Correction: RV144 HIV-1 vaccination impacts post-infection antibody responses.

[This corrects the article DOI: 10.1371/journal.ppat.1009101.].

RV144 HIV-1 vaccination impacts post-infection antibody responses.

The RV144 vaccine efficacy clinical trial showed a reduction in HIV-1 infections by 31%. Vaccine efficacy was associated with stronger binding antibody responses to the HIV Envelope (Env) V1V2 region, with decreased efficacy as responses wane. High levels of Ab-dependent cellular cytotoxicity (ADCC) together with low plasma levels of Env-specific IgA also correlated with decreased infection risk. We investigated whether B cell priming from RV144 vaccination impacted functional antibody responses to HIV-1 following infection. Antibody responses were assessed in 37 vaccine and 63 placebo recipients at 6, 12, and 36 months following HIV diagnosis. The magnitude, specificity, dynamics, subclass recognition and distribution of the binding antibody response following infection were different in RV144 vaccine recipients compared to placebo recipients. Vaccine recipients demonstrated increased IgG1 binding specifically to V1V2, as well as increased IgG2 and IgG4 but decreased IgG3 to HIV-1 Env. No difference in IgA binding to HIV-1 Env was detected between the vaccine and placebo recipients following infection. RV144 vaccination limited the development of broadly neutralizing antibodies post-infection, but enhanced Fc-mediated effector functions indicating B cell priming by RV144 vaccination impacted downstream antibody function. However, these functional responses were not associated with clinical markers of disease progression. These data reveal that RV144 vaccination primed B cells towards specific binding and functional antibody responses following HIV-1 infection.

Awkward Choreographies from Cancer's Margins: Incommensurabilities of Biographical and Biomedical Knowledge in Sexual and/or Gender Minority Cancer Patients' Treatment.

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were conducted with a diverse group (n=81) of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge.

HPV vaccination discourses and the construction of "at-risk" girls.

RéSUMé: OBJECTIF: L'objectif était d'étudier le déploiement des discours sur la vaccination contre les VPH (VVPH) et leur impact sur les filles, les parents, les infirmiers/infirmières et les médecins canadiens. MéTHODES: Des entrevues ont été réalisées avec des participant(e)s (n = 146) de quatre provinces canadiennes. Une analyse poststructuraliste du discours a permis d'examiner les campagnes de VVPH et les transcriptions d'entrevues pour documenter la façon dont les participant(e)s interprètent les VVPH et se positionnent comme sujets au sein des discours de l'industrie ou des agences de santé publique. RéSULTATS: Les campagnes de VVPH sont sexistes, hétéro-normatives et trompeuses. Émergeant de l'analyse des entrevues est le manque d'information des filles et des parents en ce qui a trait à la VVPH. Les mères se construisent en tant que bio-citoyennes responsables, mais au prix de l'impuissance, de l'anxiété et de la peur ressenties parallèlement à l'impératif d'agir pour minimiser le risque de cancer de leur fille. Quant aux professionnel(le)s de la santé, ils s'approprient les discours dominants sur la VVPH et utilisent la peur comme stratégie pour fabriquer le consentement pour la VVPH. Les occasions de dialogue sur la VVPH et la santé sexuelle des filles sont perdues et les positions en tant que sujets sont problématiques pour tous les types de participant. CONCLUSIONS: Nous nous questionnons à savoir si la santé publique est bien servie quand les discours sur la VVPH transforment des corps en santé en corps « à risque ¼ et quand la peur du cancer est instrumentalisée pour la pharmacologisation de la santé publique.

Cancer's Margins: Trans* and Gender Nonconforming People's Access to Knowledge, Experiences of Cancer Health, and Decision-Making.

