IL6 and FAS/FASL gene polymorphisms may be associated with disease progression in HIV-1-positive ethnically mixed patients.

The progression of AIDS depends on the complex host and virus interactions. The most important disease progression hallmarks are immune activation and apoptosis. In this study, we address the prevalence of polymorphisms related to proinflammatory and apoptotic genes, such as IFNG (+874T/A), TNF (308G/A), IL6 (-174G/C), IL8 (-251A/T), FAS (-670A/G), and FASL (-124A/G) in 160 ethnically mixed HIV-1-infected patients from multicentre cohorts with different clinical outcomes (13 elite controllers [EC], 66 slow long-term non-progressors [LTNPs], and 81 progressors [P]). The genotyping was accomplished by TaqMan-qPCR. Among all the polymorphisms analyzed in the cytokines, the IL6 -174G/C polymorphism showed a higher frequency of GG genotype in the LTNP and LTNP+EC groups as compared to the P group. Moreover, there was a significantly higher frequency of the G allele in the LTNP and LTNP+EC groups as compared to the P group. On the other hand, the levels of CD4+ T lymphocytes were higher among individuals showing the AA and AG genotypes for the FASL -124A/G polymorphism as compared to the GG genotype. Furthermore, the AG and AA genotypes were more frequent, as compared to the GG genotype, in individuals showing a lower viral load. In contrast, for the FAS -670A/G polymorphism, a significantly higher viral load was observed in individuals with the AG genotype as compared to the GG genotype. In conclusion, we found three genetic allelic variants of the IL6 -174G/C, FASL -124A/G, and FAS -670A/G polymorphisms that were related to disease progression and immunological and virological markers in cohorts of HIV-1-positive ethnically mixed patients.

Differences in Cervical Cancer Screening Knowledge and Practices by HIV Status and Geographic Location: Implication for Program Implementation in Zambia.

The knowledge and perceptions of cervical cancer among HIV negative and positive women, aged 25-49 years, from rural and urban locations in Zambia was systematically accessed in this study to determine any differences. Data were coded and analyzed using NVivo software. Compared to HIV negative women, HIV positive women had more accurate information about cervical cancer. They were more likely to cite male circumcision as the best approach to cervical cancer prevention. HPV infection was more commonly mentioned as a risk factor among HIV positive women. However, HIV positive women displayed little knowledge about HPV being the major cause of cervical cancer. Among HIV positive women, lack of time was the major screening barrier cited while HIV negative women mentioned being symptomatic as a determinant for early detection. Compared to rural residents, urban residents cited a wider range of cervical cancer information sources, including media and workplace although all of the participants who stated that they had no knowledge of cervical cancer were urban residents. Overall, knowledge and perceptions of cervical cancer among study participants was high, although differences exist between subgroups. Sharing accurate and standardized information on cervical cancer would improve participation in cervical cancer screening services.

Autoria, subjetividade e poder: devolução de dados em um centro de saúde na Guariroba (Ceilândia/DF) / Authority, subjectivity and power: data devolution at a primary care unit in Guariroba (Ceilândia/Federal District/Brazil)

ResumoA devolução, restituição ou compartilhamento pode significar, dentre outras possibilidades, entregar produtos aos partícipes de um empreendimento de pesquisa/extensão. A entrega de resultados não é uma prática nova na antropologia, embora ainda seja pouco usual, sistematizada e valorizada. Neste artigo, relato e discuto uma experiência de devolução de materiais de um projeto de extensão da antropologia, que foi desenvolvido dentro de um centro de saúde, na região periférica do Distrito Federal. As reações aos materiais foram muito diferentes do esperado pela equipe do projeto, mas ainda assim permitiu fazer avançar o diálogo entre os envolvidos e, mais do que isso, permitiu que o conhecimento sobre as relações de trabalho dentro dessa instituição de saúde fosse aprofundado. Não é somente porque foi logrado o aval de comitês de ética que as negociações sobre a entrada e permanência em projetos acadêmicos estão garantidas continuamente. As relações de subjetividade, poder e autoria permeiam qualquer iniciativa antropológica, antes de começá-la e muito depois de, supostamente, terminá-la.

