21 research outputs found
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Effect of Rectal Hygiene on Sexually Transmitted Infections Among HIV-Negative Men Who Have Sex with Men (MSM)
Abstract
Background
Rectal gonorrhea (NG) and chlamydia (Connecticut) infections are common among men who have sex with men (MSM). Rectal douching/enema (RDE) is a common practice among MSM that can affect the rectal microbiome. It is unclear if this practice is associated with acquiring rectal infections (RI) with either NG or CT.
Methods
From 2013–2015, 398 adult HIV-negative MSM and transwomen were enrolled in a randomized controlled study on text messaging for adherence to pre-exposure prophylaxis (PrEP). Participants were surveyed on sexual behavior, frequency of RDE, drug use, and nutritional habits in conjunction with routine sexually transmitted infection testing. Pearson’s χ 2 and two sample t-tests were used to measure significance of RDE and other risk factors with RI. Multivariable logistic regression model was used to control for confounding and assess the association of RDE with RIs. Confounders (i.e., age, number anal receptive sex, number sex partners) were selected a priori for inclusion in the final model based on a causal model and statistical significance.
Results
Of 397 participants, 262 (67%) performed RDE and 132 (33%) had at least one NG or CT rectal infection over 48 weeks. Number of condomless anal receptive sex acts (mean = 19, P < 0.001), condom use for anal receptive sex (P = 0.017), number of male sex partners in past 3 months (mean = 14, P = 0.001), and the use of poppers (P < 0.001) were associated with RI. There was no significant association between nutritional habits, probiotic foods or supplements and RI, with the exception of energy bars (P = 0.029). Controlling for confounders, RI was associated with RDE less than weekly with OR = 1.02 (95% CI 0.52–1.99) while RDE weekly or more had OR = 2.08 (95% CI 1.03–4.17). Stratified by number of partners, MSMs with more than the median (>6) number of partners had OR = 4.96 (95% CI 1.29–19.03) if performing RDE less than weekly, and OR = 6.03 (95% CI 1.55–23.49) if weekly or more.
Conclusion
Rectal hygiene with douching/enemas is a common practice among MSMs on PrEP, which increases the odds of acquiring rectal NG and/or CT. This finding is suggestive for the use of rectal hygiene products/practices as potential targets for sexually transmitted infection prevention.
Disclosures
All authors: No reported disclosures
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Characteristics of a cohort of high-risk men who have sex with men on pre-exposure prophylaxis reporting transgender sexual partners.
Transgender people continue to be at high-risk for HIV acquisition, but little is known about the characteristics of their sexual partners. To address this gap, we examined sociodemographic and sexual characteristics of cisgender men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) reporting transgender sexual partners.A cohort of 392 MSM in southern California in a randomized clinical trial for PrEP adherence were followed from 2013 to 2016. Multivariable generalized estimating equation and logistic models identified characteristics of MSM reporting transgender sexual partners and PrEP adherence.Only 14 (4%) MSM reported having transgender sexual partners. MSM were more likely to report transgender partners if they were African American, had incident chlamydia, reported injection drug-using sexual partners, or received items for sex. Most associations remained significant in the multivariable model: African American (adjusted odds ratio [AOR] 11.20, P = .01), incident chlamydia (AOR 3.71, P = .04), and receiving items for sex (AOR 5.29, P = .04). There were no significant differences in PrEP adherence between MSM reporting transgender partners and their counterpart.MSM who report transgender sexual partners share characteristics associated with individuals with high HIV prevalence. Identifying this group distinct from larger cohorts of MSM could offer new HIV prevention opportunities for this group of MSM and the transgender community
ISLAND: in-silico proteins binding affinity prediction using sequence information
Background:
Determining binding affinity in protein-protein interactions is important in the discovery and design of novel therapeutics and mutagenesis studies. Determination of binding affinity of proteins in the formation of protein complexes requires sophisticated, expensive and time-consuming experimentation which can be replaced with computational methods. Most computational prediction techniques require protein structures that limit their applicability to protein complexes with known structures. In this work, we explore sequence-based protein binding affinity prediction using machine learning.
Method:
We have used protein sequence information instead of protein structures along with machine learning techniques to accurately predict the protein binding affinity.
Results:
We present our findings that the true generalization performance of even the state-of-the-art sequence-only predictor is far from satisfactory and that the development of machine learning methods for binding affinity prediction with improved generalization performance is still an open problem. We have also proposed a sequence-based novel protein binding affinity predictor called ISLAND which gives better accuracy than existing methods over the same validation set as well as on external independent test dataset. A cloud-based webserver implementation of ISLAND and its python code are available at https://sites.google.com/view/wajidarshad/software.
