Prevalence of HIV Infection and Prior HIV Testing among Young Men Who have Sex with Men. The Baltimore Young Men’s Survey

Data are presented from the Baltimore Young Men’s Survey, a cross-sectional, venue-based sample survey of risks associated with HIV and report of a prior HIV test, conducted between 1996 and 2000, and enrolling 843 young men who have sex with men (MSM) aged 15–29 years. HIV prevalence was 12.1% overall and racial disparities in HIV prevalence were pronounced (range, 2.9% among non-Hispanic whites to 27.1% among non-Hispanic blacks). Risks independently associated with being HIV-positive were: being between 26 and 29 years of age, being non-Hispanic black or of other/mixed race, having had 20 or more lifetime male sex partners, having been diagnosed with a sexually transmitted disease (STD), and not being currently enrolled in school. The majority of participants (78.9%) reported a prior HIV test. In multivariate analysis, being older, having had five or more lifetime male sex partners, having had anal intercourse with males, reporting an STD diagnosis, and reporting recent unprotected anal sex were associated with report of a prior HIV test. Prevention efforts must address high HIV prevalence among young non-Hispanic black MSM and must make testing and effective counseling for young MSM readily available.     

The characteristics and risk factors for HIV infection among Beijing drug users in different settings

Background

Treatment for drug addiction in China can take place in mandatory detoxification centers (MDC), voluntary detoxification centers (VDC), or at outreach programs located in the community. To date little is known about HIV prevalence or associated risk factors among the current and past drug users (DU) in each setting.

Methods

Cross-sectional surveys were conducted at three different settings in Beijing, China; 795 subjects were enrolled at MDC, 824 at VDC, and 520 within the community. Subjects who provided informed consent took part in face-to-face interviews and provided blood samples for HIV and syphilis testing.

Results

Significant differences were found across enrollment sites in terms of demographic, drug use and sexual behavior characteristics. Overall HIV sero-prevalence was 2.9%, and was particularly high in MDC (5.2% versus 1.0% in VDC and 2.3% among community drug users). Adjusted odds ratios (OR) for HIV infection were 50.5 (95% CI: 19.07-133.85) for being of Yi ethnicity, 29.4 (95% CI: 15.10-57.24) for Uyghur ethnicity, 3.4 (95% CI: 1.57-7.52) for injection drug users who did not share equipment, and 18.8 (95% CI: 8.31-42.75) among injection drug users who shared injection equipment.

Conclusions

The vast differences among DU in various enrollment sites in terms of demographic characteristics, socioeconomic status, and HIV related risk profiles underscore the importance of familiarity with population characteristics and drug user environment to better inform targeted prevention programs. Prevention programs targeting DU in Chinese settings must also consider differences in ethnicities, culture, and residential status.     

Epidemiology and risk factors for human papillomavirus infection in a diverse sample of low-income young women

BackgroundTwo HPV vaccines prevent infection with HPV-16 and HPV-18, high-risk (cancer-associated) HPV types which together cause approximately 70% of cervical cancers; one vaccine also prevents HPV-6 and HPV-11, which together cause approximately 90% of anogenital warts. Defining type-specific HPV epidemiology in sexually experienced women will help estimate the potential clinical benefits of vaccinating this population.ObjectivesTo examine HPV epidemiology in a diverse sample of sexually experienced women, and to determine factors associated with high-risk HPV and vaccine-type HPV (HPV-6, HPV-11, HPV-16 and HPV-18).Study designCross-sectional study of 13–26-year-old women (N = 409) who completed a questionnaire and provided a cervicovaginal swab. Swabs were genotyped for HPV using PCR amplification. Logistic regression models were used to determine whether participant characteristics, knowledge, and behaviors were associated with high-risk and vaccine-type HPV.ResultsMost women (68.4%) were positive for ≥1 HPV type, 59.5% were positive for ≥1 high-risk type, 33.1% were positive for ≥1 vaccine-type HPV, and 3.5% were positive for both HPV-16 and HPV-18: none was positive for all four vaccine types. In adjusted logistic regression models, Black race (OR 2.03, 95% CI 1.21–3.41) and lifetime number of male sexual partners (OR 4.79, 95% CI 2.04–11.23 for ≥10 partner vs. ≤1 partner) were independently associated with high-risk HPV infection.ConclusionsHPV prevalence was very high in this sample of sexually active young women, but <5% were positive for both HPV-16 and HPV-18, suggesting that vaccination could be beneficial for many individual women who are sexually experienced.     

Quantification of print,radio and television exposure among previous blood donors in Kenya: an opportunity for encouraging repeat donation in a resource‐limited setting?

Blood services in sub‐Saharan Africa experience blood shortages and low retention of voluntary, non‐remunerated donors. To boost collections by encouraging repeat donations, the Kenya National Blood Transfusion Service is exploring the likelihood of reaching previous donors through targeted print, radio and television advertising. We analysed data from a national AIDS Indicator Survey to determine whether previous donors have significant exposure to media. Respondents reporting history of blood donation had significantly higher exposure to print, radio and television media than those without history of blood donation. Targeted media campaigns encouraging repeat donation are likely to reach previous donors even in resource‐limited settings.     

