Evidence for a role of LPGAT1 in influencing BMI and percent body fat in Native Americans.

OBJECTIVE: A genome-wide association study (GWAS) was recently completed in 1120 Pima Indians to identify loci that influence BMI. Among the top 100 signals were three variants that mapped within the lysophosphatidylglycerol acyltransferase 1 (LPGAT1) gene. LPGAT1 belongs to a large family of acyltransferases, which are involved in a variety of biological processes including pathways that regulate energy homeostasis and body weight. Therefore LPGAT1 was analyzed as a candidate gene for obesity in Pima Indians. DESIGN AND METHODS: Variants (n = 26) located within and adjacent to LPGAT1 including a novel 27bp deletion in the 5'-untranslated region identified by sequencing were genotyped in a population-based sample of 3,391 full-heritage Pima Indians living in the Gila River Indian Community. Replication of selected variants was assessed in a second sample of 3,327 mixed-heritage Native Americans from the same community. RESULTS: Variants with nominal associations with BMI in each of the two independent samples (tagged by rs112662024 and rs12058008) had associations of P = 1-4 × 10(-5) in the combined sample (n = 6718). A haplotype that includes the novel 27bp deletion, which does not occur in Caucasians, showed the strongest association with BMI in the full-heritage Pima Indians. In vitro functional studies provided suggestive evidence that this 27bp deletion may affect transcriptional or posttranscriptional regulation. Analysis of LPGAT1 cDNA from human preadipocytes identified an additional exon whose sequence could potentially serve as a mitochondrial targeting peptide. CONCLUSIONS: LPGAT1 is a novel gene that influences BMI in Native Americans.

The Use of Female Commercial Sex Workers' Services by Latino Day Laborers.

This article reports the characteristics of Latino day laborers who have sex with female commercial sex workers (CSWs). A sample of 450 day laborers in Los Angeles was utilized. Multivariate logistic regression was used to determine the association of independent variables with the likelihood of having sex with a CSW. Overall, 26% of the 450 day laborers reported having had sex with a CSW in the previous 12 months. A lower likelihood of having sex with a CSW was found for those with more than six years of education and for those who were married and living with their spouses. A higher likelihood of having sex with a CSW was found for those who met the criteria for harmful drinking or drug dependence. Commercial sex work has been associated with sexually transmitted infections and other problems among clients of CSWs and warrants further attention by providers working with day laborers.

Sexual solicitation of Latino male day laborers by other men / Solicitación sexual de hombres jornaleros latinos por otros hombres

OBJECTIVE: To examine the likelihood of Latino day laborers being solicited for sex by other men. MATERIAL AND METHODS: 450 Latino day laborers were recruited in Los Angeles, California, from July to September 2005. Logistic regression analysis was used to determine which day laborers were more likely to be solicited and subsequently to have sex. RESULTS: Thirty-eight percent reported being solicited for sex by another man while seeking work. Those solicited were more likely to live longer in the US, be more educated and screen positive for drug dependence. Of those solicited, 9.4 percent had sex with their solicitors. Those screening positive for drug dependence were more likely to have sex. Most of the day laborers who had anal sex with their solicitors did not always use condoms. CONCLUSIONS: HIV prevention efforts should target drug dependent day laborers, who may place themselves at risk for HIV through sex with male solicitors.

OBJETIVO: Examinar hasta qué punto los jornaleros latinos son solicitados por otros hombres para tener relaciones sexuales. MATERIAL Y MÉTODOS: Cuatrocientos cincuenta jornaleros latinos fueron reclutados en Los Ángeles, California, de julio a septiembre de 2005. Un análisis de regresión logística fue utilizado para determinar cuáles jornaleros tenían más probabilidades de que fueran solicitados y, subsecuentemente, de que tuvieran sexo. RESULTADOS: Treinta y ocho por ciento reportaron que fueron solicitados para sexo por otros hombres mientras buscaban trabajo. Estos hombres que fueron solicitados tenían más probabilidades de haber vivido más tiempo en los Estados Unidos, tener más educación formal y dar resultados positivos en dependencia de drogas. De los solicitados, 9.4 por ciento tuvieron sexo con los solicitadores. Aquellos que dieron resultados positivos para dependencia de drogas tenían más probabilidades de tener sexo. La mayoría de los jornaleros que tuvieron sexo anal con los solicitadores no siempre usaron condón. CONCLUSIONES: Esfuerzos de prevención del VIH deben dirigirse a jornaleros dependientes de drogas quienes pueden estar exponiéndose al riesgo de contraer VIH al tener sexo con solicitadores masculinos.

Sexual solicitation of Latino male day laborers by other men.

