A Trans Youth of Color Study to Measure Health and Wellness: Protocol for a Longitudinal Observation Study.

BACKGROUND: Growing research on transgender youth is accounting for the variety of ways in which young people define their genders and sexualities. Because of this growing representation, more research is needed to understand how intersectional identities and stigma affect risk for HIV acquisition along the HIV care continuum and engagement in mental and physical health care. Little is known about accessibility to HIV-related prevention services of nonbinary and transmasculine youth, and further understanding of the impacts on transfeminine people-those who have historically faced the highest prevalence of HIV positivity-is crucial. OBJECTIVE: The overarching aims of the Trans Youth of Color Study are to conduct longitudinal research with a cohort of transgender minority youth (TGMY), explore factors that aid in the prevention of new HIV infection and transmission, and reduce HIV- and AIDS-related disparities by focusing on successful engagement in care. Findings from this research will be used to inform the development of new interventions designed to engage TGMY in the HIV prevention and care continua. METHODS: Longitudinal research (baseline and follow-up assessments every 6 months for 3 waves of data collection) followed a cohort (N=108) of transgender youth of color recruited in Los Angeles, California, United States. Participants were recruited using multiple community-informed strategies, such as from local venues, social media, and participant referral. In addition to self-report surveys, urine was collected to assess recent use of illicit drugs, and blood, rectal, and throat swabs were collected to test for current sexually transmitted infection and HIV infection. Additional blood and plasma samples (10 mL for 4 aliquots and 1 pellet) were collected and stored for future research. RESULTS: Participants in the Trans Youth of Color Study were recruited between May 25, 2018, and December 7, 2018. Baseline and longitudinal data are being analyzed as of August 2022. CONCLUSIONS: The findings from this research will inform adaptations to existing evidence-based HIV prevention interventions and help to guide new interventions designed to engage TGMY, especially those who are Black, Indigenous, or people of color, in the HIV prevention and care continua. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39207.

Homocysteine-lowering exercise effect is greater in hyperhomocysteinemic people living with HIV: a randomized clinical trial.

Elevated concentration of homocysteine has been identified as an independent risk factor for the development of cardiovascular disease and is frequently associated with oxidative stress. Moreover, studies have shown that people living with human immunodeficiency virus (PLHIV) present elevated concentration of homocysteine and oxidative stress compared with people without HIV. Our purpose was to describe blood homocysteine and oxidative stress markers in PLHIV and those without HIV infection, and to examine the effects of a 16-week combined training exercise program (CTE) on oxidative stress and homocysteine concentrations of PLHIV. We included 49 PLHIV (21 men, 28 women) and 33 people without HIV infection (13 men, 20 women). After baseline evaluations, 30 PLHIV were randomized to either CTE (trained group, n = 18) or the control group (n = 12); CTE consisted of aerobic and strength exercise sessions during 16 weeks, 3 times a week. Plasma homocysteine, oxidative damage markers, folate, and vitamin B12 were assessed pre- and post-training and by hyperhomocysteinemia (homocysteine ≥ 15 µmol/L) status. At baseline, PLHIV had higher levels of homocysteine and malondialdehyde, as well as reduced circulating folate when compared with people without HIV infection. CTE resulted in a 32% reduction (p < 0.05) in homocysteine concentration and a reduction in lipid hydroperoxide in PLHIV with hyperhomocysteinemia, which was not observed in those without hyperhomocysteinemia. Hyperhomocysteinemic participants experienced a 5.6 ± 3.2 µmol/L reduction in homocysteine after CTE. In summary, 16 weeks of CTE was able to decrease elevated homocysteine concentration and enhance redox balance of PLHIV with hyperhomocysteinemia, which could improve their cardiovascular risk.

Markov Chain Modelling Analysis of HIV/AIDS Progression: A Race-based Forecast in the United States.

