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Article ReferenceGenetic Clustering Analysis for HIV Infection among Men Who Have Sex with Men in Nigeria
Background:  The  HIV  epidemic continues to grow among  MSM  in countries across sub-Saharan Africa including  Nigeria . To inform prevention efforts, we used a  phylogenetic cluster  method to characterize  HIV  genetic clusters and factors associated with cluster formation among  MSM  living with  HIV  in  Nigeria . Methods:  We analyzed  HIV -1 pol sequences from 417  MSM  living with  HIV  enrolled in the TRUST/RV368 cohort between 2013 and 2017 in Abuja and Lagos,  Nigeria . A genetically linked cluster was defined among participants whose sequences had pairwise genetic distance of 1.5% or less. Binary and multinomial logistic regressions were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with  HIV  genetic cluster membership and size. Results:  Among 417  MSM  living with  HIV , 153 (36.7%) were genetically linked. Participants with higher viral load (AOR = 1.72 95% CI: 1.04–2.86), no female partners (AOR = 3.66; 95% CI: 1.97–6.08), and self-identified as male sex (compared with self-identified as bigender) (AOR = 3.42; 95% CI: 1.08–10.78) had higher odds of being in a genetic cluster. Compared with unlinked participants,  MSM  who had high school education (AOR = 23.84; 95% CI: 2.66–213.49), were employed (AOR = 3.41; 95% CI: 1.89–10.70), had bacterial sexually transmitted infections (AOR = 3.98; 95% CI: 0.89–17.22) and were not taking antiretroviral therapy (AOR = 6.61; 95% CI: 2.25–19.37) had higher odds of being in a large cluster (size > 4). Conclusion:  Comprehensive  HIV  prevention packages should include behavioral and biological components, including early diagnosis and treatment of both  HIV  and bacterial sexually transmitted infections to optimally reduce the risk of  HIV  transmission and acquisition.
Located in MPRC People / Hongjie Liu, Ph.D. / Hongjie Liu Publications
Public Health Researchers Win Data Contract to Study LGBTQ Health Disparities
Access to new dataset opens up research opportunities
Located in Research / Selected Research
Article Reference Troff document (with manpage macros)Availability of Services Related to Achieving Pregnancy in U.S. Publicly Funded Family Planning Clinics
Background Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods A nationally representative sample of publicly funded clinics was surveyed in 2013–2014 (n = 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PR) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42–1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01–1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01–1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40–0.74) and primary care services (aPR, 0.74; 95% CI, 0.68–0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway.
Located in MPRC People / Marie Thoma, Ph.D. / Marie Thoma Publications
Article Reference Troff document (with manpage macros)Externalizing trajectories predict elevated inflammation among adolescents exposed to early institutional rearing: A randomized clinical trial
  BACKGROUND: There has been mounting interest in the pathophysiological relation between inflammation and psychopathology. In this paper, we examined associations between internalizing and externalizing psychopathology and inflammation in adolescents with a history of severe psychosocial deprivation and children reared in typical family contexts. METHOD: The Bucharest Early Intervention Project is a longitudinal randomized trial of high-quality foster care as an alternative to institutional care. This report is based on 56 institutionalized children randomized to care as usual, 59 institutionalized children randomized to foster care, and 101 never institutionalized children who were recruited as an in-country comparison sample. Externalizing and internalizing behaviors were reported by parents and teachers at ages 8, 12, and 16. At age 16, C-reactive protein (CRP) was derived from blood spots in a subset of participants (n = 127). Multiple-group latent growth curve models were used to examine externalizing and internalizing trajectories and their associations with CRP. RESULTS: Among children assigned to care as usual, higher levels of externalizing behaviors at age 8, as well as smaller decreases in these behaviors from 8 to 16 years predicted higher levels of CRP at age 16. In the same group of children, higher internalizing behaviors at age 8, but not the rate of change in these behaviors, also predicted higher levels of CRP. In contrast, these relations were not observed in the children assigned to foster care and never institutionalized controls. CONCLUSIONS: Early institutional rearing is associated with a coupling of psychopathology and inflammation, whereas early placement into foster care buffers against these risks. These findings have implications for promoting healthy mental and physical development amongst institutionalized children.
Located in Retired Persons / Natalie Slopen, Sc.D. / Natalie Slopen Publications
Article Reference Troff document (with manpage macros)Antibiotic and herbicide concentrations in household greywater reuse systems and pond water used for food crop irrigation: West Bank, Palestinian Territories
Greywater is increasingly treated and reused for agricultural irrigation in off-grid communities in the Middle East and other water scarce regions of the world. However, there is a dearth of data regarding levels of antibiotics and herbicides in off-grid greywater treatment systems. To address this knowledge gap, we evaluated levels of these contaminants in two types of greywater treatment systems on four farms in the West Bank, Palestinian Territories. Samples of household greywater (influent, n = 23), treated greywater effluent intended for agricultural irrigation (n = 23) and pumped groundwater held in irrigation water ponds (n = 12) were collected from October 2017 to June 2018. Samples were analyzed using high performance liquid chromatography tandem mass spectrometry (LC-MS/MS) for the following antibiotics and herbicides: alachlor, ampicillin, atrazine, azithromycin, ciprofloxacin, erythromycin, linezolid, oxacillin, oxolinic acid, penicillin G, pipemidic acid, sulfamethoxazole, triclocarban, tetracycline, triflualin, and vancomycin. All tested antibiotics and herbicides were detected in greywater influent samples at concentrations ranging from 1.3 to 1592.9 ng/L and 3.1–22.4 ng/L, respectively. When comparing influent to effluent concentrations, removal was observed for azithromycin, alachlor, linezolid, oxacillin, penicillin G, pipemidic acid, sulfamethoxazole, triclocarban, and vancomycin. Removal was not observed for atrazine, ciprofloxacin, erythromycin, oxolinic acid, tetracycline, and trifluralin. Pond water also contained the majority of tested contaminants, but at generally lower concentrations. To our knowledge, this is the first description of an extensive array of antibiotics and herbicides detected in household greywater from off-grid treatment systems.
