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Foley S, Keene DE, Shrestha R, Brown SE, Gautam K, Sutherland RA, Maviglia F, Saifi R, Wickersham JA. Exploring Attitudes Toward Pre-Exposure Prophylaxis for HIV Prevention Prior to Implementation Among Female Sex Workers in Malaysia: Results from a Qualitative Study. Patient Prefer Adherence 2024; 18:797-807. [PMID: 38595805 PMCID: PMC11003429 DOI: 10.2147/ppa.s413423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 02/08/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Pre-exposure prophylaxis (PrEP) is an effective method for prevention of HIV transmission. Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population, yet little is known about this population's current HIV prevention practices or acceptance of PrEP. This study aims to inform the culturally relevant implementation of PrEP through the qualitative exploration of (1) the potential need for PrEP in this population and (2) the factors that determine FSW willingness to use oral PrEP. Methods In-depth, semi-structured interviews (n = 30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach. Results FSW express positive interest in PrEP but prefer it as a supplement to condoms, not a replacement. Perceived challenges to PrEP use include cost, adherence, and side effects. Conclusion The findings suggest that in combination with condom use, PrEP may be an acceptable method of HIV prevention. Effective PrEP rollout may also include condom promotion using a peer-driven model, cost subsidies, and sex work harm reduction and empowerment components.
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Affiliation(s)
- Shaylen Foley
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Danya E Keene
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Ryan A Sutherland
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Francesca Maviglia
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Rumana Saifi
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jeffrey A Wickersham
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Palmer L, Maviglia F, Wickersham JA, Khati A, Kennedy O, Copenhaver NM, Uyer C, Halim MAA, Ikhtiaruddin WM, Azwa I, Gautam K, Shrestha R. Chemsex and Harm Reduction Practices Among Men Who Have Sex with Men in Malaysia: Findings from a Qualitative Study. J Psychoactive Drugs 2023:1-10. [PMID: 37610135 PMCID: PMC10884347 DOI: 10.1080/02791072.2023.2250342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/10/2023] [Indexed: 08/24/2023]
Abstract
Chemsex is a form of sexualized drug use commonly practiced among MSM with psychoactive substances, such as methamphetamine. While this phenomenon has gained global attention in the past two decades, there is a dearth of empirical data to inform culturally competent interventions. The current work investigates the socio-contextual factors related to chemsex and harm reduction practices among Malaysian MSM. Between February and August 2022, we conducted six online focus group sessions with Malaysian MSM who had engaged in chemsex during the previous 6 months (N = 22). We queried participants about perceived benefits and harms, harm reduction practices, and informational needs. Most participants' first chemsex experience occurred in a casual sexual encounter, often facilitated by mobile technology. Participants reported engaging in harm reduction practices before (e.g. medication reminders), during (e.g. peer support), and after (e.g. rest) chemsex. These findings have implications for future efforts to develop and implement tailored interventions to address the specific and acute needs of Malaysian MSM engaging in chemsex.
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Affiliation(s)
- Lindsay Palmer
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Francesca Maviglia
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Jeffrey A Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Olivia Kennedy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Christopher Uyer
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Mohd Akbar Ab Halim
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Mohd Ikhtiaruddin
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Iskandar Azwa
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Kim RS, Wickersham JA, Maviglia F, Galka JM, Azwa I, Gautam K, Shrestha R. Drivers of HIV self-testing among female sex workers: Findings from a multi-state study in Malaysia. Front Med (Lausanne) 2023; 10:1022746. [PMID: 37089614 PMCID: PMC10117675 DOI: 10.3389/fmed.2023.1022746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundAlthough research on HIV self-testing (HIVST) has rapidly increased, few studies have explored HIVST uptake in female sex workers (FSW), and none in Malaysia. Therefore, we endeavored to assess the willingness to use HIVST in this at-risk, vulnerable population.MethodsA cross-sectional survey study was conducted among 113 HIV-negative Malaysian FSW in 2017. Participants were recruited using advertisements on social media, flyers, and direct referrals from community-based organizations. Data were collected using self-administered surveys. Multivariable logistic regression was used to identify correlates of willingness to use HIVST.ResultsNearly a third of participants (30.1%) reported they would be willing to use HIVST. Multivariable analyses adjusting for Malay ethnicity, stable housing, living in Kuala Lumpur (KL), years in sex work, age of first sex work, childhood sexual assault, history of HIV testing, and previously in prison indicated that living in KL [adjusted odds ratio (aOR) = 5.214, p = 0.0137] was associated with a greater willingness to use HIVST. In contrast, having stable housing (aOR = 0.100, p = 0.0064) was negatively associated with willingness to use HIVST.ConclusionsOur results indicate that HIVST may potentially enhance the uptake of HIV testing among FSWs living in an urban environment and experiencing unstable housing, but an overall willingness to use HIVST is low. These findings highlight the need for efforts to increase awareness of HIVST among FSWs and additional research on the effective implementation of HIVST for FSW.
