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Abstract. The present study was conducted during the period 2019 - 2021 at the Institute of Agriculture, Kyustendil. The productivity, fruit quality, and sensitivity to codling moth of 10 apple cultivars and 9 hybrids were evaluated. Standard technology was implemented to grow the fruit-bearing trees, which were grafted on MM 106 rootstock and planted at a distance 4.5×2.5 m. The highest average yields were obtained from the cultivar Rosana (30.4 kg/tree) and hybrid 9 (28.3 kg/tree). Fruit weight ranged from 83 g (hybrid 2/4) to 248 g (Charden). Goldrush had the highest fruit flesh firmness – 10.0 kg/cm2 and hybrid 1/7 the lowest – 6.7 kg/cm2. No differences in the sensitivity to codling moth were observed among cultivars and hybrids. The percentage of damage ranged from 3.7% (hybrid 1/3) to 5% (Rosana) in 2020 and from 43.6% (hybrid 2/4) to 55.7% (Golden Resistan) in 2021

bstract. The living environment of progressively increasing population worldwide is significantly encroaching on and occupying areas of wild nature. At the marginal zones where human activity and environment meet, biodiversity is subjected to the effects of agriculture and its modern intensification. The grasslands within human settlements serve as intersections where farm animals and wildlife meet and interact, sometimes directly competing for resources. One aspect of this interaction involves active management of encounters between wild and domestic animals in order to control animal health at both individual and herd levels, aiming to minimize economic losses and maximize productivity and sustainability of livestock production. On the other hand, wild animals are also directly and indirectly influenced by the type of animal husbandry practices developed in each region, often with adverse consequences for wildlife. Human-wildlife conflict is among the most urgent and well-researched issues for the creation and implementation of effective wildlife conservation measures worldwide. However, systematic knowledge of these conflicts remains insufficient. In order to explore the spatial overlap between livestock and wildlife leading to conflicts between them, this study aims to assess the incidence of wildlife poisoning cases and their relation to changes in the type of livestock farming by economic planning regions in the country. For this study, we analyzed variations in the number of farm animals raised in specific regions from 2000 to 2019, and the trends in structural changes of registered livestock facilities in Bulgaria. We examined the influence of the structure of livestock holdings and the intensification of animal husbandry on the rate of patient admissions to the “Green Balkans” Wildlife Rehabilitation and Breeding Centre in Stara Zagora.

Abstract The sequence of events associated with the triggering of energy release during substorm expansion phase onset is still not well‐understood. Oberhagemann and Mann (2020b, https://doi.org/10.1029/2019gl085271) proposed a new substorm onset mechanism, where the transition toward parallel proton pressure anisotropy during tail stretching in the late growth phase could trigger a pressure anisotropic ballooning instability. Here we examine the evolution of energetic proton parallel pressure anisotropy at geosynchronous altitudes, seeking evidence in support of the proposed substorm onset mechanism. We use the Geostationary Operational Environment Satellite (GOES) proton flux and magnetometer data combined with substorm onset indicators derived from ground‐based magnetometers. Superposed epoch analysis of substorm onset times for 2014 using the isolated substorm list (Ohtani & Gjerloev, 2020, https://doi.org/10.1029/2020ja027902) clearly shows signatures of energetic proton parallel pressure anisotropy immediately before substorm onset, potentially supportive of the Oberhagemann and Mann theory.

Introduction: We report the full analysis of the COMMANDS trial assessing efficacy and safety of luspatercept versus epoetin alfa (EA) in ESA-naive patients with LR-MDS. Methods: 363 patients (aged ≥18 y, with transfusion-dependent LR-MDS, serum erythropoietin

Modern tourism is a complex socio-economic and cultural phenomenon of multifaceted significance. Apart from the traditional types of tourism, the modern (alternative, traditional) types of tourism are becoming more and more attractive. One of them is health tourism. Health tourism covers the following subtypes of tourism: balneo, spa and wellness, thalassotherapy and medical. Its development on a global, European and national scale is considered. In Bulgaria there are excellent conditions for its development. The role of human resources in relation to health tourism is also growing. Their personnel development, education and training are monitored. The index of specialization allows to establish what is the health and tourism specialization and the opportunities for overcoming the existing disparities in terms of staffing.

