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Men who have sex with men (MSM) in the United States are at disproportionate risk for HIV. Once-daily pre-exposure prophylaxis (PrEP) for HIV prevention is a highly effective method of preventing HIV infection; however, optimal adherence is necessary to maintain effectiveness. Many studies have profiled perceived barriers to adherence among at-risk MSM; however, nearly a decade after FDA approval, there has been little work examining experienced barriers to adherence among MSM who have previously used the medication. To assess the current state of this literature and its implications for behavioral interventions, we conducted a meta-ethnography (i.e., A systematic review and synthesis of qualitative studies) of experiences with PrEP use among cis-gender MSM in the United States. We found that structural-level interventions, such as telehealth and pharmacist-prescribed approaches to PrEP distribution, may circumvent barriers to uptake and adherence for some MSM, but may not be enough for already underserved communities, such as MSM of color. Furthermore, interpersonal-level factors, such as enacted PrEP stigma by providers and peers, highlight the necessary consideration of social identity in the branding of PrEP for HIV prevention. Tailored interventions should consider experienced barriers to PrEP adherence across socioecological levels to be most effective. [ABSTRACT FROM AUTHOR]

Integration of feminizing hormone therapy (FHT) and antiretroviral therapy (ART) is critical in providing gender-affirming HIV care for transgender (trans) women living with HIV. However, interpersonal communications with HIV providers who are not competent with FHT may complicate this integration. We conducted semi-structured interviews with trans women (n = 9) who self-reported as HIV-positive and their HIV providers (n = 15) from community-based venues (e.g., clinics) in Manila, Philippines. We identified five key themes from our qualitative data: (1) provider's concerns; (2) patient's goals; (3) affirmative vs. non-affirmative provider rhetoric; (4) alignment vs. misalignment of provider rhetoric to patient goals; and (5) FHT and ART-related decisions. Based on these themes, we describe a gender-affirmative HIV care framework to understand FHT-ART decisions among trans women living with HIV. Based on our data, this framework shows that provider-patient communications regarding ART and FHT consists primarily of provider concerns and patient goals regarding FHT. These communications can take on a gender-affirmative or non-affirmative style of rhetoric that either aligns or misaligns with patient goals and may lead to differences in FHT and ART-related decisions among trans women living with HIV. There exist mixed regimens and beliefs about taking FHT and ART among this sample of trans women. While trans participants' main source of health information is their HIV provider, providers are likely to communicate non-affirmative rhetoric that negatively impacts trans women's decision to take FHT and ART. Research is needed to elucidate co-prescriptions of gender-affirmative services with HIV care among this group in the Philippines. [ABSTRACT FROM AUTHOR]

Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV, and there have been calls to improve availability of culturally sensitive HIV prevention programs for this population. This article provides a systematic review of intervention programs to reduce condomless sex and/or increase HIV testing among Latino MSM. We searched four electronic databases using a systematic review protocol, screened 1777 unique records, and identified ten interventions analyzing data from 2871 Latino MSM. Four studies reported reductions in condomless anal intercourse, and one reported reductions in number of sexual partners. All studies incorporated surface structure cultural features such as bilingual study recruitment, but the incorporation of deep structure cultural features, such as machismo and sexual silence, was lacking. There is a need for rigorously designed interventions that incorporate deep structure cultural features in order to reduce HIV among Latino MSM. [ABSTRACT FROM AUTHOR]

This study describes sexual health knowledge in perinatally HIV-infected (PHIV+) and perinatally exposed uninfected (PHIV−) ethnic-minority youth, aged 9–16 years, residing in New York City (N = 316). Data on youth sexual health knowledge (e.g., pregnancy, sexually transmitted diseases, birth control) and caregiver–adolescent communication about sexual health were examined. Participants in both groups answered only 35% of the sexual health knowledge questions correctly (mean = 6.6 of 19). Higher scores were found among youth who reported more communication about sex with caregivers (vs. those who did not report talking about sex with caregivers; 8.54 vs. 5.84,p < .001) and among PHIV+ youth who were aware of their status (vs. PHIV+ youth who were not; 7.27 vs. 4.70,p < .001). Age was positively correlated with sexual health knowledge (β = .489,p < .001). Both PHIV+ and PHIV− youth had poor sexual health knowledge, suggesting a need for sexual health education for both groups. Data suggest that interventions focused on caregiver–child risk communication may be important for prevention. [ABSTRACT FROM AUTHOR]