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Affiliation(s)
- Rayne S. Kim
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Jeffrey A. Wickersham
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Francesca Maviglia
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Jonathan M. Galka
- Department of the History of Science, Harvard University, Cambridge, MA, United States
| | - Iskandar Azwa
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Roman Shrestha
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- *Correspondence: Roman Shrestha,
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Richiusa M, Ireland P, Maviglia F, Nicholas J, Vizvary Z. Advances in material phase change modelling approach for EU-DEMO limiter’s plasma-facing components. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Maviglia F, Wickersham JA, Azwa I, Copenhaver N, Kennedy O, Kern M, Khati A, Lim SH, Gautam K, Shrestha R. Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey. Int J Environ Res Public Health 2022; 20:294. [PMID: 36612617 PMCID: PMC9819808 DOI: 10.3390/ijerph20010294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Background: Chemsex is the use of illicit drugs—particularly methamphetamine, gamma hydroxybutyrate (GHB), and gamma-butyrolactone (GBL)—to enhance sexual activity. Chemsex, which occurs primarily among communities of men who have sex with men (MSM), is associated with greater HIV risk behaviors, including multiple sex partners, group sex, condomless sex, and injection drug use. Despite evidence showing chemsex engagement among Malaysian MSM, there is a paucity of research on chemsex among MSM in Malaysia. Methods: This cross-sectional study was conducted through an online survey (August to September 2021) among 870 Malaysian MSM. Participants were recruited through targeted advertisements on social networks. We collected information regarding participants’ recent (<6 months) engagement in chemsex, demographic characteristics, psychosocial factors, pre-exposure prophylaxis (PrEP) knowledge and history, and recent sexual- and drug-related behavior. Multivariable logistic regression was used to identify factors associated with recent (<6 months) chemsex engagement. Results: Just under 1 in 10 (9.0%) of participants reported having engaged in chemsex in the previous six months. More than two-thirds of participants (69.1%) had not disclosed their sexual orientation to anyone in their family and 35.2% reported moderate to severe depressive symptoms. Multivariable analysis found that recent injection drug use (adjusted odds ratio: aOR = 6.61; 95% confidence interval: CI, 2.30−19.03), having shared pre-exposure prophylaxis (PrEP) with someone else (aOR = 5.60; 95% CI, 1.76−17.77), higher perceived HIV risk (aOR = 3.15; 95% CI, 1.25−7.93), knowing someone using PrEP (aOR = 2.93; 95% CI, 1.62−5.31), recent engagement in transactional sex (aOR = 2.38; 95% CI, 1.06−5.39), having a recent STI diagnosis (aOR = 2.36; 95% CI, 1.25−4.44), recent engagement in anal sex (aOR = 2.21; 95% CI, 1.07−4.57), and recent sexual intercourse with an HIV-positive partner (aOR = 2.09; 95% CI, 1.07−4.08) were associated with recent engagement in chemsex. Conclusions: Malaysian MSM who practice chemsex are vulnerable to several HIV risk factors, such as transactional sex, HIV-positive sexual partners, and injection drug use. There is an urgent need for programs that integrate drug, sexual health, and mental health services, with a focus on harm reduction (e.g., condoms, access to and utilization of HIV testing and PrEP services, drug knowledge, and safer drug use) tailored for MSM who practice chemsex.
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Affiliation(s)
- Francesca Maviglia
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, New Haven, CT 06510, USA
| | - Jeffrey A. Wickersham
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, New Haven, CT 06510, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia
| | - Iskandar Azwa
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia
| | - Nicholas Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Olivia Kennedy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Monique Kern
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Sin How Lim
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia
| | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Roman Shrestha
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, New Haven, CT 06510, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
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Skaathun B, Maviglia F, Vo A, McBride A, Seymour S, Mendez S, Gonsalves G, Beletsky L. Prioritization of carceral spending in U.S. cities: Development of the Carceral Resource Index (CRI) and the role of race and income inequality. PLoS One 2022; 17:e0276818. [PMID: 36520883 PMCID: PMC9754598 DOI: 10.1371/journal.pone.0276818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Policing, corrections, and other carceral institutions are under scrutiny for driving health harms, while receiving disproportionate resources at the expense of prevention and other services. Amidst renewed interest in structural determinants of health, roles of race and class in shaping government investment priorities are poorly understood. METHODS Based on the Social Conflict Model, we assessed relationships between city racial/ economic profiles measured by the Index of Concentration at the Extremes (ICE) and budgetary priorities measured by the novel Carceral Resource Index (CRI), contrasting investments in carceral systems with funding for health and social support across the 50 most populous cities in the United States (U.S.). Bivariate correlations, and unadjusted and adjusted polynomial regression models were used to assess the relationship between budgetary investments and population concentration at extremes in terms of income, racial/ethnic composition, and education, controlling for other demographic characteristics. RESULTS In our sample, median CRI was -0.59 (IQR -0.64, -0.45), with only seven cities exhibiting positive CRI values. This indicates that most large U.S. cities spend more on carceral systems than on health and supportive services, combined. Adjusted polynomial models showed a convex relationship between the CRI and ICE-Education, and ICE-Race(White vs. Black)+Income, with quadratic terms that were positive and significant at p<0.05. After controlling for age, the strongest prioritization of carceral systems was observed in cities where the proportion of low-income Black residents approached or exceeded that of high-income white residents. CONCLUSIONS Municipal prioritization of carceral investments over health and social support is pervasive in the U.S and exacerbated by racial and economic disparities. The CRI offers new opportunities to understand the role of government investments as a structural determinant of health and safety. Longitudinal research is warranted to examine the relationship between budget priorities, structural racism, and health outcomes.
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Affiliation(s)
- Britt Skaathun
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
- * E-mail:
| | - Francesca Maviglia
- Yale School of Public Health, Public Health Modeling Unit, Yale University, New Haven, CT, United States of America
| | - Anh Vo
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
| | - Allison McBride
- Health in Justice Action Lab, School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States of America
| | - Sarah Seymour
- Health in Justice Action Lab, School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States of America
| | - Sebastian Mendez
- Health in Justice Action Lab, School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States of America
| | - Gregg Gonsalves
- Yale School of Public Health, Public Health Modeling Unit, Yale University, New Haven, CT, United States of America
| | - Leo Beletsky
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
- Health in Justice Action Lab, School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States of America
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Khati A, Altice FL, Vlahov D, Eger WH, Lee J, Bohonnon T, Wickersham JA, Maviglia F, Copenhaver N, Shrestha R. Nurse Practitioner-Led Integrated Rapid Access to HIV Prevention for People Who Inject Drugs (iRaPID): Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e42585. [PMID: 36222826 PMCID: PMC9597427 DOI: 10.2196/42585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The ongoing volatile opioid epidemic remains a significant public health concern, alongside continued outbreaks of HIV and hepatitis C virus among people who inject drugs. The limited access to and scale-up of medications for opioid use disorder (MOUD) among people who inject drugs, coupled with multilevel barriers to pre-exposure prophylaxis (PrEP) uptake, makes it imperative to integrate evidence-based risk reduction and HIV prevention strategies in innovative ways. To address this need, we developed an integrated rapid access to HIV prevention program for people who inject drugs (iRaPID) that incorporates same-day PrEP and MOUD for this population. OBJECTIVE The primary objective of this pilot study is to assess the feasibility and acceptability of the program and evaluate its preliminary efficacy on PrEP and MOUD uptake for a future randomized controlled trial (RCT). We also aim to explore information on the implementation of the program in a real-world setting using a type I hybrid implementation trial design. METHODS Using a type I hybrid implementation trial design, we are pilot testing the nurse practitioner-led iRaPID program while exploring information on its implementation in a real-world setting. Specifically, we will assess the feasibility and acceptability of the iRaPID program and evaluate its preliminary efficacy on PrEP and MOUD uptake in a pilot RCT. The enrolled 50 people who inject drugs will be randomized (1:1) to either iRaPID or treatment as usual (TAU). Behavioral assessments will occur at baseline, and at 1, 3, and 6 months. Additionally, we will conduct a process evaluation of the delivery and implementation of the iRaPID program to collect information for future implementation. RESULTS Recruitment began in July 2021 and was completed in August 2022. Data collection is planned through February 2023. The Institutional Review Boards at Yale University and the University of Connecticut approved this study (2000028740). CONCLUSIONS This prospective pilot study will test a nurse practitioner-led, integrated HIV prevention program that incorporates same-day PrEP and MOUD for people who inject drugs. This low-threshold protocol delivers integrated prevention via one-stop shopping under the direction of nurse practitioners. iRaPID seeks to overcome barriers to delayed PrEP and MOUD initiation, which is crucial for people who inject drugs who have had minimal access to evidence-based prevention. TRIAL REGISTRATION ClinicalTrials.gov NCT04531670; https://clinicaltrials.gov/ct2/show/NCT04531670. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42585.
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Affiliation(s)
- Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | | | - David Vlahov
- Yale School of Nursing, West Haven, CT, United States
| | - William H Eger
- AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Jessica Lee
- AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Terry Bohonnon
- AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | | | | | - Nicholas Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- AIDS Program, Yale School of Medicine, New Haven, CT, United States
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Khoshnood K, Smoyer AB, Maviglia F, Kara J, Khouri D, Fouad FM, Heimer R. Stress, Marginalization, and Disruption: A Qualitative Rapid Situational Assessment of Substance Users and HIV Risk in Lebanon. Int J Environ Res Public Health 2022; 19:ijerph19159242. [PMID: 35954600 PMCID: PMC9368310 DOI: 10.3390/ijerph19159242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022]
Abstract
Lebanon is a diverse and dynamic nation of six million people that has experienced considerable disruption for the last two decades. The Syrian Civil War, which began in 2011, resulted in the displacement of 1.1 million Syrians to Lebanon. Today, Lebanon is the country with the largest per capita number of refugees in the world. In addition, the country experienced a social, economic, and political crisis in 2019 that destabilized the entire society-circumstances that were further complicated by COVID-19 pandemic. With all of the competing calamities in Lebanon, there has been limited scientific investigation into substance use and the risk of HIV infection among the country's population. To address this gap in knowledge, a qualitative rapid situational assessment (RSA) of substance use and risk of HIV infection in and around Beirut, the nation's capital, was conducted. The goal of this analysis is to describe the demographics and drug use patterns of this population, explore their HIV knowledge and risks, and build knowledge about their perceptions of and access to substance use treatment and other social services.
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Affiliation(s)
- Kaveh Khoshnood
- Center for Interdisciplinary Research on AIDS at Yale, Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT 06520, USA; (F.M.); (J.K.); (R.H.)
- Correspondence:
| | - Amy B. Smoyer
- Department of Social Work, Southern Connecticut State University, New Haven, CT 06520, USA;
| | - Francesca Maviglia
- Center for Interdisciplinary Research on AIDS at Yale, Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT 06520, USA; (F.M.); (J.K.); (R.H.)
| | - Janine Kara
- Center for Interdisciplinary Research on AIDS at Yale, Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT 06520, USA; (F.M.); (J.K.); (R.H.)
| | | | - Fouad M. Fouad
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1100, Lebanon;
| | - Robert Heimer
- Center for Interdisciplinary Research on AIDS at Yale, Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT 06520, USA; (F.M.); (J.K.); (R.H.)
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Shrestha R, Maviglia F, Altice FL, DiDomizio E, Khati A, Mistler C, Azwa I, Kamarulzaman A, Halim MAA, Wickersham JA. Mobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey. J Med Internet Res 2022; 24:e36917. [PMID: 35877172 PMCID: PMC9361153 DOI: 10.2196/36917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/14/2022] [Accepted: 05/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The growth in mobile technology access, utilization, and services holds great promise in facilitating HIV prevention efforts through mobile health (mHealth) interventions in Malaysia. Despite these promising trends, there is a dearth of evidence on the use of mHealth platforms that addresses HIV prevention among Malaysian men who have sex with men. OBJECTIVE The goal of this study was to gain insight into (1) access and utilization of communication technology (eg, landline phone, internet, mobile phone), (2) acceptability of mHealth-based interventions for HIV prevention services, and (3) preferences regarding the format and frequency of mHealth interventions among Malaysian men who have sex with men. METHODS We conducted a cross-sectional survey with Malaysian men who have sex with men between July 2018 and March 2020. Participants were recruited using respondent-driven sampling in the Greater Kuala Lumpur region of Malaysia. We collected information on demographic characteristics, HIV risk-related behaviors, access to and the frequency of use of communication technology, and acceptability of using mHealth for HIV prevention using a self-administered questionnaire with a 5-point scale (1, never; 2, rarely; 3, sometimes; 4, often; 5, all the time). RESULTS A total of 376 men participated in the survey. Almost all respondents owned or had access to a smartphone with internet access (368/376, 97.9%) and accessed the internet daily (373/376, 99.2%), mainly on a smartphone (334/376, 88.8%). Participants on average used smartphones primarily for social networking (mean 4.5, SD 0.8), followed by sending or receiving emails (mean 4.0, SD 1.0), and searching for health-related information (mean 3.5, SD 0.9). There was high acceptance of the use of mHealth for HIV prevention (mean 4.1, SD 1.5), including for receiving HIV prevention information (345/376, 91.8%), receiving medication reminders (336/376, 89.4%), screening and monitoring sexual activity (306/376, 81.4%) or illicit drug use (281/376, 74.7%), and monitoring drug cravings (280/376, 74.5%). Participants overwhelmingly preferred a smartphone app over other modalities (eg, text, phone call, email) for engaging in mHealth HIV prevention tools. Preference for app notifications ranged from 186/336 (53.9%), for receiving HIV prevention information, to 212/336 (69.3%), for screening and monitoring sexual activity. Acceptance of mHealth was higher for those who were university graduates (P=.003), living in a relationship with a partner (P=.04), engaged in sexualized drug use (P=.01), and engaged in receptive anal sex (P=.006). CONCLUSIONS Findings from this study provide support for developing and deploying mHealth strategies for HIV prevention using a smartphone app in men who have sex with men-a key population with suboptimal engagement in HIV prevention and treatment.
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Affiliation(s)
- Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Francesca Maviglia
- Section of Infectious Diseases, Yale University, New Haven, CT, United States
| | - Frederick L Altice
- Section of Infectious Diseases, Yale University, New Haven, CT, United States
| | - Elizabeth DiDomizio
- Section of Infectious Diseases, Yale University, New Haven, CT, United States
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Colleen Mistler
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Iskandar Azwa
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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10
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11
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Siccinio M, Graves J, Kembleton R, Lux H, Maviglia F, Morris A, Morris J, Zohm H. Development of the plasma scenario for EU-DEMO: Status and plans. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113047] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Wickersham JA, Meyer JP, Shenoi S, Altice FL, Barakat LA, Virata M, Olivares M, Maviglia F, Khati A, Shrestha R. Willingness to Be Vaccinated Against COVID-19 Among People With HIV in the United States: Results From a National Survey. Front Med (Lausanne) 2022; 9:886936. [PMID: 35847816 PMCID: PMC9280331 DOI: 10.3389/fmed.2022.886936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Approximately 215 million Americans have been fully vaccinated for COVID-19, representing over 65% of the total population. People with HIV (PWH) may be more susceptible to COVID-19 infection or severe disease, elevating the importance of COVID-19 vaccination uptake in the population. We report results from a national survey of PWH to evaluate the likelihood of receiving a COVID-19 vaccine. Methods We conducted an online survey of 1,030 PWH living in the United States between December 6, 2020 and January 8, 2021 to evaluate likelihood of receiving a COVID-19 vaccine. Results Overall, participants were highly willing to be vaccinated, with 83.8% stating they "strongly agree" (65.7%) or "somewhat agree" (18.1%). Participants' top vaccine-related concerns were side-effects (39.3%), safety (14.7%), and fair/equitable distribution of the vaccine to affected communities (13.6%). Participants were more willing to be vaccinated if they reported receiving an annual influenza vaccination (p < 0.001), had previously tested positive for (p = 0.043) COVID-19, had been hospitalized for (p = 0.027) COVID-19 infection, or had an undetectable HIV viral load (p = 0.002). Black (p < 0.001), politically conservative (p < 0.001), and participants with an annual income of ≤ $19,999 (p = 0.005) were significantly less willing to be vaccinated for COVID-19. Conclusions The vast majority of PWH were willing to be vaccinated, though predominantly those who were already engaged in HIV care or directly affected by COVID-19. Findings from this large survey of PWH suggest intensive outreach efforts are needed to support engagement in vaccination programs, particularly among Black and politically conservative PWH.
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Affiliation(s)
- Jeffrey A Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Jaimie P Meyer
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States.,Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States
| | - Sheela Shenoi
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Frederick L Altice
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Lydia Aoun Barakat
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Michael Virata
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Miriam Olivares
- Marx Science and Social Science Library, Yale University Library, Yale University, New Haven, CT, United States
| | - Francesca Maviglia
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.,Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
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You J, Bachmann C, Belardi V, Binder M, Bowden D, Calabrò G, Fanelli P, Fursdon M, Garkusha I, Gerashchenko S, Hunger K, de Luca R, Makhlai V, Mantel N, Maviglia F, Müller AV, Nemati N, Roberts J, Vivio F, Vizvary Z, Zhang K. Limiters for DEMO wall protection: Initial design concepts & technology options. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2021.112988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pedersen CJ, Wickersham JA, Altice FL, Kamarulzaman A, Khoshnood K, Gibson BA, Khati A, Maviglia F, Shrestha R. Prevalence and Correlates of Active Amphetamine-Type Stimulant Use Among Female Sex Workers in Malaysia. Front Psychiatry 2022; 13:879479. [PMID: 35774093 PMCID: PMC9237260 DOI: 10.3389/fpsyt.2022.879479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
The use of amphetamine-type stimulants (ATS) has been associated with increased sexual risk behaviors and HIV transmission, among other adverse health outcomes. However, ATS use among female sex workers (FSWs) in Malaysia has not yet been characterized. We examined the prevalence and correlates associated with ATS use among Malaysian FSW. Between February and December 2016, 492 FSWs, including cisgender (n = 299) and transgender (n = 193) women, were recruited using respondent-driven sampling in Greater Kuala Lumpur, Malaysia. A structured questionnaire was used to collect demographic characteristics, sexual behaviors, ATS and other substance use, behavioral health issues, involvement in criminal justice, and experience of physical and sexual trauma. Logistic regression analyses were conducted to determine factors associated with active ATS use, defined as ATS use in the last 30 days. Nearly one-third (32.3%) of participants reported active ATS use. In the multivariable model, ATS use was associated with drug use during sex work (aOR = 17.10; 8.32-35.15), having moderate to severe level of substance use disorder (aOR = 3.38; 1.48-7.70), and engaging in sex work with multiple clients per day (two clients: aOR = 3.39; 1.36-8.46; three clients: aOR = 5.06; 1.81-14.10). A high prevalence of ATS use was documented in our sample. The presence of moderate to severe substance use disorder, the use of drugs during sex work activity, and having multiple sex work clients per day were significantly associated with active ATS use. Given these findings, prevention and harm reduction strategies need to be tailored to address the increasing ATS use and the associated adverse health consequences among FSWs in Malaysia.
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Affiliation(s)
- Courtney J Pedersen
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Jeffrey A Wickersham
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Frederick L Altice
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Adeeba Kamarulzaman
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Britton A Gibson
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Francesca Maviglia
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Roman Shrestha
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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Giorgetti F, Bachmann C, Calabrò G, Fanelli P, Maviglia F. Influence of DEMO vacuum vessel shell thickness on its electromagnetic response. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Daryani P, Ensha L, Frank M, Kofke L, Maviglia F, Miller AM. When principles and pedagogy clash: Moving beyond the limits of scholarly practices in an academic-community partnership with sex worker activists. Glob Public Health 2021; 17:2500-2511. [PMID: 34710344 DOI: 10.1080/17441692.2021.1991973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While U.S. public health education increasingly promotes community-based participatory research (CBPR) as a mode of socially-responsive research, today's intertwined health and social injustice crises demand honest reckoning with the limitations of CBPR as a framework for change. We are a team of students, fellows, and faculty reflecting on the complexities encountered over three years of collaborative work with street-based sex worker activists, in a city characterised by stark wealth disparities reinforced by policies of the university within which we operate. We centre a peer-based needs assessment survey and report on barriers to resources and services for sex workers to highlight hard choices and often unacknowledged challenges to academic partnerships. Our process intends to unsettle the too-sanguine narratives of CBPR, draw from insights arising in the discipline of law, and illuminate practices needed to honour commitments, translate knowledge to power-shifting action, and constructively engage with those most affected in determining the policies that structure their lives.We ask: Can our privileged position within the academy be usefully analysed, confronted, instrumentalised, and even subverted as we shape new practices and interventions in the name of health justice? How might we imagine principles and practices towards a movement public health?
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Affiliation(s)
- Poonam Daryani
- Yale Law School, Yale University, New Haven, Connecticut, USA
| | - Leila Ensha
- Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Mariah Frank
- Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Lily Kofke
- Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Francesca Maviglia
- Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Alice M Miller
- Yale Law School, Yale University, New Haven, Connecticut, USA.,Yale School of Public Health, Yale University, New Haven, Connecticut, USA
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Ambrosino R, Ariola M, Bachmann C, Castaldo A, Maviglia F, Mattei M, Tartaglione G. Sweeping control performance on DEMO device. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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De Luca R, Fanelli P, Hünteler C, Vivio F, Zhang K, von Müller A, Calabrò G, Maviglia F, You J. Comparison between finite element and experimental evidences of innovative W lattice materials for sacrificial limiter applications. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Maviglia F, Siccinio M, Bachmann C, Biel W, Cavedon M, Fable E, Federici G, Firdaouss M, Gerardin J, Hauer V, Ivanova-Stanik I, Janky F, Kembleton R, Militello F, Subba F, Varoutis S, Vorpahl C. Impact of plasma-wall interaction and exhaust on the EU-DEMO design. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2020.100897] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Richiusa M, Arter W, Firdaouss M, Gerardin J, Maviglia F, Vizvary Z. Poloidal distribution of penalty factors for DEMO Single Module Segment with limiters in normal operation. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2020.112210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Moscheni M, Carr M, Dulla S, Maviglia F, Meakins A, Nallo G, Subba F, Zanino R. Radiative heat load distribution on the EU-DEMO first wall due to mitigated disruptions. Nuclear Materials and Energy 2020. [DOI: 10.1016/j.nme.2020.100824] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Richiusa M, Arter W, Calleja D, Firdaouss M, Gerardin J, Kovari M, Maviglia F, Vizvary Z. Bare and limiter DEMO single module segment concept first Wall misalignment study by 3D field line tracing. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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de Luca R, Fanelli P, Mingozzi S, Calabrò G, Vivio F, Maviglia F, You J. Parametric design study of a substrate material for a DEMO sacrificial limiter. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bachmann C, Ciattaglia S, Cismondi F, Federici G, Franke T, Gliss C, Härtl T, Keech G, Kembleton R, Maviglia F, Siccinio M. Key design integration issues addressed in the EU DEMO pre-concept design phase. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111595] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vizvary Z, Arter W, Barrett T, Calleja D, Firdaouss M, Gerardin J, Kovari M, Maviglia F, Richiusa M. DEMO First Wall misalignment study. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.04.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kembleton R, Federici G, Ambrosino R, Maviglia F, Siccinio M, Reimerdes H, Ha S, Merriman S, Bachmann C, Suiko M. Engineering and integration risks arising from advanced magnetic divertor configurations. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gerardin J, Firdaouss M, Maviglia F, Arter W, Barrett T, Kovari M. Simplified heat load modeling for design of DEMO discrete limiter. Nuclear Materials and Energy 2019. [DOI: 10.1016/j.nme.2019.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Federici G, Bachmann C, Barucca L, Biel W, Boccaccini L, Brown R, Bustreo C, Ciattaglia S, Cismondi F, Coleman M, Corato V, Day C, Diegele E, Fischer U, Franke T, Gliss C, Ibarra A, Kembleton R, Loving A, Maviglia F, Meszaros B, Pintsuk G, Taylor N, Tran M, Vorpahl C, Wenninger R, You J. DEMO design activity in Europe: Progress and updates. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.04.001] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maviglia F, Albanese R, Ambrosino R, Arter W, Bachmann C, Barrett T, Federici G, Firdaous M, Gerardin J, Kovari M, Loschiavo V, Mattei M, Villone F, Wenninger R. Wall protection strategies for DEMO plasma transients. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.02.064] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Visca E, Böswirth B, Cacciotti E, Cerri V, Crescenzi F, Gallay F, Greuner H, Reale A, Richou M, Roccella S, You J, Maviglia F. Manufacturing and testing of ITER-like divertor plasma facing mock-ups for DEMO. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.05.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bachmann C, Ciattaglia S, Cismondi F, Eade T, Federici G, Fischer U, Franke T, Gliss C, Hernandez F, Keep J, Loughlin M, Maviglia F, Moro F, Morris J, Pereslavtsev P, Taylor N, Vizvary Z, Wenninger R. Overview over DEMO design integration challenges and their impact on component design concepts. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2017.12.040] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cismondi F, Boccaccini L, Aiello G, Aubert J, Bachmann C, Barrett T, Barucca L, Bubelis E, Ciattaglia S, Del Nevo A, Diegele E, Gasparotto M, Di Gironimo G, Di Maio P, Hernandez F, Federici G, Fernández-Berceruelo I, Franke T, Froio A, Gliss C, Keep J, Loving A, Martelli E, Maviglia F, Moscato I, Mozzillo R, Poitevin Y, Rapisarda D, Savoldi L, Tarallo A, Utili M, Vala L, Veres G, Zanino R. Progress in EU Breeding Blanket design and integration. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.04.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Maviglia F, Federici G, Wenninger R, Albanese R, Ambrosino R, Bachmann C, Barbato L, Cismondi F, Firdaouss M, Loschiavo V, Lowry C. Effect of engineering constraints on charged particle wall heat loads in DEMO. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.02.077] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Viola B, Calabró G, Jaervinen A, Lupelli I, Maviglia F, Wiesen S, Wischmeier M, Contributors JET. EDGE2D-EIRENE simulations of the impact of poloidal flux expansion on the radiative divertor performance in JET. Nuclear Materials and Energy 2017. [DOI: 10.1016/j.nme.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Federici G, Bachmann C, Biel W, Boccaccini L, Cismondi F, Ciattaglia S, Coleman M, Day C, Diegele E, Franke T, Grattarola M, Hurzlmeier H, Ibarra A, Loving A, Maviglia F, Meszaros B, Morlock C, Rieth M, Shannon M, Taylor N, Tran M, You J, Wenninger R, Zani L. Overview of the design approach and prioritization of R&D activities towards an EU DEMO. Fusion Engineering and Design 2016. [DOI: 10.1016/j.fusengdes.2015.11.050] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Albanese R, De Magistris M, Fresa R, Maviglia F, Minucci S. Accuracy Assessment of Numerical Tracing of Three-Dimensional Magnetic Field Lines in Tokamaks with Analytical Invariants. Fusion Science and Technology 2015. [DOI: 10.13182/fst15-127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- R. Albanese
