Efficacy of nano-hydroxyapatite prepared by an aqueous solution combustion technique in healing bone defects of goat

The present study was undertaken to evaluate porous hydroxyapatite (HAp), the powder of which was prepared by a novel aqueous solution combustion technique, as a bone substitute in healing bone defects in vivo, as assessed by radiologic and histopathologic methods, oxytetracycline labeling, and angiogenic features in Bengal goat. Bone defects were created in the diaphysis of the radius and either not filled (group I) or filled with a HAp strut (group II). The radiologic study in group II showed the presence of unabsorbed implants which acted as a scaffold for new bone growth across the defect, and the quality of healing of the bone defect was almost indistinguishable from the control group, in which the defect was more or less similar, although the newly formed bony tissue was more organized when HAp was used. Histologic methods showed complete normal ossification with development of Haversian canals and well-defined osteoblasts at the periphery in group II, whereas the control group had moderate fibro-collagenization and an adequate amount of marrow material, fat cells, and blood vessels. An oxytetracycline labeling study showed moderate activity of new bone formation with crossing-over of new bone trabeculae along with the presence of resorption cavities in group II, whereas in the control group, the process of new bone formation was active from both ends and the defect site appeared as a homogenous non-fluoroscent area. Angiograms of the animals in the control group showed uniform angiogenesis in the defect site with establishment of trans-transplant angiogenesis, whereas in group II there was complete trans-transplant shunting of blood vessel communication. Porous HAp ceramic prepared by an aqueous combustion technique promoted bone formation over the defect, confirming their biologic osteoconductive property

Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers.

BACKGROUND: It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. METHODS: The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients' consistent condom use with FSW. RESULTS: Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. CONCLUSION: Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks

Factors associated with the likelihood of further movement among mobile female sex workers in India: A multinomial logit approach

Female sex workers (FSWs) are vulnerable to HIV infection. Their socioeconomic and behavioural vulnerabilities are crucial push factors for movement for sex work. This paper assesses the factors associated with the likelihood of movement of sex workers from their current place of work. Data were derived from a cross-sectional survey conducted among 5498 mobile FSWs in 22 districts of high in-migration across four states in southern India. A multinomial logit model was constructed to predict the likelihood of FSWs moving from their current place of work. Ten per cent of the sampled mobile FSWs were planning to move from their current place of sex work. Educational attainment, marital status, income at current place of work, debt, sexual coercion, experience of violence and having tested for HIV and collected the results were found to be significant predictors of the likelihood of movement from the current place of work. Consistent condom use with different clients was significantly low among those planning to move. Likewise, the likelihood of movement was significantly higher among those who had any STI symptom in the last six months and those who had a high self-perceived risk of HIV. The findings highlight the need to address factors associated with movement among mobile FSWs as part of HIV prevention and access to care interventions

Correlates of health care utilization under targeted interventions: The case of female sex workers in Andhra Pradesh, India

Accessibility and frequency of use of health care services among female sex workers (FSWs) are constrained by various factors. In this analysis, we examined the correlates of frequency of using health care services under targeted interventions among FSWs. A sample of FSWs (N = 1,973) was obtained from a second round (2012) of Behavioral Tracking Survey, conducted in five districts of Andhra Pradesh, a high-HIV-prevalence state in southern India. We used negative binomial regression models to analyze frequency of utilization of health care services among FSWs. Based on our analysis, we suggest that various predisposing and enabling factors were found to be significantly associated with the visit to NGO clinics for treatment of any health problem, any sexually transmitted infection symptom, and the number of condoms received from the peer worker or condom depot. We suggest the need for further research with respect to various correlates of frequency of using health care among FSWs to develop effective intervention strategies in countries that have high HIV prevalence among FSWs and targeted interventions need more diligent implementation to reach the unreached

Does mass-media public communication campaign normalize discussion, attitude and behavior about condom use among married men in India?

Background: \u27Condom\u27 is a stigmatized topic in India. Open discussion about its use and promotion are considered inappropriate. This study examines the association between exposure to public service announcements (PSA) around condoms and discussion, attitude and behavioral intentions about condom use among married men by their age and socio-economic status. Methods: A sub-sample of monogamous married men (N=2502) was obtained from 2009 BBC World Service Trust’s condom normalization survey among men in four high HIV prevalence states in India. The multiple logistic regression models were used to analyze the association of exposure to PSA around condoms with discussion, attitudes and behavioral intentions about condom and its usage. Result: More than half married men (55%) were younger ( \u3c =35 years), having better socio-economic status (educated above secondary levels and employed) (55%) and exposed to condom PSA (64%). Exposure to PSA was associated with greater likelihood to seek condom information (AOR: 1.33; p=0.010), positive attitude (AOR: 1.24; p=0.008), higher self-efficacy (AOR: 1.53; p=0.006) in using and, last time condom use (AOR: 2.15; p=0.023) among better SES group; with positive caring attitude (AOR: 1.27; p=0.010), ease in purchasing condom (AOR: 2.04, p=0.009) among older (35+ years) men, and with last time condom use among younger men (AOR: 1.85; p=0.037). Conclusion: The findings of the study highlight an important contention that linkage between mass-media campaigns and promotion of condom normalization through discussion, seeking information and intention to use and its usage goes beyond as a behavior change strategy to include dimensions of age, educational attainment and economic status. The effectiveness of mass media campaigns for normalizing condom discussion is largely mediated by demographic and socio-economic variables. Future campaigns need to address these variables to be more effective

Association between community collectivization and mental depression among men who have sex with men in Andhra Pradesh, India

