Youth,violence and non-injection drug use: nexus of vulnerabilities among lesbian and bisexual sex workers

Despite increasing evidence of enhanced HIV risk among sexual minority populations, and sex workers (SWs) in particular, there remains a paucity of epidemiological data on the risk environments of SWs who identify as lesbian or bisexual. Therefore, this short report describes a study that examined the individual, interpersonal and structural associations with lesbian or bisexual identity among SWs in Vancouver, Canada. Analysis drew on data from an open prospective cohort of street and hidden off-street SWs in Vancouver. Bivariate and multivariable logistic regressions were used to examine the independent relationships between individual, interpersonal, work environment and structural factors and lesbian or bisexual identity. Of the 510 individuals in our sample, 95 (18.6%) identified as lesbian or bisexual. In multivariable analysis, reporting non-injection drug use in the last six months (adjusted odds ratio [AOR] = 2.89; 95% confidence intervals [CI] = 1.42, 5.75), youth ≤24 years of age (AOR = 2.43; 95% CI = 1.24, 4.73) and experiencing client-perpetrated verbal, physical and/or sexual violence in the last six months (AOR = 1.85; 95% CI = 1.15, 2.98) remained independently associated with lesbian/bisexual identity, after adjusting for potential confounders. The findings demonstrate an urgent need for evidence-based social and structural HIV prevention interventions. In particular, policies and programmes tailored to lesbian and bisexual youth and women working in sex work, including those that prevent violence and address issues of non-injection stimulant use are required.     

A Systematic Review of the Correlates of Violence Against Sex Workers

We conducted a systematic review in June 2012 (updated September 2013) to examine the prevalence and factors shaping sexual or physical violence against sex workers globally.We identified 1536 (update = 340) unique articles. We included 28 studies, with 14 more contributing to violence prevalence estimates. Lifetime prevalence of any or combined workplace violence ranged from 45% to 75% and over the past year, 32% to 55%. Growing research links contextual factors with violence against sex workers, alongside known interpersonal and individual risks.This high burden of violence against sex workers globally and large gaps in epidemiological data support the need for research and structural interventions to better document and respond to the contextual factors shaping this violence. Measurement and methodological innovation, in partnership with sex work communities, are critical.Frequent reports of incidents of widespread violence against sex workers continue to emerge globally,1–3 including media reports of abuse, human rights violations, and murder.4–7 Despite increasing recognition of violence in the general population as a public health and human rights priority by policymakers, researchers, and international bodies,8–10 violence against sex workers that occurs within and outside the context of sex work is frequently overlooked in international agendas to prevent violence. Although increasing research has explored the prevalence, determinants, and correlates of violence against women,8,11–14 comparable research specifically among sex workers is lacking. There remains limited review of the magnitude, severity, or type of violence experienced by sex workers globally. This paucity of data on prevalence and incidence of violence against sex workers has been highlighted in a review on the magnitude and scope of violence globally.15Negative health effects of intimate partner violence in the general population include poor health overall, physical and sexual injury, and mental health problems including depression, anxiety, and posttraumatic stress disorder.16–21 Intimate partner violence faced by women in the general population has also been linked to unwanted pregnancy, abortion, and increased risk for HIV and other sexually transmitted infections (STIs), through different direct and indirect mechanisms.22–26 Victims of violence in early childhood are also more likely to have increased risk for HIV and other STIs.27 However, the role of violence, both workplace violence and violence by intimate or other nonpaying partners, in influencing negative health outcomes among sex workers, who are highly stigmatized and often criminalized, has received comparably less attention.The legal status of sex work can be a critical factor in shaping patterns of violence against sex workers.1,28 In many settings, the criminalized or quasicriminalized nature of sex work means that violence that occurs in the context of sex work (i.e., as a workplace harm and abuse) is not monitored by any formal bodies, with few to no legal protections afforded to sex workers by police and judicial systems.1,28 Violence against sex workers is often not registered as an offense by the police and in some cases is perpetrated by police.29,30 Physical and sexual violence, and verbal abuse or threats of abuse from police, can prevent sex workers from reporting violence to the police or accessing other public agencies (e.g., health or social services), exacerbating their trauma and health risks.1,29,30 These risks include the risk for HIV and other STIs, and in some settings, threats of arrest for possession of condoms as evidence of engaging in sex work can deter sex workers from carrying condoms.30–32 This can create a climate of tolerance of violence and thereby perpetuate violence against sex workers.We conducted a systematic review to examine the documented magnitude of violence against sex workers and to review the factors that shape risk for violence against sex workers. In our review we were guided by theoretical frameworks that implicate structural factors in shaping vulnerabilities experienced by vulnerable populations.33–35 Within the interrelated physical, social, economic, and policy environments, factors operate to create different levels of susceptibility and risk.33–35 The current review provides an evidence base pertaining to violence against sex workers from which to better inform the development of public health and social interventions to reduce violence and ameliorate its impacts on sex workers.     

