Women’s Perceptions of HIV- and Sexuality-Related Stigma in Relation to PrEP: Qualitative Findings from the Masibambane Study,Durban, South Africa

AIDS and Behavior - Daily oral pre-exposure prophylaxis (PrEP) offers effective HIV prevention. In South Africa, PrEP is publicly available, but use among young women remains low. We explored young...     

Fat shaming under neoliberalism and COVID-19: Examining the UK’s Tackling Obesity campaign

This article explores the dynamics between fat shaming, neoliberalism, ideological constructions of health and the ‘obesity epidemic’ within the UK, using the UK Government’s recent Tackling Obesity campaign in response to Covid-19 as an illustration. We draw attention to how fat shaming as a practice that encourages open disdain for those living with excess weight operates as a moralising tool to regulate and manage those who are viewed as ‘bad’ citizens. In doing so, we begin by outlining how the ideological underpinnings of ‘health’ have been transformed under neoliberalism. We then consider the problematic use of fat shaming discourses that are often used as tools to promote ‘healthy’ lifestyle choices by those who view it as not only an acceptable way of communicating the health risks associated with obesity but also a productive way of motivating people with obesity to lose weight. Drawing on Graham Scambler’s theoretical framework regarding shame and blame (2020), we discuss how ‘heaping blame on shame’ has become a ‘wilful political strategy’ under neoliberalism, particularly as it relates to individuals with obesity, and how the Tackling Obesity campaign leverages concerns around ‘choices’ and ‘costs’ as a means through which to encourage normative models of self-care and self-discipline.     

Fingerprick Versus Oral Swab: Acceptability of Blood-Based Testing Increases If Other STIs Can Be Detected

Self-testing has untapped potential as a strategy to improve access to HIV testing and to increase testing frequency. User acceptability of self-administered oral swab HIV tests is consistently high in both hypothetical and actual-use studies. We explored preferences for oral versus fingerprick HIV self-tests among men who have sex with men with a high risk profile. Participants indicated greater likelihood of using an oral swab over a blood-based test, notwithstanding lower price or quicker results from the latter. However, the likelihood of using an HIV fingerprick test substantially increased if it also offered information on other sexually transmitted infections.     

Variations in microbicide gel acceptability among young women in the USA and Puerto Rico

In a multi-site study of vaginal microbicide acceptability conducted with sexually active young women, quantitative assessments revealed significant differences in acceptability by site. Participants in Puerto Rico rated the gel more favourably than mainland US participants in terms of liking the gel and likelihood of future use. To explain these differences, we examined responses to qualitative behavioural assessments. Young women in mainland USA associated gel leakage with uncomfortable sensations experienced during menstruation, while young women in Puerto Rico had positive associations of gel use with douching. These negative or positive associations affected assessments of the gel's physical qualities. In addition, young women's perceptions of primary partners' support for microbicide use influenced sexual satisfaction with the gel and, ultimately, product acceptability. Finally, geographic HIV-risk context contributed to heightened HIV-risk perception, which influenced likelihood of future microbicide use, even for women in stated monogamous relationships. Future microbicide acceptability studies should take into account potential differences in acceptability by site such as HIV-risk perception based on local HIV prevalence, popularity of vaginal hygiene products in a specific area and male attitudes in different cultures concerning women's use of HIV protection strategies.     

The Use of Rectal Douches among HIV-uninfected and Infected Men who Have Unprotected Receptive Anal Intercourse: Implications for Rectal Microbicides

Although some rectal douches result in surface epithelium loss and potential increase of HIV transmission, men who have sex with men (MSM) continue to use them. We describe the prevalence of this practice among MSM engaging in unprotected receptive anal intercourse (URAI) in risky circumstances. A multiethnic sample with overrepresentation of HIV-negative MSM who had URAI in the previous year was recruited exclusively through the Internet. Participants were 105 MSM (78 HIV-negative, 27 HIV-positive). A total of 53% of HIV-negative and 96% of HIV-positive men douched in preparation for sex, most of them frequently or always, mainly for hygienic purposes. 27% of HIV-negative and 44% of HIV-positive douched after sex, partly believing douching protected from infections. Douching practices started around age 25. Regression analyses found the association between HIV status and douching occasions persisted after controlling for demographic characteristics and number of URAI occasions. Rectal douching in preparation for sex is common among men who practice URAI. This population could benefit from alternatives to condoms, such as rectal microbicides. Given the popularity of pre-coital douching and its frequency, a harmless rectal douche that could deliver a rectal microbicide could have great acceptability.     