AbstractDevolution, restitution or sharing can mean, within other possibilities, to offer products to participants of a research or an extension project. Far from a new practice in Anthropology, returning results is still unusual, little organized and valued. This paper presents and discusses a devolution experience by an extension project in Anthropology that was developed in a primary care unit in the outskirts of Distrito Federal (Brazil). Local reactions were very different from what was expected by the project's staff, but still permitted dialogue with the health professionals and, more important, deepened our knowledge about work relations in this health institution. Even though IRB approval has been granted, negotiations about starting and continuing academic projects have to be negotiated continuously. Subjectivity, power and authority permeate any anthropological initiative from its beginning and much after it supposedly has been concluded.

Human Papilloma Virus and Cervical Cancer Education Needs among HIV-Positive Haitian Women in Miami.

BACKGROUND: Haitian immigrant women, the largest growing Black ethnic group in Miami, experience the highest rates of cervical cancer and account for one of the largest populations diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in South Florida. Using community-based participatory research methods, we conducted a pilot study to examine human papilloma virus (HPV)/cervical cancer knowledge and identify intervention preferences among HIV positive Haitian women. METHODS: Community health workers conducted three focus groups with 21 HIV-positive Haitian women. All sessions were conducted in Haitian Kreyol, digitally recorded, and subsequently interpreted and transcribed into English. The first focus group assessed HPV/cervical cancer knowledge, the second session explored HPV/cervical cancer considerations specific to HIV-positive women, and the third focus group discussed HPV/cervical cancer screening and intervention preferences. Data analysis was guided by a grounded theory approach. FINDINGS: Our sample had limited HPV/cervical cancer knowledge. Misconceptions about screening, transmission, and treatment were common. Participants felt that stigma by providers impacted negatively the care they received and that stigma by the community diminished social support. Strong support for culturally tailored interventions to improve HPV/cervical cancer knowledge was expressed. Although no participants had participated in research previously, all were willing to participate in future trials. CONCLUSIONS: There is critical need for culturally relevant interventions to improve HPV/cervical cancer knowledge among HIV-positive Haitian women.

Piloting a Social Networks Strategy to Increase HIV Testing and Counseling Among Men Who Have Sex with Men in Greater Accra and Ashanti Region, Ghana.

The 2011 Ghana Men's Study identified a high prevalence of HIV among men who have sex with men (MSM) in Accra/Tema (34.4 %) and in Kumasi (13.6 %), whereas the HIV rate among MSM referred through peer educators (PEs) to HIV testing and counseling (HTC) services in these two sites was substantially lower (8.4 %). These findings raised questions about possible limitations of the peer-education strategy to reach high-risk MSM. Therefore, a pilot study was conducted to assess the feasibility of using a social network strategy (SNS) to identify and refer MSM to HTC services. Within 3 months, 166 MSM were reached and referred to HTC services: 62.7 % reported no recent exposure to PEs; 61.5 % were unaware of their recent HIV serostatus; and 32.9 % were newly diagnosed HIV positive. This pilot study suggests that an SNS could be an important strategy to reach MSM and to increase the uptake of HTC.

Home-based HIV testing for men who have sex with men in China: a novel community-based partnership to complement government programs.

BACKGROUND: The coverage of HIV testing among Chinese men who have sex with men (MSM) remains low after the scale-up of free HIV testing at government-sponsored testing sites. We evaluated the feasibility of home-based HIV self-testing and the willingness to be HIV tested at community-based organizations (CBO). METHODS: We recruited MSM via on-line advertisement, where they completed an on-line informed consent and subsequent questionnaire survey. Eligible MSM received HIV rapid testing kits by mail, performed the test themselves and reported the result remotely. RESULTS: Of the 220 men taking a home-based HIV self-testing, 33 MSM (15%) were seropositive. Nearly 65% of the men reported that they were willing to take HIV testing at CBO, while 28% preferred receiving free HIV testing in the government programs at local Centers for Disease Control and Prevention (CDC). Older and lower-income MSM, those who self-reported homosexual orientation, men with no history of sexually transmitted diseases and a lower number of sexual partners in the past six months were associated with preference for taking HIV testing at CBOs. The top three self-reported existing barriers for HIV testing were: no perception of HIV risk (56%), fear of an HIV positive result being reported to the government (41%), and fear of a positive HIV test result (36%). CONCLUSION: Home-based HIV self-testing is an alternative approach for increasing the coverage of HIV testing among Chinese MSM. CBO-based HIV testing is a potential alternative, but further studies are needed to evaluate its feasibility.