Introduction Previously, environmental vulnerability for schizophrenia assessed through exposome score for schizophrenia (ES-SCZ) was associated with the risk for psychosis development. Objectives The current study aims to investigate the longitudinal association between ES-SCZ and symptom severity in individuals with first episode psychosis (FEP) to understand how environmental exposures affect illness course. Methods Baseline and 1-month follow-up assessments were available for 225 individuals with FEP from the Athens FEP Research Study. The Positive and Negative Syndrome Scale (PANSS) was used to measure clinical features. In accordance with previous reports, the ES-SCZ was calculated by summing log-odds weighted environmental exposures (childhood adversities, winter birth, and cannabis use). To model the course of clinical features over time the effects of the ES-SCZ-by-time interaction, ES-SCZ, and time were analyzed with multilevel regression analyses. Age, sex, and education were added as covariates Results The analyses of change of PANSS total score over time indicated that clinical features decreased from baseline to the 1-month follow-up assessment. The association between ES-SCZ and PANSS total score were not statistically significant. The analyses of the PANSS total score over time indicated an ES-SCZ-by-time interaction (B = 2.82 [95% CI 0.28; 5.35], P-value = 0.029), meaning the decrease of the PANSS total score over time were dependent on ES-SCZ and individuals with high ES-SCZ showed less improvement Conclusions The findings show that the total environmental predisposition to schizophrenia (ES-SCZ) not only increases the risk for psychosis development but may also influences the illness course. Disclosure No significant relationships.

Abstract Background Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems with accessing in-person care, such as childcare or transportation. Task sharing of treatment to non-specialist providers with delivery on telemedicine platforms could address such barriers. However, the equivalence of these strategies to specialist and in-person models remains unproven. Methods This study protocol outlines the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) randomized trial. SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. Specialists (psychologists, psychiatrists, and social workers with ≥ 5 years of therapy experience) and non-specialists (nurses and midwives with no formal training in mental health care) were trained in the BA protocol, with the latter supervised by a BA expert during treatment delivery. Consenting pregnant and postpartum women with Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10 (N = 1368) will be randomized to one of four arms (telemedicine specialist, telemedicine non-specialist, in-person specialist, in-person non-specialist), stratified by pregnancy status (antenatal/postnatal) and study site. The primary outcome is participant-reported depressive symptoms (EPDS) at 3 months post-randomization. Secondary outcomes are maternal symptoms of anxiety and trauma symptoms, perceived social support, activation levels and quality of life at 3-, 6-, and 12-month post-randomization, and depressive symptoms at 6- and 12-month post-randomization. Primary analyses are per-protocol and intent-to-treat. The study has successfully continued despite the COVID-19 pandemic, with needed adaptations, including temporary suspension of the in-person arms and ongoing randomization to telemedicine arms. Discussion The SUMMIT trial is expected to generate evidence on the non-inferiority of BA delivered by a non-specialist provider compared to specialist and telemedicine compared to in-person. If confirmed, results could pave the way to a dramatic increase in access to treatment for perinatal depression and anxiety. Trial registration ClinicalTrials.gov NCT 04153864 . Registered on November 6, 2019.

Plane (Platanus orientalis) is a popular park tree in Europe but is almost extinct in natural ecosystems, because of climate changes. In our study, two ecotypes of plane tree (Bulgarian and Italian) were submitted to moderately elevated temperature that occurs in summer. Our aim was to compare stress reactions, tolerance, and adaptability of these plants. Leaf age had a significant impact on the stress effects. For correct interpretation of the results, we investigated leaves at different positions from the apical bud, i.e., leaves of different age. We assessed their photosynthetic efficiency at room temperature and after treatment at moderately high temperature by simultaneous measurement of prompt and delayed chlorophyll fluorescence, as well as light reflection at 820 nm. For more precise interpretation of the obtained results we did principal component analysis. The two studied plane ecotypes showed different tolerance to the elevated temperature. Plants of Italian ecotype showed better adaptivity and developed advantageous photosynthetic characteristics, while Bulgarian ecotype was more affected. Plants of both ecotypes recovered from the heat stress.

We present electron phase space density (PSD) calculations as well as concurrent Pc5 and chorus wave activity observations during two intense geomagnetic storms caused by interplanetary coronal mass ejections (ICMEs) resulting in contradicting net effect. We show that, during the 17 March 2013 storm, the coincident observation of chorus and relativistic electron enhancements suggests that the prolonged chorus wave activity seems to be responsible for the enhancement of the electron population in the outer radiation belt even in the presence of pronounced outward diffusion. On the other hand, the significant depletion of electrons, during the 12 September 2014 storm, coincides with long-lasting outward diffusion driven by the continuous enhanced Pc5 activity since chorus wave activity was limited both in space and time.

Background Epidemiological models are frequently utilised to ascertain disease prevalence in a population; however, these estimates can have wider practical applications for informing targeted scale-up and optimisation of mental health services. We explore potential applications for a conflict-affected population, Syria. Methods We use prevalence estimates of major depression and post-traumatic stress disorder (PTSD) in conflict-affected populations as inputs for subsequent estimations. We use Global Burden of Disease (GBD) methodology to estimate years lived with a disability (YLDs) for depression and PTSD in Syrian populations. Human resource (HR) requirements to scale-up recommended packages of care for PTSD and depression in Syria over a 15-year period were modelled using the World Health Organisation mhGAP costing tool. Associated avertable burden was estimated using health benefit analyses. Results The total number of cases of PTSD in Syria was estimated at approximately 2.2 million, and approximately 1.1 million for depression. An age-standardised major depression rate of 13.4 (95% UI 9.8–17.5) YLDs per 1000 Syrian population is estimated compared with the GBD 2010 global age-standardised YLD rate of 9.2 (95% UI 7.0–11.8). HR requirements to support a linear scale-up of services in Syria using the mhGAP costing tool demonstrates a steady increase from 0.3 FTE in at baseline to 7.6 FTE per 100 000 population after scale-up. Linear scale-up over 15 years could see 7–9% of disease burden being averted. Conclusion Epidemiological estimates of mental disorders are key inputs into determining disease burden and guiding optimal mental health service delivery and can be used in target populations such as conflict-affected populations.

Background It is increasingly recognised that intersectoral linkages between mental health and other health and support sectors are essential for providing effective care for individuals with severe and persistent mental illness. The extent to which intersectoral collaboration and approaches to achieve it are detailed in mental health policy has not yet been systematically examined. Methods Thirty-eight mental health policy documents from 22 jurisdictions in Australia, New Zealand, the United Kingdom, Ireland and Canada were identified via a web search. Information was extracted and synthesised on: the extent to which intersectoral collaboration was an objective or guiding principle of policy; the sectors acknowledged as targets for collaboration; and the characteristics of detailed intersectoral collaboration efforts. Results Recurring themes in objectives/guiding principles included a whole of government approach, coordination and integration of services, and increased social and economic participation. All jurisdictions acknowledged the importance of intersectoral collaboration, particularly with employment, education, housing, community, criminal justice, drug and alcohol, physical health, Indigenous, disability, emergency and aged care services. However, the level of detail provided varied widely. Where detailed strategies were described, the most common linkage mechanisms were joint service planning through intersectoral coordinating committees or liaison workers, interagency agreements, staff training and joint service provision. Conclusions Sectors and mechanisms identified for collaboration were largely consistent across jurisdictions. Little information was provided about strategies for accountability, resourcing, monitoring and evaluation of intersectoral collaboration initiatives, highlighting an area for further improvement. Examples of collaboration detailed in the policies provide a useful resource for other countries.

Проводится исследование двух видов активности – действия и поступка. Уровень техничности действий и высокая степень результативности не устраняет отчуждения. Обретение личностного бытия возможно при совершении поступка. Бытийная позиция, актуализируемая в поступках, выступает условием для возможности сосуществования, взаимодействия различных смыслов и способов понимания

Bacteriocins are known for anti-microbial properties against various pathogens. In the present study, bacteriocin ST22Ch produced by Lactobacillus sakei isolated from salpicão, a traditional pork product from the northwest of Portugal, inhibited the growth of Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Lactobacillus rhamnosus, Listeria ivanovii subsp. ivanovii, Listeira monocytogenes, Pseudomonas spp., Staphylococcus aureus, Streptococcus caprinus and Streptococcus spp. In particular, low levels of bacteriocin ST22Ch activity (approximately 200 AU/mL) was detected after 3 h of growth in MRS broth. Maximal production (1600 AU/mL) of bacteriocin ST22Ch was recorded after 19 h in MRS broth, stay constant only for 5 h and decrease to 800 AU/mL and only when incubated at 30 °C. During 35 h of growth, the optical density increased from 0.15 to 5.73. Highest bacteriocin ST22Ch production (3200 AU/mL) was records in presence of yeast extract as single organic nitrogen source (20.0 g/L). Presence of tryptone (20.0 g/L) or combination of tryptone and meat extract (12.5 g/L and 7.5 g/L) or yeast extract and meat extract (10.0 g/L and 10.0 g/L, respectively) yielded 1600 AU/mL bacteriocin production. Presence of glycerol at 1.0 g/L to 5.0 g/L not effect the bacteriocin ST22Ch production. Tween 80 added to the MRS medium (5.0 g/L) increase bacteriocin ST22Ch production up to 6400 AU/mL. Exclusion of manganese sulphate results in reduction of activity in the cell-free supernatant. Exclusion of magnesium sulphate from the media formula increases the bacteriocin production to 3200 AU/mL.

The concordance of communication between patients and health professionals is essential to promoting positive health outcomes. However, concordance may be broken where language barriers exist therefore creating a need to use interpretation services. This is the case when rapid diagnostic testing (RDT) of HIV, HBV, and HCV is offered to migrants. The use of interpreters to establish communication with patients having limited French proficiency (LFP) however, is often not used and can be problematic. Despite being offered, interpretation services are frequently underutilised, which makes communication challenging. This problem has not received enough attention in the literature, particularly in a technologically advanced setting where solutions may be found. Our objective was to explore how interpreters are used within the context of medical consultations when RDT for HIV, HBV, and HCV is offered to legal migrants with LFP. A cross-sectional qualitative study was used with a purposive sample that included doctors and nurses who had conducted rapid screening tests with migrants in four centers in France and who had access to interpretive services. Semi-structured interviews explored healthcare providers' (HP) use of interpreters at the OFII. The use of professional or ad hoc interpreters, telephone interpreters, and the equivalence of concepts such as health literacy between the HP and the interpreter were explored. The utility of a new tool to promote communication concordance was evaluated. Twenty interviews were conducted with eleven doctors and nine nurses with a median age of 58 years (25-67 years). All participants had access to interpretive services although many did not solicit them because of 1) unawareness on how to use the services, 2) preconceived notions of the length of time to involve an interpreter and how this would add to consultation times, or 3) the proximity of an ad hoc interpreter. Not using interpreter services could result in RDTs not being offered to immigrants. Subjects such as confidentiality, the embarrassment of a third party's presence, the lack of appropriate training and differing levels of health literacy were also discussed by participants. Insight from HPs allows us to better understand how both telephone and in-person interpretation are used, viewed, and why they are underused to communicate with limited French language skills patients. Our findings will help us develop a conceptual model for a digital communication tool to overcome barriers with migrant patients with limited French language skills., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Brown et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Migrants underuse screening opportunities for HIV, hepatitis B, and hepatitis C despite elevated risk factors for contracting these infections. Language barriers are an often given as reasons for limiting access to services. Translation and communication apps increase communication and overall patient satisfaction in the patient-provider relationship. In the development and adoption of new technology, expectations play an important role., Objective: This study aimed to explore health care professionals' opinions and attitudes regarding their screening practices with migrants and their expectations for a new communication tool that could improve migrants' screening use., Methods: In this qualitative study, a purposive (diverse) sampling method was used to invite doctors and nurses who conduct rapid screening tests with migrants from 4 centers of the French Office of Immigration and Integration in 3 geographic regions of France. Semistructured interviews were conducted to survey their opinions on the rapid testing of migrants, the use of telephone interpreters, the concept of health literacy, and their expectations of a new communication tool that could overcome language barriers and promote rapid screening in the new migrant population., Results: In all, 20 interviews were conducted with 11 doctors and 9 nurses with a median age of 58 (range 25-67) years. Participants favored the integration of an innovative communication tool in the context of rapid screening of migrants. However, there were concerns related to the implementation and added value of the tool while migrants were already reluctant to be screened. Expectations were for a tool that would present information in simplified French or a chosen language but also supports a positive attitude toward screening. Health professionals also expressed the wish that the technology could help with the collection of health data., Conclusions: Feedback from health professionals provides a better understanding of potential formats, characteristics, functions, content, and use of an innovative, digital method to communicate with migrants with limited French proficiency. Findings contribute to the conceptual development of an electronic app and its implementation within the ApiDé study, which aims to validate a digital app to address language barriers to increase the use of screening among migrants with limited French proficiency in France., (©Carter Brown, Guillaume Roucoux, Svetlane Dimi, Saleh Fahmi, Raj-Banou Jeevan, Olivier Chassany, John Chaplin, Martin Duracinsky. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 03.02.2023.)