Interactions between smoking and other exposures associated with lung cancer risk in women: diet and physical activity

The objective of the study is to estimate the differences in the impact of diet and physical exercise on lung cancer risk in female nonsmokers vs. smokers, and reveal interactions, if any. In a hospital based case-control study, data collected by in-person interviews from 569 female lung cancer cases and 2120 controls were analyzed using unconditional logistic regression stratifying by appropriate factors. Protective effects were observed for intake of milk/dairy products (OR=0.57, 95%CI 0.35-0.94), vegetables (OR=0.60, 95%CI 0.40-0.91), apples (OR=0.69), wine (OR=0.77), and physical exercise (OR=0.59, 95%CI 0.42-0.83) among smokers only, while no similar effects were found among nonsmokers. In contrast, the intake of black tea was associated with a protective effect (OR=0.66, 95%CI 0.47-0.94) among nonsmokers only. Comparing the effects of dietary items and physical activity on lung cancer risk among nonsmokers versus smokers, statistically significant effect modifications were found for black tea (P 0.005), and milk/dairy products (P 0.047). Borderline effect modifications emerged for physical exercise (P 0.077). CONCLUSIONS: These results indicate protective effects of some components of healthful diet and physical exercise among smokers, and of the intake of black tea among nonsmokers. The observed interactions of the impact of black tea, milk/dairy products and physical activity upon lung cancer risk in women at different levels of the smoking habit deserve further studies.     

Alcohol, marijuana, cocaine use, and relationship quality among HIV serodiscordant male couples

The association between substance use and relationship quality was explored in a sample of 117 serodiscordant male couples. Several measures of relationship quality were used including dyadic satisfaction, affection, commitment, sexual satisfaction, and domestic violence. Although frequency of use was assessed for several substances, only alcohol, marijuana, and cocaine were used frequently enough for statistical analyses. The highest frequency of use within the couple in the past 2 months as well as the discrepancy in the frequency of use between the 2 members of the couple were considered. Although daily substance use was relatively rare in this sample, alcohol use was reported by 79%, marijuana use by 35%, and cocaine use by 15% of the men. Domestic violence was not associated with any substance use variable. Marijuana use was generally not associated with relationship quality. Alcohol and cocaine use were moderately associated with several indicators of poorer relationship quality.     

Is an acetylcholine transport system responsible for nonquantal release of acetylcholine at the rodent myoneural junction?

Experiments were performed to investigate the effects on the spontaneous, nonquantal release of acetylcholine (AcCho) from motor nerve terminals of substances known to inhibit the AcCho transport system present in cholinergic synaptic vesicles. In mouse diaphragms, the hyperpolarization normally produced by d-tubocurarine in the endplate area of muscle fibers that had been treated by an anticholinesterase was partly or completely blocked by 2-(4-phenylpiperidino)cyclohexanol (AH5183, 0.1-1 microM), quinacrine (0.1 microM), and tetraphenylborate (1 microM). Since the sensitivity of the subsynaptic area to AcCho was not changed, the block of the hyperpolarizing action of d-tubocurarine indicated in inhibition of the spontaneous, nonquantal release of AcCho. This was confirmed in experiments on rat diaphragm using direct radioenzymatic measurement of the AcCho released into the incubation medium. The release of AcCho from the innervated diaphragm was decreased by about 50% in the presence of AH5183 (0.01-1 microM) and by 42% in the presence of quinacrine (0.1-1 microM). The AcCho released was presumably neural, since the release of AcCho from 4-day denervated diaphragms was not diminished by either AH5183 or quinacrine. The results indicate that the spontaneous release of AcCho from the motor nerve terminals is highly sensitive to low concentrations of specific inhibitors and is probably mediated by a carrier. It is proposed that spontaneous release is due to the incorporation into the membrane of the nerve terminal during exocytosis of the vesicular transport system responsible for moving AcCho into the vesicle.     

Inconsistent Counselor Fidelity in Delivering an Evidence-Based Adherence Intervention During a PrEP Trial

AIDS and Behavior - Evidence-based adherence counseling interventions must be delivered with fidelity to ensure that their effectiveness is retained, but little is known regarding how counselors in...