Comparison of racial differences in plaque composition and stenosis between HIV-positive and HIV-negative men from the Multicenter AIDS Cohort Study.

Previous studies demonstrated that blacks have less coronary artery calcification (CAC) than whites. We evaluated racial differences in plaque composition and stenosis in the Multicenter AIDS Cohort Study. HIV-positive and HIV-negative men underwent noncontrast cardiac computed tomography (CT) if they were aged 40 to 70 years, weighed <136 kg, and had no history of cardiac surgery or revascularization and, if eligible, coronary CT angiography (CTA). There were 1,001 men who underwent CT scans and 759 men CTA. We measured CAC on noncontrast CT and identified total plaque, noncalcified plaque, calcified plaque, mixed plaque, and coronary stenosis >50% on CTA. The association of presence and extent of plaque with race was determined after adjustment for HIV serostatus, cardiovascular risk factors, and measures of socioeconomic status. The prevalences of any plaque on CTA and noncalcified plaque were not different between black and white men; however, black men had lower prevalences of CAC (prevalence ratio [PR] 0.79, p = 0.01), calcified plaque (PR 0.69, p = 0.002), and stenosis >50% (PR 0.59, p = 0.009). There were no associations between black race and extent of plaque in fully adjusted models. Using log-linear regression, black race was associated with a lower extent of any plaque on CTA in HIV-positive men (estimate = -0.24, p = 0.051) but not in HIV-negative men (0.12, p = 0.50, HIV interaction p = 0.005). In conclusion, a lower prevalence of CAC in black compared with white men appears to reflect less calcification of plaque and stenosis rather than a lower overall prevalence of plaque.

Discrepancies between HIV prevention communication attitudes and actual conversations about HIV testing within social and sexual networks of African American men who have sex with men.

BACKGROUND: Promoting communication among African American men who have sex with men (AA MSM) and their social networks about HIV testing is an avenue for altering HIV prevention social norms. This study examined the attitudes of AA MSM on talking with peers about HIV testing and characteristics of their network members with whom they have these conversations. METHODS: Data came from a cross-sectional survey of 226 AA MSM who were 18 years or older and self-reported sex with another male in the prior 90 days. Participants completed an inventory to characterize network members with whom they had conversations about HIV testing and HIV status. RESULTS: Most of the sample reported that it was important/very important to talk to male friends about HIV (85%) and that they were comfortable/very comfortable talking with their friends about sexual behaviors (84%). However, a small proportion of the social network had been talked to by the participant about HIV testing (14%). Among sexual networks, 58% had been talked to about their HIV status, and this was positively associated with main and casual partner type compared with partners with whom money or drugs were exchanged. CONCLUSIONS: Findings suggest that positive attitudes about communication may be necessary but not sufficient for actual conversations to occur. Designing interventions that increase communication with social networks is warranted.

Comparison of strategies to increase HIV testing among African-American gay, bisexual, and other men who have sex with men in Washington, DC.

This paper presents results from a study conducted to compare the relative effectiveness of three strategies - alternate venue testing (AVT), the social network strategy (SNS), and partner counseling and referral services (PCRS; standard care) - for reaching and motivating previously undiagnosed, African-American men who have sex with men (AA MSM) to be tested for HIV. Data were collected between June 2008 and February 2010 at a gay-identified, community-based organization (CBO) serving AA MSM in Washington, DC. Men were eligible to participate if they were 18-64 years old, self-identified as black or African-American, were biologically male, and self-reported oral or anal sex with a man in the past six months. Fisher's exact test of independence was used to assess differences in demographics, testing history, HIV status and sexual behaviors across the three strategies. The final sample included 470 men who met all eligibility requirements. There were no statistically significant differences in HIV positivity rates across the three strategies. However, relative to standard care, the SNS, and (to a lesser degree) the AVT strategies were more successful in recruiting men that had never been tested. Additionally, the results indicate that each strategy recruited different subgroups of men. Specifically, heterosexually identified men and men who reported engaging in unprotected sex were most likely to be recruited via SNS. Bisexually identified men and older men were most likely to be recruited via AVT or SNS, while standard care tended to reach greater proportions of young men and homosexually identified men. These findings suggest that a combination of strategies may be the best approach for engaging African-American MSM in HIV testing.

