74 research outputs found
TRAJECTORIES OF RISKY SEXUAL BEHAVIOR, DEPRESSIVE SYMPTOMS, AND SUBSTANCE USE IN A COHORT OF MIDDLE-AGED AND OLDER ADULTS IN THE PITT MEN'S STUDY
There is a general misperception that sexuality and sexual orientation are not important in the lives of older adults. Older gay and bisexual men remain an invisible population in which health behaviors and health status are less well-known. While an enormous body of research has documented the disparities of substance use, depression, and HIV prevalence among Men who have Sex with Men (MSM) compared to heterosexual men, less is known about how patterns of substance use, depression, and risky sexual behavior evolve as MSM age. Using a semi-parametric, group-based approach, this study investigated the effect of aging on risky sexual behavior, depression, and illicit drug use in a cohort of middle-aged and older MSM in the Pitt Men's Study. In the three presented manuscripts, results indicate that the majority of participants did not have unprotected anal intercourse partners or use illicit drugs, and reported very low depressive symptoms across the age range of the study. At the same time, the analysis identified trajectory groups with respect to midlife exposure to risky sexual behavior, chronic depressive symptoms, and multiple illicit drug use. Several correlates such as socio-demographic variables, health behaviors (smoking and binge drinking), and psychological variables (HIV-related attitudes) were differentially associated with the trajectory groups.The results of the study refuted the negative stereotypes of older gay and bisexual men as "sad, undesirable, and depressed", yet the study managed to provide a more realistic picture of the development of mental health and HIV risk behaviors of this cohort from middle to early old age. This confirms the diversity and heterogeneity of this population noted by previous researchers. Public Health Significance: Using this epidemiologic approach, future researchers can identify subgroups of men who are at most risk for depression, substance abuse, and risky sexual behaviors over an extended period of time. As a result, public health resources such as prevention and intervention programs can be allocated to these men in a cost-effective way. In addition, investigations of the risk factors associated to each trajectory group may give clues to different etiologies of group characteristics among a cohort of aging sexual minorities
Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol
Introduction: Private sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC.
Methods and analysis: This review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with 90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results.
Ethics and dissemination: The results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research
Viral load and sequence analysis reveal the symptom severity, diversity, and transmission clusters of Rhinovirus infections
Background:Rhinovirus (RV) is one of the main viral etiologic agents of acute respiratory illnesses. Despite the heightened disease burden caused by RV, the viral factors that increase the severity of RV infection, the transmission pattern, and seasonality of RV infections remain unclear.
Methods: An observational study was conducted among 3935 patients presenting with acute upper respiratory illnesses in the ambulatory settings between 2012 and 2014.
Results: The VP4/VP2 gene was genotyped from all 976 RV-positive specimens, where the predominance of RV-A (49%) was observed, followed by RV-C (38%) and RV-B (13%). A significant regression in median nasopharyngeal viral load (VL) (P < .001) was observed, from 883 viral copies/µL at 1-2 days after symptom onset to 312 viral copies/µL at 3-4 days and 158 viral copies/µL at 5-7 days, before declining to 35 viral copies/µL at ≥8 days. In comparison with RV-A (median VL, 217 copies/µL) and RV-B (median VL, 275 copies/µL), RV-C-infected subjects produced higher VL (505 copies/µL; P < .001). Importantly, higher RV VL (median, 348 copies/µL) was associated with more severe respiratory symptoms (Total Symptom Severity Score ≥17, P = .017). A total of 83 phylogenetic-based transmission clusters were identified in the population. It was observed that the relative humidity was the strongest environmental predictor of RV seasonality in the tropical climate.
