Digital Commons Network^™

Interferon-Γ Regulates Cellular Metabolism And Mrna Translation To Potentiate Macrophage Activation, Xiaodi Su, Yingpu Yu, Yi Zhong, Eugenia Giannopoulou, Xiaoyu Hu, Hui Liu, Justin R. Cross, Gunnar Rätsch, Charles M. Rice, Lionel B. Ivashkiv

Publications and Research

Interferon-γ (IFN-γ) primes macrophages for enhanced inflammatory activation by Toll-like receptors (TLRs) and microbial killing, but little is known about the regulation of cell metabolism or mRNA translation during priming. We found that IFN-γ regulates human macrophage metabolism and translation by targeting the kinases mTORC1 and MNK that both converge on the selective regulator of translation initiation eIF4E. Physiological downregulation of mTORC1 by IFN-γ was associated with autophagy and translational suppression of repressors of inflammation such as HES1. Genome-wide ribosome profiling in TLR2-stimulated macrophages revealed that IFN-γ selectively modulates the macrophage translatome to promote inflammation, further reprogram metabolic pathways, and …

Risk Factors For Loss To Follow-Up Prior To Art Initiation Among Patients Enrolling In Hiv Care With Cd4+ Cell Count ≥200 Cells/Μl In The Multi-Country Mtct-Plus Initiative, R Charon Gwynn, Ashraf Fawzy, Ida Viho, Yingfeng Wu, Elaine J. Abrams, Denis Nash

Publications and Research

Background In resource-limited settings, many HIV-infected patients are lost to follow-up (LTF) before starting ART; risk factors among those not eligible for ART at enrollment into care are not well described. Methods We examined data from 4,278 adults (3,613 women, 665 men) enrolled in HIV care through March 2007 in the MTCT-Plus Initiative with a CD4 count ≥200 cells/mm3 and WHO stage ≤ 2 at enrollment. Patients were considered LTF if > 12 months elapsed since their last clinic visit. Gender-specific Cox regression models were used to assess LTF risk factors. Results The proportion LTF was 8.2 % at 12 months …

Predicting And Exploring Network Components Involved In Pathogenesis In The Malaria Parasite Via Novel Subnetwork Alignments, Hong Cai, Timothy G. Lilburn, Changjin Hong, Jianying Gu, Rui Kuang, Yufeng Wang

Publications and Research

Background Malaria is a major health threat, affecting over 40% of the world's population. The latest report released by the World Health Organization estimated about 207 million cases of malaria infection, and about 627,000 deaths in 2012 alone. During the past decade, new therapeutic targets have been identified and are at various stages of characterization, thanks to the emerging omics-based technologies. However, the mechanism of malaria pathogenesis remains largely unknown. In this paper, we employ a novel neighborhood subnetwork alignment approach to identify network components that are potentially involved in pathogenesis. Results Our module-based subnetwork alignment approach identified 24 functional …

Emerging Roles Of Health Care Providers To Mitigate Climate Change Impacts: A Perspective From East Harlem, New York, Perry E. Sheffield, Kathleen T. Durante, Elena Rahona, Christina Zarcadoolas

Publications and Research

Professional associations of health care workers are issuing policy statements on climate change and health with greater frequency, calling on their members to act in their duty to protect and fulfill the right to health. These health care providers’ perceptions of their roles in the intersection of climate and health, however, have not been well-studied. This article presents results from a qualitative study using focus groups conducted with health care providers serving the low-income, ethnic minority population in East Harlem, New York. The focus groups sought to identify and explore providers’ perceived health threats of climate change, as well as …

Exploring The Complex Pattern Of Information Spreading In Online Blog Communities, Sen Pei, Lev Muchnik, Shaoting Tang, Zhiming Zheng, Hernán A. Makse

Publications and Research

Information spreading in online social communities has attracted tremendous attention due to its utmost practical values in applications. Despite that several individual-level diffusion data have been investigated, we still lack the detailed understanding of the spreading pattern of information. Here, by comparing information flows and social links in a blog community, we find that the diffusion processes are induced by three different spreading mechanisms: social spreading, self-promotion and broadcast. Although numerous previous studies have employed epidemic spreading models to simulate information diffusion, we observe that such models fail to reproduce the realistic diffusion pattern. In respect to users behaviors, strikingly, …