Lessons learned from use of social network strategy in HIV testing programs targeting African American men who have sex with men.

OBJECTIVES: We report lessons derived from implementation of the Social Network Strategy (SNS) into existing HIV counseling, testing, and referral services targeting 18- to 64-year-old Black gay, bisexual, and other men who have sex with men (MSM). METHODS: The SNS procedures used in this study were adapted from a Centers for Disease Control and Prevention-funded, 2-year demonstration project involving 9 community-based organizations (CBOs) in 7 cities. Under the SNS, HIV-positive and HIV-negative men at high risk for HIV (recruiters) were enlisted to identify and recruit persons from their social, sexual, or drug-using networks (network associates) for HIV testing. Sites maintained records of modified study protocols for ascertaining lessons learned. The study was conducted between April 2008 and May 2010 at CBOs in Washington, DC, and New York, New York, and at a health department in Baltimore, Maryland. RESULTS: Several common lessons regarding development of the plan, staffing, training, and use of incentives were identified across the sites. Collectively, these lessons indicate use of SNS is resource-intensive, requiring a detailed plan, dedicated staff, and continual input from clients and staff for successful implementation. CONCLUSIONS: SNS may provide a strategy for identifying and targeting clusters of high-risk Black MSM for HIV testing. Given the resources needed to implement the strategy, additional studies using an experimental design are needed to determine the cost-effectiveness of SNS compared with other testing strategies.

Decade of HIV in Rhode Island: demographic and clinical characteristics of patients diagnosed in 2001 and 2010.

UNLABELLED: This article provides an overview of the current epidemiology of HIV infection in Rhode Island, summarizes disease trends over the last decade, and describes circumstances surrounding patient diagnosis. METHODS: We performed a retrospective chart review of patients newly diagnosed with HIV who presented to the Immunology Clinic of The Miriam Hospital in 2001 and 2010. RESULTS: From 2001 to 2010 there was an increase in patients reporting MSM (men who have sex with men) as their primary risk factor, and in diagnosis occurring at outpatient sites (p=.03). CD4 count at diagnosis was highest when diagnosed at an HIV testing site and lowest in inpatients (p=.0003). Late presenters were more likely to be tested because of illness (p=.001), as inpatients (p=.000), and heterosexuals (p=.017)). CONCLUSIONS: MSM and minorities are overrepresented in the RI HIV population. Patients without traditional risk factors are more likely to present late and are poorly served by historic screening practices.

Recruitment approaches to identifying newly diagnosed HIV infection among African American men who have sex with men.

To determine effectiveness of alternate venue testing (AVT), social network strategy (SNS) and provider referral (PR) for identifying previously undiagnosed HIV-infected 18-64-year-old African American men who have sex with men (AA MSM) by a health department. For AVT, staff used a mobile clinic to conduct HIV testing. For PR, staff solicited contact information from HIV-infected AA MSM, located contacts and offered HIV testing. For SNS, HIV-positive AA MSM recruited network associates for HIV testing. Two hundred and eighteen self-identified AA MSM were tested through AVT (25.2% HIV positivity) of whom 20 were newly identified HIV-positive. Fourteen HIV-positive men participated in SNS; 22 AA MSM contacts were recruited through SNS, eight (36.4%) were HIV positive and none were new positives. Two HIV-infected men participated in the PR strategy, yielding two AA MSM sex partners (one previously positive). The results suggest the need for health departments to consider using several complimentary strategies for identifying previously undiagnosed HIV infections in AA MSM in urban environments such as Baltimore.

Assessing the influence of health literacy on HIV-positive women's cervical cancer prevention knowledge and behaviors.