Conclusions: Our findings underline the role of VL in increasing disease severity attributed to RV-C infection, and unravel the factors that fuel the population transmission dynamics of R
Co-pyrolysis of Chlorella vulgaris with plastic wastes: Thermal degradation, kinetics and Progressive Depth Swarm-Evolution (PDSE) neuro network-based optimization
The search of sustainable route for biofuel production from renewable biomass have garnered wide interest to seek for various routes without compromising the environment. Co-pyrolysis emerges as a promising thermochemical route that can improve the pyrolysis output from simultaneously processing more than two feedstocks in an inert atmosphere. This paper focuses on the kinetic modeling and neuro-evolution optimization in the application of catalytic co-pyrolysis of microalgae and plastic waste using HZSM-5 supported on limestone (HZSM-5/LS), in which co-pyrolysis of binary mixture of microalgae and plastic wastes (i.e. High-Density Polyethylene and Low-Density Polyethylene) was investigated over different heating rates. The results have shown a positive synergistic effect between the microalgae and polyethylene in which the apparent activation energies values have reduced significantly (
20 kJ/mol) compared to that obtained by pyrolysis of individual microalgae component. The kinetic models reflect that the mixture of microalgae and Low-Density Polyethylene for use as co-pyrolysis feedstock requires activation energy that is 23% and 13% lower compared to that required by pure microalgae and the mixture of microalgae and High-Density Polyethylene, respectively. The Progressive Depth Swarm-Evolution (PDSE) was used for neural architecture search, which subsequently provided optimal reaction condition at 873 K can achieve 99.6 % of degradation rate using a tri-combination of LDPE (0.13 %) + HDPE (0.77 %) + MA (0.11 %) in the presence of HZSM-5/LS catalyst
HIV and adolescents: focus on young key populations
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/1/jia20076.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/2/jia20076-sup-0001.pd
Data-Driven Analysis of COVID-19 Reveals Persistent Immune Abnormalities in Convalescent Severe Individuals
Severe SARS-CoV-2 infection can trigger uncontrolled innate and adaptive immune responses, which are commonly associated with lymphopenia and increased neutrophil counts. However, whether the immune abnormalities observed in mild to severely infected patients persist into convalescence remains unclear. Herein, comparisons were drawn between the immune responses of COVID-19 infected and convalescent adults. Strikingly, survivors of severe COVID-19 had decreased proportions of NKT and Vδ2 T cells, and increased proportions of low-density neutrophils, IgA+/CD86+/CD123+ non-classical monocytes and hyperactivated HLADR+CD38+ CD8+ T cells, and elevated levels of pro-inflammatory cytokines such as hepatocyte growth factor and vascular endothelial growth factor A, long after virus clearance. Our study suggests potential immune correlates of “long COVID-19”, and defines key cells and cytokines that delineate true and quasi-convalescent states
A Qualitative Study of Young Men Who Have Sex With Men and Multilevel Factors Related to HIV Risks in Malaysia
Young men who have sex with men (YMSM) are a group at high risk for HIV infection, yet no research has been conducted to understand this population in Malaysia. Semistructured interviews from a combination of YMSM aged 18–25 (n = 20) and local service providers of sexual health services (n = 4) were conducted from May to June 2015. Thematic analysis was used to identify common themes in participant responses from transcripts. Participants reported societal and internalized homophobia, an absence of sex education and difficulty accessing confidential HIV testing. This study provides insights into how homophobia in Malaysian society influences individual risk behavior for HIV in Malaysian YMSM, and makes practical suggestions for more effective HIV prevention in this population
“Allah will decide my life and death”: Religion and spirituality among populations at risk for HIV in Malaysia
We examined the influence of religion and spirituality on HIV risk contexts through in-depth interviews with men who have sex with men (n = 10) and female commercial sex workers (n = 10) in Malaysia. Using a grounded theory approach, five themes emerged from the interviews: (a) religion encourages caring for health, (b) health is influenced by a higher power, (c) prayer is a conduit to health assistance, (d) stigma is compounded by religion but it does not limit one’s spirituality, and (e) religion is not but should be incorporated into HIV campaigns. Incorporation of spirituality in service provision and addressing stigma is warranted
Group sex, suicidality and online partners: implications for HIV and suicide prevention: a short report
HIV-related factors and suicide-risk status were assessed among YMSM aged 18-24 years recruited through various MSM-related online social apps in Bangkok (N=1394). The online survey assessed demographic characteristics, sexual behaviours and suicide-risk status. Measure of suicide risk was taken from the Suicidal Behaviors Questionnaire-Revised (cut-off score of seven or higher). Among participants, 249 (17.9%) reported suicide-risk. In multivariable logistic regression, correlates of suicide-risk status included having sometimes or often ever participated in group sex (AOR=1.58, 95% CI: 1.17-2.14), having received money or opportunities for sex (AOR=1.54, 95% CI: 1.09-2.17), often seeking partners online (AOR=1.59, 95% CI: 1.05-2.39), inconsistent condom use (AOR=1.67, 95% CI: 1.26-2.21), and self-assessed as having “medium” or “high” HIV risk (AOR=2.53, 95% CI: 1.61-3.98 and AOR=3.35, 95% CI: 1.92-5.82, respectively). Findings suggest that HIV risk behaviours shown by YMSM are significantly associated with higher risk of suicide
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