Improved HIV and Substance Abuse Treatment Outcomes for Released HIV-Infected Prisoners: The Impact of Buprenorphine Treatment

HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these, 30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX. Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline, the proportion with a non-detectable viral load (61% vs 63% log10 copies/mL) and mean CD4 count (367 vs 344 cells/mL) was unchanged at 12 weeks. Opiate-negative urine testing remained 83% for the 21 who completed induction. Using means from 10-point Likert scales, opioid craving was reduced from 6.0 to 1.8 within 3 days of BPN/NLX induction and satisfaction remained high at 9.5 throughout the 12 weeks. Adverse events were few and mild. BPN/NLX therapy was acceptable, safe and effective for both HIV and opioid treatment outcomes among released HIV-infected prisoners. Future randomized controlled trials are needed to affirm its benefit in this highly vulnerable population

Journal of Shopping Center Research Consumer Preferences for Retail Formats: Implications for Tenant Mix Strategies Teens and Shopping Mall Preferences: A Conjoint Analysis Approach to Understanding the Generational Shift Toward an Experience Economy Mixe

REITs offer a unique and convenient way to study retail property portfolios because of abundant available information with which the market prices risk and return metrics. In this study, we assess how retail portfolio risk is priced in the public real estate investment market. The results reveal which retail portfolio risk factors, such as the degree of diversification (measured with Herfindahl indexes based on retail property sub-type and geography), portfolio obsolescence (measured as the weighted effective age of the property portfolio), and other factors affect various measures of financial risk. Also, in contrast to most other financial studies, we will test the retail portfolio risk effects associated with various demographic trends and forecasts. The results show that the retail portfolio risk of REITs increase with diversification into different geographic regions and decrease with selfmanagement, property type diversification, net leased properties, and increased portfolio size

HIV-related research in correctional populations: now is the time.

The incarcerated population has increased to unprecedented levels following the 1970 US declaration of war on illicit drug use. A substantial proportion of people with or at risk for HIV infection, including those with substance use and mental health disorders, have become incarcerated. The overlapping epidemics of incarceration and HIV present a need for academic medical centers to collaborate with the criminal justice system to improve the health of incarcerated populations. With coordinated collaboration and new programmatic initiatives it is possible to reduce HIV-associated risk behaviors and the likelihood of acquisition and transmission of HIV. Centers for AIDS Research (CFAR), funded by the National Institutes of Health, have proactively responded to this need through Collaboration on HIV in Corrections (CHIC) to improve the diagnosis, treatment, linkage to care, and prevention of HIV. This collaboration serves as a model for aligning academic expertise with criminal justice to confront this challenge to individual and public health. This is especially relevant given recent evidence of the effectiveness of antiretroviral therapy in reducing HIV transmission

Journal of Shopping Center Research Consumer Preferences for Retail Formats: Implications for Tenant Mix Strategies Teens and Shopping Mall Preferences: A Conjoint Analysis Approach to Understanding the Generational Shift Toward an Experience Economy Mixe

This study focuses on the shopping mall preferences of teens 12-17, a trendsetting segment that tends to be heavy users of enclosed shopping malls. Conjoint analysis and a web survey are used to address the primary research questions or objectives: (1) What are the important attributes that teens consider when choosing among shopping malls?; (2) What does the "ideal" shopping mall look like to teens?; and (3) What trade-offs are teens willing to make among different mall attributes and attribute levels? A representative sample of 918 U.S. teens completed an online conjoint task that asked them to choose among hypothetical mall products. The findings indicated that the most important attributes in teens' choice of a mall to frequent are how friendly and welcoming the mall is to teens and whether the mall contains "cool" stores. Further, the most preferred or "ideal" mall (i.e., the one with the greatest overall utility), across all respondents, is one that has "lots of" everything (cool stores, entertainment options, etc.), is a good place to hang out with friends, and is very attractively designed. Teens are also almost twenty times more likely to choose to go to a mall with lots of experiential characteristics (skateboard and theme parks, cultural and live music events, theaters, etc.) than to go to the typical status quo mall with a movie theater (76% versus 4%, respectively), everything else being equal. This paper concludes with a discussion of the need for malls to develop a comprehensive experiential retail strategy that meets the needs of the teen recreational shopper

Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load.

BackgroundSubstance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved.MethodsThis was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies. We used joint longitudinal and survival models to examine the impact of decreasing drug use and of abstinence for each drug on viral suppression. We repeated analyses using linear mixed models to examine associations between change in frequency of drug use and VL.ResultsThe number of PLWH who were using each drug at baseline ranged from n = 568 (illicit opioids) to n = 4272 (marijuana). Abstinence was associated with higher odds of viral suppression (odds ratio [OR], 1.4-2.2) and lower relative VL (ranging from 21% to 42% by drug) for all 4 drug categories. Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with VL suppression (OR, 2.2, 1.6, respectively). Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with lower relative VL (47%, 38%, respectively).ConclusionsAbstinence was associated with viral suppression. In addition, reducing use of illicit opioids or methamphetamine/crystal, even without abstinence, was also associated with viral suppression. Our findings highlight the impact of reducing substance use, even when abstinence is not achieved, and the potential benefits of medications, behavioral interventions, and harm-reduction interventions