The current attention that is being paid to college sexual assault in policy circles and popular media overlooks a critical issue: the possible role played by the urban social environment in intimate partner violence (IPV) risk for the large number of urban commuter college students throughout the USA and beyond. This article helps to illuminate this dynamic using qualitative research collected at an urban commuter campus in New York City. Specifically, we conducted focus groups and in-depth interviews with 18 female undergraduate students, exploring the nature and consequences of IPV in students' lives, perceived prevalence of IPV, and resources for addressing IPV. Our results indicate that college attendance may both elevate and protect against IPV risk for students moving between urban off- and on-campus social environments. Based on this, we present a preliminary model of IPV risk for undergraduate women attending urban commuter colleges. In particular, we find that enrolling in college can sometimes elevate risk of IPV when a partner seeks to limit and control their student partner's experience of college and/or is threatened by what may be achieved by the partner through attending college. These findings suggest a role for urban commuter colleges in helping to mitigate IPV risk through policy formulation and comprehensive ongoing screening and prevention activities. [ABSTRACT FROM AUTHOR]

Recommendations suggest that older children and adolescents perinatally infected with HIV (PHIV+) be informed of their HIV diagnosis; however, delayed disclosure is commonly reported. This study examined the prevalence and timing of HIV disclosure to PHIV+ adolescents and the associations between the timing of disclosure and psychological functioning and other behavioral outcomes. Recruitment took place at four medical centers in New York City between December 2003 and December 2008. This sample included data from 196 PHIV+ youth and their caregivers: 50% of youth were male, 58% African American, 42% Hispanic, with a mean age of 12.71 years. According to caregiver reports, 70% of the PHIV+ youth knew their HIV diagnosis. Youths who had been told were more likely to be older; youths with a Spanish-speaking Latino caregiver and whose caregivers had a grade school education were told at an older age. Youths who had been told their HIV status were significantly less anxious than those who had not been told; there were no other differences in psychological functioning. Youths who knew their status for longer reported higher intentions to self-disclose to potential sex partners. In multivariate analyses only demographic differences associated with timing of disclosure remained. In summary, PHIV+ youth who had been told their HIV status did not show an increase of psychological problems and were more likely to have intentions to self-disclose to sexual partners. Yet, almost one third was entering puberty without important information regarding their illness. Caregivers need support to address factors impeding HIV disclosure. [ABSTRACT FROM AUTHOR]

In Mexico City, male sex workers (MSWs) are up to 126 times more likely to be living with HIV than the general public. We conducted interviews with 23 MSWs in Mexico City to examine their subjective understandings about their sexual risk behaviors and explore opportunities about HIV pre-exposure prophylaxis (PrEP) as a prevention approach in this group. Despite knowledge about sexual HIV risks, most participants reported condomless anal sex with clients. There was very little prior knowledge about PrEP, but very high interest in using a daily pill for prevention. Several participants expected an increase in condomless anal sex if taking PrEP, because of monetary incentives from clients or a perceived increase in pleasure. Additionally, seasonal sex workers expressed interest in using PrEP only during months when they were performing sex work. PrEP implementation efforts through Mexico's healthcare system should recognize the varying needs and sexual risk behaviors of MSWs. [ABSTRACT FROM AUTHOR]

