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In efforts to prevent the spread of COVID-19, jurisdictions across the globe, including Canada, enacted containment measures that affected intimacy and sexual relations. This article examines how public health measures during COVID-19 impacted the sexual practices of sexual minority men- gay, bisexual, queer and other men who have sex with men-and how they adopted and modified guidelines to prevent the transmission of COVID-19, HIV and other sexually transmitted infections (STIs). We conducted 93 semi-structured interviews with men (

Background Gay, bisexual, and other men who have sex with men (GBM) who engage in transactional sex (sex in exchange for drugs, money, or goods) experience increased risk of sexually transmitted infections (STI), including HIV. This study explored additional psychosocial and health-related factors associated with transactional sex among GBM. Methods Respondent-driven sampling was used to recruit GBM in Vancouver, Canada, from 2012 to 2015, with follow up every 6 months until July 2019. We examined factors associated with transactional sex using multivariable three-level mixed-effects modelling. Results Among 698 GBM, 22.1% reported ever receiving drugs, money, or goods for sex. Transactional sex was more likely to be reported by GBM who were younger (

Accessibility of pre-exposure prophylaxis (PrEP) in Canada remains complex as publicly funded coverage and delivery differs by province. In January 2018, PrEP became publicly funded and free of charge in British Columbia (BC), whereas PrEP coverage in Ontario and Montreal is more limited and may require out-of-pocket costs. We examined differences over time in PrEP uptake and assessed factors associated with PrEP awareness and use.Gay, bisexual and other men who have sex with men (GBM) were recruited through respondent-driven sampling (RDS) in Toronto, Vancouver and Montreal, Canada, in a prospective biobehavioural cohort study. We applied generalized estimating equations with hierarchical data (RDS chain, participant, visit) to examine temporal trends of PrEP use and correlates of PrEP awareness and use from 2017 to 2020 among self-reported HIV-negative/unknown GBM.Of 2008 self-identified HIV-negative/unknown GBM at baseline, 5093 study visits were completed from February 2017 to March 2020. At baseline, overall PrEP awareness was 88% and overall PrEP use was 22.5%. During our study period, we found PrEP use increased in all cities (all plt;0.001): Montreal 14.2% during the first time period to 39.3% during the last time period (plt;0.001), Toronto 21.4-31.4% (plt;0.001) and Vancouver 21.7-59.5% (plt;0.001). Across the study period, more Vancouver GBM used PrEP than Montreal GBM (aOR = 2.05, 95% CI = 1.60-2.63), with no significant difference between Toronto and Montreal GBM (aOR = 0.90, 95% CI = 0.68-1.18).Full free-of-charge public funding for PrEP in BC likely contributed to differences in PrEP awareness and use. Increasing public funding for PrEP will improve accessibility and uptake among GBM most at risk of HIV.

The last Canadian biobehavioural surveillance study of HIV and other sexually transmitted and blood-borne infections (STBBI) among gay, bisexual and other men who have sex with men (GBM) was conducted in 2010. We designed a study to measure STBBI prevalence among GBM in metropolitan Montreal, Toronto and Vancouver and to document related preventive and risk behaviours.The Engage Cohort Study used respondent-driven sampling (RDS) to recruit GBM who reported sex with another man in the past 6 months. At baseline, we examined recruitment characteristics of the samples, and the RDS-II-adjusted distributions of socio-demographics, laboratory-confirmed HIV and other STBBI prevalence, and related behaviours, with a focus on univariate differences among cities.A total of 2449 GBM were recruited from February 2017 to August 2019. HIV prevalence was lower in Montreal (14.2%) than in Toronto (22.2%) or Vancouver (20.4%). History of syphilis infection was similar across cities (14-16%). Vancouver had more HIV-negative/unknown participants who reported never being HIV tested (18.6%) than Toronto (12.9%) or Montreal (11.5%). Both Montreal (74.9%) and Vancouver (78.8%) had higher proportions of men who tested for another STBBI in the past 6 months than Toronto (67.4%). Vancouver had a higher proportion of men who used pre-exposure prophylaxis (PrEP) in the past 6 months (18.9%) than Toronto (11.1%) or Montreal (9.6%).The three largest cities of Canada differed in HIV prevalence, STBBI testing and PrEP use among GBM. Our findings also suggest the need for scale-up of both PrEP and STI testing among GBM in Canada.RéSUMé: OBJECTIFS: La dernière étude canadienne portant sur la surveillance biocomportementale du VIH et des autres infections transmissibles sexuellement et par le sang (ITSS) chez les hommes gais, bisexuels et autres hommes ayant des relations sexuelles avec des hommes (GBH) a été menée en 2010. Nous avons mis en œuvre une étude visant à estimer la prévalence des ITSS parmi les GBH résidant dans les régions métropolitaines de Montréal, Toronto et Vancouver ainsi qu’à documenter les comportements préventifs et à risque associés à ces infections. MéTHODES: La méthode « d’échantillonnage dirigé par les répondants » (RDS) a été utilisée pour recruter des GBH ayant eu des relations sexuelles avec un autre homme au cours des six derniers mois. Nous avons examiné les distributions, ajustées selon l’approche RDS-II, des caractéristiques socio-démographiques des répondants, et la prévalence du VIH et d’autres ITSS mesurées par des tests de laboratoire ainsi que les comportements associés. Nous avons porté une attention particulière aux différences entre les villes décelées par analyses univariées. RéSULTATS: Nous avons recruté un total de 2 449 GBH entre février 2017 et août 2019. La prévalence du VIH était plus basse à Montréal (14,2 %) qu’à Toronto (22,2 %) ou à Vancouver (20,4 %) alors que celle de la syphilis (résultat de test compatible avec une infection au cours de la vie) était similaire dans les trois villes (14 à 16 %). Vancouver comptait plus de participants de statut VIH négatif/inconnu ayant déclaré n’avoir jamais passé un test de détection du VIH à vie (18,6 %) comparativement à Toronto (12,9 %) ou à Montréal (11,5 %) alors que les proportions de répondants ayant passé un test de détection d’une autre ITSS au cours des six derniers mois étaient plus élevées à Montréal (74,9 %) et à Vancouver (78,8 %) qu’à Toronto (67,4 %). Vancouver comptait une plus forte proportion d’hommes ayant eu recours à la prophylaxie du VIH pré-exposition (PrEP) au cours des six derniers mois (18,9 %) que Toronto (11,1 %) ou Montréal (9,6 %). CONCLUSION: Les trois plus grandes villes du Canada différaient en ce qui concerne la prévalence du VIH, le dépistage des ITSS et l’utilisation de la PrEP au sein des GBH. Nos résultats suggèrent la nécessité d’intensifier le dépistage des ITSS et le recours à la PrEP chez les GBH au Canada.

