"Never reflected anywhere": body image among ethnoracialized gay and bisexual men

A growing body of literature has highlighted the increased prevalence of body image concerns and associations with health outcomes among gay and bisexual men (GBM). Little research, however, has examined the link between body image and social oppression for ethnoracialized GBM. Using an intersectionality lens and qualitative inductive analysis, data were collected through focus groups and interviews with GBM (n=61) who identify with one of four ethnoracial groups (Black, East/Southeast Asian, South Asian, Latino/Brazilian). Three main themes emerged: (1) body image idealization in gay/bisexual male culture, (2) negotiating a racialized body image, and (3) negotiating the impact of body image on relationship with self and others. The study results highlighted how multiple forms of oppression (e.g., racism, sexism) intersected with one another to impact the body image and overall well-being among ethnoracialized GBM.

Abstract P4-09-06: miR-187 is an independent prognostic factor in lymph node-positive breast cancer patients

Purpose: MicroRNAs (miRNAs) involved in cancer progression have now become the focus of much attention as they represent a new class of biomarkers and potential drug targets. Here, we describe an integrated bioinformatics, functional analysis and translational pathology approach for the identification of novel miRNAs involved in breast cancer progression.

Experimental Design

Differential gene expression can, in part, be attributed to the activity of specific miRNAs. Given a database of miRNA binding site motifs and gene expression levels determined by transcriptomic profiling, correspondence analysis, between group analysis and co-inertia analysis can be combined to produce a ranked list of miRNAs associated with a specific gene signature and phenotype. Here, using two independent breast cancer cohorts, this approach was employed to produce a ranked list of miRNAs associated with disease progression. Functional studies were subsequently carried out in MCF7 cells assessing for alterations in growth, tumorigenicity and agressiveness and miRNA expression was evaluated in two cohorts of breast cancer patients by locked nucleic acid in situ hybridisation on tissue microarrays.

Results: CIA identified miR-187 as a key miRNA associated with poor outcome in breast cancer.

Ectopic expression of miR-187 in MCF7 cells resulted in a more aggressive phenotype (evidenced by increased anchorage-independent growth, migratory and invasive potential).

In a test cohort (n = 117) breast cancer patients, high expression of miR-187 was associated with a trend towards reduced breast cancer-specific survival (BCSS) (p = 0.058), and a significant association with reduced BCSS in lymph node-positive patients (p = 0.036). In a validation cohort (n = 470), high miR-187 was significantly associated with reduced BCSS in the entire cohort (p = 0.021) and, again, in lymph node-positive patients (p = 0.012).

Multivariate cox regression analysis revealed that miR-187 is an independent prognostic factor in both TMA cohorts (Cohort 1 HR-7.369 (95% CI 2.048–26.509, p = 0.002); Cohort 2 HR-2.798 (95% CI 1.518–5.157, p = 0.001).

Conclusions: miR-187 expression in breast cancer leads to the formation of a more aggressive, invasive phenotype and acts as an independent predictor of outcome.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-09-06.

HIV treatment optimism and sexual risk behaviors among HIV positive African American men who have sex with men

The association between HIV treatment optimism--beliefs about susceptibility to transmit HIV, motivation to use condoms, and severity of HIV--and sexual risk behavior was examined among HIV-positive African American men who have sex with men (MSM). Participants were 174 men recruited in four major metropolitan areas of the United States to participate in a weekend HIV risk reduction intervention. Baseline results revealed that beliefs in less susceptibility to transmit HIV and less motivation to use condoms were significantly associated with more unprotected anal intercourse among serodiscordant casual partners. Less motivation to use condoms also predicted more unprotected insertive and receptive anal sex and was more important than susceptibility beliefs in predicting these behaviors. Suggestions are offered of ways to better inform HIV-positive African American MSM about their misperceptions about HIV treatment and how their level of optimism about HIV treatment may diminish or encourage condom use.

The cocaine- and amphetamine-regulated transcript mediates ligand-independent activation of ERα, and is an independent prognostic factor in node-negative breast cancer

Personalized medicine requires the identification of unambiguous prognostic and predictive biomarkers to inform therapeutic decisions. Within this context, the management of lymph node-negative breast cancer is the subject of much debate with particular emphasis on the requirement for adjuvant chemotherapy. The identification of prognostic and predictive biomarkers in this group of patients is crucial. Here, we demonstrate by tissue microarray and automated image analysis that the cocaine- and amphetamine-regulated transcript (CART) is expressed in primary and metastatic breast cancer and is an independent poor prognostic factor in estrogen receptor (ER)-positive, lymph node-negative tumors in two separate breast cancer cohorts (n=690; P=0.002, 0.013). We also show that CART increases the transcriptional activity of ERα in a ligand-independent manner via the mitogen-activated protein kinase pathway and that CART stimulates an autocrine/paracrine loop within tumor cells to amplify the CART signal. Additionally, we demonstrate that CART expression in ER-positive breast cancer cell lines protects against tamoxifen-mediated cell death and that high CART expression predicts disease outcome in tamoxifen-treated patients in vivo in three independent breast cancer cohorts. We believe that CART profiling will help facilitate stratification of lymph node-negative breast cancer patients into high- and low-risk categories and allow for the personalization of therapy.

Factors associated with a drive for muscularity among gay and bisexual men

Among gay and bisexual men, body dissatisfaction can manifest itself in the form of a desire for increased muscularity. Possibly in response to homophobia, the socio-sexual culture of gay and bisexual men privileges muscularity and may help to perpetuate a sense of body dissatisfaction. Little is known about factors associated with a drive for muscularity among gay and bisexual men. This study recruited participants (n = 400) at Toronto's 2008 lesbian, gay, bisexual and transgender festival to provide data used to examine the relationship between a drive for muscularity and demographics (age, race, education, HIV status), psychological factors (depression, disordered eating, internalised homophobia, substance use), body mass, a history of childhood sexual abuse and sexual risk. Multivariate analyses revealed that a drive for muscularity was associated with age, disordered eating, depression, sexual risk and internalised homonegativity. These findings can be used to advance the health and wellbeing of gay and bisexual men, particularly interventions designed to mitigate the effects of internalised homonegativity and policies aimed at reducing homophobia.

Recent Advances in the Synthesis of Polyfluorenes as Organic Semiconductors

New poly(fluorene-thiophene) alternating copolymers are described in which either the dioctylfluorene or bithiophene units in poly(9,9-dioctylfluorene-alt-bithiophene) (F8T2) are replaced by other fluorene or thiophene-based groups, respectively. Improvements in solubility are realized when the bithiophene unit of F8T2 is replaced by dihexylterthiophene or dihexylpentathiophene units. Melting temperatures are also lowered by 50 – 100°C in these polymers when compared to F8T2. Replacement of the bithiophene unit of F8T2 with a dihexylpentathiophene unit also results in a significant improvement in hysteresis (< 2 V vs. 3.5 – 5 V for F8T2). Initial results are also reported on the thermal cleavage of the C8 side groups of F8T2, which yields an insoluble polymeric semiconductor film that continues to exhibit transistor switching characteristics as part of a bottom gate device.

Polyfluorenes as Organic Semiconductors for Polymeric Field Effect Transistors

Polyfluorenes are a class of polyaromatic macromolecules that are characterized by an alternating backbone structure that consists of a 9,9-dialkylfluorene unit in combination with another aromatic group. The nature of this aromatic unit plays a key role in the electronic properties of the polymers. For example, polyfluorenes which combine chromophoric and charge transporting aromatic units have received a great deal of attention over the last several years as the emissive layer in polymeric light emitting diodes [LUMATION* Light-Emitting Polymers (LEPs)]. More recently, polyfluorenes have also been designed to perform as the organic semiconducting layer in polymeric field effect transistors (PFETs). This effort has led to a class of polymeric semiconductors with an excellent combination of charge mobility, environmental stability, and processability. One such polymer is the polyfluorene based on an alternating backbone of 9,9-dioctylfluorene and 2,2'-bithiophene units. This material has been shown to have charge mobilities as high as 0.02 cm2/V-s with current on/off ratios of up to 106. The poly(fluorene-bithiophene) is more resistant to doping by atmospheric oxygen than other polymeric semiconductors such as poly(3-hexylthiophene). Inks based on solutions of poly(fluorene-bithiophene) in xylene, mesitylene, and other solvents have also been prepared. The paper will focus on the recent advances in the synthesis, fabrication, and electrical characterization of poly(fluorene-bithiophene). *Trademark of The Dow Chemical Company

Men's sexual orientation and health in Canada

OBJECTIVES

Previous large-scale population studies have reported that gay and bisexual men may be at increased risk for health disparities. This study was conducted to determine whether health status and health risk behaviours of Canadian men vary based on sexual orientation identity.