HIV/AIDS has reached a pandemic level across the world with more than 33 million people who are living with HIV. In the United States, more than half a million people have been victims of AIDS. This study investigates the most vulnerable racial minority population (the African Americans) in the United States and the second least affected (the Caucasians) in order to predict the trends of the epidemic. A Markov chain analysis was used to model the progression of the disease among vulnerable people, infective people and AIDS cases for the two races separately, based on the 2009 Centers of Disease Control and Prevention HIV/AIDS Surveillance Report. Based on the Markov model, our study predicts that the number of African American people living with AIDS diagnosis and HIV infection and dead due to HIV/AIDS will be 662.2, 1225.3 and 62.9 in 2015 and 794.9, 1566.5 and 79.2 in 2030, respectively. The number of Caucasian people living with AIDS diagnosis and HIV infection and dead due to HIV/AIDS will be 96.4, 160 and 6.5 in 2015 and 118.6, 206.9 and 8.3 in 2030, respectively. The numbers of deaths due to HIV/AIDS are quite stable over the years in both the races. There is an increasing trend in the number of people living with HIV infection and AIDS diagnosis in Caucasians compared with African Americans. The absolute number of Caucasians living with AIDS diagnosis and HIV infection is quite smaller compared with African Americans. The results reveal discrepancy in HIV infection, AIDS diagnosis and deaths due to HIV/AIDS among the African Americans and the Caucasians races. There is a need for interventions focusing on HIV/AIDS prevention and management, optimum resource allocation and development of antiAIDS campaigns to reduce the infection rate.

Symptomatic profile of infected individuals with HIV/AIDS in a physiotherapy department / Perfil Sintomatológico de indivíduos com HIV/AIDS em um setor de fisioterapia

Abstract Introduction Changes in the profile of infected individuals with HIV and the chronicity of this condition become necessary a better understanding about the clinical changes caused by the disease. Objective This study characterizes the physical symptoms of infected individuals with HIV in a physiotherapy department of a specialized HIV treatment center. Methods A descriptive study with quantitative analysis was performed. All registered users in the physiotherapy department (138 individuals) from 2009 to 2013 were included. Data analysis considered absolute and relative frequencies of the variables of interest. Results Most patients were female (55%) and the mean age was 35.0 years (± 16.8). Most users were usingantiretroviral therapy and had 4 to 10 years (51.8%) of the HIV diagnosis. Many patients have comorbidities and the most prevalent was cerebral toxoplasmosis. The most common physical complaints were hemiparesis, pain, alteration in muscle tone and lipodystrophy. Conclusion According the symptomatic profile found, expanding the role of physiotherapists for infected individuals with HIV is necessary, since the physiotherapy has a wide range of preventive and therapeutic interventions that can increase functionality, independence level and social participation.

Resumo Introdução Com a modificação do perfil dos indivíduos vivendo com HIV/AIDS, relacionada à cronicidade destas condições, torna-se necessário um melhor entendimento das alterações clínicas provocadas pela doença. Objetivo Caracterizar os sintomas físicos de indivíduos com HIV/AIDS do ambulatório de fisioterapia de um centro de referência para o tratamento de HIV/AIDS. Métodos Realizou-se um estudo do tipo descritivo com abordagem quantitativa. Foram incluídos todos os usuários cadastrados no setor de fisioterapia, no período de 2009 a 2013, totalizando 138 indivíduos. A análise dos dados considerou frequências relativas e absolutas das variáveis de interesse. Resultados Os pacientes foram caracterizados pela maioria do sexo feminino (55%) e média de idade de 35,0 anos (± 16,8). A maioria utilizava a terapia antirretroviral, com tempo de diagnóstico entre 4 e 10 anos. Foi comum a presença comorbidades, sendo a mais prevalente a neurotoxoplasmose. As queixas físicas mais frequentes foram hemiparesia, dor, alteração do tônus e lipodistrofia. Conclusão Diante do perfil sintomatológico apresentado, é necessária a ampliação da atuação dos fisioterapeutas com os indivíduos com HIV/AIDS, visto que, a fisioterapia possui uma série de medidas preventivas e terapêuticas capazes de aumentar a funcionalidade, o grau de independência e a participação social.