Gay, bisexual, and other men who have sex with men (gbMSM) remain disproportionately affected by human immunodeficiency virus (HIV). Interaction between psychosocial factors likely plays a role in HIV acquisition risk. We aimed to analyze the association of loneliness and self-rated attractiveness with HIV acquisition risk, and determine whether these associations were mediated by gay telephone chatlines or online dating platforms.This cross-sectional study included HIV-negative gbMSM 16 years or older enrolled into the Momentum Health Study from February 2012 to February 2015. Loneliness, self-rated attractiveness (exposures) and use of gay chatlines or online dating platforms (mediators) were assessed through self-interviews. Human immunodeficiency virus acquisition risk (outcome) was assessed by the HIV Incidence Risk Index. Weighted logistic regression modeled the association and moderation effect between exposures and outcome. Mediation models estimated 3-way direct effect among exposures, mediators, and outcome.Of 542 gbMSM, those who were lonely (adjusted odds ratio [aOR], 1.54; 95% confidence intervals [CI], 1.04-2.28) and attractive (aOR, 1.69; 95% CI, 1.04-2.76) had increased odds for HIV acquisition risk. Our moderation analysis demonstrated a heightened joint effect among lonely and attractive participants (aOR, 1.70; 95% CI, 1.08-2.65). Use of gay telephone chatlines or online dating platforms mediated 30.5% of the association between loneliness and HIV acquisition risk, but did not mediate attractiveness and HIV acquisition risk.Our findings suggest that the provision of interventions focusing on mental health support and safer sex practices through gay telephone chatlines or online dating platforms is promising to help alleviate the HIV burden among gbMSM.

We developed measures of relational beliefs and expectations among single young gay and bisexual men (YGBM). Data come from an online cross‐sectional study YGBM, which ran from July 2012 until January 2013. There were 50 items on relational beliefs and 25 items on relational expectations. We used random split samples and a priori analysis to group items together and applied principal axis factoring with varimax orthogonal rotation. We had a total N = 1582 in our analytical sample and identified six constructs of relational expectations (restrictions, negative break up, masculine and gender norms, optimism, cheating, immediacy) and two constructs of relational beliefs (sex beliefs, equality). Our findings highlight specific relational cognitions among YGBM and offer insight into the beliefs and expectations that may inform their relationships. Findings may be useful for health professionals to help YGBM reflect and understand the health implications of their beliefs and expectations about same‐sex relationships to promote healthy decision-making as they seek future partners.

In 2010, Andrews investigated a variety of parity questions in the classical partition identities of Euler, Rogers, Ramanujan and Gordon. In particular, he considered the Rogers-Ramanujan-Gordon partitions with some constraints on even and odd parts. At the end of this paper, he left fifteen open questions, of which the eleventh is to extend his parity consideration to overpartitions. The main purpose of this paper is to undertake that question. In 2013, Chen, Sang and Shi derived an overpartition analogue of the Rogers–Ramanujan–Gordon theorem. Motivated by their work, we define two kinds of Rogers–Ramanujan–Gordon type overpartitions with some parity constraints on even and odd parts. We then provide the generating functions for such partitions in some cases.

Wall-driven flow in square cavities has been studied extensively, yet it appears some main flow characteristics have not been fully investigated. Previous research on the classic lid-driven cavity (S1) flow has produced the critical Reynolds numbers separating the laminar steady and unsteady flows. Wall-driven cavities with two opposing walls moving at the same speed and the same (S2p) or opposite (S2a) directions have seldom been studied in the literature and no critical Reynolds numbers characterizing transitional flows have ever been investigated. After validating the LBM code for the three configurations studied, extensive numerical simulations have been undertaken to provide approximate ranges for the critical Hopf and Neimark-Sacker bifurcations for the classic and two two-sided cavity configurations. The threshold for transition to chaotic motion is also reported. The symmetries of the solutions are monitored across the various bifurcations for the two-sided wall driven cavities. The mirror-symmetry of the base solution for case S2p is lost at the Hopf bifurcation. The exact same scenario occurs with the pi-rotational symmetry of the base state for case S2a.

BackgroundDue to stigma and discrimination, gay, bisexual and other men who have sex with men (gbMSM) potentially carry a heightened burden of loneliness. This analysis investigates loneliness among gbMSM and its relationship with self-rated physical health, along with the mediating effect of depression.MethodsParticipants were recruited using respondent-driven sampling into the Momentum Health Study (February 2012–February 2015) with follow-up visits occurring every 6 months until February 2018. Using computer-assisted self-interviews, measures of loneliness were assessed using a 6-item Loneliness Scale for Emotional and Social Loneliness (lonely vs not lonely). Current physical health was self-assessed (poor, fair, good, very good or excellent). A multivariable generalised linear-mixed model with a logit link function was used to examine the relationship between loneliness and self-rated physical health. We further investigated the mediating effect of depressive symptomatology on this relationship via the Hospital Anxiety and Depression Scale.ResultsOf the 770 participants included, we found that 61% (n=471) experienced loneliness at baseline. Of the 674 (88%) who reported good/very good/excellent physical health, 59% (n=391) reported loneliness, compared with 87% (n=80) of those in poor/fair self-rated physical health. After adjustment for confounding, loneliness was associated with poor self-rated physical health (adjusted OR 1.71; 95% CI 1.13 to 2.60). Depressive symptomatology was found to partially mediate this relationship.ConclusionThere may be a need for the integration of social, mental and physical health programming, targeted towards gbMSM, to alleviate the degree of loneliness experienced and its co-occurrence with poor self-rated physical health.