Twitter Sentiment Classification For Measuring Public Health Concerns, Xiang Ji, Soon Ae Chun, Zhi Wei, James Geller

Publications and Research

An important task of public health officials is to keep track of health issues, such as spreading epidemics. In this paper, we are addressing the issue of spreading public concern about epidemics. Public concern about a communicable disease can be seen as a problem of its own. Keeping track of trends in concern about public health and identifying peaks of public concern are therefore crucial tasks. However, monitoring public health concerns is not only expensive with traditional surveillance systems, but also suffers from limited coverage and significant delays. To address these problems, we are using Twitter messages, which are available …

Adolescent Girls, Human Rights And The Expanding Climate Emergency, Holly G. Atkinson, Judith Bruce

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing.¹ These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent. The authors urge key actors responding to both the threats and opportunities that climate change poses to understand adolescent girls as exceptionally at risk on the one hand, and as exceptionally resilient and …

Statement And Action Agenda From The Girls In Emergencies Collaborative, Omar Robles, Judith Bruce, Holly G. Atkinson, Dale Buscher, Karen Scriven, Kristin Kim Bart, Shelby French, Judithe Registre, Audrey Anderson

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing. These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent.

Comparison Of Α-Glucosyl Hesperidin Of Citrus Fruits And Epigallocatechin Gallate Of Green Tea On The Loss Of Rotavirus Infectivity In Cell Culture, Steven M. Lipson, Fatma S. Ozen, Samantha Louis, Laina Karthikeyan

Publications and Research

A number of secondary plant metabolites (e.g., flavonoids) possess antiviral/antimicrobial activity. Most flavonoids, however, are difficult to study, as they are immiscible in water-based systems. The relatively new semisynthetic α-glucosyl hesperitin (GH), and the natural plant product epigallocatechin gallate (EGCG) are unique among most flavonoids, as these flavonoids are highly soluble. The antiviral activity of these plant metabolites were investigated using the rotavirus as a model enteric virus system. Direct loss of virus structural integrity in cell-free suspension and titration of amplified RTV in host cell cultures was measured by a quantitative enzyme-linked immunosorbent assay (qEIA). After 30 min. 100 …

Phylogenomic Identification Of Regulatory Sequences In Bacteria: An Analysis Of Statistical Power And An Application To Borrelia Burgdorferi Sensu Lato, Che I. Martin, Tika Y. Sukarna, Saymon Akther, Girish Ramrattan, Pedro Pagan, Lia Di, Emmanuel F. Mongodin, Claire M. Fraser, Steven E. Schutzer, Benjamin J. Luft, Sherwood R. Casjens, Wei-Gang Qiu

Publications and Research

Phylogenomic footprinting is an approach for ab initio identification of genome-wide regulatory elements in bacterial species based on sequence conservation. The statistical power of the phylogenomic approach depends on the degree of sequence conservation, the length of regulatory elements, and the level of phylogenetic divergence among genomes. Building on an earlier model, we propose a binomial model that uses synonymous tree lengths as neutral expectations for determining the statistical significance of conserved intergenic spacer (IGS) sequences. Simulations show that the binomial model is robust to variations in the value of evolutionary parameters, including base frequencies and the transition-to-transversion ratio. We …

Accuracy Of Highly Sexually Active Gay And Bisexual Men’S Predictions Of Their Daily Likelihood Of Anal Sex And Its Relevance For Intermittent Event-Driven Hiv Pre-Exposure Prophylaxis, Jeffrey T. Parsons, H. Jonathon Rendina, Christian Grov, Ana Ventuneac, Brian Mustanski

Publications and Research

Objective: We sought to examine highly sexually active gay and bisexual men’s accuracy in predicting their sexual behavior for the purposes of informing future research on intermittent, event-driven HIV Pre-Exposure Prophylaxis (PrEP).

