Search

No longer is there a question of whether the football World Cup is an immense media spectacle; instead, the question now is how immense the World Cup is in the overall human experience. Despite all the global excitement related to the World Cup, the bulk of the general U.S. public is seemingly exempt from the charms of the World Cup. This article examines American media coverage of the 2010 FIFA Men's World Cup. A qualitative content analysis identified 6 major themes in U.S. popular-press coverage of the event in South Africa, highlighting the communicative undercurrents of media discussions in order to comprehend the disconnect between American attitudes toward the World Cup and those held by the rest of the world. Themes of media discourse range from the increase in participation of Americans in soccer to resistance to mainstreaming soccer in popular culture to how soccer affects cultural literacy. Overall, the results indicate some enthusiasm for World Cup soccer while outlining stronger resistance for the sport in general. Potential future research projects related to this line of inquiry are also suggested. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) account for nearly 70% of new HIV diagnoses, with young black MSM at the highest risk for infection in the United States. Pre-exposure prophylaxis (PrEP) can decrease HIV acquisition in at-risk individuals by over 90%. However, therapeutic efficacy requires a daily pill, posing adherence challenges. Experimental modalities, including injectable PrEP given once every 2 months, may improve adherence among those most in need. To assess interest in and preference for injectable PrEP, an online survey was mounted on two popular MSM sexual networking apps. Differences by age, race, and other characteristics were examined using multinomial logistic regressions. Of 4638 respondents, 73% expressed interest in injectable PrEP and 47% indicated they would prefer an injection (compared to 17% who prefer a daily pill and 36% who were unsure). Within this sample, interest in and preference for injectable PrEP was highest among MSM at highest risk for HIV infection (i.e., younger age groups, racial/ethnic minorities, those with risker sexual behavior). As a result, if proven effective in clinical trials, injectable PrEP has the potential to reduce social disparities in HIV transmission among MSM. [ABSTRACT FROM AUTHOR]

This paper is a critical engagement with Freud's anthropological theory of the origins of law and religion, which Freud developed as his representation and development of the Oedipal myth. Freud's mythology, it is argued, is the theoretical result of the essentially narrative nature of psychoanalytical praxis. Freud's myth, especially its treatment of patricide as the original sin, is seen to be a displacement of the biblical myth of fratricide as the original sin. It is argued that the biblical myth is more coherent than Freud's myth, and that it corresponds to the reality of the human condition better than Freud's myth. The paper concludes with the suggestion that the acceptance of the biblical myth in place of Freud's does not necessarily entail a rejection of psychoanalysis as a praxis. [ABSTRACT FROM AUTHOR]

To date, little data on pre-exposure prophylaxis (PrEP) users outside of the clinical trial setting are available. A repeated cross-sectional survey of one of the largest social and sexual networking websites for men who have sex with men (MSM) in the United States was conducted in August 2013 (Wave 1) and January 2014 (Wave 2). Multivariable logistic regression models were used to assess factors associated with having heard of and having taken post-exposure prophylaxis (PEP) and PrEP in Wave 1 (N = 4043) and Wave 2 (N = 2737) separately. In Wave 1, 147 (3.6 %) and 61 (1.5 %) reported using PEP and PrEP, respectively, compared to 119 (4.4 %) and 62 (2.3 %) in Wave 2. Higher-risk sexual behaviors were associated with having taken PEP and PrEP, and previous PEP use was associated with having taken PrEP. Understanding factors that are associated with early use of PrEP may help inform wider utilization of PrEP by at risk MSM. [ABSTRACT FROM AUTHOR]

The current analysis evaluates interest in and acceptability of daily PrEP during short episodes of anticipated increased risk (i.e. Epi-PrEP). In 2013, U.S. members of an internet-based MSM sexual networking site were invited to complete a survey about HIV prevention practices in the context of vacationing. 7305 MSM responded to the survey. Of respondents who had vacationed in the past year, 25.6 % reported condomless anal sex (CAS) with new male sex partners while vacationing. Most (92.6 %) respondents agreed that having to use PrEP every day was a barrier to PrEP use and 74.3 % indicated they would take PrEP if they knew it would be helpful for short periods of anticipated increased risk. MSM who reported increased CAS while on vacation in the past year were more likely to indicate that they would take PrEP if it were helpful when used for short periods than respondents who did not (aOR = 2.02, 95 % CI 1.59-2.56, p < 0.001). Studies designed to evaluate uptake, adherence, and protective benefit of short PrEP courses are warranted. [ABSTRACT FROM AUTHOR]