The present study focuses on the flow over a 2D square cylinder with a plate placed in front of it. An in-house code using the lattice Boltzmann method was employed for all the simulations presented. Few cases were simulated using the open source code Nektar++, the results obtained from both methodologies were compared. Regarding the plate, three related parameters, velocity ratio, distance between the plate and cylinder and the thickness of the plate, were studied in order to evaluate the impact of these parameters on the flow behavior. The interactions between these parameters were as well investigated. The effect of these parameters on flow transitional properties such as Hopf and Neimark–Sacker bifurcations were discussed. Whenever the velocity ratio exceeds a certain value, Kelvin–Helmholtz instabilities dominate the vortex shedding. As velocity ratio increases, drag coefficient and vortex shedding frequency increase. The POD method was employed to predict the flow behavior based on the existing information. It turned out the POD method is a trustable methodology to mathematically pre-investigate the flow field, therefore it is capable of saving large computational resources.

Introduction In 2010, British Columbia (BC) implemented HIV Treatment as Prevention (TasP) as policy. We examined trends in virologic suppression and determinants of significant viremia among a prospective biobehavioural cohort of men who have sex with men (gbMSM) in Vancouver from 2012–2017. Methods Respondent-driven sampling was used to recruit sexually active gbMSM (≥16 years) who completed biannual study visits with a computer-assisted self-interview and clinical CD4 and viral load (VL) testing. We linked participant data with the BC HIV Drug Treatment Program to obtain antiretroviral dispensing and VL data. We conducted a trend analysis of VL suppression using univariable generalized estimating equation (GEE) multi-level modelling and multivariable GEE to identify factors associated with episodes of VL ≥200 copies/mL. Results Of 774 participants, 223 were living with HIV at baseline and 16 were diagnosed during follow-up (n = 239). We observed a significant trend towards reduced levels of unsuppressed VL (>200 copies/mL) from 22% (07/2012-12/2012) to 12% (07/2016-12/2016) (OR:0.87; 95%CI:0.83–0.91 for each 6-month period). Among those with at least one follow-up visit, (n = 178, median follow-up = 3.2 years, median age = 46.9 years), younger age (aOR:0.97; 95%CI:0.94–0.99, per year), ecstasy use (aOR:1.69; 95%CI:1.13–2.53), crystal methamphetamine use (aOR:1.71; 95%CI:1.18–2.48), seeking sex via websites (aOR:1.46; 95%CI:1.01–2.12), and lower HIV treatment optimism (aOR:0.94; 95%CI:0.90–0.97) were associated with episodes of elevated viremia. Conclusions During a period when TasP policy was actively promoted, we observed a significant trend towards reduced levels of unsuppressed VL. Continued efforts should promote HIV treatment optimism and engagement, especially among younger gbMSM and those who use ecstasy and crystal methamphetamine.

While crystal methamphetamine use by gay, bisexual, and other men who have sex with men (GBM) is associated with increased risk for sexually transmitted infection (STI) transmission, less is understood about the causal pathways between crystal methamphetamine use and STIs. We examined whether the association between greater crystal methamphetamine risk and prevalent bacterial STI diagnosis among GBM was mediated by two types of attitudinal variables: attitudes toward condoms, and sexual escape motives, defined as the use of substances to escape self-awareness during sex, and by sexual behaviors.We used computer-assisted self-interview questionnaires from 2449 sexually active GBM (18% living with HIV; median age = 33, interquartile range, 27-45) recruited via respondent-driven sampling in Vancouver, Toronto, and Montreal, Canada. Using the baseline data from the Engage cohort study, we fit a series of structural mediation models of the associations between greater crystal methamphetamine risk and bacterial STI (syphilis, gonorrhea, and chlamydia) diagnosis. We estimated indirect paths from greater crystal methamphetamine risk, attitudes toward condoms, sexual escape motives, and sexual risk behaviors, adjusting for self-reported demographic variables.In the mediated model, the direct association between greater crystal methamphetamine risk and bacterial STI diagnosis was non-significant; however, five indirect paths were significant. Greater crystal methamphetamine risk was associated with bacterial STIs via condom use attitudes and escape motives, which in turn were associated with number of male anal sex partners, condomless anal sex, and oral sex.Public health and counselling interventions for GBM who use crystal methamphetamine and who are at higher risk for STIs should target evidence-based causal paths that consider sexual attitudes and sexual practices.

Objective: Supportive social relationships can have direct positive effects on health and miti-gate the negative impact of stressors. This study investigated the main effect of perceived social support on STI/HIV risk and prevention behaviors. The buffering effect of perceived social support on the impact of proximal minority stressors, like internalized homonegativity, was also examined on one risk behavior specifically, condomless anal sex (CAS) without HIV pre-exposure prophylaxis (PrEP) use. Methods: HIV-negative gay, bisexual, and other men who have sex with men (GBM) were recruited using respondent driven sampling from three major Canadian urban centers (n = 1,409). GBM completed measures of perceived social support, proximal minority stress, and engagement in STI/HIV risk and prevention behaviors. Results: Higher perceived social support was positively associated with a several health behaviors, in-cluding recent STI and HIV testing, discussing HIV status with prospective partners, the use of behavioral HIV-risk reduction strategies during sexual encounters, and a lower likelihood of en-gaging in CAS without PrEP. There was evidence of moderation as well. Among GBM with higher perceived social support, internalized homonegativity was no longer associated with in-creased odds of engaging in CAS without PrEP. Conclusions: The results of the current study advance social support theory to GBM in the context of biomedical prevention, showing both evidence of both direct associations and buffering effects on STI/HIV risk and prevention be-haviors. This highlights the importance of promoting social support seeking in interventions aimed at improving GBM health.

Syphilis rates have increased in BC and disproportionately affect gay, bisexual, and other men who have sex with men (gbMSM). A social marketing campaign (Syphistory) ran from January to September 2017 with the primary goal of increasing syphilis knowledge and a secondary goal of increasing syphilis screening among gbMSM in BC.We used pre- and post-campaign surveys to assess changes in syphilis knowledge from a convenience sample of clients attending STI clinics using one-sided t-tests. We used online Piwik metrics to examine the campaign reach, and provincial testing data to examine trends in syphilis screening. We used data from the Engage Study to examine factors associated with campaign awareness and associations with syphilis testing.Of the 2155 visitors to the Syphistory website with known geography, 79.4% were from BC. Moreover, STI clinic participants who saw the campaign demonstrated a greater knowledge of syphilis (9.7/12, 80.8%) than those who did not see the campaign (mean 8.9/12, 74%) (p0.001). Provincial syphilis testing rates were 8764 and 9749 in the 12 months before and after the campaign; however, we did not find an overall trend in testing before versus after the campaign (p = 0.147). Among Engage participants, 12.7% reported seeing the campaign and we found an association between campaign exposure and recent syphilis testing (aOR = 2.73; 95% CI = 1.51, 4.93).gbMSM who saw the campaign were more likely to report being tested for syphilis in the previous 6 months. STI clinic attendees who reported seeing the campaign also had higher syphilis knowledge compared to those who did not.RéSUMé: OBJECTIFS: Les taux de syphilis ont augmenté en Colombie-Britannique et affectent de manière disproportionnée les hommes gais, bisexuels et autres hommes ayant des relations sexuelles avec des hommes (gbHARSAH). Une campagne de marketing social (Syphistory) a été mené de janvier à septembre 2017 avec pour objectif principal d’informer sur la syphilis et pour objectif secondaire d’augmenter le dépistage de la syphilis chez les gbHARSAH en Colombie-Britannique. MéTHODES: Nous avons réalisé deux sondages, l’un avant et l’autre après la campagne, sur un échantillon de convenance constitué de patients fréquentant des cliniques ITS, pour évaluer les changements dans les connaissances sur la syphilis à l’aide de tests t unilatéraux. Nous avons utilisé les mesures Piwik en ligne pour examiner la portée de la campagne et les données provinciales sur les tests pour examiner les tendances quant au dépistage de la syphilis. Nous avons utilisé les données de l’étude Engage à Vancouver, pour identifier les facteurs associés à la sensibilisation lors de la campagne et les associations avec le dépistage de la syphilis. RéSULTATS: Sur les 2 155 visiteurs du site Web Syphistory dont la position géographique était connue, 79,4 % provenaient de la Colombie-Britannique. De plus, les participants aux cliniques ITS ayant vu la campagne ont démontré une meilleure connaissance de la syphilis (9,7/12, 80,8 %) par rapport à ceux n’ayant pas vu la campagne (moyenne 8,9/12, 74 %) (p0,001). Les taux provinciaux de dépistage de la syphilis étaient de 8 764 et 9 749 au cours des 12 mois précédant et suivant la campagne; cependant, nous n’avons pas trouvé de tendance globale à la hausse des dépistages suite à la campagne (p=0,147). Parmi les participants Engage, 12,7 % ont déclaré avoir vu la campagne en ligne et nous avons trouvé une association entre l’exposition à la campagne et le dépistage récent de la syphilis (RCa=2,73; IC à 95 %=1,51, 4,93). CONCLUSION: Les gbHARSAH qui ont vu la campagne étaient plus susceptibles de déclarer avoir été testés pour la syphilis au cours des six derniers mois. Les participants aux cliniques ITS qui ont déclaré avoir vu la campagne avaient également une meilleure connaissance de la syphilis que ceux qui ne l’ont pas vue.

Background Availability and public funding of pre-exposure prophylaxis (PrEP) varies by jurisdiction in Canada. We conducted a multi-site prospective-longitudinal study to assess trends and correlates of PrEP awareness and use among gay, bisexual and other men who have sex with men (GBM) in Vancouver, Toronto and Montreal. Methods Sexually-active GBM, aged ≥16 years, were recruited through respondent-driven sampling (RDS) from February 2017 with follow-up data collected to March 2020. Participants completed a Computer-Assisted Self-Interview to assess PrEP awareness and use. Analyses were limited to HIV-negative GBM. We used generalized estimating equations accounting for two levels of clustering (RDS recruitment chain; participant) to evaluate temporal trends (monthly prevalence) of awareness and past six-month usage of PrEP. Multivariable models were built using backward selection to minimize QIC to identify correlates for two outcomes 1) PrEP awareness, and 2) PrEP use. Results We recruited 2008 HIV-negative GBM (N=622 from Vancouver, N=418 from Toronto, and N=968 from Montreal). Awareness of PrEP increased significantly in all three sites: Montreal, 81.2% during the first 6-month period to 91.4% during the last 6-month period (p Conclusions PrEP awareness was very high among GBM in all three cities. Uptake was highest in Vancouver where full public funding and active health promotion began in 2018 for those clinically eligible. Health policy and public health intervention can remove key barriers to PrEP implementation.

HIV testing remains a critical point of entry to HIV treatment services and now biomedical prevention as well. Yet despite the high HIV prevalence among Black men who have sex with men (MSM), insufficient attention has been given to factors associated with those Black MSM in the United States who have never received an HIV test in their lifetime. Promoting Our Worth, Equality, & Resilience (POWER) is a cross-sectional observational study that recruited Black MSM at Black Pride events across six cities in the United States from 2014 to 2017. Participants completed an anonymous questionnaire and were offered free, confidential HIV testing. Of the 4174 Black MSM without a prior HIV diagnosis, 404 (9.68%) had never tested for HIV (mean age = 31.03 years). Lower education and greater internalized homophobia were associated with never having tested for HIV. Higher age (AOR = 1.05, 95%, 1.02–1.07) and assumption of HIV-positivity (AOR = 3.24, 95% CI 1.53–6.84) were both associated with increased odds of an HIV-positive test result (n = 119; 36%). To compare, HIV prevalence among Black MSM who had received at least one HIV test before study participation was 23%. While a minority of Black MSM had never received an HIV test, this group had a significantly higher likelihood of HIV infection. Alternative HIV testing strategies are needed to facilitate HIV testing initiation among Black MSM for whom conventional HIV testing modalities are insufficient.