Design: For 30 days, 92 HIV-negative men completed a daily survey about their sexual behavior (n = 1,688 days of data) and indicated their likelihood of having anal sex with a casual male partner the following day.

Method: We utilized multilevel modeling to analyze the association between self-reported likelihood of and subsequent engagement in anal sex.

Results: We found a linear association between men’s reported likelihood …

A Reproducible Approach To High-Throughput Biological Data Acquisition And Integration, Daniela Börnigen, Yo Sup Moon, Gholamali Rahnavard, Levi Waldron, Lauren Mciver, Afrah Shafquat, Eric A. Franzosa, Larissa Miropolsky, Christopher Sweeney, Xochitl C. Morgan, Wendy S. Garrett, Curtis Huttenhower

Publications and Research

Modern biological research requires rapid, complex, and reproducible integration of multiple experimental results generated both internally and externally (e.g., from public repositories). Although large systematic meta-analyses are among the most effective approaches both for clinical biomarker discovery and for computational inference of biomolecular mechanisms, identifying, acquiring, and integrating relevant experimental results from multiple sources for a given study can be time-consuming and error-prone. To enable efficient and reproducible integration of diverse experimental results, we developed a novel approach for standardized acquisition and analysis of high-throughput and heterogeneous biological data. This allowed, first, novel biomolecular network reconstruction in human prostate cancer, …

Informal Child Care And Adolescent Psychological Well-Being: Hong Kong’S “Children Of 1997” Birth Cohort, Cherry Y. Leung, Gabriel M. Leung, Mary Schooling

Publications and Research

Background
Informal child care (child care by untrained family members, relatives or employees in the home) in Western populations is often associated with poorer psychological well-being, which may be confounded by socioeconomic position. We examined the association of informal child care, common in non-Western settings, with adolescent psychological wellbeing, using Hong Kong’s Chinese “Children of 1997” birth cohort.

Methods
Multivariable linear regression was used to examine the adjusted associations of informal child care (at 0.5, 3, 5 and 11 years) with parent-reported Rutter score for child behavior at 11 years, self-reported Culture-Free Self-Esteem Inventories score at 11 years and selfreported …

New Functionally-Enhanced Soy Proteins As Food Ingredients With Anti-Viral Activity, Aizhan Sabirzhanovna Turmagambetova, Nadezhda Sergeevna Sokolova, Andrey Pavlinovich Bogoyavlenskiy, Vladimir Eleazvich Berezin, Mary Ann Lila, Diana M. Cheng, Vyacheslav Dushenkov

Publications and Research

Respiratory viruses are a major public health problem because of their prevalence and high morbidity rate leading to considerable social and economic implications. Cranberry has therapeutic potential attributed to a comprehensive list of phytochemicals including anthocyanins, flavonols, and unique A-type proanthocyanidins. Soy flavonoids, including isoflavones, have demonstrated anti-viral effects in vitro and in vivo. Recently, it was demonstrated that edible proteins can efficiently sorb and concentrate cranberry polyphenols, including anthocyanins and proanthocyanins, providing greatly stabilized matrices suitable for food products. The combination of cranberry and soy phytoactives may be an effective dietary anti-viral resource. Anti-viral properties of both cranberry juice-enriched …

Endothelial Surface Glycocalyx Can Regulate Flow-Induced Nitric Oxide Production In Microvessels In Vivo, Wanyi Yen, Bin Cai, Jinlin Yang, Lin Zhang, Min Zeng, John M. Tarbell, Bingmei M. Fu

Publications and Research

Due to its unique location, the endothelial surface glycocalyx (ESG) at the luminal side of the microvessel wall may serve as a mechano-sensor and transducer of blood flow and thus regulate endothelial functions. To examine this role of the ESG, we used fluorescence microscopy to measure nitric oxide (NO) production in post-capillary venules and arterioles of rat mesentery under reduced (low) and normal (high) flow conditions, with and without enzyme pretreatment to remove heparan sulfate (HS) of the ESG and in the presence of an endothelial nitric oxide synthase (eNOS) inhibitor, NG-monomethyl-L-arginine (L-NMMA). Rats (SD, 250–300g) were anesthetized. The mesentery …

