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Introduction Despite older adults (age ≥50 years) continuing to account for 1 in 6 new HIV diagnoses, the majority of research has focused on young adults. Assessing PrEP use and stigma among this understudied population is key to achieving the U.S.’s goals of Ending the HIV Epidemic, a federal initiative focusing on reducing new HIV infections by at least 90% by 2030. Methods Data for this analysis came from the Columbus Health Aging Project ( N = 794). This study was designed to assess several domains of health among adults aged 50 years and older in Columbus, Ohio. Multiple logistic and linear regression models were used to examine the associations between sociodemographic factors and past 6-month PrEP use, PrEP stigma, and concurrent use of PrEP and other prevention methods, adjusting for known confounders. Results Overall, 93 (11.7%) participants reported past 6-month PrEP use. Transgender women (aOR = 6.90; 95% CI: 2.19, 21.72), cisgender gay men (aOR = 5.58; 95% CI: 2.49, 12.50), cisgender lesbians (aOR = 2.24; 95% CI: 1.05, 4.80), and those living with family members or roommates (aOR = 6.59; 95% CI: 3.49, 12.45) were each more likely to report past 6-month PrEP use relative to cisgender women, heterosexuals, and those living with a spouse/partner, respectively. Relative to cisgender women, PrEP-related stigma was lower among transgender women (β = −5.05; 95% CI: −8.44, −1.66) and higher among cisgender men (β = 1.96; 95% CI: 0.46, 3.46). Conclusion Future research should aim to continue developing a firm understanding of PrEP use and stigma among older adults to reduce HIV risk among this population and to understand unique needs of sub-populations of older adults.

PURPOSE: Sexual minority (SM) older adults report poorer mental health than their heterosexual peers. While all older adults can experience age discrimination and other aging concerns (e.g., functional decline), SM older adults also experience sexual orientation-related discrimination and aging concerns (e.g., that they will have to be less open about their sexual orientation to get support as they age). The goals of this study were to examine the roles of (1) sexual orientation and age discrimination and (2) sexual orientation-specific and general aging concerns in depression and anxiety among SM older adults. METHODS: As part of a larger study, 477 SM older adults (aged ≥50 years) completed an online survey in September 2021. The majority were gay/lesbian (83%), cisgender men (40%) or cisgender women (34%), and non-Latinx White (39%) or Latinx (34%). Analyses controlled for age, sexual orientation, gender identity, and race/ethnicity. RESULTS: Sexual orientation discrimination and age discrimination were positively associated with depression and anxiety. A significant interaction indicated that sexual orientation discrimination was positively associated with anxiety at low, moderate, and high levels of age discrimination, but the association was strongest at the low level. Sexual orientation-specific and general aging concerns were also positively associated with depression and anxiety. Significant interactions indicated that sexual orientation-specific aging concerns were associated with higher depression and anxiety at low and moderate, but not high, levels of general aging concerns. CONCLUSIONS: A range of factors contribute to mental health among SM older adults and there are complex relationships between general and sexual orientation-specific factors.

Past research has suggested that sexual and gender minorities experience elevated levels of systemic inflammation which in turn has been linked to worse mental health outcomes. Therefore, the goals of this work are to develop a better understanding of the relationship between mental health variables and inflammation among this high-risk population. Data were collected among a sample of young men who have sex with men and transgender women (YMSM/TGW,N= 685) aged 16–20 at the time of enrollment. Multiplex plasma cytokine and inflammatory biomarkers were quantified. Mental health variables were self-reported and included perceived stress, depression, and suicidal ideation. Latent profile analyses (i.e., latent class analyses intended for continuous variables) were utilized to identify four unique profiles of individuals with similar inflammatory markers followed by adjusted multinomial logistic regression to estimate the association between inflammatory profiles and mental health variables. Participants experienced moderate levels of perceived stress, normal levels of depression and ten percent reported suicidal ideation in the past 6 months. Multinomial regression models indicated that being in the highest inflammation profile, compared to the lowest inflammation profile, was significantly associated only with increased perceived stress and suicidal ideation. In sum, we observed significant relationships between inflammation and both perceived stress and suicidal ideation, but not between inflammation and depression. Future research should continue to assess these relationships using longitudinal data as they are intricate and likely bidirectional and may be key to reducing health disparities among this population.

Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals are disproportionately impacted by the HIV epidemic. Uptake and adherence to pre-exposure prophylaxis (PrEP) is suboptimal among SMMGD Black and Hispanic/Latino individuals, but most research has approached this population as homogenous (e.g., a group operationalized as men who have sex with men). Bisexual men are less likely to disclose their sexual identity and report more mental health problems than their gay counterparts, but there is less attention to the impact of different sexual identities on PrEP use over time. We utilized data from three waves of a national longitudinal study (2020-2021) to characterize Black and Hispanic/Latino SMMGD participants' PrEP use including: 1) PrEP uptake during the study; 2) consistent PrEP use across the study; and 3) discontinuation of PrEP use since study baseline. We found bisexual men were significantly less likely than gay men to be consistent PrEP users and were more likely to discontinue PrEP use over the course of the study. Of the sample who reported PrEP use across surveys, 10% initiated PrEP during the study period, 0% of whom were bisexual. Additionally, bisexual participants reported statistically significantly higher anticipated PrEP stigma relative to gay participants. These findings have implications for HIV prevention interventions. Given the differences in PrEP experiences as a function of sexual identity, researchers and clinicians should consider the disruptive role of stigma (both biphobia and anticipated PrEP stigma) in PrEP care and adherence.

Head and neck squamous cell carcinoma (HNSCC) remains a prevalent diagnosis with current treatment options that include radiotherapy and immune-mediated therapies, in which tumor necrosis factor-α (TNFα) is a key mediator of cytotoxicity. However, HNSCC and other cancers often display TNFα resistance due to activation of the canonical IKK–NFκB/RELA pathway, which is activated by, and induces expression of, cellular inhibitors of apoptosis proteins (cIAPs). Our previous studies have demonstrated that the IAP inhibitor birinapant sensitized HNSCC to TNFα-dependent cell death in vitro and radiotherapy in vivo. Furthermore, we recently demonstrated that the inhibition of the G2/M checkpoint kinase WEE1 also sensitized HNSCC cells to TNFα-dependent cell death, due to the inhibition of the pro-survival IKK-NFκB/RELA complex. Given these observations, we hypothesized that dual-antagonist therapy targeting both IAP and WEE1 proteins may have the potential to synergistically sensitize HNSCC to TNFα-dependent cell death. Using the IAP inhibitor birinapant and the WEE1 inhibitor AZD1775, we show that combination treatment reduced cell viability, proliferation and survival when compared with individual treatment. Furthermore, combination treatment enhanced the sensitivity of HNSCC cells to TNFα-induced cytotoxicity via the induction of apoptosis and DNA damage. Additionally, birinapant and AZD1775 combination treatment decreased cell proliferation and survival in combination with radiotherapy, a critical source of TNFα. These results support further investigation of IAP and WEE1 inhibitor combinations in preclinical and clinical studies in HNSCC.

OBJECTIVES: We examined whether molecular cluster membership was associated with public health identification of HIV transmission potential among named partners in Chicago. DESIGN: Historical cohort study METHODS: We matched and analyzed HIV surveillance and partner services data from HIV diagnoses (2012–2016) prior to implementation of cluster detection and response interventions. We constructed molecular clusters using HIV-TRACE at a pairwise genetic distance threshold of 0·5% and identified clusters exhibiting recent and rapid growth according to the CDC’s definition (3 new cases diagnosed in past year). Factors associated with identification of partners with HIV transmission potential were examined using multivariable Poisson regression. RESULTS: There were 5,208 newly diagnosed index clients over this time period. Average age of index clients in clusters was 28; 47% were Black, 29% Latinx/Hispanic, 6% female and 89% men who have sex with men (MSM). Of the 537 named partners, 191 (35·6%) were linked to index cases in a cluster and of those 16% were either new diagnoses or viremic. There was no statistically significant difference in the probability of identifying partners with HIV transmission potential among index clients in a rapidly growing cluster versus those not in a cluster (adjusted Relative Risk 1·82, (0·81–4·06)). CONCLUSION: Partner services that were initiated from index clients in a molecular cluster yielded similar new HIV case finding or identification of those with viremia as did interviews with index clients not in clusters. It remains unclear whether these findings are due to temporal disconnects between diagnoses and cluster identification, unobserved cluster members, or challenges with partner services implementation.

BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; men who have sex with men (MSM) have higher prevalence of infection and related disease compared with other men. We assessed whether differences in HPV acquisition exist among MSM according to their sexual positioning practices, as well as self-reported receipt of HPV vaccination. METHODS We enrolled young MSM and transgender women aged 18 to 26 years in Chicago, IL (N = 666). Participants self-reported their history of HPV vaccination and submitted self-collected anal swab specimens for type-specific HPV detection using an L1-consensus PCR assay. Multivariable logistic regression analyses were used to assess relationships between sexual positioning practices and detection of any HPV or quadrivalent HPV vaccine (4vHPV) types by vaccination status, defined as self-reported receipt of ≥1 HPV vaccine dose versus none. RESULTS Among 666 participants, 400 (60.1%) had any anal HPV, and 146 (21.9%) had a 4vHPV type. Among vaccinated participants, 18, 36, and 177 reported exclusively insertive, exclusively receptive, or both sexual positioning practices, respectively. Compared with participants reporting exclusively insertive anal sex, odds of any HPV were significantly higher among participants engaging exclusively in receptive anal sex (adjusted odds ratio [aOR], 5.90; 95% confidence interval [CI], 2.52-13.78), as well as those engaging in both (aOR, 3.32; 95% CI, 1.71-6.44). Vaccinated participants, compared with unvaccinated participants, had lower odds of 4vHPV-type HPV regardless of sexual positioning practices (aOR, 0.56; 95% CI, 0.34-0.92). CONCLUSIONS Adult men and transgender women who practice anal receptive sex have high prevalence of infection with any HPV. Routine vaccination of all adolescents is expected to reduce HPV-related disease incidence among adult MSM and transgender women as vaccinated cohorts age.

Background: There is a high rate of marijuana use among young sexual and gender minorities (SGM) and, as a result of recent state-level, fragmented marijuana laws, there is also likely high variability in their perceptions of marijuana decriminalization (PMD). Methods: Data came from two cohorts of young SGM (aged 16–29) in Chicago, RADAR and FAB400, recruited from 2015 to 2017 (N=1,114). We developed a measure to assess PMD among this population, performed initial validation, and assessed its relationship to longitudinal changes in patterns of marijuana use and geographic distribution. Results: In multivariable models, mean PMD score was prospectively associated with general (adjusted odds ratio [aOR]=2.00; 95% confidence interval [CI]: 1.46–2.77), but not problematic marijuana use. An increase in perceived decriminalization also predicted a significant increase in odds of general (aOR=1.67; 95% CI: 1.18–2.39) marijuana use. Significant concentrations of high PMD scores existed in across the city. Conclusion: These results suggest further study of longitudinal changes in marijuana use as decriminalization or legalization increases in the U.S. to better understand shifting trends in use.

Purpose: Heightened rates of prescription opioid misuse have been observed among sexual minority (SM) compared with heterosexual populations. In addition, depression and suicidal ideation are risk factors for misuse, and they are also elevated among SM populations. The purpose of this analysis was to examine whether depression and suicidal ideation attenuate disparities in prescription opioid misuse among SM adults. Methods: Data came from a publicly available, nationally representative data set, the National Survey on Drug Use and Health, 2015–2018. Among adults, survey-weighted logistic regression was used to assess the relationship between sexual orientation and past-year opioid misuse adjusting for demographics and either past-year major depressive episode or suicidal ideation. Probabilities of prescription opioid misuse were also assessed under counterfactual rates of depression and suicidal ideation. Analyses were stratified by sex. Results: Among participants in the analytic sample (N = 169,759; SM = 11,268), 9254 (5.5%) reported past-year prescription opioid misuse. The overall rate of opioid misuse decreased from 6.2% in 2015 to 4.6% in 2018. The association between sexual orientation and opioid misuse was attenuated downward for gay men, lesbian women, and bisexual individuals (men and women) after adjusting for either major depressive episode or suicidal ideation, but opioid misuse remained higher among most SM groups. In addition, rates of opioid misuse were found to be lower in counterfactual analyses with a nearly 2.5- and 4-fold decrease in depression and suicidal ideation among gay men and bisexual women, respectively. Conclusion: Efforts to reduce disparities in depression and suicidal ideation affecting SM individuals may reduce disparities in prescription opioid misuse affecting this population.

OBJECTIVE: Sexual and gender minorities (SGM) are at increased risk for substance use and depression. However, little research has examined the directionality of associations between substance use and depression in this high-risk population, and we are not aware of any to parse associations between depression and changes in the frequency of substance use versus substance use cessation. Such research can help to inform the development of future interventions to address health disparities affecting SGM. METHOD: We used data from two longitudinal cohorts of SGM assigned male at birth (SGM-AMAB; N = 1,418) to examine associations between changes in frequency of alcohol, cannabis, and stimulant use and depressive symptoms. Multilevel models tested whether changes in substance use predicted changes in depressive symptoms and vice versa. RESULTS: Results indicate that when SGM-AMAB decreased their alcohol use or ceased alcohol, cannabis, or stimulant use, they experienced concurrent decreases in depressive symptoms. Only reducing stimulant use (not alcohol or cannabis use) was associated with decreases in depressive symptoms over the subsequent 6 months. Depressive symptoms did not prospectively predict cessation or reduction in the use of any substance. CONCLUSIONS: These findings suggest that clinical interventions targeting substance use may simultaneously reduce depressive symptoms and that reductions in alcohol use (even in the absence of cessation) may simultaneously benefit mental health among SGM-AMAB. The limited evidence of prospective effects over 6 months suggests that studies with shorter lags may be better equipped to examine the directionality of the association between depressive symptoms and substance use/reduction.