Men who have sex with men and women (MSMW), including those who are Black, experience HIV-related disparities compared to men who have sex with men only (MSMO). Few studies have assessed the prevalence and correlates of pre-exposure prophylaxis (PrEP) awareness and use among Black MSMW. We recruited MSM ≥ 18 attending Black Gay Pride events between 2014–2017. We conducted multivariable logistic regressions to assess differences in PrEP awareness and use among HIV-negative Black MSM (n = 2398) and within Black MSMW (n = 419). MSMW were less likely than MSMO to report PrEP awareness (p

Religious Freedom Restoration Acts and sexual minority population health in the United States ABSTRACT: Religious Freedom Restoration Acts (RFRAs) in the United States (US) potentially facilitate discrimination against lesbian, gay, and bisexual individuals (i.e., sexual minorities). This investigation explored whether a population health metric among sexual minority adults changed over time based on the presence, absence, or introduction of a state RFRA. Data are from 21 US states that gathered sexual orientation data from population-based samples of non-institutionalized adults in the 2015 Behavioral Risk Factor Surveillance System. The analytic sample included 4,911 sexual minority individuals. Time was measured in four 3-month quarters (i.e., Q1, Q2, Q3, Q4). For each state, the prevalence of sexual minority adults reporting ≥14 unhealthy days/30 days was calculated. Only Indiana (the only state in the sample that passed a RFRA in 2015) exhibited significant increasing proportions over time of sexual minority adults reporting ≥14 unhealthy days (Q1=24.5%, Q2=34.8%, Q3=41.2%, Q4=59.5%) (ß=0.50, SE=0.23, P=.037). Post hoc analyses revealed that unhealthy days did not increase for heterosexual adults in Indiana. Indiana’s RFRA could have contributed to the increasing prevalence of unhealthy days among sexual minority adults in that state during 2015. Public health surveillance tools are needed to facilitate expeditious analysis of the impact of laws on minority population health.

Rig was erected on a foundation that must be able to support the forces caused by the rig. The purpose of this research is to find out how big the difference between the axial and lateral bearing capacity of RIG ARJUNA #28 foundation. The research was conducted at RIG Arjuna #28 in Prabumulih City. In this research, an analysis of the carrying capacity of the pile foundation was carried out using Sondir and N-SPT data which will then be compared with the results of these calculations. It can be concluded that with data analysis using CPT/Sondir, the foundation will use 12 piles with a depth of 17 m, while using N-spt data the foundation will use 8 piles with a depth of 24 m.

Introduction Treatment as prevention strategies have been variously applied across provinces in Canada. We estimated HIV care cascade indicators and correlates of unsuppressed viral load (VL) among gay, bisexual and other men who have sex with men (GBM) recruited in Vancouver, Toronto and Montreal. Methods Sexually active GBM, aged ≥16 years, were recruited through respondent‐driven sampling (RDS) from February 2017 to August 2019. Participants completed a Computer‐Assisted Self‐Interview and tests for HIV and other sexually transmitted infections (STIs). We conducted bivariate analyses comparing RDS‐adjusted proportions across cities. We used multivariable logistic regression to examine factors associated with having a measured VL ≥ 200 copies/mL with data pooled from all three cities. Results We recruited 1179 participants in Montreal, 517 in Toronto and 753 in Vancouver. The RDS‐adjusted HIV prevalence was 14.2% (95% CI 11.1 to 17.2) in Montreal, 22.1% (95% CI 12.4 to 31.8) in Toronto and 20.4% (95% CI 14.5 to 26.3) in Vancouver (p

(1) Background: Condomless anal sex and substance use are associated with STI risk among gay, bisexual, and other men who have sex with men (gbMSM). Our first study objective was to describe event-level sexual risk and substance use trends among gbMSM. Our second study objective was to describe substances associated with event-level sexual risk. (2) Methods: Data come from the Momentum Health Study in Vancouver, British Columbia and participants were recruited from 2012–2015, with follow-up until 2018. Stratified by self-reported HIV status, we used generalized estimating equations to assess trends of sexual event-level substance use and assessed interactions between substance use and time period on event-level higher risk sex defined as condomless anal sex with an HIV serodifferent or unknown status partner. (3) Results: Event-level higher risk anal sex increased across the study period among HIV-negative/unknown (baseline prevalence: 13% vs. study end prevalence: 29%) and HIV-positive gbMSM (baseline prevalence: 16% vs. study end prevalence: 38%). Among HIV-negative/unknown gbMSM, event-level erectile drug use increased, while alcohol use decreased over the study period. Overall, interactions between substance use and time on higher risk anal sex were not statistically significant, regardless of serostatus. However, we found a number of time-specific significant interactions for erectile drugs, poppers, Gamma-hydroxybutyrate (GHB), crystal methamphetamine and ecstasy/MDMA use among HIV-negative/unknown gbMSM. (4) Conclusion: Significant differences in substance use trends and associated risks exist and are varied among gbMSM by serostatus. These findings provide a more comprehensive understanding of the effects of event-level substance use on sexual risk through longitudinal follow-up of nearly six years.

Sexual and gender minority youth (SGMY) have higher rates of bullying than their heterosexual peers and must disproportionately cope with bullying victimization. The purpose of this research is to highlight various coping strategies employed by SGMY. We conducted 20 cross-sectional, semi-structured online interviews with SGMY about their bullying experiences and coping strategies. We coded interviews with descriptive qualitative research to illustrate a comprehensive summary of bullying-related coping methods. We found SGMY engage in multiple coping strategies that include (1) emotion-focused coping—rumination; self-harm and considering or attempting suicide; seeking social and emotional support; engaging in creative endeavors; self-acceptance and community connectedness—and (2) problem-focused coping—reporting the bully; confronting the bully; conceal orientation; ignoring the bullying; and changing environment. Additionally, most SGMY reported using multiple coping techniques or changing how they coped over time (i.e., coping flexibility). These findings can inform future interventions to promote positive coping mechanisms among SGMY.