OBJECTIVE: To examine the likelihood of Latino day laborers being solicited for sex by other men. MATERIAL AND METHODS: 450 Latino day laborers were recruited in Los Angeles, California, from July to September 2005. Logistic regression analysis was used to determine which day laborers were more likely to be solicited and subsequently to have sex. RESULTS: Thirty-eight percent reported being solicited for sex by another man while seeking work. Those solicited were more likely to live longer in the US, be more educated and screen positive for drug dependence. Of those solicited, 9.4% had sex with their solicitors. Those screening positive for drug dependence were more likely to have sex. Most of the day laborers who had anal sex with their solicitors did not always use condoms. CONCLUSIONS: HIV prevention efforts should target drug dependent day laborers, who may place themselves at risk for HIV through sex with male solicitors.

Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward.

Although stigma is considered a major barrier to effective responses to the HIV/AIDS epidemic, stigma reduction efforts are relegated to the bottom of AIDS programme priorities. The complexity of HIV/AIDS-related stigma is often cited as a primary reason for the limited response to this pervasive phenomenon. In this paper, we systematically review the scientific literature on HIV/AIDS-related stigma to document the current state of research, identify gaps in the available evidence and highlight promising strategies to address stigma. We focus on the following key challenges: defining, measuring and reducing HIV/AIDS-related stigma as well as assessing the impact of stigma on the effectiveness of HIV prevention and treatment programmes. Based on the literature, we conclude by offering a set of recommendations that may represent important next steps in a multifaceted response to stigma in the HIV/AIDS epidemic.

Evaluation of a prevention intervention to reduce HIV Risk among Angolan soldiers.

We developed and evaluated a military-focused HIV prevention intervention to enhance HIV risk-reduction knowledge, motivation, and behaviors among Angolan soldiers. Twelve bases were randomly assigned to HIV prevention or control conditions, yielding 568 participants. HIV prevention participants received training in preventing HIV (4.5 days) and malaria (0.5 days). Control participants received the reverse. Monthly booster sessions were available after each intervention. We assessed participants at baseline, 3 and 6 months after the training. HIV prevention participants reported greater condom use and less unprotected anal sex at 3 months, as well as greater HIV-related knowledge and perceived vulnerability at 3 and 6 months. Within-group analyses showed HIV prevention participants increased condom use, reduced unprotected vaginal sex, and reduced numbers of partners at both follow-ups, while control participants improved on some outcomes at 3 months only. A military-focused HIV prevention intervention may increase HIV-related knowledge, motivation, and risk reduction among African soldiers.

HIV/AIDS behavioral surveillance among Angolan military men.

To assess HIV-related risk behavior among military men in a post-conflict sub-Saharan African country with low HIV prevalence this study evaluated sexual risk taking and related behaviors among a stratified random sample of 1,710 military personnel in four regions of Angola. Over 90% were sexually active and 60% had two or more sexual partners within the past year. Condom use varied depending on partner type, from a low of 10% to a high of 54%. Factors independently predicting the number of sexual partners included younger age, younger age of sexual debut, being away from home, being in the eastern part of the country, higher military rank, higher education, alcohol before sex, and problem alcohol use. Independent predictors of sexually transmitted infection symptoms included age of sexual debut, lower education, higher rank, and having had sex with a casual partner or a commercial sex worker in the previous 12 months. These findings indicate high rates of HIV risk-taking behaviors among military personnel and the need for aggressive prevention campaigns to reduce HIV risk among military personnel and the populations they serve.

Evidence-based recommendations for prevention of human immunodeficiency virus and sexually transmitted infections in the Angolan Armed Forces: challenges and opportunities at the end of 30 years of war.

OBJECTIVE: The goal was the development of culturally sensitive, evidence-based recommendations for human immunodeficiency virus (HIV) prevention for Angolan soldiers. METHODS: Eight focus groups (N = 68) were conducted with Angolan soldiers in 2002. Qualitative data were analyzed for soldiers' HIV/sexually transmitted infections (STIs)-related knowledge and behaviors. RESULTS: More than 37% of participants reported having more than one sexual partner at the time of the study. Many soldiers had little knowledge regarding HIV/STI transmission and symptoms, and most did not use condoms. Soldiers identified the following factors that need to be addressed in HIV/STI prevention campaigns among military personnel: lack of HIV awareness and knowledge, limited condom availability and use, heavy alcohol use before sex, and the tendency to have multiple sexual partners. CONCLUSIONS: Recommendations for prevention in the Angolan military are presented. A multifaceted HIV prevention program for the Angolan military that addresses informational, interpersonal, and system-level barriers must be implemented now.

Protecting our militaries: a systematic literature review of military human immunodeficiency virus/acquired immunodeficiency syndrome prevention programs worldwide.

