South African Fathers Involvement and Their Adolescents’ Sexual Risk Behavior and Alcohol Consumption

Although considerable research has examined the influence of parent-adolescent relationships on the sexual health of adolescents, there is a great need for research to understand the influence of fathers on their children’s HIV sexual risk behavior, particularly in sub-Saharan Africa. We examined how the residence and the involvement of fathers are related to their children’s HIV sexual risk and alcohol consumption behaviors. A cross-sectional survey was completed by 175 sixth-grade adolescents in the Eastern Cape Province, South Africa. Analyses showed that adolescents living with their fathers had fewer sexual partners (B?=?? 0.606, SE?=?0.299, p?=?.043) and consumed alcohol less frequently (B?=?? 0.642, SE?=?0.294, p?=?.029). Adolescents who spent more quality days with their fathers in the past 30 days had fewer sexual partners (B?=?? 0.103, SE?=?0.039, p?=?.008) and had condomless sex less frequently (B?=?? 0.097, SE?=?0.047, p?=?0.041). It was also found that there were significant father-residence?×?child-gender interactions on sexual debut (B?=?1.132, SE?=?0.564, p?=?.045) and on frequency of condomless sex (B?=?? 2.140, SE?=?0.924, p?=?.021). These interactions indicate that boys living with their fathers were less likely to have had vaginal intercourse than girls and that girls living with their fathers were less likely to have unprotected sex than boys. This study highlights the importance of South African fathers’ roles in their adolescent children’s HIV sexual risk and alcohol drinking behaviors and the need to promote father-child relationships for adolescent health. The results suggest that health programs aiming to reduce South African adolescents’ HIV sexual risk behaviors and alcohol consumption consider strategies that target their fathers.

     

Neighborhood Context and Black Heterosexual Men’s Sexual HIV Risk Behaviors

The effects of neighborhood context on sexual risk behavior are understudied, particularly for Black heterosexual men who do not inject drugs or report heavy drug use. Evidence of a generalized HIV epidemic (>1 %) among Black heterosexuals in low-income urban U.S. communities underscores the importance of examining the effects of neighborhood context on Black heterosexual men’s sexual risk, however. We used structural equation modeling to test the pathways between neighborhood context (neighborhood disorder, personal violence, neighborhood threats), depression, substance use, and sexual risk behavior. Participants were 526 self-identified Black heterosexual men, ages 18–45, recruited via randomized venue-based probability sampling in Philadelphia, PA. Analyses of model fit statistics from Mplus indicated statistically significant direct pathways between neighborhood context, depression, substance use, and sexual risk behavior. The total indirect effect of neighborhood context on sexual risk behavior through substance use was also significant. The study’s results highlight a need for more research on neighborhood context and sexual HIV risk, and for multilevel interventions to address the effects of negative neighborhood context on Black heterosexual men’s sexual HIV risk.     

Partnership-Level Analysis of African American Women’s Risky Sexual Behavior in Main and Non-Main Partnerships

The majority of research on risky sexual behavior in African American women has examined global associations between individual-level predictors and behavior. However, this method obscures the potentially significant impact of the specific relationship or relationship partner on risky sexual behavior. To address this gap, we conducted partnership-level analysis of risky sexual behavior among 718 African American women recruited from HIV counseling, testing, and referral sites in four states. Using mixed model regressions, we tested relationships between condomless vaginal intercourse with men and variables drawn from the Theory of Planned Behavior, Theory of Gender and Power, and previous research specifically on sexual risks among African American women. Significant associations with risky sexual behavior indicate the need for continued emphasis on condom attitudes, condom negotiation behaviors, and overcoming partner resistance to condoms within both main and non-main partnerships when implementing interventions designed to address HIV and sexually transmitted infection risks among African American women.     