- Consorzio CREATE, Naples, Italy
- Università di Napoli FEDERICO II, Dip. di Ingegneria Elettrica e delle Tecnologie dell’Informazione (DIETI), Naples, Italy
| | - M. De Magistris
- Consorzio CREATE, Naples, Italy
- Università di Napoli FEDERICO II, Dip. di Ingegneria Elettrica e delle Tecnologie dell’Informazione (DIETI), Naples, Italy
| | - R. Fresa
- Consorzio CREATE, Naples, Italy
- Università della Basilicata, Scuola di Ingegneria, Potenza, Italy
| | - F. Maviglia
- Consorzio CREATE, Naples, Italy
- Università di Napoli FEDERICO II, Dip. di Ingegneria Elettrica e delle Tecnologie dell’Informazione (DIETI), Naples, Italy
| | - S. Minucci
- Consorzio CREATE, Naples, Italy
- Università di Napoli FEDERICO II, Dip. di Ingegneria Elettrica e delle Tecnologie dell’Informazione (DIETI), Naples, Italy
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Valcárcel D, Alves D, Card P, Carvalho B, Devaux S, Felton R, Goodyear A, Lomas P, Maviglia F, McCullen P, Reux C, Rimini F, Stephen A, Zabeo L, Zastrow KD. The JET real-time plasma-wall load monitoring system. Fusion Engineering and Design 2014. [DOI: 10.1016/j.fusengdes.2013.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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De Tommasi G, Ambrosino G, Ariola M, Calabrò G, Galeani S, Maviglia F, Pironti A, Rimini FG, Sips ACC, Varano G, Vitelli R, Zaccarian L. Shape Control with the eXtreme Shape Controller During Plasma Current Ramp-Up and Ramp-Down at the JET Tokamak. J Fusion Energ 2013. [DOI: 10.1007/s10894-013-9652-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Tommasi G, Galeani S, Jachmich S, Joffrin E, Lennholm M, Lomas P, Neto A, Maviglia F, McCullen P, Pironti A, Rimini F, Sips A, Varano G, Vitelli R, Zaccarian L. First experimental results with the Current Limit Avoidance System at the JET tokamak. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Crisanti F, Cucchiaro A, Albanese R, Artaserse G, Baruzzo M, Bolzonella T, Brolatti G, Calabrò G, Crescenzi F, Coletti R, Costa P, Corte AD, Di Zenobio A, Frosi P, Harting D, Taroni LL, Maddaluno G, Marcuzzi D, Maviglia F, Muzzi L, Pericoli-Ridolfini V, Pizzuto A, Polli G, Ramogida G, Reccia L, Rigato V, Rita C, Roccella S, Santinelli M, Sonato P, Subba F, Turtù S, Valisa M, Villari R, Viola B, Wiesen S. FAST: A European ITER satellite experiment in the view of DEMO. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.02.065] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Maviglia F, Artaserse G, Albanese R, Calabrò G, Crisanti F, Pironti A, Pizzuto A, Ramogida G. Poloidal field circuits sensitivity studies and shape control in FAST. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.01.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Albanese R, Ambrosino G, Ariola M, Artaserse G, Bellizio T, Coccorese V, Crisanti F, De Tommasi G, Fresa R, Lomas P, Mattei M, Maviglia F, Neto A, Piccolo F, Pironti A, Portone A, Rimini F, Sartori F, Sorrentino A, Toigo V, Villone F, Viola B, Zabeo L. Overview of modelling activities for Plasma Control Upgrade in JET. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.01.146] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ramogida G, Calabro G, Cocilovo V, Crisanti F, Cucchiaro A, Marinucci M, Pizzuto A, Rita C, Zonca F, Albanese R, Artaserse G, Maviglia F, Mattei M. Plasma scenarios, equilibrium configurations and control in the design of FAST. Fusion Engineering and Design 2009. [DOI: 10.1016/j.fusengdes.2009.02.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sartori F, Crisanti F, Albanese R, Ambrosino G, Toigo V, Hay J, Lomas P, Rimini F, Shaw S, Luchetta A, Sousa J, Portone A, Bonicelli T, Ariola M, Artaserse G, Bigi M, Card P, Cavinato M, De Tommasi G, Gaio E, Jennison M, Mattei M, Maviglia F, Piccolo F, Pironti A, Soppelsa A, Villone F, Zanotto L. The JET PCU project: An international plasma control project. Fusion Engineering and Design 2008. [DOI: 10.1016/j.fusengdes.2007.10.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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