The predominant relationship between sexual environment characteristics and HIV-serodiscordant condomless anal sex among HIV-positive men who have sex with men (MSM)

In some studies, situational factors have been shown to be stronger predictors of condomless sex than individual risk factors. Cross-sectional relationships between condomless anal sex (CAS) with HIV-serodiscordant partners and risk factors across ecological levels (individual, sexual environment) were examined using a sample (N = 60) of HIV-positive men who have sex with men (MSM) who reported multiple recent episodes of CAS. Negative binomial regressions were used to evaluate the association of contextual risk factors (e.g., substance use during sex, transactional sex, public sex, sex at a sex party) with recent condomless sex, controlling for demographics and mental health. Results demonstrated that sexual environment factors, particularly sex under the influence of drugs or alcohol (B = .019, p < .05), transactional sex (B = .035, p < .01), and public sex (B = .039, p < .01) explained a large proportion of the variance in CAS. Only sex at a sex party was not related to CAS (p = .39). For each additional sexual environment in which men engaged, their rates of CAS increased (B = .39, p < .01). Secondary prevention interventions that are tailored to the proximal sexual environment could be maximally effective, particularly if they address substance use and other challenging sexual situations.We are very grateful to the participants for their time and efforts in the study. Support for the current study came from a feasibility grant (PI: Conall O'Cleirigh) from the Harvard University Center for AIDS Research (Parent Grant: P30AI060354, PI: Bruce Walker, MD) awarded to Dr. Conall O'Cleirigh. Investigator support for Dr. Steven Safren also came from NIH Grant K24MH094214. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. (P30AI060354 - Harvard University Center for AIDS Research; K24MH094214 - NIH)Accepted manuscrip

Cognitive behavioral therapy for body image and self-care (CBT-BISC) in sexual minority men living with HIV: a randomized controlled trial

OBJECTIVE: Body image disturbance is a distressing and interfering problem among many sexual minority men living with HIV, and is associated with elevated depressive symptoms and poor HIV self-care (e.g., antiretroviral therapy [ART] nonadherence). The current study tested the preliminary efficacy of a newly created intervention: cognitive–behavioral therapy for body image and self-care (CBT-BISC) for this population. METHOD: The current study entailed a 2-arm randomized controlled trial (N = 44) comparing CBT-BISC to an enhanced treatment as usual (ETAU) condition. Analyses were conducted at 3 and 6 months after baseline. The primary outcome was body image disturbance (BDD-YBOCS), and secondary outcomes were ART adherence (electronically monitored via Wisepill), depressive symptoms (MADRS), and global functioning (GAF). RESULTS: At 3 months, the CBT-BISC condition showed substantial improvement in BDD-YBOCS (b = −13.6, SE = 2.7, 95% CI [−19.0, −8.3], p < .001; dppc2 = 2.39); MADRS (b = −4.9, SE = 2.8, 95% CI [−10.6, .70], p = .086; dppc2 = .87); ART adherence (b = 8.8, SE = 3.3, 95% CI [2.0, 15.6], p = .01; dppc2 = .94); and GAF (b = 12.3, SE = 3.2, 95% CI [6.1, 18.6], p < .001; dppc2 = 2.91) compared with the ETAU condition. Results were generally maintained, or improved, at 6 months; although, adherence findings were mixed depending on the calculation method. CONCLUSIONS: CBT-BISC shows preliminary efficacy in the integrated treatment of body image disturbance and HIV self-care behaviors among sexual minority men living with HIV. (APA PsycInfo Database Record (c) 2019 APA, all rights reserved)Funding from this project came from K23MH096647. Author time for Steven A. Safren was supported by K24DA040489 (formally K24MH094214). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. (K23MH096647; K24DA040489; K24MH094214)Accepted manuscrip

Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men

Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24–5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02–2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04–7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56–6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16–6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9–8.7) and CSA with Intense Fear (OR 5.16: CI 2.5–10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.This study was supported by a Grant from the NIMH (R01 MH095624) PI: O'Cleirigh; Author time (Safren) was supported, in part, by Grant 5K24MH094214. (R01 MH095624 - NIMH; 5K24MH094214)Accepted manuscrip

The Feasibility and Acceptability of a Smartphone-Based Music Intervention for Acute Pain