HIV Sexual Risk Behavior by Men Who use the Internet to Seek Sex with Men: Results of the Men’s INTernet Sex Study-II (MINTS-II)

This study sought to identify the magnitude of HIV risk in a diverse sample of Men who use the Internet to seek Sex with Men (MISM), and test if specific subpopulations are at sufficiently increased risk to warrant tailored interventions. A sample of 2,716 American MISM, stratified by race/ethnicity, completed an Internet survey of online and offline sex seeking behavior during the last 3 months. Across most demographics, a minority of MISM reported unprotected anal intercourse with male partners (UAIMP). Across all demographics, risk of UAIMP substantially increased with partners met online. Other predictors of increased online partner risk include being 30–39 years old, having children, not living in the Northeast, and low income. HIV-positive men and African Americans reported increased online and offline partner risk. To address higher risk of UAIMP, online HIV interventions should prioritize the needs of MISM, especially HIV-positive men, with content focused on online-mediated liaisons.     

Scaling Sexual Behavior or “Sexual Risk Propensity” Among Men at Risk for HIV in Kisumu,Kenya

We present a scale to measure sexual risk behavior or “sexual risk propensity” to evaluate risk compensation among men engaged in a randomized clinical trial of male circumcision. This statistical approach can be used to represent each respondent’s level of sexual risk behavior as the sum of his responses on multiple dichotomous and rating scale (i.e. ordinal) items. This summary “score” can be used to summarize information on many sexual behaviors or to evaluate changes in sexual behavior with respect to an intervention. Our 18 item scale demonstrated very good reliability (Cronbach’s alpha of 0.87) and produced a logical, unidimensional continuum to represent sexual risk behavior. We found no evidence of differential item function at different time points (except for reporting a concurrent partners when comparing 6 and 12 month follow-up visits) or with respect to the language with which the instrument was administered. Further, we established criterion validity by demonstrating a statistically significant association between the risk scale and the acquisition of incident sexually transmitted infections (STIs) at the 6 month follow-up and HIV at the 12 month follow-up visits. This method has broad applicability to evaluate sexual risk behavior in the context of other HIV and STI prevention interventions (e.g. microbicide or vaccine trials), or in response to treatment provision (e.g., anti-retroviral therapy).     

The Relationship Between HRCT and Pulmonary Function in Behcet’s Disease

The purpose of this study was to compare the pulmonary functions in female Behcets patients with or without pathological pulmonary lesions using high resolution computerized tomography (HRCT). Twenty-nine female patients aged 19–54 yrs and 20 healthy females aged 19–50 yrs (control group) were accepted into the study. HRCT images were taken and according to HRCT patients were divided into HRCT (+) and HRCT (–) groups (18 patients in each). Pulmonary function tests (PFT) through a spirometer were performed and FVC, FEV₁, FEF_25–75%, PEF, VC, RV, FRC, DLCO and DLCO/VA were determined. No statistically significant difference was observed when the PFT values were compared between HRCT (+) and HRCT (–) patients for the obtained results and the percentage of the expected values. When the PFT values were compared for both HRCT (+) and HRCT (–) patients with the control group separately there was no statistical difference between the best values. A statistically low DLCO/VA value was observed between the percentage of the expected values. It is concluded that though there is a pulmonary restriction in Behcets disease, this restriction has no relation to pulmonary functions. It would be useful to perform pulmonary function tests in the patients with Behcets disease both with or without any pathological findings in HRCT for obtaining information about pulmonary functions. We suggest that even when the results of the pulmonary function tests are normal, considering some pathological changes in HRCT, HRCT investigations may be useful for following up the disease.     

Correction to: Social Determination of HIV: Women’s Relationship Work in the Context of Mass Incarceration and Housing Vulnerability

We contrast a typical “social determinants of health” framing with a more dynamic and complex “social determination of health” framing to analyze HIV-related sexual risk among women in low-income, segregated neighborhoods in New Haven, CT. Using an abductive approach, we analyze repeated, longitudinal qualitative interviews conducted over a 2-year period with a sample of 14 HIV-negative women who engaged in sex with men during the study period. Three case studies are presented to demonstrate how behaviors and sexual practices typically described as HIV “risks” can be understood as part of the work of establishing and maintaining monogamous committed relationships, which we call “relationship work,” shaped in a context characterized by housing vulnerabilities and the many manifestations of mass incarceration and the surveillance state. We conclude by suggesting that for these women, their relationship work is the work of HIV prevention and life in low-income segregated neighborhoods is their HIV-related risk.

