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AN ANALYSIS OF PUERTO RICAN TESTIMONIOS OF OPPRESSION AND RESISTANCE IN POSTSECONDARY EDUCATION
College enrollment rates for Puerto Ricans in the United States and in the Commonwealth of Puerto Rico have been steadily increasing over the last twenty years; however, enrollment rates for 18- to 24-year-old Latinos remain low compared to whites of the same age groups. The rationale for this gap often portrays Latinos as deficient, using terms such as âacademic underachievementâ and âat-risk.â This framingâcentered on the individualâshifts the focus away from systemic barriers, such as limited financial resources for Latinos, culturally relevant pedagogy, intergenerational transfer of disadvantage, and systemic racism, among other factors explored this this study. This study contributes to our collective understanding of the Puerto Rican educational experience (as the second-largest Latino subgroup) through Lightfootâs portraiture methodology. In doing so, this study synthesizes the stories and other sources of data collected from four participants for the purpose of further analysis. These portraits seek to reconstruct in-depth lived-experience stories of Puerto Ricans who successfully navigated their educational journeys to the doctorate. As investigator, also a Puerto Rican earning a doctorate, I examine these portraits through the lens of Community Cultural Wealth (Yosso, 2005), which unpacks the forms of capital (aspirational, linguistic, familial, social, navigational, and resistant) each participant leveraged along their educational journeys. The portraits allow the investigator and the reader to ascertain a more nuanced understanding of the studentsâ educational journeys. For example, while participant portraits reflect highly varied backgrounds, participants experienced such barriers as poverty; access to books; and physical, emotional and/or sexual abuse. On the other hand, participants also experienced a number of factors that helped facilitate their educational journeys, such as community expectations; faculty member and/or advisor influence; and support from friends, peers, and loved ones. The portraits in this work shed light on the Puerto Rican experience through the doctorate, and contributes to limited literature regarding Puerto Rican doctoral degree attainment. The significance of this study highlights the need for more research on the educational experiences of Puerto Ricans, and the Latino diaspora more broadly. Recommendations for students, faculty, and administrators is also presented
Analysis of E2 gene integrity in HPV16 and HPV58 viruses isolated from women with cervical pathology
Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.
Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (â„2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of â„1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch
Children living with HIV in Europe: do migrants have worse treatment outcomes?
International audienceTo assess the effect of migrant status on treatment outcomes among children living with HIV in Europe
Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study
BACKGROUND: In human immunodeficiency virus (HIV)-positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART. METHODS: Sixteen cohorts from the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children <18 years at ART initiation, with sustained viral suppression (VS) (â€400 copies/mL) for â„1 year were included. The prevalence of PIR (defined as World Health Organization advanced/severe immunosuppression for age) at 1 year of VS was described. Factors associated with PIR were assessed using logistic regression. Rates of acquired immunodeficiency syndrome (AIDS) or death on suppressive ART were calculated by PIR status. RESULTS: Of 2318 children included, median age was 6.4 years and 68% had advanced/severe immunosuppression at ART initiation. At 1 year of VS, 12% had PIR. In multivariable analysis, PIR was associated with older age and worse immunological stage at ART start, hepatitis B coinfection, and residing in Thailand (all P †.03). Rates of AIDS/death (95% confidence interval) per 100 000 person-years were 1052 (547, 2022) among PIR versus 261 (166, 409) among immune responders; rate ratio of 4.04 (1.83, 8.92; P < .001). CONCLUSIONS: One in eight children in our cohort experienced PIR despite sustained VS. While the overall rate of AIDS/death was low, children with PIR had a 4-fold increase in risk of event as compared with immune responders
Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study
International audienceIn human immunodeficiency virus (HIV)-positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART