Faith-based Community Engagement in HIV-Testing and Awareness of HIV Status in Southern, Rural, African American Communities.

The Deep South is the epicenter of the HIV-epidemic in the United States, with rural AAs bearing the greatest burden. Traditional efforts to improve testing efforts have been largely unsuccessful due to their failure to recognize and leverage the sociopolitical and cultural factors that affect the uptake of HIV-screening interventions at the community level. The purpose of this study was to gain a deeper understanding of the socio-cultural contexts impacting HIV-testing in the rural South, and to assess strategies to increase testing in rural, Southern communities. Focus groups (n = 8) and semi-structured interviews (n = 31) were conducted among community and faith-based leaders in Alabama and Mississippi, to inform our understanding of local perceptions of HIV infection, barriers and facilitators impacting HIV-testing, and best strategies for improving testing efforts at the local level. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed to extract major themes. While both faith-based and community leaders reported at least some stigmatizing attitudes towards HIV infection, faith-based leaders were more likely to report discomfort being around someone with HIV and were more likely to link the spread of HIV to immoral behaviors. The combination of the cultural importance of the Church, deep-seated religiosity among community members, and faith-based messages associating HIV infection with immorality directly impacted HIV stigma within the community-in turn, decreasing willingness to participate in HIV-testing, disclose positive HIV serostatus, or openly discuss transmission protection behaviors. The Church was identified as crucial to include to improve HIV-testing efforts in the rural South, due to their prominent sociopolitical roles within communities and ability to influence community members' perceptions of HIV stigma. Faith-based leaderships should be included in initiatives to increase improve HIV-testing and awareness of status and reduce HIV disparities in the Deep South.

Auberger red cell antigens are not part of the Kell, Colton, or Dornbrock blood group systems.

Since 1981, red cell samples from families were tested with anti-Aua and, since 1986, with both anti-Aua and anti-Aub in an attempt to elevate Auberger to a blood group system status. The results show that Auberger is not pan of the Kell (five families), Colton (three Families), or Dombrock (two families) blood group systems. Exclusion from four more systems (Di, Yt, LW, Ch:Rg) is required before system status may be claimed.

Evidence that the low-incidence red cell antigens Rla and Lsa are identical.

Testing of Ls(a+) and Rl(a+) red cells with numerous antisera containing antibodies to low-incidence antigens indicated that these antigens are identical. This conclusion was confirmed by adsorption and elution tests, and supported by immunoblotting of Ls(a+) and Rl(a+) cells with antibodies to glycophorin C and glycophorin D.

Rhmod phenotype: a parentage problem solved by denaturing gradient gel electorphoresis of genomic DNA.

Initial Rh phenotyping of a man with hemolytic anemia, his wife, and son appeared to exclude paternity. No exclusion was found in other blood groups or in the human leukocyte antigen (HLA) system; excluding Rh, the paternity index was 98.58 percent. Samples from these three family members, and two other family members, were tested with additional Rh antisera. The results indicated that the propositus has an Rhmod phenotype with expression of c, weak e, and very weak D, E, and G antigens. To support this hypothesis, DNA analysis of the RHD and RHCE genes was performed on the five family members. Polymerase chain reaction (PCR) products from exons 2 and 5 were analyzed by denaturing gradient gel electrophoresis (DGGE). The DNA results corroborated the serologic findings and refuted the exclusion of paternity.

En(a-) phenotype in a Japanese blood donor.

The first Japanese En(a-) individual (T.N.) was found by screening red cells from 250,000 Japanese blood donors with monoclonal anti-Ena. His serum contained no atypical antibodies and his partial red cell phenotype was M-N-S+s-, although a trypsin- resistant N antigen was detected. His red cells were En(a-) and Wr(b-), as determined by various human and mouse monoclonal antibodies. The absence of glycophorin A (GPA) and the presence of apparently normal glycophorin B (GPB) were demonstrated by immunoblotting with antibodies to the extracellular and cytoplasmic domain of GPA and to epitopes common to GPA and GPB. Sialic acid levels of T.N.'s intact red cells were substantially lower than those of control MN cells. Serologic tests suggested that both of T.N.'s parents were heterozygous for a recessive GPA deficiency gene.