Introduction: The sexual quality of life is a neglected concern in women living with HIV (WHIV) or with HCV (WHCV), which can further be affected by their experience with stigma, social instability, fear of transmission and reduced access to treatment. The objective of this study was to identify sociodemographic, psychosocial, and behavioural factors associated with sexual quality of life (SQoL) in this study group., Methods: Between December 2017 and December 2018, PROQoL-Sex Life questionnaire was administered to 404 WHIV and WHCV in five countries. PROQoL-SQoL consists of four dimensions: positive sexual perception (Psp), stigma and social distress (Sti), soft sexual practices (Sof), sexual practices with a partner (Sp), all of which were scored from 0 to 100 and considered as main outcomes, lower scores mean better sexual quality of life. Linear mixed effects models were used to evaluate the association with sociodemographic and psychosocial factors., Results: Of the participants analyzed, 191 were living with HCV, 180 with HIV and 33 with HIV and HCV, median age was 48. Among WHIV, a higher satisfaction with health care, and talking about sexuality with healthcare workers were associated with lower scores in all the dimensions of the SQoL, while psychoactive substance use was associated with lower scores of Sti and Sof. Moreover, higher satisfaction with health care, talking about sexuality with healthcare workers, and psychoactive substance use (except cocaine use) in WHCV were associated with lower scores in Psp, Sti, and Sof. Besides, cocaine use was associated with higher scores of Sof., Conclusion: This study highlighted strong relationship between the quality of health care, and psychoactive substance use (except cocaine) and the sexual quality of life in WHIV and WHCV in these five countries. These findings draw attention to the different interventions that can be proposed for improving the sexual quality of life., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Rodriguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Asymptomatic sexually transmitted infections (STI) are frequent among men who have sex with men (MSM). Identifying asymptomatic STIs is a crucial issue, not only for secondary but also for primary prevention, as early treatment can reduce transmission risk. We aimed to develop a self-reported predictive score for early identification of asymptomatic STIs., Methods: Participants provided clinical data and completed a self-administered questionnaire including sociodemographic variables and behaviors during the 6 previous months. We used multivariable logistic regression to identify factors associated with asymptomatic STIs. We calculated the accuracy of the model by the non-parametric area (AUC) under the receiver-operating-characteristic (ROC) curve to find the optimal discriminant threshold for screening., Results: A total of 781 HIV-positive MSM were included with a mean age of 46.8 years. Asymptomatic STI prevalence was 13.2%. Detectable plasma HIV RNA (adjusted odds ratio (aOR [95% CI): 2.54 [1.23;5.25]), inconsistent condom use during anal sex (2.20 [1.36;3.56]), group sex (2.00 [1.15;3.45]), during or-genital practices (1.83 [1.12;3.01]), not being in stable relationship (1.70 [1.01;2.66] and an item from a sensation-seeking behavioral scale "I don't like watching porn videos" (1.61 [1.01;2.59] were associated with asymptomatic STI. AUC was 0.7 and with optimal threshold of 0.1082 for this model; sensitivity was 80.4%. Self-reported asymptomatic STI predictive score was built with this threshold according to the 6 factors in the final model., Conclusions: As this predictive score is not designed to be diagnostic, but to provide indications for diagnostic tests, its ease of administration and sensitivity remain the most important features. Its use in clinical practice for early detection of asymptomatic STIs potentially can reinforce STI primary and secondary prevention.