Women living with HIV (WLH) bear a disproportionate burden of cervical cancer and may face challenges understanding health information. The purpose of this study was to assess the influence of health literacy on WLH cervical cancer screening knowledge and behaviors. WLH were recruited from clinic- and community-based settings in the southeastern USA. The majority of women completing a questionnaire assessing factors related to cervical cancer were African American (90 %). About 38 % of women reported low health literacy. Compared to women with high health literacy, these women were more likely to report having had ≥ 2 Pap tests during the year after HIV diagnosis (p=0.02), and less likely to have had a Pap test <1 year previously (p=0.05). There was no difference in cervical cancer or human papillomavirus knowledge among those with low versus high health literacy. Results revealed mixed finding on the influence of health literacy on screening knowledge and behaviors.

Missed opportunities: refusal to confirm reactive rapid HIV tests in the emergency department.

BACKGROUND: HIV infection remains a major US public health concern. While HIV-infected individuals now benefit from earlier diagnosis and improved treatment options, progress is tempered by large numbers of newly diagnosed patients who are lost to follow-up prior to disease confirmation and linkage to care. METHODOLOGY: In the randomized, controlled USHER trial, we offered rapid HIV tests to patients presenting to a Boston, MA emergency department. Separate written informed consent was required for confirmatory testing. In a secondary analysis, we compared participants with reactive results who did and did not complete confirmatory testing to identify factors associated with refusal to complete the confirmation protocol. PRINCIPAL FINDINGS: Thirteen of 62 (21.0%, 95% CI (11.7%, 33.2%)) participants with reactive rapid HIV tests refused confirmation; women, younger participants, African Americans, and those with fewer HIV risks, with lower income, and without primary care doctors were more likely to refuse. We projected that up to four true HIV cases were lost at the confirmation stage. CONCLUSIONS: These findings underscore the need to better understand the factors associated with refusal to confirm reactive HIV testing and to identify interventions that will facilitate confirmatory testing and linkage to care among these populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT00502944; NCT01258582.

Project Exhale: preliminary evaluation of a tailored smoking cessation treatment for HIV-positive African American smokers.

This study examined the feasibility, acceptability, and outcomes of a culturally tailored smoking cessation intervention for HIV-positive African American male smokers. Eligible smokers were enrolled in a seven-session group-based treatment combined with nicotine patch. The mean age of participants was M=46 years. The majority were daily smokers (71%), smoked a mentholated brand (80%), and averaged 8.6 (standard deviation [SD]=8.1) cigarettes per day. Baseline nicotine dependency scores (M=5.8) indicated a moderate to high degree of physical dependence. Of the 31 participants enrolled, the majority completed treatment (≥3 sessions; 68%), 1-month follow-up (74%), and 3-month follow-up (87%) interviews. Program acceptability scores were strong. However, adherence to the patch was low, with 39% reporting daily patch use. The majority of participants (80%, n=24) made a quit attempt. Furthermore, over the course of the intervention, smoking urge, cigarettes smoked, nicotine dependence, withdrawal symptoms, and depression scores all significantly decreased. Follow-up quit rates at 1 and 3 months ranged from 6% to 24%, with treatment completers having better outcomes. This first of its kind intervention for HIV-positive African American male smokers was feasible, acceptable, and showed benefit for reducing smoking behaviors and depression scores. Smoking cessation outcomes were on par with other similar programs. A larger trial is needed to address limitations and to confirm benefits.

Cognitive-behavioral stress management and psychological well-being in HIV+ racial/ethnic minority women with human papillomavirus.

OBJECTIVE: This study is a secondary analysis examining the effects of a cognitive-behavioral stress management (CBSM) intervention on indicators of positive psychological well-being and negative psychological well-being in HIV-positive racial/ethnic minority women at risk for cervical cancer due to human papillomavirus (HPV) infection and/or cervical intraepithelial lesions (CIN). METHOD: Racial/ethnic minority women with HIV and HPV and/or CIN I were randomized to a 10-week CBSM group or a 1-day psychoeducational seminar. Participants completed a battery of measures of positive and negative psychological well-being at 3 time points: preintervention, 3 months postenrollment, and 9 months postenrollment. RESULTS: Women in the CBSM group reported significant increases in domains of positive well-being, with no changes among women in the psychoeducational seminar, F(6, 63) = 2.42, p < .05, η² = .19. There were no significant changes in domains of negative well-being across time for either group, F(2, 65) = 2.60, p = .08, η² = .07. CONCLUSION: These findings suggest that racial/ethnic minority women with HIV at risk for cervical cancer who were randomized to a 10-week CBSM group experienced enhanced positive well-being. The lack of effects on negative well-being may be due to the relatively low levels of negative well-being present in this sample at study entry. Future research should examine whether these effects are replicated in a randomized controlled trial of women with biopsy-confirmed CIN who present with greater distress levels that also employs a time-equivalent comparison condition.

