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Kutner BA, Pho AT, López-Rios J, Lentz C, Dolezal C, Balán IC. Attitudes and Perceptions About Disclosing HIV and Syphilis Results Using Smarttest, a Smartphone App Dedicated to Self- and Partner Testing. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:234-248. [PMID: 34014111 PMCID: PMC8209687 DOI: 10.1521/aeap.2021.33.3.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We explored interest in disclosing test results through a smartphone app dedicated to self- and partner testing for HIV/syphilis. Fifty-nine cisgender men and transgender women each participated in an in-person survey and interview. We examined their interests in sharing test results by audience (e.g., partners, physicians) and by positive versus negative test result. Participants wanted the ability to share results, with notable interest in disclosing negative results to sexual partners and on social media and forwarding positive results to physicians. Participants envisioned smartphone sharing as a means to normalize testing, to notify partners of results, and to expedite linkage to care. Some questioned the authenticity of results shared by smartphone, while others voiced optimism that a personalized, authenticated app could ensure the security and veracity of results. Smartphone testing apps for HIV/syphilis may facilitate disclosure, partner notification, and linkage to care, but need to address concerns about the security and veracity of results.
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Affiliation(s)
- Bryan A. Kutner
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA
| | - Anthony T. Pho
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 1701 Page Mill Road, MC5376, Palo Alto, CA 94304, USA
| | - Javier López-Rios
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA
| | - Cody Lentz
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA
| | - Curtis Dolezal
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA
| | - Iván C. Balán
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA
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Behavioral Intentions to Use Patient Portals to Disclose HIV and Other Sexually Transmitted Infection Testing Histories with Sexual Partners Among U.S. Sexual Minority Men. AIDS Behav 2021; 25:1199-1209. [PMID: 33185776 DOI: 10.1007/s10461-020-03092-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
Disclosure of HIV and other sexually transmitted infection (HIV/STI) testing history to sexual partners is low among gay, bisexual, and other U.S. sexual minority men (SMM). Patient portals (PP) could increase HIV/STI testing history disclosure. This study estimated the predictive validity of the Enhancing Dyadic Communication (EDC) latent construct for perceived behavioral intentions to use PP for HIV/STI test disclosures. A randomized subset of SMM completed the Patient Portal Sexual Health Instrument as part of the 2018 American Men's Internet Survey. Multivariable logistic regression models estimated associations between EDC and intentions to use PP for test disclosures. Among a sample of 1,509 SMM aged 15 to 77 years, EDC was associated with intentions to use PP to disclose test history with main partners (aOR 2.17; 95% CI 1.90 to 2.47) and non-main partners (aOR 2.39; 95%CI 2.07 to 2.76). Assessing EDC could be useful in clinical settings for interventions encouraging patients to communicate with partners about testing.
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Anderson CK, Reilly SP, Brossay L. The Invariant NKT Cell Response Has Differential Signaling Requirements during Antigen-Dependent and Antigen-Independent Activation. THE JOURNAL OF IMMUNOLOGY 2020; 206:132-140. [PMID: 33229442 DOI: 10.4049/jimmunol.2000870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
Invariant NKT (iNKT) cells are an innate-like population characterized by their recognition of glycolipid Ags and rapid cytokine production upon activation. Unlike conventional T cells, which require TCR ligation, iNKT cells can also be stimulated independently of their TCR. This feature allows iNKT cells to respond even in the absence of glycolipid Ags, for example, during viral infections. Although the TCR-dependent and -independent activation of iNKT cells have been relatively well established, the exact contributions of IL-12, IL-18, and TLRs remain unclear for these two activation pathways. To definitively investigate how these components affect the direct and indirect stimulation of iNKT cells, we used mice deficient for either MyD88 or the IL-12Rβ2 in the T cell lineage. Using these tools, we demonstrate that IL-12, IL-18, and TLRs are completely dispensable for the TCR activation pathway when a strong agonist is used. In contrast, during murine CMV infection, when the TCR is not engaged, IL-12 signaling is essential, and TLR signaling is expendable. Importantly, to our knowledge, we discovered an intrinsic requirement for IL-18 signaling by splenic iNKT cells but not liver iNKT cells, suggesting that there might be diversity, even within the NKT1 population.
