Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men and Transgender Women in 2 US Cities, 2012–2014

BackgroundSince 2011, in the United States, quadrivalent human papillomavirus (HPV) vaccine has been recommended for boys aged 11 to 12 years, men through age 21, and men who have sex with men (MSM) through age 26. We assessed HPV vaccination coverage and factors associated with vaccination among young MSM (YMSM) and transgender women (TGW) in 2 cities.MethodsDuring 2012-2014, 808 YMSM and TGW aged 18 to 26 years reported vaccination status in a self-administered computerized questionnaire at 3 sexually transmitted disease (STD) clinics in Los Angeles and Chicago. Associations with HPV vaccination were assessed using bivariate and multivariable models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).ResultsFew of the diverse participants (Hispanic/Latino, 38.0%; white, 27.0%; and black/African American, 17.9%) reported receiving 1 or more HPV vaccine doses (n = 111 [13.7%]) and even fewer reported 3 doses (n = 37 [4.6%]). A multivariable model found associations between vaccination and having a 4-year college degree or higher (aOR, 2.83; CI, 1.55-5.17) and self-reported STDs (aOR, 1.21; CI, 1.03-1.42). In a model including recommendation variables, the strongest predictor of vaccination was a health care provider recommendation (aOR, 11.85; CI, 6.70-20.98).ConclusionsHuman papillomavirus vaccination coverage was low among YMSM and TGW in this 2-US city study. Our findings suggest further efforts are needed to reach YMSM seeking care in STD clinics, increase strong recommendations from health care providers, and integrate HPV vaccination with other clinical services such as STD testing

Using a Multitest Algorithm to Improve the Positive Predictive Value of Rapid HIV Testing and Linkage to HIV Care in Nonclinical HIV Test Sites

BackgroundUse of a rapid HIV testing algorithm (RTA) in which all tests are conducted within one client appointment could eliminate off-site confirmatory testing and reduce the number of persons not receiving confirmed results.MethodsAn RTA was implemented in 9 sites in Los Angeles and San Francisco; results of testing at these sites were compared with 23 sites conducting rapid HIV testing with off-site confirmation. RTA clients with reactive results on more than 1 rapid test were considered HIV+ and immediately referred for HIV care. The positive predictive values (PPVs) of a single rapid HIV test and the RTA were calculated compared with laboratory-based confirmatory testing. A Poisson risk regression model was used to assess the effect of RTA on the proportion of HIV+ persons linked to HIV care within 90 days of a reactive rapid test.ResultsThe PPV of the RTA was 100% compared with 86.4% for a single rapid test. The time between testing and receipt of RTA results was on average 8 days shorter than laboratory-based confirmatory testing. For risk groups other than men who had sex with men, the RTA increased the probability of being in care within 90 days compared with standard testing practice.ConclusionsThe RTA increased the PPV of rapid testing to 100%, giving providers, clients, and HIV counselors timely information about a client's HIV-positive serostatus. Use of RTA could reduce loss to follow-up between testing positive and confirmation and increase the proportion of HIV-infected persons receiving HIV care

Circadian Genes, <i>xBmal1</i> and <i>xNocturnin</i>, Modulate the Timing and Differentiation of Somites in <i>Xenopus laevis</i>

<div><p>We have been investigating whether <i>xBmal1</i> and <i>xNocturnin</i> play a role in somitogenesis, a cyclic developmental process with an ultradian period. Previous work from our lab shows that circadian genes (<i>xPeriod</i>1, <i>xPeriod2</i>, <i>xBmal1</i>, and <i>xNocturnin</i>) are expressed in developing somites. Somites eventually form the vertebrae, muscles of the back, and dermis. In <i>Xenopus</i>, a pair of somites is formed about every 50 minutes from anterior to posterior. We were intrigued by the co-localization of circadian genes in an embryonic tissue known to be regulated by an ultradian clock. Cyclic expression of genes involved in <i>Notch</i> signaling has been implicated in the somite clock. Disruption of <i>Notch</i> signaling in humans has been linked to skeletal defects in the vertebral column. We found that both depletion (morpholino) and overexpression (mRNA) of xBMAL1 protein (bHLH transcription factor) or xNOCTURNIN protein (deadenylase) on one side of the developing embryo led to a significant decrease in somite number with respect to the untreated side (p<0.001). These manipulations also significantly affect expression of a somite clock component (<i>xESR9</i>; p<0.05). We observed opposing effects on somite size. Depletion of xBMAL1 or xNOCTURNIN caused a statistically significant decrease in somite area (quantified using NIH ImageJ; p<0.002), while overexpression of these proteins caused a significant dose dependent increase in somite area (p<0.02; p<0.001, respectively). We speculate that circadian genes may play two separate roles during somitogenesis. Depletion and overexpression of xBMAL1 and NOCTURNIN both decrease somite number and influence expression of a somite clock component, suggesting that these proteins may modulate the timing of the somite clock in the undifferentiated presomitic mesoderm. The dosage dependent effects on somite area suggest that xBMAL1 and xNOCTURNIN may also act during somite differentiation to promote myogenesis.</p></div