The Future Of Public Health Informatics: Alternative Scenarios And Recommended Strategies, Margo Edmunds, Lorna Thorpe, Martin Sepulveda, Clem Bezold, David A. Ross

Publications and Research

Background: In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care. Workshop Context: During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology …

Characteristics And Comprehensiveness Of Adult Hiv Care And Treatment Programmes In Asia-Pacific, Sub-Saharan Africa And The Americas: Results Of A Site Assessment Conducted By The International Epidemiologic Databases To Evaluate Aids (Iedea) Collaboration, Stephany N. Duda, Amanda M. Farr, Mary Lou Lindegren, Meridith Blevins, C William Wester, Kara Wools-Kaloustian, Didier K. Ekouevi, Matthias Egger, Jennifer Hemingway-Foday, David A. Cooper, Richard D. Moore, Catherine C. Mcgowan, Denis Nash

Publications and Research

Introduction HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey …

Frequency And Fitness Consequences Of Bacteriophage Φ6 Host Range Mutations, Brian E. Ford, Bruce Sun, James Carpino, Elizabeth S. Chapler, Jane Ching, Yoon Choi, Kevin Jhun, Jung D. Kim, Gregory G. Lallos, Rachelle Morgenstern, Shalini Singh, Sai Theja, John J. Dennehy

Publications and Research

Viruses readily mutate and gain the ability to infect novel hosts, but few data are available regarding the number of possible host range-expanding mutations allowing infection of any given novel host, and the fitness consequences of these mutations on original and novel hosts. To gain insight into the process of host range expansion, we isolated and sequenced 69 independent mutants of the dsRNA bacteriophage Φ6 able to infect the novel host, Pseudomonas pseudoalcaligenes. In total, we found at least 17 unique suites of mutations among these 69 mutants. We assayed fitness for 13 of 17 mutant genotypes on P. pseudoalcaligenes …

Raw Milk, Raw Power: States Of (Mis)Trust, Diana Mincyte

Publications and Research

In recent years, raw milk has emerged as one of the most contentious food commodities, considered a serious health risk by public health officials and a source of healing and nourishment by raw milk proponents. The purpose of this article is to explore the ways in which consumers construct and experience trust in food that is often procured in informal markets. Because the image of an overreaching, exploitative government features prominently in popular narratives surrounding raw milk consumption, this article is explicitly concerned with the role of the state in public food debates. Drawing on two complementary empirical cases of …

High Local Diversity Of Trypanosoma In A Common Bat Species, And Implications For The Biogeography And Taxonomy Of The T. Cruzi Clade, Veronika M. Cottontail, Elisabeth K. V. Kalko, Iain Cottontail, Nele Wellinghausen, Marco Tschapka, Susan L. Perkins, C. Miguel Pinto

Publications and Research

The Trypanosoma cruzi clade is a group of parasites that comprises T. cruzi sensu lato and its closest relatives. Although several species have been confirmed phylogenetically to belong to this clade, it is uncertain how many more species can be expected to belong into this group. Here, we present the results of a survey of trypanosome parasites of the bat Artibeus jamaicensis from the Panama´ Canal Zone, an important seed disperser. Using a genealogical species delimitation approach, the Poisson tree processes (PTP), we tentatively identified five species of trypanosomes – all belonging to the T. cruzi clade. A small monophyletic …

Improving Mycobacterium Bovis Bacillus Calmette-Guèrin As A Vaccine Delivery Vector For Viral Antigens By Incorporation Of Glycolipid Activators Of Nkt Cells, Manjunatha M. Venkataswamy, Tony W. Ng, Shalu S. Kharkwal, Leandro J. Carreño, Alison J. Johnson, Shajo Kunnath-Velayudhan, Zheng Liu, Robert Bittman, Peter J. Jervis, Liam R. Cox, Gurdyal S. Besra, Xiangshu Wen, Weiming Yuan, Moriya Tsuji, Xiangming Li, David D. Ho, John Chan, Sunhee Lee, Richard Frothingham, Barton F. Haynes

