Evaluating the impact of policies recommending PrEP to subpopulations of men and transgender women who have sex with men based on demographic and behavioral risk factors.

IntroductionDeveloping guidelines to inform the use of antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention in resource-limited settings must necessarily be informed by considering the resources and infrastructure needed for PrEP delivery. We describe an approach that identifies subpopulations of cisgender men who have sex with men (MSM) and transgender women (TGW) to prioritize for the rollout of PrEP in resource-limited settings.MethodsWe use data from the iPrEx study, a multi-national phase III study of PrEP for HIV prevention in MSM/TGW, to build statistical models that identify subpopulations at high risk of HIV acquisition without PrEP, and with high expected PrEP benefit. We then evaluate empirically the population impact of policies recommending PrEP to these subpopulations, and contrast these with existing policies.ResultsA policy recommending PrEP to a high risk subpopulation of MSM/TGW reporting condomless receptive anal intercourse over the last 3 months (estimated 3.3% 1-year HIV incidence) yields an estimated 1.95% absolute reduction in 1-year HIV incidence at the population level, and 3.83% reduction over 2 years. Importantly, such a policy requires rolling PrEP out to just 59.7% of MSM/TGW in the iPrEx population. We find that this policy is identical to that which prioritizes MSM/TGW with high expected PrEP benefit. It is estimated to achieve nearly the same reduction in HIV incidence as the PrEP guideline put forth by the US Centers for Disease Control, which relies on the measurement of more behavioral risk factors and which would recommend PrEP to a larger subset of the MSM/TGW population (86% vs. 60%).ConclusionsThese findings may be used to focus future mathematical modelling studies of PrEP in resource-limited settings on prioritizing PrEP for high-risk subpopulations of MSM/TGW. The statistical approach we took could be employed to develop PrEP policies for other at-risk populations and resource-limited settings

Galactic Winds and the Photo-chemical Evolution of Elliptical Galaxies: The Classic Model Revisited

We consider the simultaneous chemical, photometric, and gaseous thermal energy evolution of elliptical galaxies. The evolution of chemical abundances in the intracluster medium (ICM) is set by the differing timescales for gas ejection, via supernovae (SNe)-driven winds, from dwarf, normal, and giant ellipticals, and is monitored concurrently. Emphasis is placed upon the influence of, and sensitivity to, the underlying stellar initial mass function (IMF), star formation efficiency, supernovae Type Ia rates, supernovae remnant (SNR) dynamics, and the most recent advances in stellar nucleosynthesis. Unlike many previous studies, we adhere to a wide range of optical (e.g. colour-metallicity-luminosity relationship) and x-ray (e.g. recent ASCA ICM abundance measurements) observational constraints. IMFs biased toward high mass stars, at least during the early phases of star formation, are implicated in order to satisfy all the observational constraints.Comment: 18 pages, LaTeX, also available at http://msowww.anu.edu.au/~gibson/publications.html, MNRAS, in pres

Probing the evolution of early-type galaxies using multi-colour number counts and redshift distributions

We investigate pure luminosity evolution models for early-type (elliptical and S0) galaxies (i.e., no number density change or morphology transition), and examine whether these models are consistent with observed number counts in the B, I and K bands and redshift distributions of two samples of faint galaxies selected in the I and K bands. The models are characterized by the star formation time scale $\tau_{SF}$ and the time $t_{gw}$ when galactic wind blows in addition to several other conventional parameters. We find the single-burst model ($\tau_{SF}$=0.1 Gyr and $t_{gw}$=0.353 Gyr), which is known to reproduce the photometric properties of early-type galaxies in clusters, is inconsistent with redshift distributions of early-type galaxies in the field environment due to overpredictions of galaxies at z\gsim1.4 even with strong extinction which is at work until $t_{gw}$. In order for dust extinction to be more effective, we change $\tau_{SF}$ and $t_{gw}$ as free parameters, and find that models with \tau_{SF}\gsim0.5 Gyr and $t_{gw}>1.0$ Gyr can be made consistent with both the observed redshift distributions and number counts, if we introduce strong extinction $(E(B-V)\geq1$ as a peak value). These results suggest that early-type galaxies in the field environment do not have the same evolutionary history as described by the single-burst model.Comment: 6 pages including 4 PS figures; accepted for publication in MNRA

Numerical Relativity Injection Infrastructure

This document describes the new Numerical Relativity (NR) injection infrastructure in the LIGO Algorithms Library (LAL), which henceforth allows for the usage of NR waveforms as a discrete waveform approximant in LAL. With this new interface, NR waveforms provided in the described format can directly be used as simulated GW signals ("injections") for data analyses, which include parameter estimation, searches, hardware injections etc. As opposed to the previous infrastructure, this new interface natively handles sub-dominant modes and waveforms from numerical simulations of precessing binary black holes, making them directly accessible to LIGO analyses. To correctly handle precessing simulations, the new NR injection infrastructure internally transforms the NR data into the coordinate frame convention used in LAL.Comment: 20 pages, 2 figures, technical repor

HIV transmission networks among transgender women in Los Angeles County, CA, USA: a phylogenetic analysis of surveillance data.