ObjectivesThis investigation sought to characterise risk factors associated with acquisition of traditional and emerging agents of sexually transmitted infection (STI) in a cohort of young men who have sex with men and transgender women.Methods917 participants provided urine and rectal swab submissions assessed by transcription-mediated amplification (TMA)-based assays for Chlamydia trachomatis and Neisseria gonorrhoeae and by off-label TMA-based Trichomonas vaginalis and Mycoplasma genitalium testing. A subset provided specimens at 6-month and 12-month follow-up visits.ResultsPrevalence of M. genitalium from rectal and urine specimens (21.7% and 8.9%, respectively) exceeded that of C. trachomatis (8.8% and 1.6%) and other STI agents. Black participants yielded higher prevalence of M. genitalium (30.6%) than non-black participants (17.0%; χ²=22.39; pM. genitalium prevalence from rectal specimens was 41.5% in HIV-positive participants vs 16.3% in HIV-negative participants (χ²=57.72; pC. trachomatis (p≥0.10), N. gonorrhoeae (p≥0.29), T. vaginalis (p≥0.18) or M. genitalium (p≥0.20) detection. While prevalence of T. vaginalis was calculated at ≤1.0%, baseline rectal and urine screening status was predictive of detection/non-detection at follow-up. A non-reactive M. genitalium baseline rectal or urine screening result was less predictive of non-reactive follow-up versus C. trachomatis, N. gonorrhoeae and T. vaginalis.ConclusionsRectal M. genitalium detection is associated with black race and HIV seropositivity. Baseline M. genitalium infection influences subsequent detection of the organism.

BACKGROUND This study's purposes were to characterize detection rates of several sexually transmitted infection (STI) agents and describe the effect additional specimen source and analyte screening has on STI detection within a cohort of young men who have sex with men and transgender women. METHODS Within a 16-month interval, 1966 encounters involved dual urine and rectal swab submissions assessed by commercial transcription-mediated amplification-based assays for Chlamydia trachomatis and Neisseria gonorrhoeae and by off-label transcription-mediated amplification-based Trichomonas vaginalis and Mycoplasma genitalium testing. Identification of STI carriers used algorithms involving Food and Drug Administration-cleared screening methods, laboratory-modified testing for extraurogenital C. trachomatis and N. gonorrhoeae, and laboratory-developed tests for T. vaginalis and M. genitalium. RESULTS Food and Drug Administration-indicated urine C. trachomatis and N. gonorrhoeae screening revealed 39 encounters (2.0%) yielding one or both agents. Via C. trachomatis and N. gonorrhoeae screening that included rectal swab analysis, 264 encounters (13.4%) yielded evidence of either (140 C. trachomatis, 88 N. gonorrhoeae) or both (36 participants) infections. Detection rates for C. trachomatis and N. gonorrhoeae were 1.4% and 0.6% for urine screening and 8.2% and 6.2% for rectal screening, respectively. Off-label screening identified 413 additional encounters with STI (5 T. vaginalis, 396 M. genitalium, 12 with both). Of these identifications, 82.1% were generated from analysis of rectal swabs (4 participants with T. vaginalis, 323 participants with M. genitalium, 12 with both). Overall detection rates of T. vaginalis (0.2% urine, 1.3% rectal) and M. genitalium (9.1% urine, 21.5% rectal) were variable. CONCLUSIONS Additive analyte testing, including extraurogenital collections, contributes to comprehensive STI screening within a high-risk demographic.

Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals report lower uptake and adherence to pre-exposure prophylaxis (PrEP) compared with White SMMGD. For some, the COVID-19 pandemic has resulted in reduced access to PrEP prescriptions and related changes to PrEP use, yet little is known how pandemic-related changes to PrEP access and sexual activity might influence sexually transmitted infection (STI) status and HIV seroconversion among SMMGD of color. We used data from 4 waves of a national study of Black and Hispanic/Latino SMMGD's HIV, PrEP, and health experiences to assess whether self-reported changes to sexual activity were associated with STI status, and whether self-reported changes to PrEP access were associated with HIV seroconversion. Those who reported greater impact to their sexual activity during the pandemic [adjusted odds ratio (aOR) = 1.24; 95% confidence interval (CI): 1.10 to 1.40] and a greater number of sexual partners (aOR = 1.29; 95% CI: 1.21 to 1.38) were more likely to report a positive STI test. In addition, we found that compared with those who did not report pandemic-related changes to PrEP access, those who did report changes to PrEP access had significantly higher odds of HIV seroconversion during the study period (aOR = 2.80; 95% CI: 1.02 to 7.68). These findings have implications for HIV and STI prevention and highlight the importance of novel interventions to improve PrEP access among Black and Hispanic/Latino SMMGD. Importantly, these findings also demonstrate the need to stay focused on key populations at risk of HIV infection during emerging public health crises to avoid an increase in rates of new diagnoses.

To date, little research has examined cardiovascular (CVD) risk among young sexual and gender minorities, a population which behavioral research has suggested may be at unique risk of poor CVD outcomes. We assessed behavioral risk factors and biomarkers of CVD risk among young sexual and gender minorities (YSGM) aged 16–29 in Chicago who are participants in the RADAR cohort (analytic N = 936). Multiplex cytokine and inflammatory biomarker assays were run on plasma from all HIV+ participants and demographically-matched HIV- participants (n = 237). Geographic data were used to assess mean C-reactive protein (CRP) level per community area of residence in Chicago. YSGM in this cohort exhibited lower rates of obesity (19.2% in RADAR vs. 35.7% in earlier studies of heterosexual youth) and comparable rates of past 30-day tobacco use (37.9 vs. 38.1%). Conversely, higher rates were observed among several other risk factors including C-reactive protein (mean = 6.9 mg/L vs. 2.1 mg/L), marijuana use (72.5 vs. 45.3%), perceived stress (mean = 15.5 vs. 14.2), and HIV (20.0 vs.

A growing body of evidence suggests that network-based interventions to reduce HIV transmission and/or improve HIV-related health outcomes have an important place in public health efforts to move towards 90–90–90 goals. However, the social processes involved in network-based recruitment may pose a risk to participants of increasing HIV-related stigma if network recruitment causes HIV status to be assumed, inferred, or disclosed. On the other hand, the social processes involved in network-based recruitment to HIV testing may also encourage HIV-related social support. Yet despite the relevance of these processes to both network-based interventions and to other more common interventions (e.g., partner services), there is a dearth of literature that directly examines them among participants of such interventions. Furthermore, both HIV-related stigma and social support may influence participants’ willingness and ability to recruit their network members to the study. This paper examines (1) the extent to which stigma and support were experienced by participants in the Transmission Reduction Intervention Project (TRIP), a risk network-tracing intervention aimed at locating recently HIV-infected and/or undiagnosed HIV-infected people and linking them to care in Athens, Greece; Odessa, Ukraine; and Chicago, Illinois; and (2) whether stigma and support predicted participant engagement in the intervention. Overall, experiences of stigma were infrequent and experiences of support frequent, with significant variation between study sites. Experiences and perceptions of HIV-related stigma did not change significantly between baseline and six-month follow-up for the full TRIP sample, and significantly decreased during the course of the study at the Chicago site. Experiences of HIV-related support significantly increased among recently-HIV-infected participants at all sites, and among all participants at the Odessa site. Both stigma and support were found to predict participants’ recruitment of network members to the study at the Athens site, and to predict participants’ interviewer-rated enthusiasm for naming and recruiting their network members at both the Athens and Odessa sites. These findings suggest that network-based interventions like TRIP which aim to reduce HIV transmission likely do not increase stigma-related risks to participants, and may even encourage increased social support among network members. However, the present study is limited by its associational design and by some variation in implementation by study site. Future research should directly assess contextual differences to improve understanding of the implications of site-level variation in stigma and support for the implementation of network-based interventions, given the finding that these constructs predict participants’ recruitment of network members and engagement in the intervention, and thereby could limit network-based interventions’ abilities to reach those most in need of HIV testing and care.

The number of US adults identifying as lesbian, gay, bisexual, transgender, or a different sexual identity has doubled since 2008, and about 40 % of the sexual and gender minority population identify as people of color. Minority stress theory posits that sexual and gender minorities are at particular risk for stress via stigma and discrimination at the structural, interpersonal, and individual levels. This stress, in turn, elevates the risk of adverse health outcomes across several domains. However, there remains a conspicuously limited amount of research on the psychoneuroimmunology of stress among sexual and gender minorities. We developed the Biopsychosocial Minority Stress Framework which posits that sexual minority status leads to unique experiences of minority stress which results in adverse health behavioral factors, elevated psychological distress and sleep disturbance, and immune dysregulation. Moderators in the model include both individual differences and intersectional identities. There is a crucial need to understand the biological-psychological axis of stress among the increasingly visible sexual and gender minority population to increase their health, longevity, and quality of life.

Cardiovascular disease is the leading cause of death worldwide. In this study, we assessed factors related to cardiovascular disease risk and outcomes among sexual minorities (SM). Data from multiple waves of the PATH study were used in this analysis. Multivariable regression models were used to assess the association between sexual identity and: tobacco or e-cigarette use, adverse cardiovascular events, and age at first diagnosis of adverse cardiovascular disease events. In our sample (N = 23,205), 1,660 (7.15%) participants identified as SM. SM men, relative to heterosexual men, are more likely to be diagnosed with high blood pressure (aRR = 1.27; 95% CI 1.10, 1.47), high cholesterol (aRR = 1.32; 95% CI: 1.12, 1.55), congestive heart failure (aRR = 2.29; 95% CI 1.13, 4.65), stroke (aRR = 2.39; 95% CI: 1.14, 5.04), heart attack (aRR = 2.40; 95% CI 1.42, 4.04), and other heart conditions (aRR = 1.52; 95% CI: 1.06, 2.18). Although no simple differences were observed among SM women compared to heterosexual women, SM women were more likely to be diagnosed at a younger age for high blood pressure (aRR = -0.69; 95% CI - 1.08, - 0.29), high cholesterol (aRR = -0.77; 95% CI - 1.15, - 0.38), stroke (aRR = - 1.04; 95% CI - 1.94, - 0.13), and heart attack (aRR = - 1.26; 95% CI - 2.42, - 0.10). SM men were only diagnosed at a younger age for stroke (aRR = - 1.18; 95% CI - 2.06, - 0.30). Compared to heterosexuals, sexual minorities are at higher risk for cardiovascular disease, more likely to develop cardiovascular disease at an earlier age, and more likely to use tobacco products. Future research should focus on decreasing cardiovascular risk among sexual minorities including reducing tobacco use and stress. Screening recommendations for sexual minority populations should also be reviewed in light of a growing body of literature suggesting elevated risk from a young age.

The use of marijuana is highly prevalent among young men who have sex with men (YMSM). Past work has also shown that inflammation is elevated among YMSM, independent of HIV status. Here, we aim to examine the relationship between marijuana use and inflammation among this high-risk cohort, relative to use of other substances. Data were collected among YMSM aged 16–29 in Chicago. Multiplex cytokine and inflammatory biomarker assays were run on plasma from all persons living with HIV (PLWH) (n = 195) and a subset of HIV-negative participants (n = 489). Bivariate analyses and multivariable models assessed relationships between various substances and inflammatory biomarkers. Models were stratified by HIV status and adjusted for demographic characteristics. Most participants reported use of marijuana in the past 30 days (416, 60.8%). Mean blood C-reactive protein (CRP) levels were above the upper limit of normal (3.0 mg/L), indicative of increased risk for cardiovascular disease (mean CRP was 3.9 mg/L; SD = 8.5). In adjusted, stratified analyses, CRP was significantly lower among participants reporting frequent marijuana use (≥ 6 times per month), relative to those reporting never using marijuana, (β = − 0.38; 95% CI: − 0.73, − 0.03). However, this was entirely accounted for by an association among the HIV-negative participants and there was no significant association between marijuana use and blood CRP level among the PLWH. In summary, YMSM had markedly elevated marijuana use and blood CRP levels. Frequent marijuana use was associated with lower inflammation among only those not diagnosed with HIV. Further research is needed to explicate why there are differences between HIV-negative participants and PLWH and to leverage this information to characterize biological mechanisms by which marijuana decreases inflammation.

BackgroundIn recent years, both methamphetamine use and STIs have been on the rise in the USA. In this analysis, we sought to ascertain whether the risk of STIs and HIV among methamphetamine users was moderated on the basis of participation in substance use treatment programmes.MethodsData came from the National Survey on Drug Use and Health, 2015–2019. Among adult participants, survey-weighted logistic regression analyses were used to assess the relationship between past year methamphetamine use and risk of HIV and STIs, stratified by methamphetamine treatment utilisation and adjusted for demographic and other risk factors.ResultsAmong participants in the analytic sample (n=210 392), 1862 (0.9%) reported past year methamphetamine use, 566 (0.3%) reported receiving treatment for its use, 5471 (2.6%) tested positive for any STI in the past year and 395 (0.2%) for HIV ever in their lifetime. Past year methamphetamine use was associated with increased risk of STIs among those who did not receive treatment (adjusted OR=3.628; 95% CI 2.75 to 4.92). Significant moderation was also present between past-year methamphetamine use, risk of STI, and substance use treatment.ConclusionIn this analysis, we demonstrated a strong relationship between methamphetamine use and risk of STIs that differed based on receipt of substance use treatment. These findings suggested that integrated STI and substance use treatment programmes may yield substantial public health benefits.