Located in MPRC People / Amir Sapkota, Ph.D. / Amir Sapkota Publications
Article Reference Troff document (with manpage macros)Use of social media, search queries, and demographic data to assess obesity prevalence in the United States
Obesity is a global epidemic affecting millions. Implementation of interventions to curb obesity rates requires timely surveillance. In this study, we estimated sex-specific obesity prevalence using social media, search queries, demographics and built environment variables. We collected 3,817,125 and 1,382,284 geolocated tweets on food and exercise respectively, from Twitter’s streaming API from April 2015 to March 2016. We also obtained searches related to physical activity and diet from Google Search Trends for the same time period. Next, we inferred the gender of Twitter users using machine learning methods and applied mixed-effects state-level linear regression models to estimate obesity prevalence. We observed differences in discussions of physical activity and foods, with males reporting higher intensity physical activities and lower caloric foods across 40 and 48 states, respectively. In addition, counties with the highest percentage of exercise and food tweets had lower male and female obesity prevalence. Lastly, our models separately captured overall male and female spatial trends in obesity prevalence. The average correlation between actual and estimated obesity prevalence was 0.797(95% CI, 0.796, 0.798) and 0.830 (95% CI, 0.830, 0.831) for males and females, respectively. Social media can provide timely community-level data on health information seeking and changes in behaviors, sentiments and norms. Social media data can also be combined with other data types such as, demographics, built environment variables, diet and physical activity indicators from other digital sources (e.g., mobile applications and wearables) to monitor health behaviors at different geographic scales, and to supplement delayed estimates from traditional surveillance systems.
Located in Retired Persons / Quynh Nguyen, Ph.D., M.S.P.H. / Quynh Nguyen Publications
Article ReferenceTop 10 Blockchain Predictions for the (Near) Future of Healthcare
To review blockchain lessons learned in 2018 and near-future predictions for blockchain in healthcare, Blockchain in Healthcare Today (BHTY) asked the world's blockchain in healthcare experts to share their insights. Here, our internationally-renowned BHTY peer-review board discusses their major predictions. Based on their responses, presented in detail below, ten major themes (Table ) for the future of blockchain in healthcare will emerge over the 12 months.
Located in MPRC People / Manouchehr (Mitch) Mokhtari, Ph.D. / Mitch Mokhtari Publications
Article Reference Troff document (with manpage macros)Health and Consumer Finance
Located in MPRC People / Manouchehr (Mitch) Mokhtari, Ph.D. / Mitch Mokhtari Publications
Article Reference Troff document (with manpage macros)Sexual and Gender Minority Youth Alcohol Use: Within-Group Differences in Associations with Internalized Stigma and Victimization
Sexual and gender minority (SGM) youth are more likely to use alcohol than their heterosexual cisgender peers. At the same time, SGM youth experience sexuality- and gender identity-specific stressors known to exacerbate negative health outcomes. Though scholars have established a link between minority stressors (e.g., internalized stigma and victimization) and increased alcohol use for SGM youth as a whole, there is little indication of whether internalized stigma and victimization are more strongly associated with alcohol use for specific groups of SGM youth. A United States sample of 11,811 racially and geographically diverse 13–17 year old SGM youth was used to employ a series of gender-stratified multivariable regression models to examine the association among internalized stigma, victimization, and alcohol-related behaviors, and whether they differed for specific groups of sexual minority youth. Sexual orientation moderated several associations between sexual minority stressors (i.e., victimization and stigma) and youth’s alcohol use (i.e., recent use and heavy episodic drinking) across models stratified by gender (i.e., male, female, and non-binary). For example, bisexual boys had stronger associations between SGM-specific victimization and alcohol use frequency and heavy episodic drinking relative to gay boys; conversely, victimization and alcohol use frequency were more weakly associated among bisexual girls relative to lesbian/gay girls. Pansexual girls showed weaker associations between internalized stigma and alcohol use frequency compared to lesbian/gay girls. This paper demonstrates who among SGM youth are more likely to engage in alcohol-related behaviors as a function of differential forms of SGM-related victimization and stigma. These findings can inform substance use interventions that are tailored to youth of diverse sexual orientations and gender identities.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article ReferenceLGBTQ Youth-Serving Community-Based Organizations: Who Participates and What Difference Does it Make?
LGBTQ youth are at greater risk for compromised health, yet large-scale health promotion programs for LGBTQ young people have been slow to develop. LGBTQ community-based organizations—which provide LGBTQ-focused support and services—have existed for decades, but have not been a focus of the LGBTQ youth health literature. The current study used a contemporary sample of LGBTQ youth (age 15–21;  M  = 18.81;  n  = 1045) to examine who participates in LGBTQ community-based organizations, and the association between participation and self-reported mental health and substance use. Youth who participated in LGBTQ community-based organizations were more likely to be assigned male at birth, transgender, youth of color, and accessing free-or-reduced lunch. Participation was associated with concurrent and longitudinal reports of mental health and substance use. LGBTQ community-based organizations may be an underutilized resource for promoting LGBTQ youth health.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications