HIV Risk Factors Among Moroccan and Turkish Same-Sex Attracted Youth in Amsterdam

This report is the outcome of a month-long exploratory study on the main HIV risk factors among Moroccan and Turkish same-sex attracted (SSA) youth in Amsterdam. Data was obtained by way of interviews conducted with five experts, categorized as: academics, sexual and ethnic minority activists, and HIV professionals. Five main risk factors were determined: cultural differences; language barriers; stigma and taboo around sexuality and HIV within Islamic communities; socioeconomic marginalization; and lack of a positive term for same-sex sexual behavior and identity among the target group. Recommendations for future research include interviews with Moroccan and Turkish SSA youth themselves. Implications for future interventions are discussed

Stigma, Citizenship, and the Transition to Community-based HIV Care Among People Returning from Incarceration

Background People in prisons and jails are a key population for HIV prevention and control. Despite high rates of HIV treatment initiation and retention inside places of detention, people returning from incarceration fail to link to community-based care and to adhere to medication at high rates in the period following release. Stigma underpins post-release barriers to care, as does the relegation of individuals returning from incarceration to an alternate citizenship status that denies them access to otherwise guaranteed rights. South Africa, with among the highest prevalence of HIV in incarcerated people globally, is an important site for advancing public health knowledge about how these social factors affect care engagement. Methods This study uses data collected as part of the corrections2community intervention in Gauteng Province, South Africa. Manuscript 1 was completed through a systematic review of interventions (n=27) to improve HIV care engagement among individuals released from prison or jail. Manuscript 2 was achieved through qualitative data analysis of interviews with a purposively selected sample of people returning from incarceration with HIV (n=42) in South Africa. Manuscript 3 was completed through qualitative data analysis of interviews with reentrants’ health and social service providers (n=24) in South Africa. Results Manuscript 1 indicated that intervention strategies associated with improvements in post-release HIV care include patient navigation strategies, especially those involving peer support, and substance use treatment. Manuscript 2 revealed that people returning from incarceration with HIV experience multiple stigmas, including HIV stigma and incarceration stigma, that converge with ideologies about people with criminal convictions in South Africa. Manuscript 3 revealed how providers’ accounts of post-release care in South Africa interface with discourses about citizenship, including that rehabilitation of individuals toward responsible self-conduct necessitates increased rights. Discussion The principal contribution of these manuscripts is their contextualization of the factors influencing post-incarceration HIV care. Future public health research and practice should further address eight key features of external contexts affecting reentrants’ HIV care, as exemplified by three existing intervention studies. South Africa is an opportune site for advancing public health research and practice that aims at changing the external contexts shaping health outcomes among reentrants

Reading “Robert R.”: Knowledge Production of America’s First AIDS Patient

Mentor: Shanti Parikh From the Washington University Undergraduate Research Digest: WUURD, Volume 6, Issue 2, Spring 2011. Published by the Office of Undergraduate Research, Joy Zalis Kiefer Director of Undergraduate Research and Assistant Dean in the College of Arts & Sciences; Kristin Sobotka, Editor

Aliens in America: Alien(ation), AIDS, and the Ideology of The X-Files

Mentor: Catherine Meeks From the Washington University Undergraduate Research Digest: WUURD, Volume 4, Issue 1, Fall 2008. Published by the Office of Undergraduate Research. Henry Biggs, Director of Undergraduate Research and Associate Dean in the College of Arts & Sciences; Joy Zalis Kiefer, Undergraduate Research Coordinator, Co-editor, and Assistant Dean in the College of Arts & Sciences; Kristin Sobotka, Editor

How empowered are girls/young women in their sexual relationships? Relationship power, HIV risk, and partner violence in Kenya.

BACKGROUND:Gendered power dynamics within couple relationships can constrain women from achieving positive sexual and reproductive health outcomes. But little is known about relationship power among adolescents, and tools to measure it are rarely validated among adolescents. We tested the Sexual Relationship Power Scale (SRPS) among adolescent girls and young women (AGYW) and examined associations with select health outcomes. METHODS:A 16-item adaptation of the SRPS was administered to AGYW aged 15-24 in Kenya (n = 1,101). Confirmatory factor analysis (CFA) and theta coefficients assessed scale performance for three age bands: 15-17, 18-20, and 21-24 years old. Relationship power levels were examined and multivariate logistic regressions assessed the relationship between power, and partner violence and HIV risk outcomes. RESULTS:CFAs confirmed a one factor structure for each subgroup, and thetas for final 15-item scales were robust (>.82). Most respondents reported limited power in their sexual relationships, however older respondents consistently reported lower levels of power. Relationship power was strongly associated with several outcomes, even when controlling for socioeconomic status and schooling. For example, AGYW who reported more relationship power were 12, 6, and 7 times less likely (ages 21-24, 18-20, and 15-17, respectively) to experience sexual violence (p<0.001). Significant relationships were also found in multivariate analyses for physical partner violence (all three age bands), using a condom at last sex (18-20-year-olds), and increased knowledge of partner's HIV status (21-24-year-olds). CONCLUSIONS:The SRPS is a good measure of relationship power for several age bands within AGYW, and power is experienced differently by older and younger AGYW. Low relationship power was a consistent predictor of partner violence, as well as an important predictor of HIV risk. Interventions seeking to address HIV and violence should also explicitly address relationship power and utilize validated tools (like the SRPS) to evaluate impacts

Adjusted odds ratios for HIV and partner violence outcomes on Sexual Relationship Power Scale (SRPS) scores, stratified by AGYW age band.

<p>Adjusted odds ratios for HIV and partner violence outcomes on Sexual Relationship Power Scale (SRPS) scores, stratified by AGYW age band.</p

Percent of AGYW who agree / strongly agree with individual items measuring power in sexual relationships via the Sexual Relationship Power Scale (SRPS), and mean scale scores (N = 1,101).

<p>Percent of AGYW who agree / strongly agree with individual items measuring power in sexual relationships via the Sexual Relationship Power Scale (SRPS), and mean scale scores (N = 1,101).</p

Bivariate associations between HIV and partner violence outcomes, and sexual relationship power (SRPS or SRPS-M) and sociodemographic characteristics.

<p>Bivariate associations between HIV and partner violence outcomes, and sexual relationship power (SRPS or SRPS-M) and sociodemographic characteristics.</p

A high-throughput, multiplexed assay for superfamily-wide profiling of enzyme activity

The selectivity of an enzyme inhibitor is a key determinant of its usefulness as a tool compound or its safety as a drug. Yet selectivity is never assessed comprehensively in the early stages of the drug discovery process, and only rarely even in the later stages, because technical limitations prohibit doing otherwise. Here, we report EnPlex, an efficient, high-throughput method for simultaneously assessing inhibitor potency and specificity, and pilot its application to 96 serine hydrolases. EnPlex analysis of widely used serine hydrolase inhibitors revealed numerous previously unrecognized off-target interactions, some of which may help to explain previously confounding adverse effects. In addition, EnPlex screening of a hydrolase-directed library of boronic acid- and nitrile-containing compounds provided dual potency/selectivity structure-activity relationships from which lead candidates could be more effectively prioritized. Follow-up of a series of dipeptidyl peptidase 4 (DPP4) inhibitors showed that EnPlex indeed predicted efficacy and safety in animal models. These results demonstrate the feasibility and value of high-throughput, superfamily-wide selectivity profiling, and suggest such profiling can be incorporated into the earliest stages of drug discovery