Retention in care and sustained viral suppression are integral outcomes in the care continuum for people living with HIV (PLWH) and HIV prevention; however, less is known about how substance use predicts sustained viral suppression over time. This study seeks to examine the predictive effects of substance use on sustained viral suppression in a sample of cisgender sexual minority men and gender minority PLWH (n = 163) drawn from a longitudinal sample in the Chicago area collected 2015-2019. Using data from 3 visits separated by 6 months, participants were coded persistently detectable, inconsistently virally suppressed, and consistently virally suppressed ( 40 copies/mL at all visits). Multinomial logistic regressions were utilized. About 40% of participants had sustained viral suppression. In multinomial logistic regressions, CUDIT-R predicted persistent detectable status and stimulant use was associated with inconsistent viral suppression. Substance use may create challenges in achieving sustained viral suppression, which has important implications for care and prevention.Retención en el cuidado de la salud y supresión viral sostenida son resultados integrales en la cascada del tratamiento de VIH para personas viviendo con el virus del SIDA (PVVS) y prevención del VIH. Sin embargo, no se sabe mucho acerca de cómo el uso de substancias predice la supresión viral sostenida a través del tiempo. Este estudio busca examinar los efectos predictivos del uso de substancias en la supresión viral sostenida en una muestra de minoría de hombres cisgéneros y minorías de género PVVS (n = 163) basada en una muestra longitudinal en la región de Chicago obtenida en 2015–2019. Utilizando datos de 3 visitas con un intervalo de 6 meses, participantes fueron identificados como detectables persistentemente, inconsistentemente viralmente suprimido, y consistentemente viralmente suprimido ( 40 copias/mL en todas las visitas). Regresión logística multinomial fue utilizada. Cerca de 40% de los participantes tenían supresión viral sostenida. En regresión logística multinomial, CUDIT-R predicho status detectable persistente y uso de estimulantes fueron asociados a la supresión viral inconsistente. Uso de substancias crean desafíos para lograr la supresión viral sostenida, lo que tiene importante trascendencia para el cuidado y prevención.

Head and neck squamous cell carcinoma (HNSCC) remains a lethal and prevalent diagnosis with limited treatment options for recurrent metastatic cases, particularly in patients with sporadic, human papillomavirus (HPV) negative disease. Recently, the Human Cancer Genome Project identified cell death and NF-κB signaling alterations in a subset of HPV- and HPV+ HNSCC. Co-amplification of Fas-associated death domain (FADD) and cellular inhibitor of apoptosis protein 1 (cIAP1) was identified in HPV- HNSCC, whereas Tumor Necrosis Factor receptor-associated factor 3 (TRAF3) deletion was linked with HPV+ HNSCC. Birinapant, a cIAP inhibitor with primary affinity for cIAP1, functions as a SMAC mimetic to modulate downstream TNF death signaling and promote apoptosis. Clinical trials with Birinapant have demonstrated tolerability and favorable pharmacokinetics but limited activity as a single agent. Our lab recently demonstrated a key interaction between TNF-NF-κB signaling and the G2/M checkpoint kinase WEE1, providing a possible rationale for combination treatment targeting these pathways. We hypothesize that dual-antagonist therapy has the potential to synergistically inhibit TNF-induced canonical NF- κB pro-survival signaling, while enhancing sensitization to TNF-caspase and G2/M mitotic cell death. To investigate this, in vitro studies of Birinapant in combination with Adavosertib, a potent WEE1 inhibitor, were performed. Birinapant and Adavosertib demonstrated drug synergism to varying degrees in all HPV- and HPV+ cell lines tested, both in the presence and absence of tumor necrosis factor alpha (TNF-α), according to the Chou-Talalay method. In the majority of cell lines, synergistic drug activity, as indicated by a low combination index, was positively correlated with percent inhibition. These results were confirmed by increased levels of apoptosis as demonstrated by flow cytometry and both early and sustained cell growth inhibition over time in impedance assays. Ongoing studies include additional characterization of the downstream effects of these agents on NF-κB pro-survival signaling and the cell cycle, along with evaluation in a preclinical murine xenograft model with combined radiotherapy. Citation Format: Tiffany Toni, Ethan Morgan, Ramya Viswanathan, Xinping Yang, Hui Cheng, Carter Van Waes. Combination treatment with cIAP and WEE1 inhibitors exhibits synergism in HPV-positive and HPV-negative head and neck squamous carcinoma cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2997.

Our goal was to understand whether PrEP users are at increased risk for STIs, a key target in prevention efforts aimed at disrupting the spread of STIs and likely downstream HIV infection risk. Data were collected as part of RADAR, a cohort study of young men who have sex with men and transgender women (YMSM/TW) (aged 16-29) in Chicago. Longitudinal lagged regression models were utilized to assess the relationship between PrEP use and odds of rectal STI acquisition. Mediation models were also utilized to consider the potential pathway between PrEP use, condomless anal sex (CAS), and rectal STI. One hundred eighty-seven (16.2%) participants had a rectal STI at baseline. In both cross-sectional and longitudinal models, no significant association was observed between PrEP use and STI. In mediation models, PrEP use was significantly associated with increased CAS, however, CAS was not associated with STI status. We demonstrated that, overall, PrEP use was not associated with STIs among YMSM/TW but did observe that PrEP users were more likely to report increased participation in CAS at the subsequent study visit.

This investigation sought to characterise risk factors associated with acquisition of traditional and emerging agents of sexually transmitted infection (STI) in a cohort of young men who have sex with men and transgender women.917 participants provided urine and rectal swab submissions assessed by transcription-mediated amplification (TMA)-based assays forPrevalence ofRectal

Background The incidence of skin and soft-tissue infections (SSTIs), for which human immunodeficiency virus (HIV) is a significant risk factor, in United States emergency departments (EDs) increased dramatically after 2000 with the emergence of community-associated methicillin-resistant Staphylococcus aureus. Few studies have examined SSTI incidence among HIV-infected and non–HIV-infected patients in the United States after 2010. Methods Data were obtained for patient encounters at all academic medical center EDs affiliated with the Vizient clinical data warehouse assigned an SSTI-associated code based on the International Classification of Diseases, Ninth Revision, between 1 January 2009 and 31 December 2014. The rate was calculated per 1000 ED encounters by year and stratified by SSTI, HIV infection, or both, and by age group, race, payer type, and region of care. Poisson regression was used to assess temporal change over the study period. Results In 2009–2014, a total of 47317 HIV-associated and 820440 SSTI-associated encounters were recorded among 25239781 ED patient encounters. The rate of SSTIs decreased by 8% among all patients and by 14.6%, among those with HIV infection. The SSTI incidence overall decreased from 32.0 to 29.7 per 1000 ED encounters between 2009 and 2014. HIV-infected patients had a significantly higher rate of SSTIs than HIV-uninfected patients (adjusted rate ratio, 1.91; 95% confidence interval, 1.84–1.99). Conclusions The decline in SSTI incidence in US EDs between 2009 and 2014 is a remarkable epidemiologic shift from the increase in SSTIs after 2000, and further research is necessary to assess reasons for this decrease.