In this paper we examine the outcomes associated with an innovative change in a state-level transportation project prioritization process within the United States (U.S.). A foundational component of the innovation is the development and implementation of a novel multi-criteria analysis (MCA) tool to aid decision-makers. The pre and post-MCA project prioritization processes are described in detail for the state of Vermont, and we use a mixed methodological approach to empirically evaluate the outcomes associated with the innovative change with respect to three objectives: (1) to make the project prioritization process more transparent, (2) to improve the project prioritization process by incorporating well-defined, objective evaluation criteria into the decision-making process, and (3) to reduce inequality in the allocation of transportation project funds between the local jurisdictions. We demonstrate that the innovative change in the project prioritization process was clearly successful in accomplishing objectives 1 and 2, but does not appear to be successful with respect to accomplishing objective 3. The findings are discussed in the context of the state of Vermont, and we offer suggestions for how funding inequality might be addressed in the future. [ABSTRACT FROM AUTHOR]

The northeast U.S. extratropical cyclone of 8-9 February 2013 produced blizzard conditions and more than 0.6-0.9 m (2-3 ft) of snow from Long Island through eastern New England. A surprising aspect of this blizzard was the development and rapid weakening of a snowband to the northwest of the cyclone center with radar ref lectivity factor exceeding 55 dB Z. Because the radar reflectivity within snowbands in winter storms rarely exceeds 40 dB Z, this event warranted further investigation. The high radar reflectivity was due to mixed-phase microphysics in the snowband, characterized by high differential reflectivity ( ZDR > 2 dB) and low correlation coefficient (CC < 0.9), as measured by the operational dual-polarization radar in Upton, New York (KOKX). Consistent with these radar observations, heavy snow and ice pellets (both sleet and graupel) were observed. Later, as the reflectivity decreased to less than 40 dB Z, surface observations indicated a transition to primarily high-intensity dry snow, consistent with lower-tropospheric cold advection. Therefore, the rapid decrease of the 50+ dB Z reflectivity resulted from the transition from higher-density, mixed-phase precipitation to lower-density, dry-snow crystals and aggregates. This case study indicates the value that dual-polarization radar can have in an operational forecast environment for determining the variability of frozen precipitation (e.g., ice pellets, dry snow aggregates) on relatively small spatial scales. [ABSTRACT FROM AUTHOR]

The forecast uncertainty of mesoscale snowband formation and evolution is compared using predictions from a 16-member multimodel ensemble at 12-km grid spacing for the 25 December 2002, 12 February 2006, and 14 February 2007 northeast U.S. snowstorms. Using these predictions, the case-to-case variability in the predictability of band formation and evolution is demonstrated. Feature-based uncertainty information is also presented as an example of what may be operationally feasible from postprocessing information from future short-range ensemble forecast systems. Additionally, the initial condition sensitivity of band location in each case is explored by contrasting the forecast evolutions of initial condition members with large differences in snowband positions. Considerable uncertainty in the occurrence, and especially timing and location, of band formation and subsequent evolution was found, even at forecast projections <24 h. The ensemble provided quantitative mesoscale band uncertainty information, and differentiated between high-predictability (14 February 2007) and low-predictability (12 February 2006) cases. Among the three cases, large (small) initial differences in the upper-level PV distribution and surface mean sea level pressure of the incipient cyclone were associated with large (small) differences in forecast snowband locations, suggesting that case-to-case differences in predictability may be related to the quality of the initial conditions. The complexity of the initial flow may also be a discriminator. Error growth was evident in each case, consistent with previous mesoscale predictability research, but predictability differences were not correlated to the degree of convection. Discussion of these results and future extensions of the work are presented. [ABSTRACT FROM AUTHOR]