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Affiliation(s)
- Courtney K Anderson
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI 02906
| | - Shanelle P Reilly
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI 02906
| | - Laurent Brossay
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI 02906
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Modi RA, McGwin GL, Willig JH, Westfall AO, Griffin RL, Amico R, Martin KD, Raper JL, Keruly JC, Golin CE, Zinski A, Napravnik S, Crane HM, Mugavero MJ. Factors Associated with HIV Disclosure Status Among iENGAGE Cohort of New to HIV Care Patients. AIDS Patient Care STDS 2020; 34:213-227. [PMID: 32396474 DOI: 10.1089/apc.2019.0271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV disclosure is an important behavior with implications for HIV treatment and prevention but understudied among new to HIV care patients who face unique challenges adjusting to a new diagnosis. This study evaluated the factors associated with HIV disclosure status and patterns of HIV disclosure among new to HIV care patients. A cross-sectional study was conducted evaluating the iENGAGE (integrating ENGagement and Adherence Goals upon Entry) cohort. Participants were enrolled in this randomized behavioral trial between December 2013 and June 2016. The primary and secondary outcomes included HIV disclosure status (Yes/No) and patterns of disclosure (Broad, Selective and Nondisclosure), respectively. Logistic and Multinomial Logistic Regression were used to evaluate the association of participant factors with HIV disclosure and patterns of HIV disclosure, respectively. Of 371 participants, the average age was 37 ± 12 years, 79.3% were males, and 62.3% were African Americans. A majority of participants (78.4%) disclosed their HIV status at baseline, 63.1% were broad disclosers and 15.2% were selective disclosers. In multivariable regression, black race, emotional support, and unmet needs predicted any HIV and broad disclosure, whereas males, emotional support, active coping, and acceptance were associated with selective disclosure. Interventions to promote early disclosure should focus on coping strategies and unmet needs, particularly among black and male people living with HIV initiating care.
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Affiliation(s)
- Riddhi A. Modi
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerald L. McGwin
- Department of Epidemiology, and University of Alabama at Birmingham, Birmingham, Alabama
| | - James H. Willig
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew O. Westfall
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Russell L. Griffin
- Department of Epidemiology, and University of Alabama at Birmingham, Birmingham, Alabama
| | - Rivet Amico
- Department of Health Behavior and Education, University of Connecticut, Storrs, Connecticut
| | - Kimberly D. Martin
- Department of Epidemiology, and University of Alabama at Birmingham, Birmingham, Alabama
| | - James L. Raper
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jeanne C. Keruly
- Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland
| | - Carol E. Golin
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Anne Zinski
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sonia Napravnik
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heidi M. Crane
- Department of Medicine, University of Washington, Seattle, Washington
| | - Michael J. Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Ward LM, Bruce MA, Thorpe RJ, Mena L, Nunn A, Crosby R. Correlates Associated With Willingness to Start Pre-exposure Prophylaxis Among Young Black Men Who Have Sex With Men (MSM) in Jackson, Mississippi. FAMILY & COMMUNITY HEALTH 2019; 42:189-196. [PMID: 31107729 DOI: 10.1097/fch.0000000000000225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Black men who have sex with men have the greatest risk for human immunodeficiency virus infection. Pre-exposure prophylaxis (PrEP) is a highly effective prevention method. However, uptake in this group is extremely low. Data from a sample of 225 human immunodeficiency virus-negative young black men who have sex with men residing in Jackson, Mississippi, were analyzed to examine correlates associated with willingness to start PrEP. Consistent condom users for both insertive and receptive sex were more likely to be willing to start PrEP than inconsistent condom users. Heterogeneity among this high-risk population is an important consideration for future studies assessing PrEP uptake and evaluating prevention efforts.
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Affiliation(s)
- Lori M Ward
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson (Drs Ward, Bruce, Thorpe, and Mena); Program for Research on Faith and Health, Center for Research on Men's Health, and Center for Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee (Dr Bruce); Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, and Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Thorpe); Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson (Dr Mena); Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island (Dr Nunn); and Department of Health Behavior, College of Public Health, University of Kentucky, Lexington (Dr Crosby)
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