Understanding pre-exposure prophylaxis (PrEP) discontinuation is key to maximizing its effectiveness at the individual and population levels. Data came from the RADAR cohort study of MSM aged 16-29 years, 2015-2017. Participants included those who reported past 6-month PrEP use and discontinued its use by the interview date. Of the 197 participants who had used PrEP in the past 6 months, 65 discontinued use. Primary reasons for PrEP discontinuation included trouble getting to doctor's appointments (14, 21.5%) and issues related to insurance coverage or loss (13, 20.0%). Few (21%) who discontinued spoke to their doctor first, which has important implications for future long acting formulations.

BACKGROUND Associations have been observed between an aggregate viral load measure, the community viral load, and new HIV diagnoses. The community viral load aggregates viral loads within chosen geographic areas, restricting inferences about HIV acquisition risk to these areas. We develop a more precise metric, the network viral load (NVL), to measure the composite viral load within a risk network of a HIV-negative individual. METHODS We examined the relationship between NVL and HIV infection among young men who have sex with men in Chicago, United States. Networks were generated using respondent-driven sampling. NVL was defined as the prevalence of viremic individuals in one's risk network, characterized as those with a viral load ≥20 k copies per milliliter. Permutation tests were conducted to account for dependency. RESULTS After controlling for total connections, age, substance use during sex, syphilis diagnosis (previous 12 months), and frequency of condomless anal sex (previous 6 months), we found a positive association between NVL and HIV infection. Compared with a network with all HIV-seronegative members, the odds of HIV infection with an NVL of

Debate remains as to the relative HIV transmission contributions from individuals who are recently HIV-infected and individuals who have long-term infections. In this study, we examine the relationship between new HIV seroconversions occurring among young black men who have sex with men and network proximity to recently or long-term HIV-infected individuals. A cohort of young black men who have sex with men (N = 618) was generated through respondent-driven sampling across 3 waves. A recent HIV infection was defined as either: (1) a confirmed seroconversion ≤9 months before interview date or (2) a laboratory confirmed acute infection; long-term HIV-infected individuals were defined as a diagnosis date ≥9 months before interview date. Respondent-driven sampling-weighted logistic regression was used to examine network proximity of HIV transmission events to HIV-infected individuals in the network. Within the cohort, 343 (55.5%) participants were identified as HIV seronegative at baseline. Of these, 33 (9.6%) seroconverted during the study period. The odds of seroconversion increased significantly with each additional recent HIV-infected individual in one's network [adjusted odds ratio = 12.96; 95% confidence interval: 5.69 to 29.50], but were not significantly altered by the number of long-term infected individuals in one's network. In addition, for each member of one's network who used pre-exposure prophylaxis, the odds of seroconversion decreased significantly (adjusted odds ratio = 0.44; 95% confidence interval: 0.20 to 0.96). Early diagnosis and treatment is a critical first step in the HIV care continuum and together with pre-exposure prophylaxis awareness and use are critical targets for disrupting the transmission of HIV through most at-risk networks.

Evidence suggests that systemic inflammation increases due to HIV infection. C-reactive protein (CRP), interleukin (IL)-6 and tumour necrosis factor (TNF)-α values were compared between HIV-positive and HIV-negative young MSM and transgender women. CRP values were more than 3 mg/l among 49.8% of participants. HIV status was not significantly associated with CRP nor IL-6. TNF-α was significantly higher among HIV-positive participants. These results suggest the need for further study of the causes and health consequences of elevated systemic inflammation among this population.

OBJECTIVETo examine trends in Staphylococcus aureus infections in adults and children at a single academic center in 2006–2014.DESIGNRetrospective cohort study.SETTINGInpatient, outpatient, and emergency department settings in a private, tertiary referral center.PATIENTSPatients with an infection culture that grew S. aureus in January 1, 2006, through March 31, 2014.METHODSThe first isolate per year for each patient was classified as community-associated (CA-), healthcare-associated (HA-), or HA-community–onset S. aureus. The incidence density of S. aureus, methicillin-susceptible S. aureus (MSSA), and methicillin-resistant S. aureus (MRSA) infections were calculated per quarter year.RESULTSOverall, 5,491 MRSA and 5,398 MSSA isolates were included. MRSA infections decreased by an average of 5.2% annually (PPP=.004). MSSA infections at all anatomic sites increased by an average of 1.9% annually (P=.007) in adults and decreased 5.1% annually (PPPCONCLUSIONSIn 2006–2014, MRSA SSTI incidence decreased among children and adults. MSSA SSTI incidence density increased in children and adults, suggesting that current empiric SSTI treatment recommendations may not be optimal. Adults experienced an overall increase in MSSA infections, which may prompt consideration of the need for horizontal infection control practices to decrease MSSA infection risk.Infect Control Hosp Epidemiol 2017;38:1226–1234

INTRODUCTION Phylogenetic analysis determines similarities among HIV genetic sequences from persons infected with HIV, identifying clusters of transmission. We determined characteristics associated with both membership in an HIV transmission cluster and the number of clustered sequences among a cohort of young black men who have sex with men (YBMSM) in Chicago. METHODS Pairwise genetic distances of HIV-1 pol sequences were collected during 2013-2016. Potential transmission ties were identified among HIV-infected persons whose sequences were ≤1.5% genetically distant. Putative transmission pairs were defined as ≥1 tie to another sequence. We then determined demographic and risk attributes associated with both membership in an HIV transmission cluster and the number of ties to the sequences from other persons in the cluster. RESULTS Of 86 available sequences, 31 (36.0%) were tied to ≥1 other sequence. Through multivariable analyses, we determined that those who reported symptoms of depression and those who had a higher number of confidants in their network had significantly decreased odds of membership in transmission clusters. We found that those who had unstable housing and who reported heavy marijuana use had significantly more ties to other individuals within transmission clusters, whereas those identifying as bisexual, those participating in group sex, and those with higher numbers of sexual partners had significantly fewer ties. CONCLUSIONS This study demonstrates the potential for combining phylogenetic and individual and network attributes to target HIV control efforts to persons with potentially higher transmission risk, as well as suggesting some unappreciated specific predictors of transmission risk among YBMSM in Chicago for future study.