The burden of STIs is particularly high in HIV-infected MSM patients. A recent increase in STIs prevalence has been noticed in the US and western European countries. We aim to assess trends in asymptomatic STIs following the publication of recommendations for STIs screening, i.e. Chlamydia (CT) and gonorrhea (NG). Seventeen centers located in the Paris area participated in the study. All asymptomatic HIV-infected MSM patients attending a follow up consultation were proposed to participated in the study. Asymptomatic patients were included over 2 periods: period 1 from April to December 2015 and period 2 from September to December 2017. Etiologic diagnosis of STIs including hepatitis B, C, syphilis, was performed using a serological test, including a non-treponemal titer with a confirmatory treponemal assay for syphilis. CT and NG were screened using a nucleic acid amplification test (NAATs) on 3 anatomical sites, i.e. urine, rectal and pharyngeal. Overall, 781 patients were included: 490 and 291 in periods 1 and 2 respectively. Asymptomatic CT, NG, and syphilis were diagnosed in 7.5%, 4.8% and, 4.2% respectively. The rate of patients having a multisite asymptomatic infection was 10.2% and 21.1% for CT and NG respectively. The most frequently involved anatomical sites for CT and NG asymptomatic infections were anorectal (66.1% and 55.2% respectively) and pharyngeal (47.4% and 60.5% respectively). CT and NG asymptomatic infection increased by 1.3- and 2-fold respectively between the two periods while syphilis decreased by 3 folds. Our results encourage to reconsider multisite screening for CT and NG in asymptomatic HIV positive MSM as the yield of screening urinary samples only might be low. Despite the more systematic STI screening of asymptomatic HIV positive MSM the prevalence of STI is increasing in MSM in France. Therefore, this strategy has not led to alter CT and NG transmission. The decrease of syphilis might involve self-medication by doxycycline, and the intensification of syphilis screening., Competing Interests: The authors have declared that no competing interests exist.

Introduction: The prevalence of HIV, hepatitis B, and hepatitis C amongst migrants in France is high. Thus, effective screening and follow-up is needed. The mandatory medical check-up for residency application is an opportunity to offer rapid HIV and hepatitis testing. The main objective of the STRADA study is to create a feasible and acceptable screening strategy for migrants. Within the STRADA study, this qualitative research examined the acceptability of conducting screening tests in the context of residency application., Methods: We conducted a qualitative study amongst legal migrants over 18 years of age with sufficient knowledge of the French, English, or Arabic language. Interviews were performed following a semi-structured interview guide of open-ended questions. Interviews were transcribed verbatim and subsequently analyzed through thematic analysis., Results: We interviewed 34 migrants. Mean age was 32.6 (min-max: 19, 59) years. The participants' region of origin was mostly Sub-Saharan Africa and the main reason for migrating to France was family reunification. Migrants' acceptability of HIV and hepatitis testing was high. Participants who accepted testing indicated a benefit for individual health and to avoid transmission. Most preferred rapid tests; reluctance was related to anxiety about the immediate results and the perceived reliability of rapid tests. Migrants' knowledge about HIV was satisfactory, but inadequate for hepatitis. Screening in the context of a compulsory medical visit did not present an obstacle for acceptability. Some expressed concern in the case of HIV but when explained, the independence between obtaining the residence permit along with screening and access to medical care was well understood., Discussion: Medical check-ups at immigration centers is an opportunity to screen for HIV and hepatitis which is considered acceptable by migrants. Informing migrants that test results do not affect residency applications, and incorporating their preferences, are all important to optimize the acceptability of screening., Competing Interests: The authors have declared that no competing interests exist.