GIL: a red cell antigen of very high frequency.

A new high-frequency red cell antigen has been identified and named GIL. GIL differs from all high-frequency antigens included in the International Society of Blood Transfusion classification. There is very little family information and GIL has not been shown to be an inherited character. Five women with anti-GIL have been found. All had been pregnant at least twice. Red blood cells of two of the babies gave positive direct antiglobulin tests, but there were no clinical signs of hemolytic disease. Anti-GIL may have been responsible for a hemolytic transfusion reaction and results of monocyte monolayer assays of two of the anti-GIL suggested a potential to cause destruction of transfused GIL+ RBCs.

Determining optimal risk retention in the healthcare industry.

Several methodologies may be used for determining the level of risk that a healthcare organization should retain as part of its overall insurance and risk management program. Approaches used in the past, however, may not be appropriate to use in the 1990s. This article proposes a more comprehensive methodology of risk determination.

Studies on anti-H reagents.

Anti-H from nine people, eight Oh and one A1 (Toml.), as well as monoclonal anti-Type 2 H (H11), anti-HI from an OHm person and the anti-H lectins from Ulex europaeus seeds, Lotus tetragonolobus seeds and eel serum were all analysed by adsorption tests using Synsorb immunoadsorbents, by inhibition tests with various oligosaccharides and body fluids and by titration tests with red cells from cord and adult samples. The adsorption tests showed that all of the reagents bound preferentially to the Type 2 H trisaccharide although only the monoclonal antibody and the serum from Toml. bound exclusively to Type 2 H. All of the Oh sera were inhibited by saliva, by H glycoprotein from ovarian cyst fluid and meconium, and by 2'-fucosyllactose but none was inhibited by lacto-difucotetraose or by lacto-N-fucopentaose I. H11 and Toml. serum again showed similar specificity in inhibition tests with milk oligosaccharides but whereas H11 is not inhibited by saliva or ovarian cyst fluid Toml. serum is. Only the three lectins were inhibited by alpha-L-fucose. Some of the Bombay sera gave similar titration scores with both cord and adult red cells whereas others gave much lower scores with cord cells than with adult cells. H11 and Toml. serum behaved like those of the former category whereas the anti-HI and the lectins behaved like the latter.

An investigation of the immune response of homozygotes for the Rh haplotype --D-- and related haplotypes. Using cells of rare Rh phenotypes.

Immune sera from people homozygous for the "deleted" gene complexes --D--, cD--, CwD--, . D . and (C)Div-- as well as heterozygous --D--/--- --- --- were studied by their reactions, and in some cases by absorption-elution tests, with cells of the following rare Rh types: two unrelated examples of homozygous . D .; three unrelated examples of Rhmod; homozygous R33; cDe with a very weak e; apparent CwD(e)/--D--. The results showed that these immune sera are clearly heterogeneous: this heterogeneity was not entirely due to the strength of the antibody (as determined by titration against CDe/cDE cells) or to the phenotype of the antibody maker. Absorption and elution tests using two of the immune sera and . D ./. D . cells demonstrated a "new" antibody, anti-Dav, for a high frequency Rh antigen in addition to anti-Rh17.

Further analysis of the monoclonal antibody H8 demonstrating a JMH-related specificity.

The monoclonal antibody H8, previously described as anti-JMH, has the same specificity as a JMH-related antibody, R.M. H8 blocks the reaction of human anti-JMH and related antibodies with JMH+ cells, suggesting that the JMH-related antigens are very closely situated to each other on the red cell membrane.

Unusual suppression of Kell system antigens in a healthy blood donor.