Publications and Research

Recombinant Mycobacterium bovis bacillus Calmette-Guèrin (rBCG) has been explored as a vector for vaccines against HIV because of its ability to induce long lasting humoral and cell mediated immune responses. To maximize the potential for rBCG vaccines to induce effective immunity against HIV, various strategies are being employed to improve its ability to prime CD8+ T cells, which play an important role in the control of HIV infections. In this study we adopted a previously described approach of incorporating glycolipids that activate CD1d-restricted natural killer T (NKT) cells to enhance priming of CD8+ T cells by rBCG strains expressing an …

Angiopoietin-1, Angiopoietin-2 And Bicarbonate As Diagnostic Biomarkers In Children With Severe Sepsis, Kun Wang, Vineet Bhandari, John S. Giuliano, Corey S. O′Hern, Mark D. Shattuck, Michael Kirby

Publications and Research

Severe pediatric sepsis continues to be associated with high mortality rates in children. Thus, an important area of biomedical research is to identify biomarkers that can classify sepsis severity and outcomes. The complex and heterogeneous nature of sepsis makes the prospect of the classification of sepsis severity using a single biomarker less likely. Instead, we employ machine learning techniques to validate the use of a multiple biomarkers scoring system to determine the severity of sepsis in critically ill children. The study was based on clinical data and plasma samples provided by a tertiary care center's Pediatric Intensive Care Unit (PICU) …

Dynamically-Expressed Prion-Like Proteins Form A Cuticle In The Pharynx Of Caenorhabditis Elegans, Julia B. George-Raizen, Keith R. Shockley, Nicholas F. Trojanowski, Annesia L. Lamb, David M. Raizen

Publications and Research

In molting animals, a cuticular extracellular matrix forms the first barrier to infection and other environmental insults. In the nematode Caenorhabditis elegans there are two types of cuticle: a wellstudied collagenous cuticle lines the body, and a poorly-understood chitinous cuticle lines the pharynx. In the posterior end of the pharynx is the grinder, a tooth-like cuticular specialization that crushes food prior to transport to the intestine for digestion. We here show that the grinder increases in size only during the molt. To gain molecular insight into the structure of the grinder and pharyngeal cuticle, we performed a microarray analysis to …

Statistical Signs Of Social Influence On Suicides, Hygor Piaget M. Melo, André A. Moreira, Élcio Batista, Hernán A. Makse, José S. Andrade

Publications and Research

By treating the suicide as a social fact, Durkheim envisaged that suicide rates should be determined by the connections between people and society. Under the same framework, he considered that crime is bound up with the fundamental conditions of all social life. The social effect on the occurrence of homicides has been previously substantiated, and confirmed here, in terms of a superlinear scaling relation: by doubling the population of a Brazilian city results in an average increment of 135% in the number of homicides, rather than the expected isometric increase of 100%, as found, for example, for the mortality due …

Comorbidity Of Infectious Diseases And Anxiety Disorders In Adults And Its Association With Quality Of Life: A Community Study, Cornelia Witthauer, Andrew T. Gloster, Andrea Hans Meyer, Renee D. Goodwin, Roselind Lieb

Publications and Research

Objective: Infectious diseases and anxiety disorders are common and both are associated with substantial burden to individual, families, and society. A better understanding of their association may be helpful in explicating possible etiological mechanisms related to both. The goal of the current study was to investigate the relationship between specific infectious diseases and anxiety disorders among adults in the community, and to examine whether the co-occurrence of the two is associated with poorer quality of life compared to subjects with one or neither condition.