In order to study the flow behavior at high Reynolds numbers, two modified models, known as the multiple-relaxation-time lattice Boltzmann method (MRT-LBM) and large-eddy-simulation lattice Boltzmann method (LES-LBM), have been employed in this paper. The MRT-LBM was designed to improve numerical stability at high Reynolds numbers, by introducing multiple relaxation time terms, which consider the variations of density, energy, momentum, energy flux and viscous stress tensor. As a result, MRT-LBM is capable of dealing with turbulent flows considering energy dispersion and dissipation. In the present paper, this model was employed to simulate the flow at turbulent Reynolds numbers in wall-driven cavities. Two-sided wall driven cavity flow was studied for the first time, based on MRT-LBM, at Reynolds numbers ranging from 2 × 1 0 4 to 1 × 1 0 6 , and employing a very large resolution2048 × 2048. It is found that whenever top and bottom lids are moving in the opposite directions, and the Reynolds number is higher than 2 × 1 0 4 , the flow is chaotic, although some quasi-symmetric properties still remain, fully disappearing at Reynolds numbers between 2 × 1 0 5 and 3 × 1 0 5 . Furthermore, between this Reynolds numbers range, 2 × 1 0 5 Re 3 × 1 0 5 , the quasi-symmetric structures turn into a much smaller and fully chaotic eddies. The LES-LBM model implements the large eddy simulation turbulent model into the conventional LBM, allowing to study the flow at turbulent Reynolds numbers. LES-LBM combined with Quadruple-tree Cartesian cutting grid (tree grid) was employed for the first time to characterize the flow dynamics over a cylinder and a hump, at relatively high Reynolds numbers. In order to construct the macroscopic quantities in the virtual boundaries separating two different grid levels, a set of new schemes were designed. The coupling of the LES-LBM and tree grid drastically reduced the computational time required to perform the simulations, thus, allowing to minimize the hardware requirements. LES-LBM model is shown to be much more efficient when combined with the tree grid instead of using the standard Cartesian grid.

Background: Methamphetamine (MA) use among gay, bisexual, and other men who have sex with men (gbMSM) is a pervasive issue, associated with detrimental health outcomes. We identified factors associated with discontinuation or reduction in MA among a subset of gbMSM reporting frequent (at least weekly) use, with a specific focus on symptoms of anxiety and depression.Methods: We recruited sexually-active gbMSM aged ≥16 years in Vancouver, Canada into a prospective-cohort study using respondent-driven sampling. Participants completed study visits once every six months. We used generalized linear mixed models to identify factors associated with reductions in MA use following a visit where participants previously reported using MA at least weekly.Results: Of 584 cohort participants with at least one follow-up visit, 67 (11.5%) reported frequent MA use at baseline or in follow-up visits. Of these, 46 (68.7%) had at least one subsequent study visit where they transitioned to less frequent (monthly or less) or no MA use. In multivariable models, reduced MA use was less likely for those who spent >50% of social time with other gbMSM (aRR=0.49, 95%CI:0.28-0.85), gave or received drugs in exchange for sex (aRR=0.34, 95%CI:0.13-0.87), injected drugs (aRR=0.35, 95%CI:0.18-0.68), or used gamma-hydroxybutyrate (GHB) (aRR=0.41, 95%CI:0.21-0.78). Symptoms of anxiety or depression were not associated with reductions in MA use.Conclusions: Social connection and drug-related factors surrounding MA use were associated with reductions, but anxiety and depressive symptomatology were not. Incorporating socialization and polysubstance-related components with MA reduction may help in developing efficacious interventions towards reducing MA use for gbMSM.

The HIV epidemic among black men who have sex with men (BMSM) demands urgent public health attention. Pre-exposure prophylaxis (PrEP) is a highly efficacious option for preventing HIV, but characteristics of PrEP use among community samples of BMSM are not well-understood.A serial cross-sectional survey assessment (N = 4184 BMSM reporting HIV-negative/unsure status) and HIV testing were conducted at Black Gay Pride events in 6 US cities in 2014, 2015, 2016, and 2017.HIV prevalence was higher among BMSM self-reporting current PrEP use (1 of 3 participants) than BMSM not self-reporting current PrEP use (1 of 5 participants) [32.3%, N = 103/319 vs. 20.0%, N = 639/3,193, adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI): 1.31 to 2.15]. BMSM reporting current PrEP use (N = 380) were more likely to report having a greater number of male sex partners (aOR = 1.02, 95% CI: 1.01 to 1.03), a sexually transmitted infection diagnosis (aOR = 2.44, 95% CI: 1.88 to 3.16), and stimulant drug use (aOR = 2.05, 95% CI, 1.21 to 3.47) when compared with BMSM not reporting current PrEP use (N = 3804). PrEP use increased from 4.7% (2014) to 15.5% (2017) (aOR = 1.19, 95% CI: 1.13 to 1.25). Among PrEP users, inability to afford health care coverage was associated with testing HIV-positive (aOR = 2.10, 95% CI: 1.24 to 3.56).The high prevalence of HIV infection among BMSM reporting PrEP use is concerning. It does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, sexually transmitted infection treatment, and medication adherence counseling. Further research to understand barriers to fully effective PrEP is needed to guide operational and behavioral interventions that close the gap on incident infection.

Primordial germ cells (PGCs), the embryonic precursors of the sperm and egg, are used for the introduction of genetic modifications into avian genome. Introduction of small defined sequences using genome editing has not been demonstrated in bird species. Here, we compared oligonucleotide-mediated HDR using wild type SpCas9 (SpCas9-WT) and high fidelity SpCas9-HF1 in PGCs and show that many loci in chicken PGCs can be precise edited using donors containing CRISPR/Cas9-blocking mutations positioned in the protospacer adjacent motif (PAM). However, targeting was more efficient using SpCas9-HF1 when mutations were introduced only into the gRNA target sequence. We subsequently employed an eGFP-to-BFP conversion assay, to directly compare HDR mediated by SpCas9-WT and SpCas9-HF1 and discovered that SpCas9-HF1 increases HDR while reducing INDEL formation. Furthermore, SpCas9-HF1 increases the frequency of single allele editing in comparison to SpCas9-WT. We used SpCas9-HF1 to demonstrate the introduction of monoallelic and biallelic point mutations into the FGF20 gene and generate clonal populations of edited PGCs with defined homozygous and heterozygous genotypes. Our results demonstrate the use of oligonucleotide donors and high fidelity CRISPR/Cas9 variants to perform precise genome editing with high efficiency in PGCs.