HIV-1 superinfection can occur in the presence of broadly neutralizing antibodies

BackgroundSuperinfection of individuals already infected with HIV-1 suggests that pre-existing immune responses may not adequately protect against re-infection. We assessed high-risk female sex workers initially infected with HIV-1 clades A, D or A/D recombinants, to determine if HIV-1 broadly neutralizing antibodies were lacking prior to superinfection.MethodsSix superinfected female sex workers previously stratified by HIV-1 high-risk behavior, infecting virus clade and volunteer CD4 counts were evaluated at baseline (n = 5) and at 350 days post-superinfection (n = 6); one superinfected volunteer lacked pre-superinfection plasma. Retrospective plasmas were assessed for neutralization of a multi-clade panel of 12 HIV-1 viruses before superinfection, and then at quarterly intervals thereafter. Similarly stratified singly infected female sex workers were correspondingly assessed at baseline (n = 19) and 350 days after superinfection (n = 24). Neutralization of at least 50% of the 12 viruses (broad neutralization), and geometric means of the neutralization titers (IC₅₀) were compared before and after superinfection; and were correlated with the volunteer HIV-1 superinfection status, CD4 counts, and pseudovirus clade.ResultsPreexisting broad neutralization occurred in 80% (4/5) of the superinfected subjects with no further broadening by 350 days after superinfection. In one of the five subjects, HIV-1 superinfection occurred when broad neutralization was lacking; with subsequent broadening of neutralizing antibodies occuring within 9 months and plateauing by 30 months after detection of superinfection. Clade B and C pseudoviruses were more sensitive to neutralization (13; [87%]); and (12; [80%]) than the locally circulating clades A (10; [67%]) and D (6; [40%]), respectively (p = 0.025). Low antibody titers correlated with clade D viruses and with >500 CD4 T cell counts, but not with the superinfection status.ConclusionThese data demonstrate that HIV-1 superinfection can occur both in the presence, and in the absence of broadly neutralizing antibodies.     

Perceived Access and Actual Intake of Healthy Diets Among Households in Vulnerable Salvadoran Communities

ObjectiveThis study aimed to examine the dietary intake of Salvadoran households according to perceived access to healthy meals (PAHD), and to identify household characteristics associated with diet quality and PAHD.MethodsSecondary data analysis with a sample of 139 Salvadoran households from resource-poor communities in El Salvador. Chi-square tests and ANOVA were used to assess differences in dietary intake across households classified according to PAHD.ResultsHigh-PAHD households had higher women's education, household food security levels, overall diet quality, and variety, and higher intakes of animal products, fats, cholesterol, vitamin C, and sodium (P < .05). Diet quality was not associated with the household characteristics studied.Conclusions and ImplicationsOverall diet quality was associated with higher levels of PAHD, but some differences in intakes were not as expected, such as higher intakes in foods and nutrients associated with low-quality diets, among high PAHD households.     

Estimating primary care attendance rates for fever in infants after meningococcal B vaccination in England using national syndromic surveillance data

BackgroundIn September 2015, the United Kingdom became the first country to introduce the multicomponent group B meningococcal vaccine (4CMenB) into a national infant immunisation programme. In early clinical trials 51–61% of infants developed a fever when 4CMenB was administered with other routine vaccines. Whilst administration of prophylactic paracetamol is advised, up to 3% of parents may seek medical advice for fever following vaccination. We used research-level general practitioner consultations to identify any increase in attendances for all-cause fever in vaccine-eligible infants following 4CMenB introduction in England.MethodsConsultations for infant all-cause fever in the year following the vaccine introduction were identified from The Phoenix Partnership (TPP) ResearchOne general practice database using Read (CTV3) codes. Average daily consultation rates and incidence rate ratios (IRRs) were calculated for vaccine-eligible age groups and compared to the two years preceding vaccine introduction. The difference between pre- and post-vaccine all-cause fever consultations was estimated.ResultsAll-cause fever consultations in vaccine-eligible 7–10 week olds were 1.6-fold higher (IRR, 1.58; 95% CI, 1.22–2.05) compared to the two previous years and 1.5-fold higher (IRR 1.47; 95% CI, 1.17–1.86) in 15–18 week-olds. There were no significant differences in 0–6 or 11–14 week-olds. Applying the difference between pre- and post-vaccine consultation rates to the 4CMenB vaccine-eligible age groups across England estimated 1825 additional fever consultations in the year following 4CMenB introduction.ConclusionsWe found a small but significant difference in all-cause fever consultation rates in vaccine-eligible infants who would have received 4CMenB with other vaccines.     

北京市朝阳区暗娼艾滋病性病综合干预效果分析

目的 探求艾滋病在大城区、低流行状况下降低暗娼人群感染艾滋病和（或）性病风险的综合防治措施。方法 采用问卷调查的方式对辖区内8家娱乐场所暗娼（female sex workers,FSW）干预前226名及干预后187名进行调查,采用χ^2检验进行统计学分析。结果 接受调查的FSW年龄范围在17-40岁[（25．22±5．81）岁];高中及初中文化程度达203名（89．82％）;未婚为166名（73．45％）,职业中无业者达205名（90．70％）;来自外省市224名（99．12％）。调查前后对性病、艾滋病防治知识的知晓率由52．6％提升至75．4％（χ^2=22．701,P〈0．01）,使刷安全套的比率由治疗前22．12％提升至34．76％（χ^2=8．14,P〈0．05）。结论 北京市朝阳区通过综合干预措施对于暗娼防治艾滋病和（或）性病取得了较为显著的效果,综合干预措施值得在大城区、低流行状况下的暗娼人群艾滋病性病干预中广泛应用。