Critical to the development of improved HIV elimination efforts is a greater understanding of how social networks and their dynamics are related to HIV risk and prevention. In this paper, we examine network stability of confidant and sexual networks among young black men who have sex with men (YBMSM). We use data from uConnect (2013–2016), a population-based, longitudinal cohort study. We use an innovative approach to measure both sexual and confidant network stability at three time points, and examine the relationship between each type of stability and HIV risk and prevention behaviors. This approach is consistent with a co-evolutionary perspective in which behavior is not only affected by static properties of an individual's network, but may also be associated with changes in the topology of his or her egocentric network. Our results indicate that although confidant and sexual network stability are moderately correlated, their dynamics are distinct with different predictors and differing associations with behavior. Both types of stability are associated with lower rates of risk behaviors, and both are reduced among those who have spent time in jail. Public health awareness and engagement with both types of networks may provide new opportunities for HIV prevention interventions.

HIV prevention programs often focus on the physical social venues where men who have sex with men (MSM) frequent as sites where sex behaviors are assumed to be practiced and risk is conferred. But, how exactly these behaviors influence venue patronage is not well understood. In this study, we present a two-mode network analysis that determines the extent that three types of sex behaviors – condomless sex, sex-drug use, and group sex -- influence the patronage of different types of social venues among a population sample of young Black MSM (YBMSM) (N=623). A network analytic technique called exponential random graph modeling (ERGM) was used in a proof of concept analysis to verify how each sex behavior increases the likelihood of a venue patronage tie when estimated as either: (1) an attribute of an individual only and/or (2) a shared attribute between an individual and his peers. Findings reveal that sex behaviors, when modeled only as attributes possessed by focal individuals, were no more or less likely to affect choices to visit social venues. However, when the sex behaviors of peers were also taken into consideration, we learn that individuals were statistically more likely in all three behavioral conditions to go places that attracted other MSM who practiced the same behaviors. This demonstrates that social venues can function as intermediary contexts in which relationships can form between individuals that have greater risk potential given the venues attraction to people who share the same risk tendencies. As such, structuring interventions around these settings can be an effective way to capture the attention of YBMSM and engage them in HIV prevention.

Objective To examine how history of criminal justice involvement (CJI) is related to HIV care continuum metrics among young black MSM 16-29 years of age. Design Population-based survey. Methods From 2013 to 2014, a representative sample of young black MSM was generated using respondent-driven sampling (RDS) in Chicago (n = 618). HIV antibody/antigen and RNA testing were performed using dry blood spots. Factors assessed in the care continuum included HIV testing, HIV diagnosis, linkage to care within 6 months, retention in care, adherence to antiretrovirals, and viral suppression. RDS-weighted regression models examined the associations between history of CJI, including frequency of CJI and durations of stay and each of the continuum metrics. Results A final analytic sample of 618 participants was generated through RDS chains of up to 13 waves in length and with a mean of 2.1 recruits per participant. At enrollment, 40.8% had prior history of CJI and 34.6% were HIV seropositive. Of persons reporting HIV seropositive status, 58.4% were linked to care, 40.2% were retained in care, 32.2% were adherent to antiretrovirals, and 24.3% were virally suppressed. Any CJI history was associated with the overall care continuum (adjusted odds ratio = 2.35; 95% confidence interval 1.13-4.88) and was most associated with increased retention in care [adjusted odds ratio = 3.72 (1.77-7.84)]. Having one CJI experience and detention for only 1 day was associated with better retention in care compared with no or more frequent CJI. Conclusion Those with a previous history of CJI were more successful in achieving most HIV care continuum metrics. Frequent and cycling CJI, however, was detrimental to HIV care.

We determined HIV-1 pol gene sequences from self-collected rectal swabs of HIV-positive young men who have sex with men and transgender women. HIV-1 pol was amplified from 39/96 (41%) rectal swabs, including 29/77 (38%) prevalent and 10/19 (53%) incident HIV-1 infections (p

BACKGROUND: Despite tremendous potential for public health impact and continued investments in development and evaluation, it is rare for eHealth behavioral interventions to be implemented broadly in practice. Intervention developers may not be planning for implementation when designing technology-enabled interventions, thus creating greater challenges for real-world deployment following a research trial. To facilitate faster translation to practice, we aimed to provide researchers and developers with an implementation-focused approach and set of design considerations as they develop new eHealth programs. METHODS: Using the Accelerated Creation-to-Sustainment model as a lens, we examined challenges and successes experienced during the development and evaluation of four diverse eHealth HIV prevention programs for young men who have sex with men: Keep It Up!, Harnessing Online Peer Education, Guy2Guy, and HealthMindr. HIV is useful for studying eHealth implementation because of the substantial proliferation of diverse eHealth interventions with strong evidence of reach and efficacy and the responsiveness to rapid and radical disruptions in the field. RESULTS: Rather than locked-down products to be disseminated, eHealth interventions are complex sociotechnical systems that require continual optimization, vigilance to monitor and troubleshoot technological issues, and decision rules to refresh content and functionality while maintaining fidelity to core intervention principles. Platform choice and sociotechnical relationships (among end users, implementers, and the technology) heavily influence implementation needs and challenges. We present a checklist of critical implementation questions to address during intervention development. CONCLUSION: In the absence of a clear path forward for eHealth implementation, deliberate design of an eHealth intervention’s service and technological components in tandem with their implementation plans is critical to mitigating barriers to widespread use. The design considerations presented can be used by developers, evaluators, reviewers, and funders to prioritize the pragmatic scalability of eHealth interventions in research.

The goal of this work is to better understand utilization and uptake of pre-exposure prophylaxis (PrEP) among young men who have sex with men (YMSM) and transgender women (TGW). We assessed trends and correlates of PrEP use and adherence across three time points of longitudinal data collection among 885 YMSM and TGW (aged 16–29) from the RADAR cohort in Chicago, 2015–2017. Past six-month PrEP use increased across three visits: from 6.6% to 17.5%. In multivariable models, past six-month PrEP use was significantly associated with participation in condomless sex, having more sexual partners, and older age. At least three-quarters of current PrEP users reported being ≥90% adherent to PrEP medication across all visits. Past six-month PrEP use increased over time with those who participated in high-risk HIV behaviors also those most likely to have taken PrEP. As PrEP uptake continues to rise, more research will be needed to understand predictors of PrEP usage, as well as patterns of sexual behavior change following uptake.

