Reducing sexual risk and promoting acceptance of men who have sex with men living with HIV in India: Outcomes and process evaluation of a pilot randomised multi-level intervention

ABSTRACT

HIV-positive men who have sex with men (HIV+MSM) in India need culturally-relevant interventions to promote safer sex. We tested a multi-level intervention among HIV+MSM that targeted individual, interpersonal, and community factors, based on the Social-Personal and Social Ecological Models. We conducted a 2?×?2 factorial RCT with 119 HIV+MSM randomised to receive either an individual-level intervention (ILI) using motivational interviewing to promote safer sex, a community-level intervention (CLI) to strengthen community norms toward safer sex and reduce stigma among MSM communities, a multi-level intervention combining the individual- and community-level interventions (ILI?+?CLI), or standard-of-care control. Participants completed pre- and post-intervention assessments of a composite sexual risk score and a process evaluation to assess fidelity and satisfaction. Out of the 119 HIV+MSM, 106 (89.0%) completed pre- and post-intervention assessments. Generalised Estimating Equation models showed that both CLI (Incidence Rate Ratio [IRR]?=?.67, 95% CI .47 to .96) and ILI?+?CLI (IRR?=?.66, 95% CI .48 to .91) groups had a statistically significant decrease in sexual risk compared to the standard-of-care. The interventions had high levels of fidelity and satisfaction. This pilot RCT demonstrated feasibility and potential effectiveness of a multi-level intervention that addresses individual, interpersonal and community-level contributors of sexual risk among HIV+MSM.     

Assessment of the Antimetastatic Activity of Extracts of Filipedula ulmaria Depending on Extractant

Pharmaceutical Chemistry Journal - Three extracts were produced from the above-ground part of the meadowsweet Filipendula ulmaria (L.) Maxim. using water, 40% ethanol, and 70% ethanol. Comparative...     

eTEP inferior access with tailored retromuscular dissection for small to mid-sized umbilical hernia repair with or without inguinal hernia: early experience

Hernia - The minimally invasive surgical repair of combined inguinal and ventral hernias often requires shifting from one approach or plane to another. The traditional enhanced-view totally...     

莫西沙星联合信必可都保对AECOPD疗效及免疫炎症反应的影响

目的探讨维生素D(VitD)联合鱼油对糖尿病前期(PDM)患者糖脂代谢、胰岛β细胞功能的影响。 方法选取PDM患者132例,随机均分为联合组(VitD+鱼油)、VitD组(VitD)和对照组(不干预)。比较各组糖脂代谢、胰岛β细胞功能、炎症反应、血管内皮功能等指标。 结果与干预前比较,干预后联合组甘油三酯降低,白细胞介素-10增高(P＜0.05),联合组和VitD组低密度脂蛋白胆固醇、肿瘤坏死因子-α、胰岛素抵抗指数、前列腺素E2、瘦素、抵抗素降低(P＜0.05),空腹胰岛素、胰岛β细胞功能指数、脂联素增高(P＜0.05),且联合组改善更为明显(P＜0.05)。 结论维生素D联合鱼油治疗PDM患者可改善其脂代谢和胰岛功能相关指标,具有一定临床应用价值。     

Haemophilic Pseudotumour: Surgical Management of a Rare Case

Haemophilia is a common cause of genetically inherited bleeding disorders. Pseudotumours occur in 1–2 % of persons with severe forms of haemophilia. These are a result of repeated haemorrhage into soft tissues, subperiosteum or a site of bone fracture with inadequate resorption of the extravasated blood. There are a number of therapeutic alternatives for this dangerous condition: surgical removal, percutaneous management, irradiation, embolization etc. In this case report, we describe the natural history, clinical course and successful surgical management of a patient with haemophilia who presented with a massive pseudotumour. We also briefly review the relevant literature on the various therapeutic modalities that have been implemented in the management of this rare complication. Though surgeons may be averse to operate on haemophiliacs, primary surgical management as done in our case may prove to be the definitive treatment option for such patients.