     

“It’s Hard to Know What is a Risky or not a Risky Decision”: Gay Men’s Beliefs About Risk During Sex

Gay men increasingly use non condom-based risk reduction strategies to reduce the possibility of HIV transmission. Such strategies rely on men’s knowledge and communication with each other, but how they employ these strategies may depend as much on their attitudes toward risk and pleasure. We explored current beliefs about safe sex, sexual desire and risk behavior in an online survey of 2306 Australian gay men. The survey included free text components to explore men’s beliefs about risk and pleasure. We conducted a principal components factor analysis on the safe sex belief items in the survey, and thematic analysis of the qualitative material was used to interrogate the concepts underpinning these beliefs. We identified two measures of safe sex beliefs: risk reduction optimism (HRRO; α = 0.703); and viral load optimism (α = 0.674). In multivariate analysis, unprotected anal intercourse with casual partners (UAIC) was associated with HRRO among non HIV-positive men only (p < 0.001), but, regardless of HIV serostatus, UAIC was associated with a belief that serosorting could be an effective risk reduction strategy and with being more sexually adventurous in general. Using the qualitative data we identified four themes in how men think about HIV: ‘seeking certainty’, ‘regretful actions’, ‘nothing is safe’, and ‘acting on beliefs’. Each theme interacted with the safe sex beliefs measures to provide a highly contextualised understanding of men’s beliefs about safe in specific circumstances. Gay men think about the risk of HIV transmission in qualitatively different ways depending on specific circumstances. While measures of belief about relative risk of HIV transmission are useful indicators of men’s propensity to take risk, they oversimplify men’s thinking about risk, and fail to account for the role of desire, both in influencing men’s thinking about risk, and in how they balance their perception of relative risk against the pursuit of pleasure.     

HIV Risk and the Internet: Results of the Men’s INTernet Sex (MINTS) Study

This study assessed the feasibility of online recruitment of high-risk Latino men who have sex with men (MSM) for HIV prevention survey research and investigated the relationship between Internet use and unsafe sex. Participants (N = 1,026) were Internet-using Latino MSM living in the U.S. recruited using online banner advertisements. Respondents completed a cross-sectional, online survey in English or Spanish. Sample characteristics reflected national statistics within 5%. Nearly all (99%) reported having used the Internet to seek sex with another man. Two-thirds of respondents reported having unprotected anal sex with ≥1 man in the last year, 57% of these with multiple partners. Participants reported engaging in anal sex and unprotected anal sex with nearly twice as many men first met online versus offline, but risk proportions did not differ. Internet-based HIV prevention research is possible even with geographically-dispersed minority populations. Efficiency appears the primary risk associated with meeting partners online.     

Young Men’s Social Network Characteristics and Associations with Sexual Partnership Concurrency in Tanzania

Social network influence on young people’s sexual behavior is understudied in sub-Saharan Africa. Previous research identified networks of mostly young men in Dar es Salaam who socialize in “camps”. This study describes network characteristics within camps and their relationship to young men’s concurrent sexual partnerships. We conducted surveys with a nearly complete census of ten camp networks (490 men and 160 women). Surveys included name generators to identify camp-based networks. Fifty seven percent of sexually active men (n = 471) reported past year concurrency, measured using the UNAIDS method. In a multivariable model, men’s individual concurrency was associated with being a member of a closer knit camp in which concurrency was the normative behavior. Younger men who had older members in their networks were more likely to engage in concurrency. Respondent concurrency was also associated with inequitable personal gender norms. Our findings suggest strategies for leveraging social networks for HIV prevention among young men.     

Investigating Cortisol Production and Pattern as Mediators in the Relationship Between Shift Work and Cardiometabolic Risk

Background

Shift work is a risk factor for many diseases, including cardiovascular disease. Although the biological pathways are still unclear, it is hypothesized that cortisol disruption during night work is an intermediate. The objective of this study is to determine whether total cortisol production and cortisol pattern mediate the relationship between current shift work and cardiometabolic risk (CMR) among female hospital employees.