Significados de las prácticas de cuidado que las madres con experiencia de VIH positivo brindan a sus hijos recién nacidos / Meanings of the care practices that mothers with HIV positive experience provide to their newborn children

Tipo de estudio: estudio de tipo etnográfico y enfoque cualitativo, aplicando el método del enfoque transcultural de Madeleine Leininger. Objetivo: Describir el significado que tienen las prácticas de cuidado ofrecido a su recién nacido para la madre con experiencia de VIH positivo dentro del contexto cultural de una ciudad de la Costa Caribe. Metodología: se utilizaron los parámetros éticos para la investigación con seres humanos, las opiniones de las diez madres entrevistadas fueron grabadas y transcritas para su posterior sistematización. Resultados: se identificaron 177 unidades de significado, 26 descriptores emicos, los cuales se consolidaron en siete patrones y tres temas a saber: el cuidado del recién nacido mantiene fuerte y retroalimenta los vínculos materno-filiales, la experiencia de seropositividad para VIH afecta los actos de cuidado al promover sobreprotección para proteger al recién nacido y el conocimiento formal recibido y el conocimiento etno-cultural se relacionan en el cuidado de los recién nacidos. En el contexto de las madres entrevistadas, se interpreta el "cuidado" en el sentido de actividades de prevención y también se le interpreta en el sentido de protección entendida como alejarlo de cualquier situación que le implique riesgo para la salud; tienen temor a la censura y estigmatización social, que acompaña a las personas que conviven con la enfermedad; situaciones de miedo al rechazo se hicieron evidentes para sí mismas y las extienden al acto de cuidado con clara orientación sobreprotectora, la supresión de la lactancia materna así como la asistencia a los controles no fueron reconocidas como una forma eficiente de cuidados en la situación de convivencia con el virus; para las madres entrevistadas el cuidado que ofrecen a sus recién nacidos es un acto de amor, en el cual disponen de los espacios y momentos para expresar a sus hijos su amor, estrechar su relación con ellos y simultáneamente cuidarlos las hace sentir vivas. Existe un componente etnocultural propio de la región que se transmite por tradición oral, al respecto se pudo reconocer que las creencias populares, influyen en la práctica de cuidados que las madres bajo la situación del VIH brindan a sus hijos recién nacidos.

Type of study: ethnographic study and qualitative approach, applying the method of the Madeleine Leininger transcultural approach. Objective: describe their meaning care practices offered to her newborn to the mother with HIV positive experience within the cultural context of a city on the Caribbean coast. Methodology: used ethical standards for research involving human subjects, the views of the ten mothers interviewed were recorded and transcribed for later systematization. Results: We identified 177 units of meaning, 26 descriptors emic, which were consolidated into seven patterns and three issues namely: newborn care and feedback remains strong mother-child ties, seropositivity experience acts of care affects to promote overprotection to protect the newborn and received formal knowledge and ethno-cultural knowledge related to the care of newborn. In the context of the mothers interviewed have means the "care" in the sense of prevention activities and is also interpreted to mean protection understood as away from any situation that involves a risk to health, have fear of censorship and social stigma that accompanies people living with the disease of fear of rejection situations were evident for themselves and care extend to act with clear guidance overprotective, suppression of breastfeeding as well as assistance to controls were not recognized as an efficient way to care for the situation of living with the virus, the mothers interviewed for the care they provide to their newborn is an act of love, which have the space and time to express their children their love, strengthen your relationship with them and look after them simultaneously makes them feel alive. There is an ethnocultural component of the region itself is transmitted by oral tradition, the matter could recognize that popular beliefs influence the practice of care that mothers in providing HIV status to their newborn children.

HIV infection among ethnic minority and migrant men who have sex with men in Britain.