BACKGROUND Individual sexual risk behaviors have failed to explain the observed racial disparity in HIV acquisition. To increase understanding of potential drivers in disparities, we assessed differences across individual, network, and social determinants. METHODS Data come from RADAR (N = 1015), a longitudinal cohort study of multilevel HIV-risk factors among young men who have sex with men (YMSM) aged 16-29 years in Chicago, IL. Data collection includes biological specimens; network data, including detailed information about social, sexual, and drug-use networks; and psychosocial characteristics of YMSM. RESULTS Compared to white YMSM (24.8%) and Hispanic YMSM (30.0%), black YMSM (33.9%) had a higher prevalence of both HIV (32%; P < 0.001) and rectal sexually transmitted infections (26.5%; P = 0.011) with no observed differences in pre-exposure prophylaxis use. Black YMSM reported lower rates of sexual risk behaviors and more lifetime HIV tests (P < 0.001) compared with all other YMSM; however, they were also significantly less likely to achieve viral suppression (P = 0.01). Black YMSM reported the highest rate of cannabis use (P = 0.03) as well as greater levels of stigma (P < 0.001), victimization (P = 0.04), trauma (P < 0.001), and childhood sexual abuse (P < 0.001). White YMSM reported higher rates of depression (P < 0.001) and alcohol use (P < 0.001). In network analyses, significant differences existed across network characteristics with black YMSM having the lowest transitivity (P = 0.002), the highest density (P < 0.001), and the highest homophily (P < 0.001). CONCLUSIONS Black YMSM do not report higher rates of HIV-risk behaviors, but social and network determinants are aligned toward increased HIV risk. These results suggest that network interventions and those addressing social determinants may help reduce disparities.

Objectives. To determine how network-level factors influence individual risk of HIV acquisition, which is key in preventing disease transmission. Methods. We recruited a cohort of young Black men who have sex with men (n = 618) in Chicago, Illinois, from 2013 to 2016. We identified potential molecular ties via pairwise genetic distance analysis of HIV pol sequences with links inferred between individuals whose sequences were 1.5% or less genetically distant. We defined clusters as 1 or more connections to another individual. We conducted entity resolution between confidant, sexual, referral, and Facebook network data between network types. Results. Of 266 (43.0%) participants identified as HIV-positive, we obtained 86 (32.3%) genetic sequences. Of these, 35 (40.7%) were linked to 1 or more other sequence; however, none of these were identified in first-, second-, or third-degree confidant and sexual networks. Minimal overlap existed between genetic and Facebook ties. Conclusions. These results suggest that HIV transmissions may have occurred before elicitation of network data; future studies should expand the data collection timeframe to more accurately determine risk networks. Virtual network data, such as Facebook, may be particularly useful in developing one’s risk environment.

Suppressing HIV viral load through daily antiretroviral therapy (ART) substantially reduces the risk of HIV transmission, however, the potential population impact of treatment as prevention (TasP) is mitigated due to challenges with sustained care engagement and ART adherence. For an undetectable viral load (VL) to inform decision making about transmission risk, individuals must be able to accurately classify their VL as detectable or undetectable. Participants were 205 HIV-infected young men who have sex with men (YMSM) and transgender women (TGW) from a large cohort study in the Chicago area. Analyses examined correspondence among self-reported undetectable VL, study-specific VL, and most recent medical record VL. Among HIV-positive YMSM/TGW, 54% had an undetectable VL (

BK polyomavirus (BKPyV; hereafter referred to as BK) causes a lifelong chronic infection and is associated with debilitating disease in kidney transplant recipients. Despite its importance, aspects of the virus life cycle remain poorly understood. In addition to the structural proteins, the late region of the BK genome encodes for an auxiliary protein called agnoprotein. Studies on other polyomavirus agnoproteins have suggested that the protein may contribute to virion infectivity. Here, we demonstrate an essential role for agnoprotein in BK virus release. Viruses lacking agnoprotein fail to release from host cells and do not propagate to wild-type levels. Despite this, agnoprotein is not essential for virion infectivity or morphogenesis. Instead, agnoprotein expression correlates with nuclear egress of BK virions. We demonstrate that the agnoprotein binding partner α-soluble N-ethylmaleimide sensitive fusion (NSF) attachment protein (α-SNAP) is necessary for BK virion release, and siRNA knockdown of α-SNAP prevents nuclear release of wild-type BK virions. These data highlight a novel role for agnoprotein and begin to reveal the mechanism by which polyomaviruses leave an infected cell.

Black men who have sex with men (BMSM) are highest risk for HIV seroconversion in the United States. Little attention has been paid to marijuana use among BMSM and potential for HIV risk. A sample of 202 BMSM was generated through respondent driven sampling. The relationship between differential marijuana use and both HIV risk behavior and social network factors were examined using weighted logistic regression. Of the BMSM in this sample 60.4 % use marijuana in general and 20.8 % use marijuana as sex-drug. General marijuana use was significantly associated with participation in group sex (AOR 3.50; 95 % CI 1.10-11.10) while marijuana use as a sex drug was significantly associated with both participation in condomless sex (AOR 2.86; 95% CI 1.07-7.67) and group sex (AOR 3.39; 95% CI 1.03-11.22). Respondents with a moderate or high perception of network members who use marijuana were more likely to use marijuana both in general and as a sex-drug. Network member marijuana use, while not associated with risk behaviors, is associated with individual marijuana use and individual marijuana use in the context of sex is associated with risk practices. Targeting interventions towards individuals and their respective networks that use marijuana as a sex drug may reduce HIV risk.

Men who have sex with men (MSM) in the USA continue to have high rates of HIV infection. Increasingly, in addition to behavioral factors, biomedical interventions have been found to play important roles in HIV prevention. In this analysis, we used four waves of cross-sectional data (2004, 2008, 2011, and 2014) from the National HIV Behavioral Surveillance System (NHBS) to examine trends in key behaviors and biomedical interventions among MSM in Chicago (N = 3298). Logistic regression was used to determine changes in behaviors and use of biomedical interventions. Condomless sex increased significantly in waves 3 and 4, compared to wave 1: wave 3 (AOR = 2.07; 95% CI 1.53, 2.78) and wave 4 (AOR = 2.19; 95% CI 1.62, 2.96). Compared to those aged 18–24, older participants were significantly less likely to be routinely tested for HIV: 30–39 (AOR = 0.63; 95% CI 0.48, 0.83), 40–49 (AOR = 0.40; 95% CI 0.29, 0.55), and >50 (AOR = 0.28; 95% CI 0.18, 0.43). Awareness of both post-exposure prophylaxis (PEP)(​AOR = 3.13; 95% CI 1.22, 8.03) and pre-exposure prophylaxis (PrEP)(​AOR = 10.02; 95% CI 2.95, 34.01) increased significantly in wave 4, compared to wave 3. These results suggest a potential increase in HIV rates among men with main and casual partners and should be monitored closely as PrEP becomes more widespread among MSM of all races and ethnicities in Chicago. This study also suggests that further analyses of the barriers to PEP and PreP uptake among high-risk populations are necessary.