Recent studies have documented that vibrators are an important part of the sexual repertoires of both men and women and have demonstrated positive sexual health outcomes among individuals who use such products. However, little is known about the use of other sexual enhancement products, particularly among gay and bisexually identified men. This study sought to document the extent to which gay and bisexually identified men report using sex toys and the sexual and relational situations within which they used them. Data were collected via an internet-based survey from 25,294 gay and bisexually identified men throughout the U.S. recruited from an Internet site popular among men seeking social or sexual interactions with other men. A majority (78.5%) of gay and bisexually identified men reported having used at least one type of sex toy, including dildos (62.1%), non-vibrating cock rings (51.9%), vibrators (49.6%), butt plugs (34.0%), masturbation sleeves (27.9%), and anal beads or balls (19.3%). Among users, toys such as dildos or butt plugs were commonly inserted into one's own anus during masturbation (95.7%, n = 11,781) and insertion into their partners anus (72.0% n = 4,197) during partnered sexual activities. These data suggest that sex toy use is common among gay and bisexual men during both solo and partnered sexual activities and considered by these men as enhancing the quality of their sexual experiences. [ABSTRACT FROM AUTHOR]

Background: In 2010, the iPrEx trial demonstrated that oral antiretroviral pre-exposure prophylaxis (PrEP) reduced the risk of HIV acquisition among high-risk men who have sex with men (MSM). The impact of iPrEx on PrEP knowledge and actual use among at-risk MSM is unknown. Online surveys were conducted to assess PrEP awareness, interest and experience among at-risk MSM before and after iPrEx, and to determine demographic and behavioral factors associated with these measures. Methods and Findings: Cross-sectional, national, internet-based surveys were administered to U.S. based members of the most popular American MSM social networking site 2 months before (n = 398) and 1 month after (n = 4 558) publication of iPrEx results. Comparisons were made between these samples with regards to PrEP knowledge, interest, and experience. Data were collected on demographics, sexual risk, and experience with post-exposure prophylaxis (PEP). Regression analyses were performed to identify factors associated with PrEP awareness, interest, and experience post-iPrEx. Most participants were white, educated, and indicated high-risk sexual behaviors. Awareness of PrEP was limited pre- and postiPrEx (13% vs. 19%), whereas interest levels after being provided with a description of PrEP remained high (76% vs. 79%). PrEP use remained uncommon (0.7% vs. 0.9%). PrEP use was associated with PEP awareness (OR 7.46; CI 1.52-36.6) and PEP experience (OR 34.2; CI 13.3-88.4). PrEP interest was associated with older age (OR 1.01; CI 1.00-1.02), unprotected anal intercourse with ≥1 male partner in the prior 3 months (OR 1.40; CI 1.10-1.77), and perceiving oneself at increased risk for HIV acquisition (OR 1.20; CI 1.13-1.27). Conclusions: Among MSM engaged in online networking, awareness of PrEP was limited 1 month after the iPrEx data were released. Utilization was low, although some MSM who reported high-risk behaviors were interested in using PrEP. Studies are needed to understand barriers to PrEP utilization by at-risk MSM. [ABSTRACT FROM AUTHOR]

The NOAA Hazardous Weather Testbed (HWT) conducts annual spring forecasting experiments organized by the Storm Prediction Center and National Severe Storms Laboratory to test and evaluate emerging scientific concepts and technologies for improved analysis and prediction of hazardous mesoscale weather. A primary goal is to accelerate the transfer of promising new scientific concepts and tools from research to operations through the use of intensive real-time experimental forecasting and evaluation activities conducted during the spring and early summer convective storm period. The 2010 NOAA/HWT Spring Forecasting Experiment (SE2010), conducted 17 May through 18 June, had a broad focus, with emphases on heavy rainfall and aviation weather, through collaboration with the Hydrometeorological Prediction Center (HPC) and the Aviation Weather Center (AWC), respectively. In addition, using the computing resources of the National Institute for Computational Sciences at the University of Tennessee, the Center for Analysis and Prediction of Storms at the University of Oklahoma provided unprecedented real-time conterminous United States (CONUS) forecasts from a multimodel Storm-Scale Ensemble Forecast (SSEF) system with 4-km grid spacing and 26 members and from a 1-km grid spacing configuration of the Weather Research and Forecasting model. Several other organizations provided additional experimental high-resolution model output. This article summarizes the activities, insights, and preliminary findings from SE2010, emphasizing the use of the SSEF system and the successful collaboration with the HPC and AWC. A supplement to this article is available online (DOI:) [ABSTRACT FROM AUTHOR]

This paper investigates the application of linear regression models and modeling techniques in predicting freight generation at the national level within the U.S. Specifically, the paper seeks to improve the performance and fit of linear regression models of freight generation. We provide insight into different variable transformation techniques, evaluate the use of spatial regression variables, and apply a spatial regression modeling methodology to correct for spatial autocorrelation. We conclude that the spatial regression model is the preferred specification for freight generation at the national level. The proliferation of Geographic Information Systems (GIS) within planning agencies affords more widespread use of spatial regression and our results indicate this technique would provide improvement to models that have been traditionally limited by insufficient data. [ABSTRACT FROM AUTHOR]

Circumcision's potential link to HIV/sexually transmitted infections (STI) has been at the center of recent global public health debates. However, data related to circumcision and sexual health remain limited, with most research focused on heterosexual men. This study sought to assess behavioral differences among a large sample of circumcised and noncircumcised men who have sex with men (MSM) in the United States. Data were collected from 26,257 U.S. MSM through an online survey. Measures included circumcision status, health indicators, HIV/STI screening and diagnosis, sexual behaviors, and condom use. Bivariate and regression analyses were conducted to determine differences between HIV/STI status, sexual behaviors, and condom use among circumcised and noncircumcised men. Circumcision status did not significantly predict HIV testing ( p > 0.05), or HIV serostatus ( p > 0.05), and there were no significant differences based on circumcision status for most STI diagnosis [syphilis, gonorrhea, chlamydia, human papilloma virus (HPV)]. Being noncircumcised was predictive of herpes-2 diagnosis, however, condom use mediated this relationship. These data provide one of the first large national assessments of circumcision among MSM. While being noncircumcised did not increase the likelihood of HIV and most STI infections, results indicated that circumcision was associated with higher rates of condom use, suggesting that those who promote condoms among MSM may need to better understand condom-related behaviors and attitudes among noncircumcised men to enhance the extent to which they are willing to use condoms consistently. [ABSTRACT FROM AUTHOR]

This essay considers the process of remediation in two North American reproductions of the song-and-dance sequence from the 1965 “Bollywood” film The song was used in the opening sequence of the 2001 U.S. independent film as a familiar-but-strange object of ironic bewilderment and fantasy for its alienated teenage protagonist Enid. But a decade before 's release, had already become the lynchpin of a complex debate about cultural appropriation and multicultural identity for an “alternative” audience in the United States. I illustrate this through an ethnographic analysis of a 1994 videotape of the Heavenly Ten Stems, an experimental rock band in San Francisco, whose performance of the song was disrupted by a group of activists who perceived their reproduction as a mockery. How is Bollywood film song, often itself a kitschy send-up of American popular culture, remediated differently for different projects of reception? How do these cycles of appropriation create overlapping conditions for new identities—whether national, diasporic, or “alternative”—within the context of transcultural media consumption? In drawing out the “ghost world” of Bollywood's juxtapositions, I argue that the process of remediation produces more than just new forms and meanings of media, but is constitutive of the cosmopolitan subjects formed in its global circulations. [ABSTRACT FROM AUTHOR]