Computer-assisted interview methods are increasingly popular in the assessment of sensitive behaviors (e.g., substance abuse and sexual behaviors). It has been suggested that the effect of social desirability is diminished when answering via computer, as compared to an interviewer-administered face-to-face (FTF) interview, although studies exploring this hypothesis among adolescents are rare and yield inconsistent findings. This study compared two interview modes among a sample of urban, ethnic-minority, perinatally HIV-exposed U.S. youth (baseline = 148 HIV+, 126 HIV−, ages 9-16 years; follow-up = 120 HIV+, 110 HIV−, ages 10-19 years). Participants were randomly assigned to receive a sexual behavior interview via either Audio Computer-Assisted Self-Interview (ACASI) or FTF interview. The prevalence of several sexual behaviors and participants' reactions to the interviews were compared. Although higher rates of sexual behaviors were typically reported in the ACASI condition, the differences rarely reached statistical significance, even when limited to demographic subgroups-except for gender. Boys were significantly more likely to report several sexual behaviors in the ACASI condition compared to FTF, whereas among girls no significant differences were found between the two conditions. ACASI-assigned youth rated the interview process as easier and more enjoyable than did FTF-assigned youth, and this was fairly consistent across subgroup analyses as well. We conclude that these more positive reactions to the ACASI interview give that methodology a slight advantage, and boys may disclose more sexual behavior when using computer-assisted interviews. [ABSTRACT FROM AUTHOR]

Introduction: Hispanics/Latinos (henceforth, Latinos) are the largest minority group in the U.S. With growing health disparities among this group, the highest burden remains among sexual and gender minority Latinos. Differences regarding sexual orientation have not been fully explored within this group using national representative samples. This study analyzed sexual and behavioral health disparities associated with sexual minority status among Latinos in the U.S.Methods: The study included data from 5,598 Latino adults who participated in the 2001-2014 waves of the National Health and Nutrition Examination Survey. Data analysis was conducted in 2016. Bivariate and multivariable logistic regression analyses examined the prevalence of HIV, sexually transmitted infections, mental health problems, cigarette smoking, and alcohol/illicit drug use among sexual minorities and heterosexual Latino adults. Sexual minorities were defined as "gay, lesbian, and bisexual" (GLB) and "other" non-heterosexual groups.Results: GLB Latinos reported higher prevalence of mental health problems and cigarette smoking compared with heterosexuals. After adjusting for covariates, GLB Latinos had greater odds of testing positive for HIV, lifetime diagnosis of sexually transmitted infections, poor mental health outcomes, cigarette smoking (including lifetime and current smoking status), and illicit drug use than heterosexuals.Conclusions: The disproportionate impact of health disparities among Latinos varies significantly by sexual orientation, with GLB individuals facing elevated prevalence. In particular, elevated odds for HIV/sexually transmitted infections, mental health problems, smoking, and illicit substance use were found. Further research, including longitudinal studies to understand the trajectories of risks, is needed to identify intervention opportunities in this population. [ABSTRACT FROM AUTHOR]

Frequent use of websites and mobile telephone applications (apps) by men who have sex with men (MSM) to meet sexual partners, commonly referred to as "hookup" sites, make them ideal platforms for HIV prevention messaging. This Rhode Island case study demonstrated widespread use of hookup sites among MSM recently diagnosed with HIV. We present the advertising prices and corporate social responsibility (CSR) programs of the top five sites used by newly diagnosed HIV-positive MSM to meet sexual partners: Grindr, Adam4Adam, Manhunt, Scruff, and Craigslist. Craigslist offered universal free advertising. Scruff offered free online advertising to selected nonprofit organizations. Grindr and Manhunt offered reduced, but widely varying, pricing for nonprofit advertisers. More than half (60%, 26/43) of newly diagnosed MSM reported meeting sexual partners online in the 12 months prior to their diagnosis. Opportunities for public health agencies to promote HIV-related health messaging on these sites were limited. Partnering with hookup sites to reach high-risk MSM for HIV prevention and treatment messaging is an important public health opportunity for reducing disease transmission risks in Rhode Island and across the United States. [ABSTRACT FROM AUTHOR]

The article discusses a qualitative interview with men having sex with men (MSM) prescribed pre-exposure prophylaxis (PrEP) at an infectious diseases outpatient center in Providence, Rhode Island to understand patients' experiences in real-world settings. Most participants reported that their primary care physicians, pharmacists and other health care providers had limited knowledge of PrEP and cites belief by primary care providers that PrEP should be offered by infectious disease specialists.