Stable Sexual Risk Behavior in a Rapidly Changing Risk Environment: Findings from Population-Based Surveys of Men Who Have Sex with Men in Seattle, Washington, 2003–2006

We assessed trends in behavioral risk for HIV infection among men who have sex with men (MSM). Seattle MSM participated in random digit dial telephone surveys in 2003 (n = 400) and 2006 (n = 400). Fourteen percent in 2003 and 9% in 2006 reported unprotected anal intercourse with a partner of different or unknown HIV status (non-concordant UAI; odds ratio [OR] = 0.7; 95% confidence interval [CI]: 0.5, 1.2). Compared to participants in 2003, participants in 2006 met a greater proportion of their anal sex partners through the Internet (OR = 2.0; 95% CI: 1.2, 3.1). Although the proportion of anal sex partnerships formed online increased between 2003 and 2006, Internet partnerships were not more risky than those initiated elsewhere. While the emergence of the Internet as a venue through which men meet partners demonstrates that sexual risk among MSM remains highly dynamic, our findings suggest that sexual risk behavior among MSM is currently stable.     

Sexual Partner’s Age as a Risk Factor for HIV Seroconversion in a Cohort of HIV-Negative Homosexual Men in Sydney

Increasing partner age may be an important risk factor for HIV infection in homosexual men. About 20 % of 1,427 participants in the Health in Men study in Sydney, Australia, reported that half or more of their partners were much older. Having more partners who were much older was associated with an increased risk of HIV seroconversion (p trend = 0.002), and this remained significant after adjustment for participants’ age, number of regular and casual partners, and sexual risk behaviour (p trend = 0.027). Men who reported much older partners were at increased risk of HIV infection, independent of unprotected anal intercourse with sero-nonconcordant partners.     

HIV Transmission Risk Behavior in a Cohort of HIV-Infected Treatment-Naïve Men and Women in the United States

Antiretroviral therapy (ART) can minimize HIV transmission. Prevention benefits may be compromised by barriers to virologic suppression, and by increased condomless sex among those initiating ART. We evaluated condomless sex in a cohort of HIVinfected US individuals poised to initiate ART in a clinical trial. We assessed partner and sex act type, condom use, and perception of infectiousness. Six percent of participants reported as not infectious; men who have sex with men were more likely to perceive high infectivity. Prevalence of condomless sex was 44 %; 74 % of those also reported homosexual acquisition of HIV. Predictors of increased risk of condomless sex included greater numbers of lifetime partners, recent stimulant drug use and an HIV-positive or unknown serostatus partner. In the context of serodifferent partners, lower perception of infectiousness was also associated with a higher risk of condomless sex. Results highlight opportunities for prevention education for HIV infected individuals at ART initiation.     

Dyslipidemia and the Risk of Alzheimer’s Disease

Whether cholesterol is implicated in the pathogenesis of Alzheimer’s disease (AD) is still controversial. Several studies that explored the association between lipids and/or lipid-lowering treatment and AD indicate a harmful effect of dyslipidemia on AD risk. The findings are supported by genetic linkage and association studies that have clearly identified several genes involved in cholesterol metabolism or transport as AD susceptibility genes, including apolipoprotein E (APOE), apolipoprotein J (APOJ, CLU), ATP-binding cassette subfamily A member 7(ABCA7), and sortilin-related receptor (SORL1). Functional cell biology studies further support a critical involvement of lipid raft cholesterol in the modulation of Aβ precursor protein processing by β-secretase and γ-secretase resulting in altered Aβ production. However, conflicting evidence comes from epidemiological studies showing no or controversial association between dyslipidemia and AD risk, randomized clinical trials observing no beneficial effect of statin therapy, and cell biology studies suggesting that there is little exchange between circulating and brain cholesterol, that increased membrane cholesterol level is protective by inhibiting loss of membrane integrity through amyloid cytotoxicity, and that cellular cholesterol inhibits colocalization of β-secretase?1 and Aβ precursor protein in nonraft membrane domains, thereby increasing generation of plasmin, an Aβ-degrading enzyme. The aim of this article is to provide a comprehensive review of the findings of epidemiological, genetic, and cell biology studies aiming to elucidate the role of cholesterol in the pathogenesis of AD.     