OBJECTIVE: To examine human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) from different ethnic and migrant groups living in Britain. METHODS: In 2007-2008, a diverse national sample of MSM living in Britain was recruited through Web sites, in sexual health clinics, bars, clubs, and other venues. Men completed an online survey that included questions on HIV testing, HIV status, and sexual behavior. RESULTS: Nine hundred and ninety-one ethnic minority MSM, 207 men born in Central or Eastern Europe (CEE), 136 men born in South or Central America, and 11,944 white British men were included in the analysis. Self-reported HIV seropositivity was low for men of South Asian, Chinese, and "other Asian" ethnicity (range, 0.0%-5.8%) and for men born in CEE (4.5%) but elevated for men born in South or Central America (18.7%), compared with white British men (13.1%) (P < 0.001). There were no significant differences between these groups in high-risk sexual behavior (P = 0.8). After adjusting for confounding factors in a multivariable model, substantial differences in the odds of HIV infection remained for South Asian and Chinese MSM as well as for migrants from CEE, but not for other groups, compared with white British men; for example, South Asian men, adjusted odds ratio 0.43, 95% confidence interval 0.23, 0.79, P = 0.007. CONCLUSION: There were marked differences in self-reported HIV seropositivity between ethnic minority, key migrant, and white British MSM in this study but not in high-risk sexual behavior. This highlights the importance of health promotion targeting MSM from all ethnic and migrant groups in Britain.

Matched cohort analysis of outcomes of definitive radiotherapy for prostate cancer in human immunodeficiency virus-positive patients.

PURPOSE: To compare the biochemical outcome and toxicity scores of men with human immunodeficiency virus (HIV) and prostate cancer with a matched control population with negative or unknown HIV status when treated with external-beam radiotherapy (EBRT). METHODS AND MATERIALS: A single-institution database of men with prostate cancer treated with EBRT from 1999 to 2009 was reviewed. Thirteen men with HIV were identified and matched to 2 control patients according to age, race, T stage, prostate-specific antigen level, Gleason score, RT dose, intensity-modulated RT vs. three-dimensional conformal RT, and whole-pelvis vs. prostate-only RT, for a total of 39 cases. The median follow-up time was 39 months (range, 3-110 months). RESULTS: The 4-year biochemical failure (BF)-free survival rate was 87% in the HIV-positive group vs. 89% in the controls (p = 0.94). Pre- and post-RT viral loads were found to be predictive of BF (p = 0.04 and p = 0.04, respectively). No men with HIV died, whereas 2 in the control group died of causes unrelated to prostate cancer. Acute and chronic genitourinary and gastrointestinal toxicity were less in the HIV-positive patients than in controls (p < 0.001, p < 0.001, p = 0.003, and p < 0.001, respectively). The HIV-positive men experienced an average decline in CD4 count of 193 cells/mm(3). CONCLUSIONS: Our findings suggest that men with HIV treated with EBRT have a similar risk of BF; however, high viral loads may contribute to an increased risk. This analysis supports that HIV-positive men with prostate cancer can be treated with definitive EBRT with similar disease control and toxicity outcomes as in the general population.

Predominance of human lymphotropic T cell virus type 2 subtype B in urban populations of Argentina.

Human T-lymphotropic virus subtype b (HTLV-2b) infection has been described among aborigines from Northern Argentina, while HTLV-2a has been described in an injecting drug user (IDU) from a Central region, similar to the situation in Spain, the United States, and Brazil. In this study, 22 of the 26 strains analyzed from blood donors and HIV-1(+) individuals were HTLV-2b (84.6%) clustering with Amerindian references, while 4 HIV-1(+) (15.4%) were HTLV-2a. HTLV-2a sequences were closely related to Brazilian references in contrast to the previous Argentinean IDU strain that clustered with Africans and Amerindians from North America. In summary, these findings show that HTLV-2b is the major strain circulating in an urban population of Argentina. HTLV-2a/b could have been introduced from endemic South American countries such as Brazil and because of contact with other populations such as IDUs from Europe despite its introduction due to the increasing internal migration of aborigines to large urban centers. Considering this results and recent data about the dissemination of HTLV-1 in residents of Buenos Aires city, new studies among non-at-risk groups for HTLV-1/2 infection should be performed.