Pain is an unpleasant experience the neurobiology of which is influenced by psychosocial factors including negative affect. Music is a ubiquitous experience that can improve affect, potentially decreasing anxiety and catastrophizing, both of which are associated with greater pain severity. We hypothesized that a machine-learning generative music intervention in the form of a smartphone web app (Unwind) could be used to modulate the experience of pain. In this pilot study, we recruited 15 individuals with acute pain who were admitted to an observation unit in the emergency department, and were being treated with opioids. Participants used the music intervention (Unwind) during this brief hospitalization, after which we assessed their response to its use through a semi- structured qualitative interview. Overall, participants responded positively to Unwind. While some reported some technical challenges, participants were willing to continue using it at home. In particular, participants reported using Unwind to address their anxiety, and many used it to facilitate sleep in the presence of pain. This study demonstrates that individuals with acute pain will accept and use a smartphone-based music protocol

Do divorcing couples become happier by breaking up?

Divorce is a leap in the dark. The paper investigates whether people who split up actually become happier. Using the British Household Panel Survey, we can observe an individual's level of psychological well-being in the years before and after divorce. Our results show that divorcing couples reap psychological gains from the dissolution of their marriages. Men and women benefit equally. The paper also studies the effects of bereavement, of having dependant children and of remarriage. We measure well-being by using general health questionnaire and life satisfaction scores

NGC 1624-2: A slowly rotating, X-ray luminous Of?cp star with an extraordinarily strong magnetic field

This paper presents a first observational investigation of the faint Of?cp star NGC 1624-2, yielding important new constraints on its spectral and physical characteristics, rotation, magnetic field strength, X-ray emission and magnetospheric properties. Modeling the spectrum and spectral energy distribution, we conclude that NGC 1624-2 is a main sequence star of mass M {\simeq} 30 M{\odot}, and infer an effective temperature of 35 {\pm} 2 kK and log g = 4.0 {\pm} 0.2. Based on an extensive time series of optical spectral observations we report significant variability of a large number of spectral lines, and infer a unique period of 157.99 {\pm} 0.94 d which we interpret as the rotational period of the star. We report the detection of a very strong - 5.35 {\pm} 0.5 kG - longitudinal magnetic field , coupled with probable Zeeman splitting of Stokes I profiles of metal lines confirming a surface field modulus of 14 {\pm} 1 kG, consistent with a surface dipole of polar strength >~ 20 kG. This is the largest magnetic field ever detected in an O-type star, and the first report of Zeeman splitting of Stokes I profiles in such an object. We also report the detection of reversed Stokes V profiles associated with weak, high-excitation emission lines of O iii, which we propose may form in the close magnetosphere of the star. We analyze archival Chandra ACIS-I X-ray data, inferring a very hard spectrum with an X-ray efficiency log Lx/Lbol = -6.4, a factor of 4 larger than the canonical value for O-type stars and comparable to that of the young magnetic O-type star {\theta}1 Ori C and other Of?p stars. Finally, we examine the probable magnetospheric properties of the star, reporting in particular very strong magnetic confinement of the stellar wind, with {\eta}* {\simeq} 1.5 {\times} 10^4, and a very large Alfven radius, RAlf = 11.4 R*.Comment: 17 pages, MNRAS accepted and in pres

Bisphenol A in Thermal Paper Receipts: Taylor et al. Respond

We agree with Schwartz and Landrigan that there is a need for change in the regulatory system for chemicals used in products in the United States. Bisphenol A (BPA) is one of thousands of chemicals of concern, but it provides a striking example of what happens when there is no requirement for premarket testing

Estradiol and Bisphenol A Stimulate Androgen Receptor and Estrogen Receptor Gene Expression in Fetal Mouse Prostate Mesenchyme Cells

doi:10.1289/ehp.9804Hormonal alterations during development have lifelong effects on the prostate gland. Endogenous estrogens, including 17β-estradiol (E2), and synthetic estrogenic endocrine disruptors, such as bisphenol A (BPA), have similar effects on prostate development. Increasing exposure to estrogens within the low-dose, physiologic range results in permanent increases in the size and androgen responsiveness of the prostate, whereas exposure within the high-dose, pharmacologic range has the opposite effects