Conclusion:
This paper highlights the fact that the true generalization performance of even the state-of-the-art sequence-only predictor of binding affinity is far from satisfactory and that the development of effective and practical methods in this domain is still an open problem
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The influence of the accessory genome on bacterial pathogen evolution
Bacterial pathogens exhibit significant variation in their genomic content of virulence factors. This reflects the abundance of strategies pathogens evolved to infect host organisms by suppressing host immunity. Molecular arms-races have been a strong driving force for the evolution of pathogenicity, with pathogens often encoding overlapping or redundant functions, such as type III protein secretion effectors and hosts encoding ever more sophisticated immune systems. The pathogens’ frequent exposure to other microbes, either in their host or in the environment, provides opportunities for the acquisition or interchange of mobile genetic elements. These DNA elements accessorise the core genome and can play major roles in shaping genome structure and altering the complement of virulence factors. Here, we review the different mobile genetic elements focusing on the more recent discoveries and highlighting their role in shaping bacterial pathogen evolution
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Cognitive Aging in Marginalized Populations
Introduction: Dementia is a progressive condition marked by a decline in cognitive abilities, impairing an individual’s daily functioning and leading to dependence. Currently, there are over 55 million dementia cases globally, with over 60% of cases concentrated in low- and middle-income countries (LMICs). The population in LMICs is particularly vulnerable for risk of dementia from exposure to indoor air pollutants due to highly prevalent use of biomass fuel for cooking and heating. Additionally in the United States, nearly half of the 16.5 million living military veterans are men 65 years or older who are vulnerable for dementia due to various hazardous exposures during their time in service. With an aging global population, it is imperative to focus on preventing and delaying the onset of dementia, including among individuals in LMICs and former US service members. This dissertation aimed to further characterize the risk of impaired cognitive function by exposure to indoor air pollutants and veteran status among marginalized populations in India and the US, respectively.Method: Using data obtained from a nationally representative cross-sectional survey in India, I estimated the effect of exposure to reported use of unclean cooking fuel compared with clean cooking fuel on culturally appropriate measures of cognitive function and prevalence of neurocognitive disorder among older Indian women and evaluated the extent to which type of housing (permanent vs. semi-permanent construction materials) modified this effect. Additionally, I estimated the effect of exposure to reported use of unclean cooking fuel within the household on cognitive function and prevalence of neurocognitive disorder among older Indian adults and identified whether this association differed by sex. I used generalized linear models to estimate mean differences in cognitive factor scores and prevalence of neurocognitive disorder by type of cooking fuel within the sample. I added an interaction term between type of cooking fuel and housing type, and type of cooking fuel and sex, to assess for effect modification by type of housing and sex, respectively.
Using data from two harmonized cohort studies, Kaiser Healthy Aging and Diverse Life Experiences and Study of Healthy Aging in African Americans, I assessed late-life cognitive function and rate of cognitive change among US male veterans compared with non-veterans, and the extent to which veteran status modified the effect of a self-reported lifetime encounter with blasts/explosions on late-life cognitive function and rate of cognitive change. I used linear mixed effects models with age as the timescale to evaluate the extent to which average cognitive function and rate of cognitive change differed by veteran status. To assess for possible effect modification by veteran status on the association between reported lifetime exposure to blasts/explosions and cognitive measures, I conducted a subgroup analysis by veteran status and a pooled analysis with interaction terms between veteran status, reported lifetime exposure to blasts/explosions and age.Result: In the population of older Indian women, overall and domain specific cognitive factor scores were worse for women who reported use of unclean cooking fuel compared with women who reported using clean cooking fuel. There was modest evidence that type of housing modified this relationship, namely, women living in homes made with semi-permanent construction materials performed poorer in the specific domains of executive function, language/fluency, and memory (P-value for interaction <0.10). The prevalence ratio (PR) of neurocognitive disorder was modestly consistent with a higher prevalence for women who reported use of unclean cooking fuel (PR: 1.16, 95% CI 0.97, 1.40), but the confidence intervals were consistent with values ranging from little or no effect to moderate increase in prevalence. When assessing whether the association between reported household use of unclean cooking fuel on late-life cognitive function differed by sex, mean differences in cognitive factor scores were slightly greater for women in the overall and specific domains of orientation, language/fluency, and visuospatial ability (P-value for interaction <0.10). Among men, reported household use of unclean cooking fuel was associated with higher prevalence of neurocognitive disorder (PR: 1.41, 95% CI 1.09, 1.83). However, among women, this association was moderately consistent with higher estimates (PR: 1.18, 95% CI 0.93, 1.50), but the confidence intervals were consistent with values ranging from little or no effect to moderate increase in prevalence. Among US men, average verbal episodic memory scores at age 75 years were slightly higher among veterans compared to non-veterans (Coefficient: 0.12, 95% CI 0.01, 0.23). There were no differences in average executive function scores at age 75 years (Coefficient: 0.06, 95% CI -0.06, 0.18) or in the annual rate of change in either cognitive domains comparing veterans to non-veterans. The overall association between reported lifetime exposure to blasts/explosions and late-life cognitive trajectory was null for the full sample and did not reveal robust evidence for effect modification by veteran status. Conclusion: Among older Indian women, upgrading homes made with semi-permanent materials to permanent materials and transitioning to sustainable use of clean fuel may help reduce risk of late-life cognitive impairment. Further exploration of potential confounders is needed including exploring possible effects of outdoor air pollution and other early and mid-life socio-economic factors to rule out alternative explanations for the association observed among men and to accurately determine differences in effect by sex. In the US, rate of cognitive change by veteran status should remain an important measure to monitor in a rapidly aging veteran population, with further work needed towards correctly assessing potential resilience mechanisms and heterogeneity within the veteran population