Beberapa proyek membutuhkan dana untuk bisa diwujudkan. Tetapi dengan spirit kolaborasi, terkadang dana yang dibutuhkan bisa diminimalisir.Perbaikan pada sistem pendanaan harus segera dilaksanakan. Peningkatan jumlah pendanaan tersebut diharapkan dapat memberikan pengaruh pada hasil dan kualitas. Hasil dari adanya dana kolaborasi akan dapat menunjang pembangunan disetiap wilayah. Pemberian dana kolaborasi dan penunjukan lokasi sasaran. Banyak permasalahan permukiman di daerah ini, seperti masalah akses jalan untuk mobilisasi masyarakat, masalah drainase, air bersih, bahkan rawan longsor. Selain itu, misalnya pada perumahan permukiman terdapat indikator kumuh, yakni keteraturan bangunan, jalan lingkungan, drainase, pembuangan air limbah rumah tangga, penyediaan air minum, pengelolaan persampahan dan pengamanan bahaya kebakaran.Pemberian dana kolaborasi ‎berpatokan pada luas kekumuhan. Dengan adanya dana kolaborasi memberikan dampak positif bagi pembangunan, dapat berjalan sesuai dengan tujuan pembangunan. Dana kolaborasi dapat memberikan kesejahteraan bagi masyarakat untuk mewujudkan pembangunan infrastruktur disekitar masyarakat

Differences across the HIV care continuum between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO) are emerging in recent literature but have not been comprehensively documented among black MSM. Although MSMW have lower HIV prevalence than MSMO, they are more likely to be HIV-positive unaware and be virally unsuppressed. Explanatory factors for these differences have not previously been assessed.Between 2014 and 2016, we surveyed sexually active black MSM 18 years or older at Black Gay Pride events in 6 U.S. cities (n = 3881), 1229 of whom either self-reported HIV-positive status or tested HIV-positive onsite. We compared HIV-positive MSMW (n = 196) with HIV-positive MSMO (n = 1033) by HIV-positive unaware status, HIV care uptake, and viral load suppression. We conducted multivariable logistic regressions and built a structural equation model assessing mediating effects of psychosocial comorbidities (violence victimization, depression, and polydrug use) on the relationship between MSMW status and unsuppressed virus.MSMW were more likely than MSMO to be HIV-positive unaware [adjusted odds ratio (aOR) = 2.17; 95% confidence interval (CI): 1.58 to 3.00]. Among those who were HIV-positive aware (n = 720), MSMW were more likely to report never receiving HIV care (aOR = 2.74; 95% CI: 1.05 to 7.16) and to report detectable viral loads (aOR = 2.34; 95% CI: 1.31 to 4.19). Psychosocial comorbidities significantly mediated (P = 0.01) the relationship between MSMW status and unsuppressed virus.Black MSMW were less likely than black MSMO to uptake biomedical care and secondary prevention. Biobehavioral intervention development specific to HIV-positive black MSMW will be most successful if psychosocial comorbidities are also addressed.

The follicle-associated epithelium (FAE) is a specialised structure that samples luminal antigens and transports them into mucosa-associated lymphoid tissues (MALT). In mammals, transcytosis of antigens across the gut epithelium is performed by a subset of FAE cells known as M cells. Here we show that colony-stimulating factor 1 receptor (CSF1R) is expressed by a subset of cells in the avian bursa of Fabricius FAE. Expression was initially detected using a CSF1R-reporter transgene that also label subsets of bursal macrophages. Immunohistochemical detection using a specific monoclonal antibody confirmed abundant expression of CSF1R on the basolateral membrane of FAE cells. CSF1R-transgene expressing bursal FAE cells were enriched for expression of markers previously reported as putative M cell markers, including annexin A10 and CD44. They were further distinguished from a population of CSF1R-transgene negative epithelial cells within FAE by high apical F-actin expression and differential staining with the lectins jacalin, PHA-L and SNA. Bursal FAE cells that express the CSF1R-reporter transgene were responsible for the bulk of FAE transcytosis of labelled microparticles in the size range 0.02-0.1 µm. Unlike mammalian M cells, they did not readily take up larger bacterial sized microparticles (0.5 µm). Their role in uptake of bacteria was tested using Salmonella, which can enter via M cells in mammals. Labelled Salmonella enterica serovar Typhimurium entered bursal tissue via the FAE. Entry was partially dependent upon Type III secretion system-1. However, the majority of invading bacteria were localised to CSF1R-negative FAE cells and in resident phagocytes that express the phosphatidylserine receptor TIM4. CSF1R-expressing FAE cells in infected follicles showed evidence of cell death and shedding into the bursal lumen. In mammals, CSF1R expression in the gut is restricted to macrophages which only indirectly control M cell differentiation. The novel expression of CSF1R in birds suggests that these functional equivalents to mammalian M cells may have different ontological origins and their development and function are likely to be regulated by different growth factors.

Depression among Black transgender women (BTW) in the USA is an often understudied mental health concern with far-reaching consequences for overall physical and mental health at both the individual and community levels. Intimate partner violence (IPV) among BTW is also a frequently understudied and important social determinant of health in need of further exploration. This study sought to address the gap in research on the relationship between IPV and depression among BTW using a time- and location-based community sample of BTW from six US cities. In addition, it sought to explore the potential protective or suppressive effect of perceived social support on this relationship. Generalized structural equation models were used to assess conditional direct and indirect effects of IPV on depression via the suppression effect of perceived social support. Evidence was found of a statistically significant conditional direct effect of IPV on depression as well as a statistically significant suppression effect for perceived social support. Specifically, there was a 20% lower likelihood of increased depressive symptomatology for every 1-unit increase in perceived social support reported by participants. These findings indicated that perceived social support may be an important intervention point for helping to improve the mental health and well-being of BTW.

