Behaviour changes following HIV diagnosis among men who have sex with men in the era of treatment as prevention: data from a prospective study.

We described the longitudinal changes in sexual behaviour and associated factors among newly diagnosed with HIV men who have sex with men participating in a prospective observational study from a London HIV clinic (2015-2018). Participants self-completed questionnaires at baseline, months 3 and 12. Information collected included socio-demographic, sexual behaviour, health, lifestyle and social support. Trends in sexual behaviours over one year following diagnosis and associated factors were assessed using generalized estimating equations with logit link. Condomless sex (CLS) dropped from 62.2% at baseline to 47.6% at month-three but increased again to 61.8% at month-12 (p-trend = 0.790). Serodiscordant-CLS increased between month-three and month-12 (from 13.1% to 35.6%, p-trend < 0.001). The prevalence of serodiscordant-CLS with high risk of transmitting to their partners at month-three was 10.7%. CLS was higher among men who reported recreational drug use (adjusted Odds Ratio (aOR) 3.03, 95%CI 1.47-6.24, p = 0.003), those with undetectable viral load (aOR 2.17, 95%CI 1.22-3.84, p = 0.008) and those who agreed with a statement "condoms are not necessary when HIV viral load is undetectable" (aOR 3.41, 95%CI 1.58-7.38, p = 0.002). MSM continued to engage in CLS after HIV diagnosis, which coincided with U = U publications and increased throughout the study.

Understanding participant perspectives around HIV-1 cure-related studies involving antiretroviral analytical treatment interruptions in the United Kingdom.

Background: To test efficacy, HIV cure-related trials often require a period of intensively monitored interruption of antiretroviral therapy (ART) (analytical treatment interruption or ATI). As individuals who started ART during primary HIV-1 infection (PHI) are often recruited, we have asked people already enrolled into an observational PHI study about their willingness and concerns around participating in cure-related studies involving ATIs. Methods: People who were diagnosed with PHI and started ART, attending two London HIV clinics, provided informed consent to complete a digital survey in clinic between 21/07/21 to October 31, 2023. Questions comprised sociodemographics, motivations, concerns and practical considerations influencing willingness to participate in studies involving ATIs. Hierarchical clustering of responses was performed using the 'pheatmap' R statistical package and ranked from most to least concerned. Responses were cross-referenced with enrolment into an ATI study which recruited from this cohort. Results: Of 352 eligible participants, 75 completed the survey. The majority were white, cisgender men who have sex with men, 34/75 (45 %) were born outside the UK. 29 (39 %) expressed interest in joining ATI studies. Participants who were interested or unsure in joining ATI studies were primarily motivated (53/65, 82 % very or moderately interested) by an altruistic desire to help scientific research. Across all participants, onward HIV transmission was the predominant concern (67/75, 89 % very or moderately concerned), and similar levels of concerns reported if the HIV-1 viral load threshold to restarting ART was increased from 500 to 50 000 copies/mL. Most participants preferred weekly (23/65, 35 %) or fortnightly (11/65, 17 %) viral load monitoring during an ATI. Before taking part in a study involving an ATI, participants stated they would prefer to discuss this with their HIV doctor (55/65, 85 %). Conclusion: In this small survey, 39 % of respondents expressed interest in joining studies involving ATIs, primarily for altruistic reasons. Participants were more interested in joining a potential ATI study if a novel intervention was included than simply an ATI alone. The main concern expressed was risk of viral transmission. To inform practical and study design considerations for future ATI studies, unrestricted access for mitigation of transmission risk should be included, and regular, frequent viral load monitoring is preferred.

Development of an analytical method for quantitative comparison of the e-waste management systems in Thailand, Laos, and China.

This study employed a set of quantitative criteria to analyse the three parameters; namely policy, process, and practice; of the respective e-waste management systems adopted in Thailand, Laos, and China. Questionnaire surveys were conducted to determine the current status of the three parameters in relation to mobile phones. A total of five, three, and six variables under Policy (P1), Process (P2), and Practice (P3), respectively, were analysed and their weighted averages were calculated. The results showed that among the three countries surveyed, significant differences at p<0.01 were observed in all the P1, P2, and P3 variables, except P305 (sending e-waste to recovery centres) and P306 (treating e-waste by retailers themselves). Based on the quantitative method developed in this study, Laos' e-waste management system received the highest scores in both P1 average (0.130) and P3 average (0.129). However, in the combined Ptotal, China scored the highest (0.141), followed by Laos (0.132) and Thailand (0.121). This method could be used to assist decision makers in performing quantitative analysis of complex issues associating with e-waste management in a country.