Background: The role of community collectivization with mental health among Men who have Sex with Men (MSM) is understudied in developing countries. This study examines the prevalence of mental depression, and its association with community collectivization among MSM in India. Data and methods: The data used for this study are from a cross-sectional, Behavioral Tracking Survey conducted between January and February, 2012 among 1176 MSM from Andhra Pradesh, a southern state of India. Mental depression among MSM was assessed using Patient Health Questionnaire-2 scale. Univariate, bivariate and multivariate logistic regression models were used for analysis in this study. Results: The average age of MSM was 28.2 years (SD: ± 6.2 years) and more than one-third of MSM (35%) in the survey reported to have any mental depression in Andhra Pradesh. MSM, who had a high level of collective identity (not ashamed to be MSM) (33% vs. 41%, AOR: 0.54, 95% CI: 0.34-0.85) and collective agency (member of the community group) (34% vs. 38%, AOR: 0.46, 95% CI: 0.26-0.81) were less likely to be depressed as compared to their counterparts. Those who were members of the community group and had not experienced any violence, were less likely to have any depression (31% vs. 37%, AOR: 0.44, p=0.012). Conclusion: This study highlights that community led structural interventions are more successful and effective in HIV prevention along with enhancing positive mental health among the key population. This study demands for more community engagement activities in order to deal with mental health problems. This study recommends for further research and to explore the new community led structural approaches with innovative ideas for integrated mental health counselling services among MSM

Degree of male mobility as a risk factor for HIV in high in-migration districts of Maharashtra, India

Background: Mobile males are vulnerable to HIV and are potential bridge for HIV transmission to their sex partners, including spouses. To understand how mobility accentuates vulnerability to HIV, we assessed the association of degree of male mobility with paid sex, alcohol use and condom use at all places visited by migrants in past two years. Methods: A cross-sectional survey was done among male migrant workers [n = 2991] in five high in-migration districts of Maharashtra in India during 2007–08. Results: Multivariate logistic regression analysis revealed that higher mobility [moving 3+ places in the past two years] was associated with “sexual debut” in paid sex [3.7% Vs 6.9%, AOR = 1.70, p \u3c 0.001] and having sex with sex worker at the current place of destination [8.7% Vs 16.9%, AOR = 2.10, p \u3c 0.001], at the previous place of destination [7.2% Vs 15.1%, AOR = 2.05, p \u3c 0.001], and at the place of origin [0.6% Vs 1.6%, AOR = 2.31, p \u3c 0.001]. However, higher mobility was associated with unpaid sex with non-marital female partners [28.4% Vs 37.2%, AOR = 1.48, p \u3c 0.001] and less consistent condom use at the current place [26.6% Vs 23.4%, AOR = 0.45, p \u3c 0.05] as well as at place of origin [12.2% Vs 7.2%, AOR = 0.48, p \u3c 0.01]. In addition, alcohol use prior to sex was more among more mobile migrants relative to less mobile migrants at current place [6.1% Vs 11.2%, AOR = 1.82, p \u3c 0.001] and previous place [7.0% Vs 13.0%, AOR = 1.77, p \u3c 0.001] of destination. Conclusion: Findings suggest that compared to the less mobile, highly mobile men report higher HIV risk behaviours: paid sex, alcohol use prior to paid sex and inconsistent condom use, at all locations along the routes of mobility. Interventions need to target men who are highly mobile along the routes of mobility and not at destination sites alone

Degree of Male Mobility as a Risk Factor for HIV in High In-Migration Districts of Maharashtra, India

Background: Mobile males are vulnerable to HIV and are potential bridge for HIV transmission to their sex partners, including spouses. To understand how mobility accentuates vulnerability to HIV, we assessed the association of degree of male mobility with paid sex, alcohol use and condom use at all places visited by migrants in past two years. Methods: A cross-sectional survey was done among male migrant workers [n = 2991] in five high in-migration districts of Maharashtra in India during 2007–08. Results: Multivariate logistic regression analysis revealed that higher mobility [moving 3+ places in the past two years] was associated with “sexual debut” in paid sex [3.7% Vs 6.9%, AOR = 1.70, p \u3c 0.001] and having sex with sex worker at the current place of destination [8.7% Vs 16.9%, AOR = 2.10, p \u3c 0.001], at the previous place of destination [7.2% Vs 15.1%, AOR = 2.05, p \u3c 0.001], and at the place of origin [0.6% Vs 1.6%, AOR = 2.31, p \u3c 0.001]. However, higher mobility was associated with unpaid sex with non-marital female partners [28.4% Vs 37.2%, AOR = 1.48, p \u3c 0.001] and less consistent condom use at the current place [26.6% Vs 23.4%, AOR = 0.45, p \u3c 0.05] as well as at place of origin [12.2% Vs 7.2%, AOR = 0.48, p \u3c 0.01]. In addition, alcohol use prior to sex was more among more mobile migrants relative to less mobile migrants at current place [6.1% Vs 11.2%, AOR = 1.82, p \u3c 0.001] and previous place [7.0% Vs 13.0%, AOR = 1.77, p \u3c 0.001] of destination. Conclusion: Findings suggest that compared to the less mobile, highly mobile men report higher HIV risk behaviours: paid sex, alcohol use prior to paid sex and inconsistent condom use, at all locations along the routes of mobility. Interventions need to target men who are highly mobile along the routes of mobility and not at destination sites alone

Average Treatment Effect on Treated (ATT) for consistent condom use with all sex workers among male clients of female sex workers by usual pickup place of FSW, IBBA, 2009.

<p>AP: Andhra Pradesh; MH: Maharashtra; TN: Tamil Nadu</p