Methods: We used data from the 1998 German Mental Health survey with 4181 subjects aged 18–65. …

Searching For Superspreaders Of Information In Real-World Social Media, Sen Pei, Lev Muchnik, José S. Andrade, Jr., Zhiming Zheng, Hernán A. Makse

Publications and Research

A number of predictors have been suggested to detect the most influential spreaders of information in online social media across various domains such as Twitter or Facebook. In particular, degree, PageRank, k-core and other centralities have been adopted to rank the spreading capability of users in information dissemination media. So far, validation of the proposed predictors has been done by simulating the spreading dynamics rather than following real information flow in social networks. Consequently, only model-dependent contradictory results have been achieved so far for the best predictor. Here, we address this issue directly. We search for influential spreaders by following …

Borreliabase: A Phylogeny-Centered Browser Of Borrelia Genomes, Lia Di, Pedro E. Pagan, Daniel Packer, Che L. Martin, Saymon Akther, Girish Ramrattan, Emmanuel F. Mongodin, Claire M. Fraser, Steven E. Schutzer, Benjamin J. Luft, Sherwood R. Casjens, Wei-Gang Qiu

Publications and Research

Background The bacterial genus Borrelia (phylum Spirochaetes) consists of two groups of pathogens represented respectively by B. burgdorferi, the agent of Lyme borreliosis, and B. hermsii, the agent of tick-borne relapsing fever. The number of publicly available Borrelia genomic sequences is growing rapidly with the discovery and sequencing of Borrelia strains worldwide. There is however a lack of dedicated online databases to facilitate comparative analyses of Borrelia genomes. Description We have developed BorreliaBase, an online database for comparative browsing of Borrelia genomes. The database is currently populated with sequences from 35 genomes of eight Lyme-borreliosis (LB) group Borrelia species and …

Hispanic Residential Ethnic Density And Depression In Post-Acute Coronary Syndrome Patients: Re-Thinking The Role Of Social Support, Ellen-Ge Denton, Jonathan A. Shaffer, Carmela Alcantra, Lynn Clemow, Elizabeth Denton

Publications and Research

Background: The ethnic density hypothesis suggests that ethnic density confers greater social support and consequently protects against depressive symptoms in ethnic minority individuals. However, the potential benefits of ethnic density have not been examined in individuals who are facing a specific and salient life stressor.

Aims: We examined the degree to which the effects of Hispanic ethnic density on depressive symptoms are explained by socioeconomic resources and social support.

Methods: Patients with acute coronary syndrome (ACS, N = 472) completed the Beck Depression Inventory (BDI) and measures of demographics, ACS clinical factors and perceived social support. Neighborhood characteristics, including median …

Environmental Data Analysis And Remote Sensing For Early Detection Of Dengue And Malaria, Md Zahidur Rahman, Leonid Roytman, Abdelhamid Kadik, Dilara A. Rosy

Publications and Research

Malaria and dengue fever are the two most common mosquito-transmitted diseases, leading to millions of serious illnesses and deaths each year. Because the mosquito vectors are sensitive to environmental conditions such as temperature, precipitation, and humidity, it is possible to map areas currently or imminently at high risk for disease outbreaks using satellite remote sensing. In this paper we propose the development of an operational geospatial system for malaria and dengue fever early warning; this can be done by bringing together geographic information system (GIS) tools, artificial neural networks (ANN) for efficient pattern recognition, the best available ground-based epidemiological and …

Association Between Symptomatic Vulvovaginal Candidiasis And Hiv Rna Levels In Plasma And Genital Secretions Among Women On Haart, Teke Apalata, William H. Carr, Benjamin Longo-Mbenza, Willem A. Sturm, P. Moodley

Publications and Research

Background. Genital tract (GT) inflammation plays a major role in HIV transmission. We aimed to determine the association between symptomatic vulvovaginal candidiasis (VVC) and HIV RNA levels in plasma and GTs of HIV-infected women on highly active antiretroviral therapy (HAART).

Method. Women with VVC on HAART were recruited from a primary healthcare clinic in KwaZulu-Natal Province, South Africa, between June 2011 and December 2011. VVC was diagnosed clinically, supported by Gram staining and culture of genital secretions. HIV RNA load was determined by reverse transcription polymerase chain reaction. CD4+ counts were obtained from patients’ medical records.

Results. Plasma HIV RNA …