From the Cover: Jupiter’s decisive role in the inner Solar System’s early evolution

The statistics of extrasolar planetary systems indicate that the default mode of planet formation generates planets with orbital periods shorter than 100 days and masses substantially exceeding that of the Earth. When viewed in this context, the Solar System is unusual. Here, we present simulations which show that a popular formation scenario for Jupiter and Saturn, in which Jupiter migrates inward from a > 5 astronomical units (AU) to a ≈ 1.5 AU before reversing direction, can explain the low overall mass of the Solar System’s terrestrial planets, as well as the absence of planets with a < 0.4 AU. Jupiter’s inward migration entrained s ≳ 10−100 km planetesimals into low-order mean motion resonances, shepherding and exciting their orbits. The resulting collisional cascade generated a planetesimal disk that, evolving under gas drag, would have driven any preexisting short-period planets into the Sun. In this scenario, the Solar System’s terrestrial planets formed from gas-starved mass-depleted debris that remained after the primary period of dynamical evolution.A full understanding of the formation and the early evolution of the Solar System ranks among natural science’s grand challenges, and, at present, even the dominant processes responsible for producing the observed planetary architecture remain elusive. Nonetheless, the past three decades have generated remarkable progress (1), and, critically, the discovery of thousands of extrasolar planets has placed Earth and the Solar System into the broader context of the galactic planetary census.Perhaps the most important exoplanet-related discovery has been the realization that roughly half of the Sun-like stars in the solar neighborhood are accompanied by systems of one or more planets on low-eccentricity orbits with periods ranging from days to months, and masses falling in the 1M_⊕ < M_p < 50?M_⊕ range (2, 3), where M_⊕ is an Earth mass unit. This dominant population of planets (which often presents tightly packed, nearly coplanar multiple systems) contrasts sharply with the Solar System, whose inner edge is marked by Mercury’s 88-d [0.4 astronomical units (AU)] orbit (see Fig. 1). An iconic example from the new planetary catalog is the Kepler-11 system, which encompasses at least six planets comprising more than ∼40 Earth masses (4). In short, the exoplanetary surveys have revealed a hitherto unrecognized oddity of the Solar System. Relative to other Sun-like, planet-bearing stars, our terrestrial region is severely depleted in mass.Open in a separate windowFig. 1.Orbital distribution of sub-Jovian extrasolar planets. A collection of transiting planet candidates with radii R < 5R_⊕ (where R_⊕ is an Earth radius unit), detected by the Kepler mission is shown. The radial distance away from the center of the figure represents a logarithmic measure of the planetary semimajor axis, such that the origin corresponds to the Sun’s surface. The sizes of the individual points represent the physical radii of the planets. Further, the points are color-coded in accordance with multiplicity. The orbits of the terrestrial planets are also shown. Despite observational biases inherent to the observed distribution (e.g., transit probability, detectability) that work against detection of planets at increasing orbital radii, the raw contrast to our own Solar System is striking.A few related peculiarities are also evident within the inner Solar System. Specifically, cosmochemical evidence suggests that while the fundamental planetary building blocks (planetesimals) formed within ∼1 My of the Sun’s birth (5), the final assembly of the terrestrial planets occurred on a timescale of 100−200 My, well after the dispersal of the nebular gas (6). This is at odds with the inferred compositions of extrasolar super-Earths, which are thought to have substantial gaseous atmospheres. Additionally, the exceptionally small masses of Mercury and Mars suggest that the terrestrial planets formed out of a narrow annulus of rocky debris, spanning 0.7−1 AU (where 1 AU is the mean distance between Earth and the Sun) (7). (See refs. 8 and 9 for an alternative view.) Such a narrow annulus is at odds with so-called minimum mass solar nebula (10, 11).Within the framework of a radially confined solid component of the inner solar nebula, the inner edge of the annulus is entirely artificial. Indeed, at present, there exists no compelling justification for its origin. A plausible explanation may stem from the dynamical evacuation of solid material by a population of primordial close-in planets (12). We shall investigate this possibility further in this study.Unlike the inner edge of the annulus, a body of previous work has demonstrated that the outer edge can be naturally sculpted by inward-then-outward migration of Jupiter (13). Within protoplanetary disks, long-range migration of giant planets results from tidal interactions with the nebula and viscous transport (14). For single planets, orbital evolution is typically inward. However, the process of resonant locking between two convergently migrating planets can lead to a reversal of the migration direction (15).The process of resonant migration reversal for gap-opening planets (i.e., objects with M ? M_Jup) is a well-understood result of planet−disk interactions, and only requires the outer planet to be somewhat less massive than the inner. To this end, it is worth noting that all of the known mean motion commensurate pairs of giant planets that reside beyond a ? 1?AU have the more massive object on the inside (16, 17), suggesting that the operation of this mechanism is widespread. [A notable system within the resonant extrasolar population is GJ 876, where the inner planet is substantially less massive than the outer. In accordance with the picture of resonant transport delineated in ref. 18, this system likely failed to satisfy the conditions required for migration reversal and decayed to a compact orbital configuration (19).]Within the Solar System, it is inferred that Jupiter initially migrated inward from its primordial formation site (presumably 3−10 AU) to ∼1.5 AU, and subsequently reversed its evolutionary track as a consequence of locking into a 3:2 mean motion resonance with a newly formed Saturn. This special case of the generic resonant migration reversal mechanism is informally referred to as the “Grand Tack” scenario (13). In addition to the aforementioned truncation of the inner solid nebula, this putative sequence of events is attractive in that it naturally explains how the Solar System’s giant planets avoided spiraling into the Sun (18), accounts for the origins of compositional differences within the Asteroid belt (13), provides a mechanism for delivery of water into the terrestrial region (20), and generates a compact orbital configuration needed for the subsequent instability-driven orbital evolution of the outer Solar System (21, 22).     