Effect of RNA injection on somite number in stage 24–28 embryos.

<p>Effect of RNA injection on somite number in stage 24–28 embryos.</p

A compilation of results from microarray analyses of temporal expression of Notch, WNT, and circadian genes in the somites [34] and suprachiasmatic nucleus, liver, and heart [35], [36], [37], [38].

<p>*CREB1 phosphorylation rhythm in <i>Xenopus</i> retina <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0108266#pone.0108266-Li1" target="_blank">[42]</a>.</p><p>A compilation of results from microarray analyses of temporal expression of Notch, WNT, and circadian genes in the somites <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0108266#pone.0108266-Curran1" target="_blank">[34]</a> and suprachiasmatic nucleus, liver, and heart <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0108266#pone.0108266-Dequeant1" target="_blank">[35]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0108266#pone.0108266-Panda1" target="_blank">[36]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0108266#pone.0108266-Storch1" target="_blank">[37]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0108266#pone.0108266-Oishi1" target="_blank">[38]</a>.</p

Overexpression of xBMAL1 or xNOCTURNIN results in fewer somites on the injected side (asterisk).

<p>Panel A shows the percent of embryos with equal, less, or more somites on the injected side when compared to the uninjected side. The concentration and type of RNA injected is shown on the horizontal axis. Embryos were also analyzed for effects on the posterior striping pattern of <i>xESR9</i> (B). The percent of embryos with equal, less, or more <i>xESR9</i> stripes on the injected side when compared to the uninjected side is indicated on the vertical axis while the concentration and type of RNA is shown on the horizontal axis. All pictures shown in panels C-O are displayed with anterior to the left and dorsal up. Panels C, G, K display the uninjected side for each treatment. Panels D, H, and L display the injected side. Panels E, I, and M show a dorsal view of each embryo for somite staining while panels F, J, and O show a dorsal view of <i>xESR9</i> expression. A GFP RNA injected embryo (500 pg) is shown in panels C, D, E, and F. <i>xBmal1</i> RNA injected embryos (500 pg) are shown in panels G, H, I, and J. <i>xNocturnin</i> RNA (500 pg) injected embryos is shown in panels K, L, M, and O. Black arrowheads show an example where the posterior <i>xESR9</i> stripes were aligned (F) or not aligned (J, O) between the injected and uninjected sides.</p

Depletion of xBMAL1 or xNOCTURNIN results in fewer somites on the injected side (asterisk).

<p>Results of injection of 1 ng of either control, <i>xBmal1</i>, or <i>xNocturnin</i> MO are shown. Panel A shows the percent of embryos with equal, less, or more somites on the injected side when compared to the uninjected side. Embryos were also analyzed for effects on the posterior striping pattern of <i>xESR9</i> (B). The percent of embryos with equal, less, or more <i>xESR9</i> stripes on the injected side when compared to the uninjected side is indicated on the vertical axis while the type of MO is shown on the horizontal axis. All pictures shown in panels C-N are displayed with anterior to the left. Panels C, G, and K display the uninjected side for each treatment. Panels D, H, and L display the injected side for control MO, <i>xBmal1</i>MO, and <i>xNocturnin</i>MO, respectively. Panels E, I, and M show a dorsal view of each embryo for somite staining while panels F,J, and N show a dorsal view of <i>xESR9</i> expression. Black arrowheads in F show normal <i>xESR9</i> expression in the posterior. Arrowheads in J show an example where no stripes are visible but the posterior border was different between injected and uninjected sides of the embryo. The embryo in panel N experienced slight exogastrulation, but somite expression and <i>xESR9</i> expression were evaluated. White arrowheads show an example of decreased expression of <i>xESR9</i> in the eye on the side injected with <i>xNocturnin</i> MO.</p