The role of moist processes in regulating mesoscale snowband life cycle within the comma head portion of three northeast U.S. cyclones is investigated using piecewise potential vorticity (PV) inversion, modeling experiments, and potential temperature tendency budgets. Snowband formation in each case occurred along a mesoscale trough that extended poleward of a 700-hPa low. This 700-hPa trough was associated with intense frontogenetical forcing for ascent. A variety of PV evolutions among the cases contributed to midlevel trough formation and associated frontogenesis. However, in each case the induced flow from diabatic PV anomalies accounted for a majority of the midlevel frontogenesis during the band’s life cycle, highlighting the important role that latent heat release plays in band evolution. Simulations with varying degrees of latent heating show that diabatic processes associated with the band itself were critical to the development and maintenance of the band. However, changes in the meso-α-scale flow associated with the development of diabatic PV anomalies east of the band contributed to frontolysis and band dissipation. Conditional stability was reduced near 500 hPa in each case several hours prior to band formation. This stability remained small until band formation, when the stratification generally increased in association with the release of conditional instability. Previous studies have suggested that the dry slot is important for the initial stability reduction at midlevels, but this was not evident for the three banding cases examined. Rather, differential horizontal temperature advection in moist southwest flow ahead of the upper trough was the dominant process that reduced the midlevel conditional stability. [ABSTRACT FROM AUTHOR]

Key results of a comprehensive survey of U.S. National Weather Service operational forecast managers concerning the assessment and communication of forecast uncertainty are presented and discussed. The survey results revealed that forecasters are using uncertainty guidance to assess uncertainty, but that limited data access and ensemble underdispersion and biases are barriers to more effective use. Some respondents expressed skepticism as to the added value of formal ensemble guidance relative to simpler approaches of estimating uncertainty, and related the desire for feature-specific ensemble verification to address this skepticism. Respondents reported receiving requests for uncertainty information primarily from sophisticated users such as emergency managers, and most often during high-impact events. The largest request for additional training material called for simulator-based case studies that demonstrate how uncertainty information should be interpreted and communicated. Respondents were in consensus that forecasters should be significantly involved in the communication of uncertainty forecasts; however, there was disagreement regarding if and how forecasters should adjust objective ensemble guidance. It is contended that whether forecasters directly modify objective ensemble guidance will ultimately depend on how the weather enterprise views ensemble output (as the final forecast or as a guidance supporting conceptual understanding), the enterprise’s commitment to provide the necessary supporting forecast infrastructure, and how rapidly ensemble weaknesses such as underdispersion, biases, and resolution are addressed. The survey results illustrate that forecasters’ operational uncertainty needs are intimately tied to the end products and services they produce. Thus, it is critical that the process to develop uncertainty information in existing or new products or services be a sustained collaborative effort between ensemble developers, forecasters, academic partners, and users. As the weather enterprise strives to provide uncertainty information to users, it is asserted that addressing the forecaster needs identified in this survey will be a prerequisite to achieve this goal. [ABSTRACT FROM AUTHOR]

An ingredients-based, time- and scale-dependent forecast strategy for anticipating cold season mesoscale band formation within eastern U.S. cyclones is presented. This strategy draws on emerging conceptual models of mesoscale band development, advances in numerical weather prediction, and modern observational tools. As previous research has shown, mesoscale band development is associated with frontogenesis in the presence of weak moist symmetric stability and sufficient moisture. These three parameters—frontogenesis, weak moist symmetric stability, and moisture—are used as the ingredients for identifying mesoscale band development in this strategy. At forecast projections beyond 2 days, the strategy assesses whether cyclogenesis is expected. Within 2 days of the event, the strategy places the band ingredients in the context of the broader synoptic flow, with attention to where deformation zones are present, to assess whether banding is possible. Within 1 day of the event, the strategy focuses on assessment of the ingredients to outline when and where band formation is favored. Plan-view and cross-sectional analyses of gridded model fields in conjunction with high-resolution model guidance are used to assess the likelihood of banding and to outline the threat area. Within 12 h, short-range forecasts of the band ingredients are evaluated in concert with observations to make specific band predictions. Particular emphasis is placed on the evolution of the frontogenetic forcing and moist symmetric stability. During the event, trends in observations and short-range model forecasts are used to anticipate the movement, intensity, and dissipation of the band. The benefits and practical challenges associated with the proposed strategy are illustrated through its operational application to the 25 December 2002 northeast U.S. snowstorm, during which intense mesoscale snowband formation occurred. Forecast products from this event demonstrate how the forecast strategy can lead to heightened situational awareness, in this case resulting in accurate band forecasts. This application shows that accurate operational forecasts of mesoscale bands can be made based on our current conceptual understanding, observational tools, and modeling capabilities. [ABSTRACT FROM AUTHOR]

This paper is the first of two papers that examines the organization of the precipitation field in central U.S. cold-season cyclones involving inverted troughs. The first portion of the study examines the varying precipitation distribution that occurred during a 6-yr synoptic climatology of inverted trough cases. The definition of inverted trough cases has been expanded from the groundbreaking work by Keshishian et al. by 1) not requiring a closed cyclonic isobar along the frontal wave along the conventional surface front and 2) not requiring a surface thermal gradient to be present along the inverted trough. Only 8.5% of the expanded dataset produced the precipitation primarily occurring to the west of the inverted trough ("behind" cases) as seen in Keshishian et al. The largest group of cases, comprising about 40% of the cases, produced precipitation that primarily occurred between the inverted trough and the conventional warm front ("ahead" cases). A composite study compared a subset of the ahead cases with a subset of the behind cases. The ahead cases tended to be more progressive with a stronger jet stream located over the center of the parent low. Broad warm-air advection and frontogenesis in the lower troposphere were observed between the inverted trough and the surface warm front. Cold-air advection to the west of the inverted trough precluded the development of "wraparound precipitation." In contrast, the behind cases had a stronger low-latitude wave couplet with a trough upstream of the surface low and a ridge downstream. The region of warm-air advection and frontogenesis were displaced to the west of the inverted trough and surface cyclone. In addition, the entrance region of a southwest-northeast-oriented jet streak aided the development of ascent to the west of the inverted trough while precluding the development of precipitation to the north of the conventional warm front. Thus, the inverted trough tended to act like a warm front in behind cases,... [ABSTRACT FROM AUTHOR]

US men who have sex with men (n = 1848) completed an online questionnaire about their willingness to use Internet-based partner notification. Eighty-one percent reported that it would be important to them to receive a partner notification e-mail if they had been exposed to a sexually transmitted infection. Seventy percent reported that if infected, they would use a public health specialist to inform partners of possible exposure through Internet notification. There was broad acceptance of Internet partner notification by at-risk US men who have sex with men, including a willingness to receive or initiate a notification e-mail. (Am J Public Health. 2008;98:1009-1011. doi:10.2105/AJPH.2006.098467) [ABSTRACT FROM AUTHOR]

• Introduces a novel iterative heuristic for clustering, allocation and routing of snow and ice control vehicles. • Heuristic addresses important real-world operational constraints. • Heuristic incorporates a continuous measure of link criticality within the allocation step. • The link-criticality measure is shown to improve the time it takes to service the most critical links in an application to the state of Vermont's roadway network. • The application also shows that advanced vehicle-allocation methods can be more effective at improving snow and ice control service than adding trucks to the fleet. Many states in the U.S. have experienced increased demand for roadway snow and ice control (RSIC) operations due to an increase in extreme winter weather. As the number and severity of extreme weather events increases, the costs associated with winter roadway maintenance materials, plow operator time, equipment maintenance and replacement, and fuel use will also increase. In this paper, we introduce a unique heuristic procedure which we combine with real-world operational constraints to advance both the modeling and practical application of RSIC operations by incorporating a continuous measure of priority into a sequenced, iterative heuristic for network clustering, vehicle allocation, and capacitated vehicle routing. The heuristic balances the competing objectives of minimizing the total vehicle hours traveled for the fleet and minimizing the total time required to service the most critical links in the roadway network, while ensuring that the entire fleet is put to use. We also introduce a new measure of route-system performance, which is based on an effective link length (adjusted for how critical the link is to the performance of the entire system) and the time it takes to service the most critical links. We demonstrate the approach in practice by running five different applications of the heuristic on the statewide roadway network in Vermont. We demonstrate conclusively that our heuristic is effective for servicing the most critical links in the network in the least amount of time. We show that our more advanced vehicle allocation methods result in more effective RSIC service operations than adding vehicles to the fleet. [ABSTRACT FROM AUTHOR]