A system dynamics model to evaluate effects of source separation of municipal solid waste management: A case of Bangkok, Thailand.

Municipal solid waste has been considered as one of the most immediate and serious problems confronting urban government in most developing and transitional economies. Providing solid waste performance highly depends on the effectiveness of waste collection and transportation process. Generally, this process involves a large amount of expenditures and has very complex and dynamic operational problems. Source separation has a major impact on effectiveness of waste management system as it causes significant changes in quantity and quality of waste reaching final disposal. To evaluate the impact of effective source separation on waste collection and transportation, this study adopts a decision support tool to comprehend cause-and-effect interactions of different variables in waste management system. A system dynamics model that envisages the relationships of source separation and effectiveness of waste management in Bangkok, Thailand is presented. Influential factors that affect waste separation attitudes are addressed; and the result of change in perception on waste separation is explained. The impacts of different separation rates on effectiveness of provided collection service are compared in six scenarios. 'Scenario 5' gives the most promising opportunities as 40% of residents are willing to conduct organic and recyclable waste separation. The results show that better service of waste collection and transportation, less monthly expense, extended landfill life, and satisfactory efficiency of the provided service at 60.48% will be achieved at the end of the simulation period. Implications of how to get public involved and conducted source separation are proposed.

Determination of the knowledge of e-waste disposal impacts on the environment among different gender and age groups in China, Laos, and Thailand.

E-waste is the fastest growing waste in the solid waste stream in the urban environment. It has become a widely recognised social and environmental problem; therefore, proper management is vital to protecting the fragile environment from its improper disposal. Questionnaire surveys were conducted to determine the knowledge of environmental impacts of e-waste disposal as it relates to mobile phones among different gender and age groups in China, Laos, and Thailand. The results revealed that gender was positively correlated with their knowledge of the status of environmental conditions (P104) (r = 0.077, n = 1994, p < 0.01) and negatively correlated with their knowledge of how to improve environmental conditions (P105) (r = -0.067, n = 2037, p < 0.01). In addition, an increase in age was positively correlated with respondents' concern over the environmental conditions (P103) (r = 0.052, n = 2077, p < 0.05) and P105 (r = 0.061, n = 2061, p < 0.01) mentioned above. The results indicated that female respondents were less knowledgeable about how to improve environmental conditions than male respondents in the three countries. Knowledge gaps were detected in the respondents, at age ⩽17, in the three countries, and from age 18-22 to 36-45 or older from Thailand and China, on their knowledge of the existing e-waste-related laws. Thus, an effort to bridge the gaps through initiating proper educational programmes in these two countries is necessary.

Microbial Transport, Retention, and Inactivation in Streams: A Combined Experimental and Stochastic Modeling Approach.

Long-term survival of pathogenic microorganisms in streams enables long-distance disease transmission. In order to manage water-borne diseases more effectively we need to better predict how microbes behave in freshwater systems, particularly how they are transported downstream in rivers. Microbes continuously immobilize and resuspend during downstream transport owing to a variety of processes including gravitational settling, attachment to in-stream structures such as submerged macrophytes, and hyporheic exchange and filtration within underlying sediments. We developed a stochastic model to describe these microbial transport and retention processes in rivers that also accounts for microbial inactivation. We used the model to assess the transport, retention, and inactivation of Escherichia coli in a small stream and the underlying streambed sediments as measured from multitracer injection experiments. The results demonstrate that the combination of laboratory experiments on sediment cores, stream reach-scale tracer experiments, and multiscale stochastic modeling improves assessment of microbial transport in streams. This study (1) demonstrates new observations of microbial dynamics in streams with improved data quality than prior studies, (2) advances a stochastic modeling framework to include microbial inactivation processes that we observed to be important in these streams, and (3) synthesizes new and existing data to evaluate seasonal dynamics.

Improving the solid waste management in Phnom Penh city: a strategic approach.

Though the solid waste management (SWM) system in Phnom Penh city in general has been upgraded since the waste collection service was franchised out to the private sector, the performance of the existing SWM system is still low. Unreliable and irregular collection service still exists. This means that there are shortcomings in the existing SWM system that need correction. This paper is an attempt to identify those shortcomings in order to find ways to improve the existing system. First, the present SWM system is reviewed. Then the system is evaluated to find constraints and shortfalls and finally some appropriate strategies are proposed that may help make SWM in the city more effective and efficient to meet environmentally sound objectives.