0.18%. Participants rated their likely intent to have sex with 10 highly attractive unfamiliar models of the opposite gender, as depicted in photographs, if the opportunity arose. Photos varied in terms of accompanying information regarding risk, with three levels: slight risk, moderate risk and high risk.

Results: BAC …

Mexico's Northern Border Conflict: Collateral Damage To Health And Human Rights Of Vulnerable Groups, Leo Beletsky, Gustavo Martinez, Tommi Gaines, Lucie Nguyen, Remedios Lozada, Gudelia Rangel, Alicia Vera, Heather L. Mccauley, Andrea Sorensen, Steffanie A. Strathdee

Leo Beletsky

Objectives: Given links between policing environment and infectious disease risk among vulnerable groups, we surveyed female sex workers who inject drugs in Tijuana and Ciudad (Cd.) Juarez. Data were used to 1. compare distributions of human rights violations and disease risk, 2. juxtapose these patterns against demographic and structural environment variables, and 3. formulate implications for structural interventions. Methods: Structured interviews and testing for sexually-transmitted infections (STIs) were conducted (October 2008-October 2009). Frequency of individual and environmental factors, including police abuse, HIV risk and protective behaviors were compared between sites using univariate logistic regression. Results: Of 624 women, almost half …

Sex And Hiv Disclosure, Aziza Ahmed, Beri Hull

Aziza Ahmed

No abstract provided.

The Value Of Critique And Distributive Analysis To Addressing The Needs Of Sex Workers In The Context Of Hiv: A Response To Libby Adler’S “Gay Rights And Lefts”, Aziza Ahmed

Aziza Ahmed

No abstract provided.

Mobile Outreach Strategies For Screening Hepatitis And Hiv In High Risk Populations, Donna M. Zucker

Donna M. Zucker

Objectives: To screen, counsel and offer hepatitis A and B vaccination for subjects at high risk for hepatitis C virus (HCV) and HIV, and determine any relationship between risk factors and HCV positivity. Design and Sample Q1 : A descriptive correlational design. We correlated risk factors and HCV positivity and measured vaccination completion rates. Two hundred and two unduplicated subjects in 4 locations in Western Massachusetts: a walk in substance abuse clinic, a homeless shelter, a county jail, and a community corrections facility. Measures: Demographic data and a standard HCV risk- screening survey were used. Results: Significantly higher rates of …

Insert Discourse: Rectal Douching Among Young Hiv-Positive And Hiv-Negative Gay Men In Vancouver, Canada, A. Schilder, Treena Orchard, C. Buchner, S. Strathdee, R. Hogg

Dr. Treena Orchard

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention …

Partner Notification And The Threat Of Domestic Violence Against Women With Hiv Infection, Karen H. Rothenberg, Richard L. North

Karen H. Rothenberg

No abstract provided.

Marriage And Divorce: Changes And Their Driving Forces, Betsey Stevenson, Justin Wolfers

Betsey A Stevenson

We document key facts about marriage and divorce, comparing trends through the past 150 years and outcomes across demographic groups and countries. While divorce rates have risen over the past 150 years, they have been falling for the past quarter century. Marriage rates have also been falling, but more strikingly, the importance of marriage at different points in the life cycle has changed, reflecting rising age at first marriage, rising divorce followed by high remarriage rates, and a combination of increased longevity with a declining age gap between husbands and wives. Cohabitation has also become increasingly important, emerging as a …

Assessing The Effectiveness Of Antiretroviral Adherence Interventions: Using Marginal Structural Models To Replicate The Findings Of Randomized Controlled Trials., Maya L. Petersen, Yue Wang, Mark J. Van Der Laan, David R. Bangsberg

Maya Petersen

Randomized controlled trials of interventions to improve adherence to antiretroviral medications are not always feasible. Marginal Structural Models (MSM) are a statistical methodology that aims to replicate the findings of randomized controlled trials using observational data. Under the assumption of no unmeasured confounders, three MSM estimators are available to estimate the causal effect of an intervention. Two of these estimators, G-computation and Inverse Probability of Treatment Weighted, can be implemented using standard software. G-computation relies on fitting a multivariable regression of adherence on the intervention and confounders. Thus, it is related to the standard multivariable regression approach to estimating causal …

“You’Re Awfully Old To Have This Disease”: Experiences Of Stigma And Ageism In Adults 50 Years An Older Living With Hiv/Aids., Charles A. Emlet

Charles Emlet

No abstract provided.

Rhetoric Or Rights?: When Culture And Religion Bar Girls' Right To Education, Elizabeth Chamblee Burch

Elizabeth Chamblee Burch

Women account for almost two-thirds of the world's illiterates. In the year 2000, the World Education Forum met in Dakar, Senegal and set goals to (1) eliminate gender disparities in primary and secondary education by 2005, and (2) achieve gender equality in education by 2015. Two months before 2004, the United Nations Educational, Scientific, and Cultural Organization (UNESCO) reported that sixty percent of the 128 countries that attended the Dakar Conference would not meet these goals. The report attributed the failure to sharp discrimination against girls in social and cultural practices. The report failed to mention that social and cultural …

Homelessness And Hiv Risk Behaviors Among Injection Drug Users, Stephen Metraux, David S. Metzger, Dennis P. Culhane

Dennis P. Culhane

This article uses data from an 8-year study of injection drug users to examine whether homelessness independently influenced the likelihood of engaging in human immunodeficiency virus (HIV) risk behaviors. Fixed effects regression analyses are used to estimate the associations between four different housing contexts and four different behaviors related to transmitting HIV infections. Results showed that 16% of the study group experienced homelessness at some point during the study, and that homelessness was significantly associated with a higher likelihood of frequenting shooting galleries (odds ratio = 2.05), but did not have a significant effect on sharing syringes, sharing other injection …

The Co-Occurrence Of Aids And Homelessness: Results From The Integration Of Administrative Data For Aids Surveillance And Public Shelter Utilization In Philadelphia, Dennis P. Culhane, Erica E. Gollub, Randall R. Kuhn, Mark Shpaner

Dennis P. Culhane

STUDY OBJECTIVE: Administrative databases from the City of Philadelphia that track public shelter utilisation (n=44 337) and AIDS case reporting (n=7749) were merged to identify rates and risk factors for co-occurring homelessness and AIDS. DESIGN: Multiple decrement life tables analyses were conducted, and logistic regression analyses used to identify risk factors associated with AIDS among the homeless, and homelessness among people with AIDS. SETTING: City of Philadelphia, Pennsylvania, USA. MAIN RESULTS: People admitted to public shelters had a three year rate of subsequent AIDS diagnosis of 1.8 per 100 person years; nine times the rate for the general population of …

A Waiting Room Of Their Own: The Family Care Network As A Model For Providing Gender-Specific Legal Services To Women With Hiv, Jeffrey Selbin, Mark Del Monte

Jeffrey Selbin

Many clients eligible for legal aid are underserved, and providers have undertaken a variety of strategies to expand assistance. Legal services providers to people with HIV have tailored delivery models in response to the needs of groups within the HIV-infected community.

This article chronicles the legal community's culture-specific responses to the changing demographics of the HIV epidemic, from the early days of the "gay plague" and the first wave of the HIV to the second-wave needs of low-income people with HIV. We identify the "third wave" of the HIV epidemic, which is marked by the large growth in the number …