Latino men represent a quickly growing segment of the U.S. population. As such, it is important to document the health of these individuals. Data were collected from one of the largest gay networking Web sites in the U.S. Using multivariate logistic regression relationships between participant characteristics and sexual health outcomes and behaviors were examined. The sample included 1,880 Latino men self-identifying as gay (83.7%) and bisexual (16.3%). Findings suggest the majority of men had not tested positive for any STD (86.8 - 92.0%) or HIV (79.9%), however overall STD testing was low (33.9%) compared to HIV testing (55.6%) during the previous year. Additionally, education level, employment, sexual orientation, and relationship status significantly influenced a variety of sexual behaviors and sexual health outcomes. [ABSTRACT FROM AUTHOR]

The article evaluates the Department of Health Internet-based Partner Notification (IPN) program of Washington, D.C. on early syphilis infections. It states that the evaluation makes use of the standard Centers for Disease Control and Prevention (CDC) Disease Investigation Specialist (DIS) disposition codes. The study shows that 43% of the sex partners that are investigated are via IPN, which leads to an eight percent increase in the overall number of syphilis patients.

Background: The structure of the sexual networks and partnership characteristics of young black men who have sex with men (MSM) may be contributing to their high risk of contracting HIV in the United States. Assortative mixing, which refers to the tendency of individuals to have partners from one's own group, has been proposed as a potential explanation for disparities., Objective: The objective of this study was to identify the age- and race-related search patterns of users of a diverse geosocial networking mobile app in seven metropolitan areas in the United States to understand the disparities in sexually transmitted infection and HIV risk in MSM communities., Methods: Data were collected on user behavior between November 2015 and May 2016. Data pertaining to behavior on the app were collected for men who had searched for partners with at least one search parameter narrowed from defaults or used the app to send at least one private chat message and used the app at least once during the study period. Newman assortativity coefficient (R) was calculated from the study data to understand assortativity patterns of men by race. Pearson correlation coefficient was used to assess assortativity patterns by age. Heat maps were used to visualize the relationship between searcher's and candidate's characteristics by age band, race, or age band and race., Results: From November 2015 through May 2016, there were 2,989,737 searches in all seven metropolitan areas among 122,417 searchers. Assortativity by age was important for looking at the profiles of candidates with correlation coefficients ranging from 0.284 (Birmingham) to 0.523 (San Francisco). Men tended to look at the profiles of candidates that matched their race in a highly assortative manner with R ranging from 0.310 (Birmingham) to 0.566 (Los Angeles). For the initiation of chats, race appeared to be slightly assortative for some groups with R ranging from 0.023 (Birmingham) to 0.305 (Los Angeles). Asian searchers were most assortative in initiating chats with Asian candidates in Boston, Los Angeles, New York, and San Francisco. In Birmingham and Tampa, searchers from all races tended to initiate chats with black candidates., Conclusions: Our results indicate that the age preferences of MSM are relatively consistent across cities, that is, younger MSM are more likely to be chatted with and have their profiles viewed compared with older MSM, but the patterns of racial mixing are more variable. Although some generalizations can be made regarding Web-based behaviors across all cities, city-specific usage patterns and trends should be analyzed to create targeted and localized interventions that may make the most difference in the lives of MSM in these areas., (©Nadia N Abuelezam, Yakir A Reshef, David Novak, Yonatan Hagai Grad, George R Seage III, Kenneth Mayer, Marc Lipsitch. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.09.2019.)

Introduction: Pre-exposure prophylaxis (PrEP), taken as a single daily coformulated pill containing tenofovir -emtricitabine, is a promising intervention to reduce the likelihood of HIV acquisition in at-risk individuals, including men who have sex with men. Little is known about the acceptability of less than daily, intermittent PrEP regimens., Methods: We conducted an online survey of North American men who have sex with men to characterize their sexual frequency and planning behaviors and correlate these with PrEP dosing preferences., Results: Of the 3217 respondents who completed the survey, 46% reported engaging in unplanned condomless anal intercourse (CAI) at least once in previous 3 months and 8% reported engaging in CAI more than once per week. In multivariable analysis, reporting unplanned CAI was associated with lower educational level, identifying as homosexual/gay as compared with bisexual, being in a monogamous relationship, having a higher self-perceived risk of HIV acquisition, reporting higher income, engaging in CAI more than five times in the last 3 months, and not having visited a health care provider in the previous year. Frequent CAI (>1 time per week) was associated with being younger, identifying as homosexual/gay as compared with bisexual, being in a monogamous relationship, and having a higher self-perceived risk of HIV. Having only planned sex over the last 3 months was associated with a preference for event-based PrEP, whereas having frequent or unplanned CAI was associated with a preference for daily or time-driven PrEP regimens, respectively., Conclusion: Our findings suggest that preferences for different PrEP regimens are associated with the sexual frequency and planning behaviors of potential users.