METHODS

Utilizing the Canadian Community Health Survey data (Cycle 2.1, 2003; n = 49,901), we conducted multivariable logistic regression to assess the independent effects of sexual orientation on health status and health risk behaviours. For all multivariate models, we calculated odds ratios, p-values, standard errors, and 95% confidence intervals (CIs) using the bootstrap re-sampling procedure recommended by Statistics Canada.

RESULTS

When compared to heterosexual men, gay and bisexual men did not report more respiratory conditions; had lower rates of obesity and overweight BMI; and reported more mood/anxiety disorders, and a history of lifetime suicidality. Gay and bisexual men did not report higher rates of daily smoking or risky drinking, however, gay men reported an almost six-fold increase in STD diagnoses when compared to heterosexual men.

CONCLUSION

This study represents the largest-known population-based data analysis on health risks and behaviours among men of varying sexual orientations. These findings raise important concerns regarding the impact of sexual orientation on mental and sexual health. Limitations of this data set, including those associated with measurement of sexual orientation, are discussed. Further research is required to understand the mechanisms that influence these health resiliencies and disparities.

HIV treatment optimism and unsafe anal intercourse among HIV-positive men who have sex with men: findings from the positive connections study

This study was designed to examine the impact of HIV treatment optimism on sexual risk among a racially diverse sample of HIV-positive MSM. Survey data were collected from 346 racially diverse HIV-positive MSM.

INCLUSION CRITERIA

18 years of age, male, at least one incident of unprotected anal intercourse (UAI) in the last year, currently on treatment. Other variables included demographics, sexual risk, depression, internalized homonegativity, HIV treatment history, alcohol/drug use and beliefs about HIV treatments (Susceptibility to transmit HIV, Severity of HIV infection and Condom Motivation). Those with lower income were more likely to report that HIV was less transmissible. A self-reported decrease in condom motivation was associated with being White, well-educated and increased alcohol/drug use. A decrease in Severity of HIV was associated with better mental health, being non-White and undetectable viral load. Sexual risk appears related to beliefs about how treatment affects the transmissibility of HIV. Race, socioeconomic status, alcohol/drug use, mental health and viral load were also associated with treatment beliefs.

Development of a treatment optimism scale for HIV-positive gay and bisexual men

Potential items to be included in an HIV Treatment Optimism scale were reviewed by 17 HIV-positive gay and bisexual men (GBM), resulting in a 21-item test instrument. After pilot testing, data were collected from a multi-city sample of high-risk HIV-positive GBM (n=346), who were currently on treatment and were recruited to attend a two-day sexual health seminar. The scale items were analyzed utilizing Principal Components Analysis and reliability testing. The factor analysis resulted in the development of three separate scales. The Susceptibility scale contained 10 items associated with a belief that HIV is less transmissible while on HIV treatment. The Condom Motivation scale contained five items addressing a decreased motivation to use condoms while on treatment and the Severity scale contained four items associated with a decreased sense of the severity of an HIV diagnosis. Reliability coefficients (alpha) and mean inter-item correlations (M) for the three scales were acceptable (Susceptibility, alpha = 0.86, M=0.39; Condom Motivation, alpha = 0.84, M = 0.50; Severity, alpha = 0.71, M=0.37). Combined as one scale,the reliability coefficient was respectable (alpha = 0.76), but the mean inter-item correlation was 0.14. Based on this analysis, use of a single measure was not supported and three separate scales were developed. The scales were equivalent across racial groups except White men were more like to report a decreased motivation to use condoms compared to Black or Latino men. Three separate scales addressing beliefs about the transmissibility of HIV while on treatment (Susceptibility), the quality of life while on HIV treatment (Severity) and the motivation to use condoms consistently while on treatment (Condom Motivation) may be better markers for assessing optimistic beliefs about HIV treatment among HIV-positive GBM.

History of childhood sexual abuse and unsafe anal intercourse in a 6-city study of HIV-positive men who have sex with men

OBJECTIVES

We assessed rates of childhood sexual abuse and its demographic and mental health correlates among HIV-positive men who reported unsafe anal intercourse with other men in the past year.

METHODS

We conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men enrolled in the Positive Connections intervention.

RESULTS

Childhood sexual abuse was reported by 47% of participants; 32% reported frequency as often or sometimes. Men reporting abuse were more likely to be Latino (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.6, 4.2; P < .001) or African American (OR = 1.8; 95% CI = 1.2, 2.7; P = .005) than White. Among those who were abused, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR] = 1.3; P < .001) and unsafe anal intercourse (often, RR = 1.5; sometimes, RR = 2.0; P < .001) compared with men who were not abused.