Background: Sexual and gender minority youth (SGMY; eg, lesbian, gay, bisexual, and transgender youth) experience myriad substance use and mental health disparities compared with their cisgender (nontransgender) heterosexual peers. Despite much research showing these disparities are driven by experiences of bullying and cyberbullying victimization, few interventions have aimed to improve the health of bullied SGMY. One possible way to improve the health of bullied SGMY is via a Web-accessible game intervention. Nevertheless, little research has examined the feasibility of using a Web-accessible game intervention with SGMY. Objective: This study aimed to describe the protocol for a randomized controlled trial (RCT) pilot, testing the feasibility and limited efficacy of a game-based intervention for increasing help-seeking–related knowledge, intentions, self-efficacy, behaviors, productive coping skills use, and coping flexibility and reducing health risk factors and behaviors among SGMY. Methods: We enrolled 240 SGMY aged 14 to 18 years residing in the United States into a 2-arm prospective RCT. The intervention is a theory-based, community-informed, computer-based, role playing game with 3 primary components: encouraging help-seeking behaviors, encouraging use of productive coping, and raising awareness of Web-based resources. SGMY randomized to both the intervention and control conditions will receive a list of SGMY-inclusive resources, covering a variety of health-related topics. Control condition participants received only the list of resources. Notably, all study procedures are conducted via the internet. We conveniently sampled SGMY using Web-based advertisements. Study assessments occur at enrollment, 1 month after enrollment, and 2 months after enrollment. The primary outcomes of this feasibility study include implementation procedures, game demand, and game acceptability. Secondary outcomes include help-seeking intentions, self-efficacy, and behaviors; productive coping strategies and coping flexibility; and knowledge and use of Web-based resources. Tertiary outcomes include bullying and cyberbullying victimization, loneliness, mental health issues, substance use, and internalized sexual and gender minority stigma. Results: From April to July 2018, 240 participants were enrolled and randomized. Half of the enrolled participants (n=120) were randomized into the intervention condition and half (n=120) into the control condition. At baseline, 52.1% (125/240) of the participants identified as gay or lesbian, 26.7% (64/240) as bisexual, 24.2% (58/240) as queer, and 11.7% (28/240) as another nonheterosexual identity. Nearly half (113/240) of participants were a gender minority: 36.7% (88/240) were cisgender boys, and 16.3% (39/240) were cisgender girls. There were no differences in demographic characteristics between intervention and control condition participants. Conclusions: Web-accessible game interventions overcome common impediments of face-to-face interventions and present a unique opportunity to reach SGMY and improve their health. This trial will provide data on feasibility and limited efficacy that can inform future Web-based studies and a larger RCT aimed at improving health equity for SGMY. Trial Registration: ClinicalTrials.gov NCT03501264; https://clinicaltrials.gov/ct2/show/NCT03501264 (Archived by WebCite at http://www.webcitation.org/72HpafarW) International Registered Report Identifier (IRRID): DERR1-10.2196/12164

Black men who have sex with men (BMSM) have the highest HIV incidence rates among all men who have sex with men (MSM) and have been less likely than other MSM to be diagnosed, linked or retained in care for HIV. The Promoting Our Worth, Equality, and Resilience (POWER) study administered a behavioral health survey and HIV test to BMSM to estimate the HIV continuum of care among a community-derived sample. Of the N = 1,680 BMSM living with HIV, n = 956 (56.9%) were aware of their HIV-positive status. BMSM who had been previously diagnosed reported progression through the care continuum at greater than 80% for linkage to medical care (97.6%), retention in medical care (97.3%), prescription of antiretroviral therapy (93.6%) and viral suppression (86.4%). Results of this analysis reveal the urgent need to ensure BMSM are being screened and diagnosed. Additionally, community-driven samples are a promising method offering the opportunity to build on the resilience of BMSM progressing though the continuum as well as engage BMSM not yet in care. Lastly, such methods can assist in communicating with those lost to retention.

Pagar Alam city is one of districts in South Sumatera province that has an area of ± 63,366 hectares (Monograph of the city of Pagaralam, 2013). So far, the people of Pagar Alam city, especially the north Pagar Alam district, have no reference to determine the soil type of its area; therefore this study carried out an analysis of the soil characteristics and conducted a mapping of its types of characteristics and the soil water content in the north Pagar Alam district.A geomap is a map that depicts existing image of the earth’s surface which is represented on a flat surface in a certain projection. Geomapping is a process of measuring, calculating and depicting the earth’s surface using certain methods. Soil is the surface layer of the earth that comes from parent material that has undergone an advanced process, due to natural changes under the influence of water, air, and various kinds of organisms, both living and dead (Dokuchaev 1870).After conducting 20 soil sample tests, it can be seen from the interpolated and overlayed sub-district map that the land in North Pagar Alam district has sandy silt soil where 19.69 km2 of the area has good grades of the soil and the other23.90 km2 of the area consists of poorly graded sand.

Using the high-stability controller Delta AS324MT and the advanced high-precision servo system through the CANOPEN bus communication mode, the z-pin implantation is controlled with high precision and high efficiency, and the second encoder is applied to the qualifying mode to completely implement the closed-loop control of the qualifying length. Solve the technical problems such as the inaccuracy of the length and position, control the position precision and the precision of the implantation through the four-axis numerical control implantation method, and achieve the action control of the cutting by the joint pneumatic loop control. The actual test results show that this method improves the accuracy and efficiency of z-pin implantation, greatly saves the labor cost, and reduces the harm of manual implantation to the human body.

According to the high-speed train body chassis connecting plate and the side wall key piece structure is complex, the processing difficulty is big, the processing is easy to deform, the precision is not easy to control, the processing efficiency is low, carries on the processing craft characteristic analysis, produces the processing craft analysis report. The dynamic milling forces in X, Y and Z directions during milling process are tested by means of testing and analyzing the dynamic characteristics of the machine tool, and the dynamic performance of the system can be tested by means of modal test, the transfer function of the system is obtained, and the modal parameters such as natural frequency, damping ratio and modal stiffness are obtained by mode fitting on the basis of the transfer function data, complete the dynamic characteristic analysis of the machine tool. Based on the modal analysis of the whole process system and the dynamic model analysis of the milling process, the chatter stability region of the milling process is simulated by using the theory of regenerative chatter, the results of chatter stability region related to milling process parameters are given.