Adaptation of the African Couples HIV Testing and Counseling Model for Men who have Sex with Men in the United States: an Application of the ADAPT-ITT Framework

To respond to the need for new HIV prevention services for men who have sex with men (MSM) in the United States, and to respond to new data on the key role of main partnerships in US MSM epidemics, we sought to develop a new service for joint HIV testing of male couples. We used the ADAPT-ITT framework to guide our work. From May 2009 to July 2013, a multiphase process was undertaken to identify an appropriate service as the basis for adaptation, collect data to inform the adaptation, adapt the testing service, develop training materials, test the adapted service, and scale up and evaluate the initial version of the service. We chose to base our adaptation on an African couples HIV testing service that was developed in the 1980s and has been widely disseminated in low- and middle-income countries. Our adaptation was informed by qualitative data collections from MSM and HIV counselors, multiple online surveys of MSM, information gathering from key stakeholders, and theater testing of the adapted service with MSM and HIV counselors. Results of initial testing indicate that the adapted service is highly acceptable to MSM and to HIV counselors, that there are no evident harms (e.g., intimate partner violence, relationship dissolution) associated with the service, and that the service identifies a substantial number of HIV serodiscordant male couples. The story of the development and scale-up of the adapted service illustrates how multiple public and foundation funding sources can collaborate to bring a prevention adaptation from concept to public health application, touching on research, program evaluation, implementation science, and public health program delivery. The result of this process is an adapted couples HIV testing approach, with training materials and handoff from academic partners to public health for assessment of effectiveness and consideration of the potential benefits of implementation; further work is needed to optimally adapt the African couples testing service for use with male–female couples in the United States

Advantages of Syphilis Testing at Non-Traditional Testing Sites

Although syphilis testing can be conducted in a clinical setting, many individuals refuse to test because they do not have proper access to testing and treatment. This presentation will show how two Community Based Organizations offered free syphilis testing to men who have sex with men in Metro Atlanta

Metapopulation Tracking Juvenile Penguins Reveals an Ecosystem-wide Ecological Trap

Climate change and fisheries are transforming the oceans, but we lack a complete understanding of their ecological impact [1; 2 ; 3]. Environmental degradation can cause maladaptive habitat selection, inducing ecological traps with profound consequences for biodiversity [4; 5 ; 6]. However, whether ecological traps operate in marine systems is unclear [7]. Large marine vertebrates may be vulnerable to ecological traps [6], but their broad-scale movements and complex life histories obscure the population-level consequences of habitat selection [8 ; 9]. We satellite tracked postnatal dispersal in African penguins (Spheniscus demersus) from eight sites across their breeding range to test whether they have become ecologically trapped in the degraded Benguela ecosystem. Bayesian state-space and habitat models show that penguins traversed thousands of square kilometers to areas of low sea surface temperatures (14.5°C–17.5°C) and high chlorophyll-a (∼11 mg m−3). These were once reliable cues for prey-rich waters, but climate change and industrial fishing have depleted forage fish stocks in this system [ 10 ; 11]. Juvenile penguin survival is low in populations selecting degraded areas, and Bayesian projection models suggest that breeding numbers are ∼50% lower than if non-impacted habitats were used, revealing the extent and effect of a marine ecological trap for the first time. These cascading impacts of localized forage fish depletion—unobserved in studies on adults—were only elucidated via broad-scale movement and demographic data on juveniles. Our results support suspending fishing when prey biomass drops below critical thresholds [ 12 ; 13] and suggest that mitigation of marine ecological traps will require matching conservation action to the scale of ecological processes [14]

Safety and Acceptability of Couples HIV Testing and Counseling for US Men Who Have Sex with Men

We tested a couples HIV testing and counseling (CHTC) intervention with male couples in Atlanta by randomizing eligible couples to receive either CHTC or separate individual voluntary HIV counseling and testing (iVCT). To evaluate the acceptability and safety of CHTC, main outcomes were satisfaction with the intervention and the proportions of couples reporting intimate partner violence (IPV) and relationship dissolution after the service. The results indicated that the service was very acceptable to men (median 7-item index of satisfaction was 34 for CHTC and 35 for iVCT, P = .4). There was no difference in either incident IPV (22% versus 17% for CHTC and iVCT, respectively, P = .6) or relationship dissolution (42% versus 51% for CHTC and iVCT, respectively, P = .5). Based on the preliminary data, CHTC is safe for male couples, and it is equally acceptable to iVCT for men who have main partners

Metapopulation Tracking Juvenile Penguins Reveals an Ecosystem-wide Ecological Trap

Climate change and fisheries are transforming the oceans, but we lack a complete understanding of their ecological impact [1; 2 ; 3]. Environmental degradation can cause maladaptive habitat selection, inducing ecological traps with profound consequences for biodiversity [4; 5 ; 6]. However, whether ecological traps operate in marine systems is unclear [7]. Large marine vertebrates may be vulnerable to ecological traps [6], but their broad-scale movements and complex life histories obscure the population-level consequences of habitat selection [8 ; 9]. We satellite tracked postnatal dispersal in African penguins (Spheniscus demersus) from eight sites across their breeding range to test whether they have become ecologically trapped in the degraded Benguela ecosystem. Bayesian state-space and habitat models show that penguins traversed thousands of square kilometers to areas of low sea surface temperatures (14.5°C–17.5°C) and high chlorophyll-a (∼11 mg m−3). These were once reliable cues for prey-rich waters, but climate change and industrial fishing have depleted forage fish stocks in this system [ 10 ; 11]. Juvenile penguin survival is low in populations selecting degraded areas, and Bayesian projection models suggest that breeding numbers are ∼50% lower than if non-impacted habitats were used, revealing the extent and effect of a marine ecological trap for the first time. These cascading impacts of localized forage fish depletion—unobserved in studies on adults—were only elucidated via broad-scale movement and demographic data on juveniles. Our results support suspending fishing when prey biomass drops below critical thresholds [ 12 ; 13] and suggest that mitigation of marine ecological traps will require matching conservation action to the scale of ecological processes [14]

“I Always Felt I Had to Prove My Manhood”: Homosexuality, Masculinity, Gender Role Strain, and HIV Risk Among Young Black Men Who Have Sex With Men

exterior, view of streetscape, 197