Red cells of a Kp(a+) donor, ascertained as a result of screening donor red cell units with anti-Kpa, reacted only very weakly with anti-Kpb and demonstrated weakened expression of various other Kell and para-Kell antigens. Family studies revealed a Kp(a+) sister with similarly weakened expression of Kpb and other Kell and para-Kell antigens. Red cell morphology was normal in both of these individuals. This phenotype is different from any previously reported and is named the Allen phenotype.

A monoclonal antibody related to the human blood group Gerbich.

The monoclonal antibody, GERO, agglutinated all samples of red cells with the exception of Gerbich-negative cells of both Ge and Yus types. Using the antiglobulin test, Gerbich-negative cells reacted as strongly with GERO as did Gerbich-positive cells.

The monoclonal antibody-specific immobilization of erythrocyte antigens assay (MAIEA) in the investigation of human red-cell antigens and their associated membrane proteins.

The monoclonal antibody-specific immobilization of erythrocyte antigens (MAIEA) technique is an immunoassay devised primarily for locating blood group antigens on specific red-cell membrane proteins. The assay involves the incubation of intact red cells with two antibodies, one human alloantibody, the other a nonhuman antibody, usually a rodent monoclonal antibody, but polyclonal antibodies of rabbit origin have been utilized. For a positive result, both antibodies must bind to the same membrane protein. The red cells are lysed, the membrane solubilized and the trimolecular complex of two antibodies and membrane protein is captured in a well coated with goat antirodent (or rabbit) immunoglobulin. The immobilized complex is then detected by the use of peroxidase-conjugated goat antihuman (or rodent) immunoglobulin. Negative results, due to mutual blocking between the human and animal antibodies when their epitopes are close together on the same molecule, have permitted a degree of localization of epitopes on some proteins. This has been most effective in the mapping of Cromer blood group system antigens on the complement control protein domains of decay-accelerating factor (DAF, CD55), but has also proved informative in the clustering of antigens on the Lutheran and Kell glycoproteins. MAIEA is an effective tool for the identification of antibodies to Knops-system antigens on complement receptor 1 (CR1, CD35) in immunohaematology reference laboratories. These antibodies are clinically unimportant, but must be identified before they can be ignored for transfusion purposes.

Homozygous.D.

A homozygote for the Rh complex .D. associated with the rare Evans antigen was identified and her family tested: .D./.D. can be clearly distinguished serologically from -D-/-D-. The immune antibody in the serum of the propositus reacts with all cells tested except homozygous -D-, CwD-, cD- and Rhnull cells.

Application of the MAIEA assay to the Kell blood group system.

The monoclonal antibody-specific immobilisation of erythrocyte antigens (MAIEA) test has been employed to investigate the Kell system using five monoclonal antibodies which recognise high frequency epitopes on the 93,000-molecular weight Kell glycoprotein: BRIC 18, BRIC 68, BRIC 107, BRIC 203 and 6-22. BRIC 107, which has anti-k-like (KEL2) specificity, identifies a distinct epitope, whilst competitive binding assays suggested that BRIC 203 (anti-Kpbc), BRIC 18, BRIC 68 and 6-22 (anti K14) comprise an overlapping set of epitopes. The MAIEA assay has been very successful in confirming the assignment of most of the Kell and para-Kell antigens to the Kell protein. Due to the competitive nature of the assay and the fact that the monoclonal antibodies bind to different regions, the results also suggest the relative positions of some of the Kell antigens on the Kell protein; these appear to be located in at least five spatially distinct regions.

A possible null phenotype in the Cromer blood group complex.

The red blood cells of a Japanese man failed to react with anti-Cra sera and with three Cromer-related sera, B.P., G.T., and K.T.O. His serum reacted with all red blood cells tested except his own. This phenotype, which may represent a null phenotype in the Cromer complex, supports the suggestion that the phenotypes of B.P., G.T., and K.T.O. are Cromer related.