Background: Stigmatizing social environments (of which 'structural stigma' is one component) negatively affect health-related outcomes. However, few studies have examined structural stigma related to sexual minority status as a risk factor for HIV outcomes among MSM., Methods: In August 2013, members of a large MSM social and sexual networking site in the United States completed a survey about HIV-prevention practices. A previously validated composite index provided values for state-level structural stigma, including density of same-sex couples, proportion of public high schools with Gay-Straight Alliances, state laws protecting sexual minorities, and public opinion toward homosexuality. Multivariable logistic generalized estimating equations assessed the relationship between structural stigma and condomless anal intercourse, use and awareness of antiretroviral-based HIV-prevention strategies (i.e. pre and postexposure prophylaxis, or PEP and PrEP), and comfort discussing male-male sex with primary care providers., Results: Among the 4098 HIV-uninfected MSM, lower state-level structural stigma was associated with decreased odds of condomless anal intercourse [adjusted odds ratio (aOR) 0.97 per one unit increase in structural stigma score, 95% confidence interval (CI) 0.94-0.99], increased odds of awareness of PEP (aOR 1.06, 95% CI 1.02-1.09), and PrEP (aOR 1.06, 95% CI 1.02-1.10), having taken PEP (aOR 1.15, 95% CI 1.05-1.26) and PrEP (aOR 1.21, 95% CI 1.01-1.44), and comfort discussing male-male sex with providers (aOR 1.08, 95% CI 1.05-1.11), after adjusting for social and state-level confounders., Conclusion: MSM living in more stigmatizing environments had decreased use of antiretroviral-based HIV-prevention strategies compared to those in less stigmatizing environments. Legal reforms protecting sexual minorities should be evaluated as structural interventions that could reduce HIV risk among MSM.

Introduction: Recent reports indicate that vibrator use during solo and partnered sexual activities is common among heterosexual men and women in the United States. However, little research has comprehensively assessed vibrator use among gay and bisexually identified men., Aims: This study sought to document the extent to which gay and bisexually identified men report using vibrators, the sexual and relational situations within which they use them, and how men use vibrators on their own and their partners' bodies., Methods: Data were collected from 25,294 gay and bisexually identified men from 50 U.S. states and from the District of Columbia via an internet-based survey., Main Outcome Measure: Measures included sociodemographics, health-related indicators, sexual behaviors, and those related to recent and past use of vibrators during solo and partnered sexual interactions with other men., Results: Approximately half (49.8%) of gay and bisexually identified men reported having used vibrators. Most men who had used a vibrator in the past reported use during masturbation (86.2%). When used during partnered interactions, vibrators were incorporated into foreplay (65.9%) and intercourse (59.4%). Men reported frequent insertion of vibrators into the anus or rectum when using them during masturbation (87.3%), which was also common during partnered interactions (∼60%), but varied slightly for casual and relationship sex partners. For both masturbation and partnered interactions, men overwhelmingly endorsed the extent to which vibrator use contributed to sexual arousal, orgasm, and pleasure., Conclusions: Vibrator use during both solo and partnered sexual acts was common among the gay and bisexually identified men in this sample and was described by men as adding to the quality of their sexual experiences., (© 2010 International Society for Sexual Medicine.)

An analysis of traditional Jewish texts yields neither the capitalist notion of medicine nor the socialist one. Neither alternative is sufficient to ground the respect for the sanctity of the human person as a being created in the image of God that is so rationally appealing. That is why the Jewish ethical tradition, which is based on this respect for the sanctity of human personhood, both individual and collective, is so attractive--if only for its insights, rather than its authority; its guidance, rather than its governance.