We examined youth-caregiver adherence report concordance and association of different adherence self-report items with HIV RNA viral load (VL) in perinatally HIV-infected adolescents assessed in 2003-2008. Youth ( n=194; 9-19 years) and their caregivers completed a multi-step 2-day recall, one item on last time medications were missed, and one item on responsibility for managing youths' medications. Across early (9-12 years), middle (13-15 years), and late (16+years) adolescence, both youth and caregivers reported having primary responsibility for youths' medication regimens and demonstrated poor to moderate youth-caregiver concordance on adherence items. Responses to the last-time-missed item had greater association with VL than did the 2-day recall, particularly for longer times (e.g., past month). By age group, significant associations with VL were found for caregiver reports in early adolescence, caregiver and youth reports in middle adolescence, and youth reports in late adolescence, suggesting that caregivers offer better reports of youth adherence during early adolescence, but by later adolescence, youth are better informants. Although design limitations preclude definitive conclusions about the reliability and validity of specific adherence items, this study suggests important issues related to age group, caregiver vs. youth informants of adherence, and recall periods for child adherence assessment that warrant further research. [ABSTRACT FROM AUTHOR]

Aircraft instrument navigation is based on radio signal technology provided by ground navigation aids (navaids). The International Civil Aviation Organization specifies the required navaids availability, quality, accuracy, and integrity for ground installations on service, including the flight inspection operations. Flight inspection is the task of validating the radio signal emitted by navaids. This paper presents the architecture of a novel system for flight inspection based on the use of unmanned aircraft. The proposed architecture is operated remotely and has flight inspection capabilities by using radio signal sensors. It also has a precise positioning system, based on global navigation satellite system, and uses a data link with low bandwidth, long range, and redundancy. Except for congested airports, the flight inspection is done in segregated airspace. These segregated airspace inspection flights could be a catapult for seriously considering unmanned aircraft benefits in civil services. Unmanned aircraft are a ready technology waiting for legal approval to operate cooperatively with manned aircraft in regular airspace. The paper presents a simulation of the flight inspection of a navaid in Huesca, Spain. The simulation is a proof of concept of the proposed architecture. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we develop an approximation to the expectation of a random variable implied in cooperation stability, presented in a previous work. This approximation is obtained by means of a continuous monotonous function that upper bounds the expectation. Finally, we analyze the quality of this approximation. [Copyright &y& Elsevier]

AKT/PKB is a protein kinase that plays a key role in pancreatic adenocarcinoma. Three isoforms with a similar structure but non-overlapping functions have been described: AKT1/PKBα, AKT2/PKBβ and AKT3/PKBγ. Our project studies the molecular routes of adaption to single AKT isoform silencing. We have individually silenced AKT isoforms using short hairpin RNAs (shRNAs) delivered by lentivirus. A shRNA against an irrelevant gene was used as control. When cells adapted to the modification, high-throughput quantitative proteomics analyses were performed to evaluate the differentially altered molecular routes. Mitochondrial protein expression was determined by Western Blot. Mitochondrial function was evaluated using Agilent SeaHorse XF. Cancer stem-cell like phenotype was determined by CD44 and EpCAM expression. A subsequent silencing of the escape routes discovered was performed. Only cells adapted to AKT1 silencing, but not AKT2 or AKT3, exhibited a cancer stem-cell like phenotype with a sharp increase in CD44/EpCAM expression compared to the other cell lines or control (p < 0.0001). shAKT1 expressing cells presented a potentiation of mitochondrial functions determined both by quantitative proteomics, and by basal and maximal oxygen consumption rate (p < 0.0001). Double silencing of AKT1 and the mitochondrial protein TFB2M caused a prolonged cell growth arrest. When exposed to stable AKT1 inhibition, pancreatic adenocarcinoma cells adapt by switching their metabolism from glycolysis to mitochondrial respiratorion, which suggests a reversion of Warburg effect, and adopting cancer stem-cell like phenotype. Cancer stem cells have been proposed as one of the main factors favouring therapy resistance. Targeting mitochondrial metabolism might improve the efficacy of conventional treatments. Grupo de Inmunomodulación. Grupo de Inmunomodulación. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]