Isolation of <Emphasis Type="Italic">Pteropine orthoreovirus</Emphasis> from <Emphasis Type="Italic">Pteropus vampyrus</Emphasis> in Garut,Indonesia

Flying foxes belonging to the genus Pteropus are known to be reservoirs of zoonotic viruses. In this study, we describe the isolation of Pteropine orthoreovirus (PRV) from rectal swab samples of Pteropus vampyrus in Indonesia. PRV is an emerging zoonotic respiratory virus that can be transmitted from bats to humans. Rectal swabs (n?=?91) were screened by PCR for PRV and 10 (11%) were positive. Phylogenetic analysis based on nucleotide sequences indicated that the S2, S3, S4, M3, L2, and L3 segments of one isolate (Garut-69) were closely related to previously isolated strains in Indonesia. The remaining gene segments showed both similarity and genetic divergence with other PRV strains, suggesting that re-assortment events had occurred. This is the first report of PRV infection to P. vampyrus in West Java, Indonesia.     

99Technetium bone scanning in experimental osteomyelitis

A rabbit model of experimental osteomyelitis was used in an attempt to clarify the natural history of bone infection associated with positive scintigraphic and negative radiological findings. In this model a pathogenic strain of Staphylococcus aureus is injected in the proximal metaphysis of the tibia of a rabbit, 15 minutes following the injection of a sclerosing agent. Scintigraphies were performed at 3, 5, 12, and 19 days following this procedure; 99m-Technetium phosphate compounds were used indifferently. On days 5, 12, and 19 a roentgenogram of the lower limbs was taken. Animals were sacrificed at random 6, 14, and 21 days following the procedure. Against expectations, the standard radiological procedure was more sensitive than the scintigraphic technique. The probability of finding a positive bone scintigrapy in the presence of osteomyelitis P(S+/O+) was 15/19 or 0.78. For the roentgenograms P(X+/O+) = 16/17 = 0.94. On pathological review the scintigraphic findings remained unexplained when fibrosis, periosteal reaction, granulocytic infiltration, and new bone formation were considered separately. In half of the cases the early scintigraphies revealed decreased uptake on the affected side, but this finding did not predict whether the final scintigraphy was positive. Finally, positivity was obvious in all cases, and a continuous range from negative to positive could not be documented. Present findings are a characteristic feature of the model. The physiological mechanism remains to be explained by independent measurements of relative bone blood flow made simultaneously with the scintigraphy and other bone tissue specific factors.     

X-ray-free ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a comparative study with historical control

International Urology and Nephrology - To compare the outcomes and complications of supine X-ray-free ultrasound-guided percutaneous nephrolithotomy (XG-PCNL) with fluoroscopy-guided (FG)-PCNL in...     

Identification of Neisseria gonorrhoeae by the Bruker Biotyper Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System Is Improved by a Database Extension

Identification of Neisseria gonorrhoeae by the Bruker matrix-assisted laser desorption ionization−time of flight mass spectrometry (MALDI-TOF MS) system may be affected by “B consistency categorization.” A supplementary database of 17 N. gonorrhoeae main spectra was constructed. Twelve of 64 N. gonorrhoeae identifications were categorized with B consistency, which disappeared using the supplementary database. Database extension did not result in misidentification of Neisseria meningitidis.