Responsibility, risk and negotiation in the discourse of gay men's group sex.

Responsibility for the practise of (un)safe sex, for taking or not taking risks in relation to HIV transmission and for the negotiation of (safe) sex have been concerns in HIV-prevention research for a long time. This paper presents the findings of a discourse analysis of interview texts collected as part of the Three or More Study. We examine what, in the discourse examined, constrains and enables 'response-ability' - the capacity to respond to others and one's self in light of the complex contingencies that operate to enliven sexual contexts. We identify three key aspects of these sexual contexts that impact on response-ability: that there is an absence of 'explicit' (verbally communicated) negotiation and the presence of action-perception links, which are understood as forms of negotiation; that some sexual contexts appear to involve the passivity of participants to the sexual event, interaction or to other men, but that there is agency in and as part of this passivity; and that there exists a social obligation to being individually responsible for sexual decision making, including the taking of risks.

Musculoskeletal pain stakeholder engagement and partnership development: determining patient-centered research priorities.

BACKGROUND: Musculoskeletal (MSK) pain is a global public health problem with increased societal burden. Increased attention has focused toward patient and other stakeholder perspectives when determining future MSK pain research priorities, however infrastructure and capacity building within the community are needed for individuals and organizations to participate in patient-centered outcomes research. The purpose of this manuscript is to describe our collaborative experiences with several MSK pain stakeholders and processes to identify a top priority research topic. METHODS: Lunch meetings and formalized workshops were used to develop infrastructure for engaging patients and other stakeholders with early capacity building for partners to identify MSK pain research ideas based on their personal experiences. Additional capacity building and engagement through literature searching further prepared partners to contribute informed decisions about MSK pain research topics and subsequent selection of an important research question. RESULTS: Several key deliverables (e.g., Governance Document, Communication Plan) were developed and completed over the course of this project to provide partnership structure. Other key deliverables included a list of preliminary comparative effectiveness research ideas (n = 8) and selection of shared decision making for MSK pain as the top priority research topic with patient partners identifying pain self-efficacy as an important outcome domain. CONCLUSIONS: Our patient partners provided the catalyst for identifying shared decision making as a high priority research topic based on a wide spectrum of stakeholder perspectives and unique experiences. Patient partners were primarily identified using a single rehabilitation health system and clinician partners were heavily weighted by physical therapists which may have introduced selection bias.

Gay men who engage in group sex are at increased risk of HIV infection and onward transmission.

Among 746 participants in the Three or More Study (TOMS) of gay men who engaged in group sex in the previous 6 months, 22.4% reported unprotected anal intercourse (UAI) with any partners they did not know to be the same HIV serostatus as themselves. Not knowing oneself to be HIV-negative, not having a clear intention to use condoms, and more frequent group sex were independently associated with UAI. This study shows that gay men who engage in group sex represent an important priority for targeted HIV prevention activities and research.

The discourse of gay men's group sex: The importance of masculinity.

Group sex has consistently been identified as one of a group of risk behaviours among gay men associated with HIV seroconversion. This paper presents a detailed description of how gender, and specifically masculinity, operates as an aspect of the discourse of gay men's group sex. The findings presented in this paper are one part of a multi-aspected discourse analysis through which we are aiming to develop an account of the discourse of gay men's group sex as it was produced in a series of qualitative interviews conducted with gay men who participate in group sex. The interviews were conducted as part of the Three or More Study (TOMS), a larger project that involved a substantial quantitative component. The overarching intent of the discourse analysis is to provide as comprehensive a mapping as possible of this discursive terrain to facilitate the targeted development of HIV and sexual health educational initiatives. The discourse of gay men's group sex reproduces some key formations of masculinity within discourses of gender, which present specific challenges for HIV prevention education. These challenges are outlined at the conclusion of this paper.

The Thomsen-Friedenreich antigen-binding lectin jacalin interacts with desmoglein-1 and abrogates the pathogenicity of pemphigus foliaceus autoantibodies in vivo.

Pemphigus foliaceus (PF) is an autoimmune skin blistering disease mediated by pathogenic autoantibodies against the desmosomal core glycoprotein desmoglein-1 (Dsg1). This study demonstrated that the O-glycan-specific plant lectin jacalin binds Dsg1 and inhibits the interaction of Dsg1/PF IgG. N-glycosylation is not involved in the interaction of Dsg1/jacalin or Dsg1/PF IgG. Subcutaneous injection of jacalin into neonatal mice drastically reduced PF IgG deposition at the epidermal cell surface and blocked PF IgG-induced skin blisters, both clinically and histologically. Interestingly, another plant lectin, peanut agglutinin, which shares the same carbohydrate specificity toward the O-linked carbohydrate structure known as Thomsen-Friedenreich antigen (TF antigen, Galß1-3GalNAcα-O-Ser/Thr), also bound Dsg1 and blocked the skin blistering. In contrast, the plant lectin vicia villosa-B4 (VVL-B4), which shares the carbohydrate specificity toward the O-linked monosaccharide known as Thomsen-nouveau antigen (GalNAc-α1-O-Ser/Thr), did not bind Dsg1 and did not show a protective effect against the disease induced by the autoantibodies. Collectively, these results suggest that the binding of jacalin to O-linked TF carbohydrate motifs on Dsg1 impairs the Dsg1/PF autoantibody interactions and abrogates its pathogenicity in vivo. TF-specific binding ligands may have a potential therapeutic value for PF.