OBJECTIVES: To systematically review published studies of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention programs targeting the world's military populations. METHODS: We systematically searched eight electronic databases (publications from 1983 to February 2005) and hand-searched the bibliographies of HIV/AIDS prevention reviews to identify evaluative studies of HIV/AIDS prevention interventions for military personnel. RESULTS: Five hundred eighty-four abstracts were identified, of which eight met formal acceptance criteria. Four prevention interventions were identified, with each reporting a positive intervention effect on one or more of the following outcomes: increasing soldiers' knowledge of HIV/AIDS, willingness to engage in preventive behaviors, changing their attitudes toward greater compliance with prevention guidelines, and HIV/AIDS incidence and prevalence. CONCLUSIONS: Published interventions to reduce the risk of HIV/AIDS among military personnel are effective under certain conditions and with a limited number of populations. We discuss problems inherent in such research and make recommendations to improve the development, evaluation, and dissemination of findings of comprehensive HIV/AIDS prevention programs among military populations.

Perceived employment barriers and their relation to workforce-entry intent among people with HIV/AIDS.

As treatments have improved health and quality of life for people with HIV/AIDS, many have contemplated workforce reentry. Workforce reentry rarely occurs among people with illness-related disability. The authors mailed a survey that included workforce-entry-related concerns to 1,991 HIV/AIDS clients. Factor analysis extracted 6 areas of concern (benefits loss, work-related health, job skills, discrimination, personal health care, workplace accommodation). Levels of concern generally increased with HIV acuity level and time since last worked. Work-related health concerns predicted consideration of workforce entry, and work-related health concerns and benefits-loss concerns predicted estimated time to return to work. Findings provide quantitative validation of intuitive categories of workforce-entry concerns among people with HIV/AIDS and suggest that concerns may shift with progress toward workforce entry.

A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders.

BACKGROUND: A prospective study of computer users was performed to determine the occurrence of and evaluate risk factors for neck or shoulder (N/S) and hand or arm (H/A) musculoskeletal symptoms (MSS) and disorders (MSD). METHODS: Individuals (n = 632) newly hired into jobs requiring > or = 15 hr/week of computer use were followed for up to 3 years. At study entry, workstation dimensions and worker postures were measured and medical and psychosocial risk factors were assessed. Daily diaries were used to document work practices and incident MSS. Those reporting MSS were examined for specific MSD. Incidence rates of MSS and MSD were estimated with survival analysis. Cox regression models were used to evaluate associations between participant characteristics at entry and MSS and MSD. RESULTS: The annual incidence of N/S MSS was 58 cases/100 person-years and of N/S MSD was 35 cases/100 person-years. The most common N/S MSD was somatic pain syndrome. The annual incidence of H/A MSS was 39 cases/100 person-years and of H/A MSD was 21 cases/100 person-years. The most common H/A disorder was deQuervain's tendonitis. Forty-six percent of N/S and 32% of H/A MSS occurred during the first month of follow-up. Gender, age, ethnicity, and prior history of N/S pain were associated with N/S MSS and MSD. Gender, prior history of H/A pain, prior computer use, and children at home were associated with either H/A MSS or MSD. CONCLUSIONS: H/A and N/S MSS and MSD were common among computer users. More than 50% of computer users reported MSS during the first year after starting a new job.

A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders.

BACKGROUND: Despite widespread recommendations regarding posture during computer use, associations between specific postures and musculoskeletal health are not well characterized. METHODS: Six hundred and thirty-two newly hired computer users were followed prospectively to evaluate associations between posture and neck or shoulder (N/S) and hand or arm (H/A) musculoskeletal symptoms and musculoskeletal disorders. Participants' postures were measured at entry and they reported symptoms on weekly diaries. Participants reporting symptoms were examined for specific disorders. Multivariate Cox regression models were used to estimate associations between postural variables and risk of symptoms and disorders, controlling for confounding variables. RESULTS: Keying with an inner elbow angle > 121 degrees, greater downward head tilt, and presence of armrests on the participants chair were associated with lower risk of N/S symptoms or N/S disorders. Keying with elbow height below the height of the "J" key and the presence of a telephone shoulder rest were associated with a greater risk of N/S symptoms or N/S disorders. Horizontal location of the "J" key > 12 cm from the edge of the desk was associated with a lower risk of H/A symptoms and H/A disorders. Use of a keyboard with the "J" key > 3.5 cm above the table surface, key activation force > 48 g, and radial wrist deviation of > 5 degrees while using a mouse was associated with a greater risk of H/A symptoms or H/A disorders. The number of hours keying/week was associated with H/A symptoms and disorders. CONCLUSIONS: The results suggest that the risk of musculoskeletal symptoms and musculoskeletal disorders may be reduced by encouraging specific seated postures.