CONCLUSIONS

History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color. Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections.

Have they really come out: gay men and their parents in Taiwan

In Chinese culture, filial piety for a son is closely linked to his capacity to produce an heir to ensure continuity of the paternal line. For Taiwanese gay men, coming out as gay may be interpreted as a refusal to produce a male heir and thus constitutes a major conflict within their family. This study explores how gay men in Taiwan come out to their parents within this cultural context. Thirty-two men in total were interviewed. Findings demonstrate that the decision to come out was often motivated by the son's perception of his parents' attitude towards homosexuality. Respondents worked hard to prepare for coming out and to minimize the risk and the impacts of the process, their report shows that some parents go through their own process of coming out and/or hiding in the closet after their gay son's coming out. Although many parents still see homosexuality as illness, some adopt alternative discourses to reinterpret the meaning of being gay as a spiritual path to eternal enlightenment or friendship. These findings imply sites of resistance to the privileged discourse of filial piety in constituting the experiences of coming out for Taiwanese gay men and their parents.

History of childhood sexual abuse and HIV risk behaviors in homosexual and bisexual men

OBJECTIVES

We examined the prevalence and frequency of childhood sexual abuse and their association with sexual risk among a sample of gay and bisexual men. Methods. Cross-sectional data were collected by survey from randomly selected gay and bisexual men who attended the 1997 and 1998 Minneapolis/St. Paul Gay, Lesbian, Bisexual, and Transgender Pride Festivals. Data included demographics, sexual activity, history of childhood sexual abuse, HIV status, history of sexually transmitted infection, use of sex-related drugs (such as crack, cocaine, Ecstasy, amyl nitrate, crystal methamphetamine, and Special K), and history of exchanging sex for payment. Results. childhood sexual abuse was reported by 15.5% of the survey respondents (n = 134). Those who reported experiencing abuse regularly were more likely to (1) be HIV positive, (2) have exchanged sex for payment, and (3) be a current user of sex-related drugs. Neither unsafe sex nor sexually transmitted infections were associated with childhood sexual abuse.

CONCLUSIONS

These findings show that more than 1 in 7 gay and bisexual men in a non-clinical, festival-based setting were victims of childhood sexual abuse and that childhood sexual abuse was associated with alarmingly high rates of men who were HIV infected and antecedent risk behaviors.

Routine mobilization of the splenic flexure is not necessary during anterior resection for rectal cancer

PURPOSE

Splenic flexure mobilization is widely considered to be an essential component of anterior resection for rectal cancer. It was our hypothesis that selective splenic flexure mobilization would reduce operative times without increasing morbidity or affecting cure.

METHODS

A total of 100 consecutive patients with rectal cancer (mean 8 (range, 4-15) cm from anal verge) who underwent anterior resection for cure between 1996 and 2002 had splenic flexure mobilization only as required to achieve a tension-free anastomosis. Operative time, postoperative morbidity, pathologic findings, and recurrence rates were recorded.

RESULTS

There were no clinicopathologic differences between those who had splenic flexure mobilization (n = 26) and those who did not (n = 74). Mean operative time in the splenic flexure mobilization group was longer, 167 (range, 130-200) minutes vs. 120 (range, 95-180) minutes in the nonmobilized group (P = 0.023). Mean length of specimen resected was longer in the splenic flexure mobilization group: 36 vs. 18 cm (P = 0.008). Anastomotic complications (4 percent), local recurrence (7 percent, median follow-up, 38 months), perioperative morbidity (32 percent) and mortality (2 percent), and survival did not differ between the two groups.

CONCLUSIONS

Routine splenic flexure mobilization is not required for safe anterior resection in patients with rectal cancer. Avoiding splenic flexure mobilization results in shorter operative times and does not increase postoperative morbidity, anastomotic leakage, or local recurrence.

Chronic lymphocytic leukaemia complicated by recurrent Bell's palsy

A patient who presented with a transient right-sided Bell's palsy (lower motor neurone lesion of the facial nerve) and chronic lymphocytic leukaemia (CLL) is described. During the following 5 years whilst receiving intermittent treatment for her CLL, the patient experienced two further episodes of Bell's palsy, one on the right side and the other left-sided. Each episode completely resolved. This is the first reported case of recurrent Bell's palsy complicating CLL.