Global Burden of HIV among Men Who Engage in Transactional Sex: A Systematic Review and Meta-Analysis

Background: Men who engage in transactional sex, the exchange of sex for money, goods, or other items of value, are thought to be at increased risk of HIV, but there have been no systematic attempts to characterize HIV burden in this population. We undertook a systematic review and meta-analysis to quantify the burden in this population compared with that of men in the general population to better inform future HIV prevention efforts. Methods: We searched seven electronic databases, national surveillance reports, and conference abstracts for studies of men who engage in transactional sex published between 2004–2013. Random effects meta-analysis was used to determine pooled HIV prevalence and prevalence ratios (PR) for the difference in HIV prevalence among men who engage in transactional sex as compared to general population men. Findings: Of 66 studies included representing 31,924 men who had engaged in transactional sex in 28 countries, pooled biological assay-confirmed HIV prevalence was 10.5% (95% CI = 9.4 to 11.5%). The highest pooled HIV prevalence was in Sub-Saharan Africa (31.5%, 95% CI = 21.6 to 41.5%), followed by Latin America (19.3%, 95% CI = 15.5 to 23.1%), North America (16.6%, 95% CI = 3.7 to 29.5%), and Europe (12.2%, 95% CI = 6.0 to 17.2%). Men who engaged in transactional sex had an elevated burden of HIV compared to the general male population (PR = 20.7, 95% CI = 16.8 to 25.5). Conclusions: The global burden of HIV is disproportionately high among men who engage in transactional sex compared with the general male population. There is an urgent need to include this population in systematic surveillance as well as to scale-up access to quality HIV prevention programs

Cranial Remodeling Orthosis for Infantile Plagiocephaly Created Through a 3D Scan, Topological Optimization, and 3D Printing Process

International audienc

Prevalence ratios comparing pooled HIV prevalence among men who engage in transactional sex to general population men aged 15 and older.

1<p>Among studies confirming HIV infection with a biological assay and among studies reporting ≥50 participants;</p>2<p>All prevalence ratios significant (<i>P</i><0.05) except for Bangladesh and Canada.</p><p>N = number of subjects; k = number of studies; I² = variation in pooled prevalence ratio due to heterogeneity; 95% CI = 95% Confidence Interval.</p

Proportion of studies reporting individual factors that affect vulnerability to HIV by region, overall and specifically among men who engage in transactional sex.

1<p>Including syphilis, gonorrhea, chlamydia, human papilloma virus (HPV), and/or herpes simplex virus (HSV);</p>2<p>Risk factor reported among any population in the study (i.e., men who have sex with men);</p>3<p>Risk factor reported specifically among men who engage in transactional sex;</p>4<p>Fisher’s exact test comparing frequency of reporting factors by geographic region of study, overall and among men who report transactional sex.</p

Pooled HIV prevalence by country among studies reporting biologically-confirmed HIV prevalence with a sample size of ≥50 (N = 66).

<p>Pooled HIV prevalence by country among studies reporting biologically-confirmed HIV prevalence with a sample size of ≥50 (N = 66).</p

Pooled HIV prevalence by HIV measurement and sample size.

<p>N = number of subjects; k = number of studies; 95% CI = 95% Confidence Interval.</p

Flow diagram of included studies.

<p>Flow diagram of included studies.</p

Pacific Spine and Pain Society (PSPS) Evidence Review of Surgical Treatments for Lumbar Degenerative Spinal Disease: A Narrative Review

Abstract Introduction Interventional treatment options for the lumbar degenerative spine have undergone a significant amount of innovation over the last decade. As new technologies emerge, along with the surgical specialty expansion, there is no manuscript that utilizes a review of surgical treatments with evidence rankings from multiple specialties, namely, the interventional pain and spine communities. Through the Pacific Spine and Pain Society (PSPS), the purpose of this manuscript is to provide a balanced evidence review of available surgical treatments. Methods The PSPS Research Committee created a working group that performed a comprehensive literature search on available surgical technologies for the treatment of the degenerative spine, utilizing the ranking assessment based on USPSTF (United States Preventative Services Taskforce) and NASS (North American Spine Society) criteria. Results The surgical treatments were separated based on disease process, including treatments for degenerative disc disease, spondylolisthesis, and spinal stenosis. Conclusions There is emerging and significant evidence to support multiple approaches to treat the symptomatic lumbar degenerative spine. As new technologies become available, training, education, credentialing, and peer review are essential for optimizing patient safety and successful outcomes

Discovery of Lipids from B. longum subsp. <i>infantis</i> using Whole Cell MALDI Analysis

Bifidobacteria are dominant members of the microbial community in the intestinal tract of infants, and studies have shown that glycolipids extracted from the cell surface of these bacteria elicit beneficial immune responses. Accordingly, the identification and structural characterization of glycolipids from the cell wall of bifidobacteria is the first step in correlating glycolipid structure with biological activity. Using whole cell MALDI as a screening tool, we herein present for the first time the identification and structural elucidation of the major polar lipids from Bifidobacterium longum subs. <i>infantis</i>. The lipids identified include an unprecedented plasmenyl cyclophosphatidic acid and a mixed acetal glycolipid, with the latter subsequently being isolated and found to suppress the innate immune response