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Reducing HIV among men who have sex with men (MSM) is a national goal, and early diagnosis, timely linkage to HIV medical care, and ongoing care and treatment are critical for improving health outcomes for MSM with HIV and preventing transmission to others. We assessed demographic, social, and economic factors associated with HIV antiretroviral treatment among HIV-infected MSM. Data are from the National HIV Behavioral Surveillance (NHBS) collected in 2014 among MSM. We estimated prevalence ratios and 95% confidence intervals using average marginal predictions from logistic regression. Overall, 89% of HIV-positive MSM reported currently taking antiretroviral therapy (ART). After controlling for other variables, we found that higher perceived community stigma and not having health insurance were significant risk factors for not taking ART. We also found that high socioeconomic status (SES) was associated with taking ART. Race/ethnicity was not significantly associated with taking ART in either the unadjusted or adjusted analyses. Findings suggest that to increase ART use for MSM with HIV, we need to move beyond individual-level approaches and move towards the development, dissemination, and evaluation of structural and policy interventions that respond to these important social and economic factors.

Bacterial pollution in the Houston metropolitan area (Texas) watersheds was studied using statistical methods to determine the Escherichia coli levels and causes of their spatial and temporal variability. Houston bayous generally exhibit elevated E. coli concentrations. The more urban watersheds had higher concentration ranges and geometric means and had more spatial variation with higher overall ranges at downstream monitoring stations. They also were less sensitive to temperature variations and more strongly influenced by rainfall events. The median flow in the more urban bayous is predominantly wastewater. Frequent rainfall in the region, combined with relatively long travel times in the bayous, results in elevated bacterial levels in the bayous. Multiple regression models using water quality parameters were more representative on the segment level and not at the watershed level and may not be useful for predictions that rely on conventional water quality measures, particularly in urban watersheds, such as those studied here. Cluster analysis for the segments resulted in two distinct clusters differentiated by their developed land-use, population density, domestic animal density, and grassy land-use.

This paper examines bacterial levels and their causes in two Houston bayous (Texas). Buffalo and Whiteoak bayous are two of the most contaminated water bodies in Texas for indicator bacteria, based on the frequency and magnitude of contact recreation water quality exceedances. Examination of historical data indicates frequent exceedances, although some improvement has been made since the 1970s. Statistical analyses showed some correlation between in-stream fecal coliform concentrations and rainfall and with land use. Differences in fecal coliform concentrations were found between high- and low-flow conditions in Whiteoak Bayou, while reservoir releases confounded this relationship in Buffalo Bayou. Wastewater treatment plant effluent was found to make up two-thirds to three-fourths of the median flow in both bayous. Effluent sampling was conducted at 72 of the approximately 140 wastewater treatment plants (WWTPs) in the watersheds, providing evidence that WWTP effluent could act to maintain low-flow concentrations of fecal coliform in the bayous.