BackgroundTransgender women are among the groups at highest risk for HIV infection, with a prevalence of 27·7% in the USA; and despite this known high risk, undiagnosed infection is common in this population. We set out to identify transgender women and their partners in a molecular transmission network to prioritise public health activities.MethodsSince 2006, HIV protease and reverse transcriptase gene (pol) sequences from drug resistance testing have been reported to the Los Angeles County Department of Public Health and linked to demographic data, gender, and HIV transmission risk factor data for each case in the enhanced HIV/AIDS Reporting System. We reconstructed a molecular transmission network by use of HIV-TRAnsmission Cluster Engine (with a pairwise genetic distance threshold of 0·015 substitutions per site) from the earliest pol sequences from 22 398 unique individuals, including 412 (2%) self-identified transgender women. We examined the possible predictors of clustering with multivariate logistic regression. We characterised the genetically linked partners of transgender women and calculated assortativity (the tendency for people to link to other people with the same attributes) for each transmission risk group.Findings8133 (36·3%) of 22 398 individuals clustered in the network across 1722 molecular transmission clusters. Transgender women who indicated a sexual risk factor clustered at the highest frequency in the network, with 147 (43%) of 345 being linked to at least one other person (adjusted odds ratio [aOR] 2·0, p=0·0002). Transgender women were assortative in the network (assortativity 0·06, p<0·001), indicating that they tended to link to other transgender women. Transgender women were more likely than expected to link to other transgender women (OR 4·65, p<0·001) and cisgender men who did not identify as men who have sex with men (MSM; OR 1·53, p<0·001). Transgender women were less likely than expected to link to MSM (OR 0·75, p<0·001), despite the high prevalence of HIV among MSM. Transgender women were distributed across 126 clusters, and cisgender individuals linked to one transgender woman were 9·2 times more likely to link to a second transgender woman than other individuals in the surveillance database. Reconstruction of the transmission network is limited by sample availability, but sequences were available for more than 40% of diagnoses.InterpretationClustering of transgender women and the observed tendency for linkage with cisgender men who did not identify as MSM, shows the potential to use molecular epidemiology both to identify clusters that are likely to include undiagnosed transgender women with HIV and to improve the targeting of public health prevention and treatment services to transgender women.FundingCalifornia HIV and AIDS Research Program and National Institutes of Health-National Institute of Allergy and Infectious Diseases

On Dwarf Galaxies as the Source of Intracluster Gas

Recent observational evidence for steep dwarf galaxy luminosity functions in several rich clusters has led to speculation that their precursors may be the source of the majority of gas and metals inferred from intracluster medium (ICM) x-ray observations. Their deposition into the ICM is presumed to occur through early supernovae-driven winds, the resultant systems reflecting the photometric and chemical properties of the low luminosity dwarf spheroidals and ellipticals we observe locally. We consider this scenario, utilising a self-consistent model for spheroidal photo-chemical evolution and gas ejection via galactic superwinds. Insisting that post-wind dwarfs obey the observed colour-luminosity-metallicity relations, we conclude that the bulk of the ICM gas and metals does not originate within their precursors.Comment: 43 pages, 8 figures, LaTeX, also available at http://msowww.anu.edu.au/~gibson/publications.html, to appear in ApJ, Vol 473, 1997, in pres

Gravitational Waves in Brans-Dicke Theory : Analysis by Test Particles around a Kerr Black Hole

Analyzing test particles falling into a Kerr black hole, we study gravitational waves in Brans-Dicke theory of gravity. First we consider a test particle plunging with a constant azimuthal angle into a rotating black hole and calculate the waveform and emitted energy of both scalar and tensor modes of gravitational radiation. We find that the waveform as well as the energy of the scalar gravitational waves weakly depends on the rotation parameter of black hole $a$ and on the azimuthal angle. Secondly, using a model of a non-spherical dust shell of test particles falling into a Kerr black hole, we study when the scalar modes dominate. When a black hole is rotating, the tensor modes do not vanish even for a ``spherically symmetric" shell, instead a slightly oblate shell minimizes their energy but with non-zero finite value, which depends on Kerr parameter $a$. As a result, we find that the scalar modes dominate only for highly spherical collapse, but they never exceed the tensor modes unless the Brans-Dicke parameter \omega_{BD} \lsim 750 for $a/M=0.99$ or unless \omega_{BD} \lsim 20,000 for $a/M=0.5$, where $M$ is mass of black hole. We conclude that the scalar gravitational waves with \omega_{BD} \lsim several thousands do not dominate except for very limited situations (observation from the face-on direction of a test particle falling into a Schwarzschild black hole or highly spherical dust shell collapse into a Kerr black hole). Therefore observation of polarization is also required when we determine the theory of gravity by the observation of gravitational waves.Comment: 24 pages, revtex, 18 figures are attached with ps file

Multiparameter Twisted Weyl Algebras

We introduce a new family of twisted generalized Weyl algebras, called multiparameter twisted Weyl algebras, for which we parametrize all simple quotients of a certain kind. Both Jordan's simple localization of the multiparameter quantized Weyl algebra and Hayashi's q-analog of the Weyl algebra are special cases of this construction. We classify all simple weight modules over any multiparameter twisted Weyl algebra. Extending results by Benkart and Ondrus, we also describe all Whittaker pairs up to isomorphism over a class of twisted generalized Weyl algebras which includes the multiparameter twisted Weyl algebras.Comment: 20 page