Background: France is the European country with the lowest level of confidence in vaccines. Measurement of patients' acceptability towards a future therapeutic HIV vaccine is critically important. Thus, the aim of this study was to evaluate patients' acceptability of a future therapeutic HIV vaccine in a representative cohort of French patients living with HIV-AIDS (PLWHs)., Methods: This multicentre study used quantitative and qualitative methods to assess PLWHs' opinions and their potential acceptance of a future therapeutic HIV vaccine. Cross-sectional study on 220 HIV-1 infected outpatients, aged 18-75 years., Results: The participants' characteristics were similar to those of the overall French PLWH population. Responses from the questionnaires showed high indices of acceptance: the mean score for acceptability on the Visual Analog Scale VAS was 8.4 of 10, and 92% of patients agreed to be vaccinated if a therapeutic vaccine became available. Acceptability depended on the expected characteristics of the vaccine, notably the duration of its effectiveness: 44% of participants expected it to be effective for life. This acceptance was not associated with socio-demographic, clinical (mode of contamination, duration of disease), quality of life, or illness-perception parameters. Acceptability was also strongly correlated with confidence in the treating physician., Conclusion: The PLWHs within our cohort had high indices of acceptance to a future therapeutic HIV vaccine., Trial Registration: This study was retroactively registered on ClinicalTrials.gov with ID: NCT02077101 in February 21, 2014.

Objective: To describe the increased incidence of sexually transmitted infections (STIs) in a cohort of HIV-infected men who have sex with men (MSM), followed in a tertiary hospital of the Île-de-France region., Materials and Methods: We performed a monocentric, retrospective, and prospective study. We included symptomatic HIV-infected MSM patients who consulted for their annual consultation., Results: One hundred and eighty patients were seen between 2008-2011 and 215 between 2012-2015. We observed an increased incidence of STIs between the two periods (14 and 29.3%, respectively). These STIs includes: syphilis, hepatitis C, urethritis, and proctitis due to Chlamydia trachomatis and Neisseria gonorrhea., Conclusion: A better management of symptomatic and asymptomatic STIs is needed for HIV-infected MSM patients., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Introduction: In 2011, a French national survey of people living with HIV (PLHIV) has shown that 40% of persons diagnosed since 2003 are originated from sub-Saharan Africa, two thirds of them being women. For them, in the short term, access to social rights is a priority. Today, over 90% of PLHIV are treated effectively and with the aging of this population, questions about their future perspectives arise. Our service provides a multidisciplinary (medical, psychological, social) approach to PLHIV. The aim of our study is to describe the future perspectives of sub-Saharan women living with HIV residing in France for more than 7 years, because it is the time required for the implementation of fundamental rights and social insertion. Do they plan to return to their country of origin after their retirement? Does the HIV infection force them to stay in France?, Materials and Methods: Prospective pilot mono-centric study. Between January and April 2014, every HIV-infected woman born in a sub-Saharan country, resident in France for at least 7 years, attending for their routine outpatient visit was consecutively included. Data were collected through a structured, semi-directed interview made by their usual hospital physician or social worker., Results: Consecutively, 76 women agreed to participate to the interview, none refused. Mean age: 42 years [26-70], time since HIV diagnosis: 12 years [1-25]. HIV diagnosis was made before arriving in France for 3% of them; in 33% diagnosis was made in the year of arrival; diagnosis made several years after arrival in 63%. Even if 69% of these women had been irregularly residing in France for a period, all of them had obtained a regular situation for residence and 50% acquired the French nationality. Mean duration of residence was 15 years [7-33]. Two thirds of them are employed. In the future, although 50% plan to have a shared residence between France and Africa, only 20% of them plan to settle back definitely in Africa and no woman declared that she would look for a medical follow up in Africa for their HIV infection., Conclusions: This study shows a good integration in France of HIV-infected sub-Saharan woman. Their links with Africa remain strong but very few plan to return in their country of origin due to lack of confidence in the African health infrastructures.

Although second-line generic antiretroviral drugs are of great value in developing countries, there are concerns regarding their quality. We studied a generic Lopinavir/ritonavir (200/50  mg; Arga-L, India) marketed in the Republic of Congo but not prequalified by WHO. Despite adequate quantitative and qualitative drug content, Arga-L had a bio-availablility of 10% compared with Kaletra. To avoid selection of drug-resistant HIV, rigorous pharmacological monitoring of generic drugs not prequalified by WHO must be a priority.