PURPOSE: Research in Canada and the United States indicates that minority gender and sexuality status are consistently associated with health disparities and poor health outcomes, including cancer health. This article investigates experiences of cancer health and care, and access to knowledge for trans* and gender nonconforming people diagnosed with and treated for breast and/or gynecologic cancer. Our study contributes new understandings about gender minority populations that will advance knowledge concerning the provision of culturally appropriate care. This is the first study we are aware of that focuses on trans* and gender nonconforming peoples' experiences of cancer care and treatment, support networks, and access to and mobilization of knowledge. METHODS: This article analyzes trans* and gender nonconforming patient interviews from the Cancer's Margins project ( www.lgbtcancer.ca ): Canada's first nationally-funded project that investigates the complex intersections of sexual and/or gender marginality, cancer knowledge, treatment experiences, and modes of the organization of support networks. RESULTS: Our analysis documents how different bodies of knowledge relative to cancer treatment and gendered embodiment are understood, accessed, and mobilized by trans* and gender nonconforming patients. Findings reported here suggest that one's knowledge of a felt sense of gender is closely interwoven with knowledge concerning cancer treatment practices; a dynamic which organizes knowledge mobilities in cancer treatment. CONCLUSIONS: The findings support the assertion that cisgender models concerning changes to the body that occur as a result of biomedical treatment for breast and/or gynecologic cancer are wholly inadequate in order to account for trans* and gender nonconforming peoples' experiences of cancer treatments, and access to and mobilization of related knowledge.

Family physician perceptions of working with LGBTQ patients: physician training needs.

BACKGROUND: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. METHOD: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. RESULTS: Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. CONCLUSIONS: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

Cancer knowledge in the plural: queering the biopolitics of narrative and affective mobilities.

In this age of DIY Health-a present that has been described as a time of "ludic capitalism"-one is constantly confronted with the injunction to manage risk by means of making healthy choices and of informed participation in various self-surveillant technologies of bioinformatics. Neoliberal governmentality has been redacted by poststructuralist scholars of bioethics as defined by the two-fold emergence of, on the one hand, populations and on the other, the self-determining individual-as biopolitical entities. In this article, we provide a genealogical-phenomenological schematization (GPS analysis) of the narration of cancer in relation to "sexual minority populations." Canonical discourses concerning minority sexualities are articulated by means of a logic of "inclusion and reification" that organizes the interiorization of norms of embodied relationality, and a positive liaison with biomedical technologies and techniques in the taking up of a rhetorical style of biographical compliance. Neoliberal DIY Health logics conflate participation with agency, and institute norms of recognition that constrain visibility to: citizens who make healthy choices and manage risk, heroic cancer stories, stories of the reconstruction of states of normalcy, or of survival against all odds. Alternatively, we trace the performative articulations of queer narrative practices that constitute an ephemeral, nomadic praxiology-a doing of knowledge in cancer's queer narration. Queer cancer narrative practices represent a relationship to health and embodiment that is predicated, not on normalcy, but predicated on troubling norms, on artful failure, and on engaging in a kind of affective mapping that might be thought constitutive of a speculative bioethical relation to the self as other.

Neonatal-age treatment with vitamin A delays postweaning vitamin A deficiency and increases the antibody response to T-cell dependent antigens in young adult rats fed a vitamin A-deficient diet.

Vitamin A supplementation for infants and young children is recommended by WHO/UNICEF for countries with a high prevalence of vitamin A deficiency, and vitamin A is often administered at immunization contacts. Using a rat model, we tested whether supplementation with vitamin A or other retinoids at the time of neonatal immunization has prospective benefit in terms of preventing postweaning vitamin A deficiency and promoting antibody responses to T-cell dependent (TD) antigens administered at the neonatal stage and at the young adult stage. Rats were treated orally on postnatal d 6-8 with oil (placebo control), vitamin A, retinoic acid, or a combination of both (VARA) (n > or = 12/group), and immunized with tetanus toxoid (TT) on d 7. The primary anti-TT response was measured on d 21, after which weanling rats were fed the vitamin A-deficient diet until approximately 10 wk. At 8 wk, rats were immunized again with TT to determine the recall response, and with a novel TD antigen, keyhole limpet hemocyanin (KLH), to assess the adult primary response. None of the supplements affected the plasma titer of anti-TT immunoglobulin G (IgG) on d 21 (P = 0.25). However, neonatal-age supplementation with vitamin A or VARA at the young adult stage resulted in: >5 times higher anti-TT IgG recall response (P < 0.01); 5- and 9-times higher anti-KLH primary IgM and IgG responses, respectively (P < 0.05), and plasma retinol in the normal range (approximately 1.0 micromol/L vs. approximately 0.35 micromol/L in retinoic acid-treated and control groups, P < 0.0001). We conclude that early-life supplementation with vitamin A or VARA can prospectively benefit the primary and recall antibody responses to TD antigens administered at the young adult stage, which may involve the maintenance of normal plasma retinol levels.