Masculinity and HIV: Dimensions of Masculine Norms that Contribute to Men’s HIV-Related Sexual Behaviors

Numerous studies have documented a relationship between masculine norms and men’s HIV-related sexual behaviors, but intervening upon this relationship requires a nuanced understanding of the specific aspects of masculine norms that shape men’s sexual behaviors. We integrate theories on masculinities with empirical HIV research to identify specific dimensions of masculine norms that influence men’s HIV-related sexual behaviors. We identify three major dimensions of masculine norms that shape men’s sexual behavior: (1) uncontrollable male sex drive, (2) capacity to perform sexually, and (3) power over others. While the existing literature does help explain the relationship between masculine norms and men’s sexual behaviors several gaps remain including: a recognition of context-specific masculinities, an interrogation of the positive influences of masculinity, adoption of an intersectional approach, assessment of changes in norms and behaviors over time, and rigorous evaluations of gender-transformative approaches. Addressing these gaps in future research may optimize prevention efforts.     

Patterns and Correlates of Risky Behavior Among HIV+ Gay Men: Are They Really Different from HIV− Men?

With the advent of highly effective antiretroviral therapies, the prospects for persons living with HIV infection (HIV+) undoubtedly include many years of continued sexual activity. Reports of unsafe sexual behavior among a subset of HIV+ men has alarmed some prevention researchers and stimulated rethinking of HIV prevention interventions for gay/bisexual men. This paper examines the rates of unsafe sex among HIV+ gay/bisexual men and their correlates, comparing them to HIV– men recruited simultaneously to the Chicago MACS/C&CS and AIM studies. Aside from initial differences in the rates of unprotected anal sex (UAS) among men prior to learning their HIV serostatus, there were no differences in actual rates of UAS or their correlates in the two samples. Further, the importance of attitudinal measures—i.e., sexual sensation seeking, preference for UAS, and belief in the efficacy of the new therapies—in predicting risky sex among gay/bisexual men regardless of serostatus argues for an emphasis on modifying these attitudes in any HIV prevention interventions for gay and bisexual men and the importance of combining primary and secondary HIV prevention strategies whenever possible.Correspondence should be addressed to David Ostrow, AIM Project, Howard Brown Health Clinic, 4334 N. Hazel Street, Chicago, Illinois 60613-1429