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Greene E, Walcott M, Guerra L, Tieu HV, Nandi V, Soler J, Diaz J, Curriero F, Latkin C, Bosompem A, Frye V. Correlates of concordance between self-reported and lab-confirmed viral load among Black and Latine men who have sex with men (BLMSM) living with HIV in New York City. AIDS Care 2024; 36:661-671. [PMID: 37399515 PMCID: PMC10761596 DOI: 10.1080/09540121.2023.2229816] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Sustained viral suppression is one of the four strategies in the U.S. Department of Health and Human Services' (HHS) plan to end the HIV epidemic in the United States. Individuals living with HIV must understand their viral load accurately for this strategy to be effective. We conducted cross-sectional analyses using baseline data from the NNHIV longitudinal study among men who have sex with men (MSM) living with HIV in New York City to identify factors associated with concordant knowledge between self-reported and lab-confirmed viral load. Of 164 Black and/or Latine participants, 67% (n = 110) reported that their viral load was undetectable, however lab tests showed only 44% (n = 72) had an undetectable viral load (<20 copies/ml). Overall, 62% of the sample (n = 102) had concordant HIV viral load knowledge (agreement of self-reported and lab viral load). In multivariable regression, those with unstable housing (PR = 0.52, 0.30-0.92) and those who had higher levels of beliefs of racism in medicine scale (PR = 0.76, 0.59-0.97) were less likely to have concordant knowledge. Our study underscores the need for implementing measures to improve viral load knowledge, U = U messaging, and strategies to achieve and maintain undetectable viral load status to reduce the burden of HIV at the population level.
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Affiliation(s)
| | - Melonie Walcott
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
| | - Lauren Guerra
- Department of Epidemiology, Columbia University Mailman School of Public Health, NY, NY
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, NY, NY
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
| | - Jorge Soler
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
| | - Jose Diaz
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Frank Curriero
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Carl Latkin
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | | | - Victoria Frye
- CUNY School of Medicine, NY, NY
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
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Keddem S, Frye V, Davis A, Koblin BA, Tieu HV, Lipsky RK, Nandi V, Teitelman AM. The Moderating Effects of HIV Relevant Factors on the Relationship Between Intimate Partner Violence and Intention to Start HIV Pre-exposure Prophylaxis (PrEP) Among Cisgender Women. Arch Sex Behav 2024; 53:1531-1539. [PMID: 38366311 DOI: 10.1007/s10508-024-02812-w] [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] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 02/18/2024]
Abstract
Intimate partner violence (IPV) and HIV are serious and related public health problems that detrimentally impact women's health. Because women who experience IPV are more likely to acquire HIV, it is critical to promote HIV prevention strategies, such as HIV pre-exposure prophylaxis (PrEP), that increase autonomy. This study of cisgender women eligible for HIV PrEP took place between 2017 and 2019 in Philadelphia and New York City. This study aimed to examine the relationship between four types of IPV (control, psychological, physical, sexual) and intention to start PrEP among PrEP-eligible cisgender women and assess the extent to which HIV relevant factors moderated the association between IPV experience and intention to start PrEP. In this sample of PrEP-eligible women (n = 214), 68.7% indicated intention to start PrEP in the next 3 months. Ethnicity was strongly associated with intention to start PrEP, with Hispanic women having the highest odds of intending to start PrEP in the next 3 months. Having a controlling partner significantly predicted intention to start PrEP. Women with more than one sex partner and a controlling partner had higher odds of intending to start PrEP as compared with those who had one or no partners and had no IPV control. These findings point to a need for patient-centered interventions that address the need for safety and autonomy among cisgender, PrEP-eligible women.
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Affiliation(s)
- Shimrit Keddem
- Center for Health Equity Research & Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA.
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
| | - Annet Davis
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Rachele K Lipsky
- VA South Central Mental Illness Research, Education and Clinical Center, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- School of Nursing, Duke University, Durham, NC, USA
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Anne M Teitelman
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Thomas Jefferson University College of Nursing, Philadelphia, PA, USA
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Walcott MM, Tieu HV, Tipre M, Nandi V, Davis A, Wu E, Wheatle M, Frye V, Figueroa JP. Factors associated with discussing HIV pre-exposure prophylaxis (PrEP) among Jamaican medical providers. Int J STD AIDS 2024; 35:188-196. [PMID: 37966358 DOI: 10.1177/09564624231201187] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND The Ministry of Health and Wellness of Jamaica has endorsed the use of pre-exposure prophylaxis (PrEP) as an HIV prevention strategy; however, PrEP was not included in the national HIV prevention program in 2021. METHODS A cross-sectional online study involving physicians in Jamaica was conducted in 2021 to describe PrEP awareness, beliefs, attitudes, and practices. The study also assessed individual and social factors associated with discussing PrEP with patients and willingness to prescribe PrEP. FINDINGS The mean age and standard deviation (SD) of the 69 physicians who completed the survey were 45.5 ± 13.6 years. Most of the participants (80%) reported that they were somewhat familiar with PrEP. PrEP attitude and perceived comfort in prescribing PrEP were moderate among participating physicians, with a mean and SD of 3.9 ± 0.8 and 3.6 ± 0.9 respectively. Six percent of physicians reported that they had prescribed PrEP and 17% had discussed PrEP with their patients in the past year. However, most (90%) reported that they were willing to prescribe PrEP after being informed about it. In the unadjusted model, identifying as Christian (compared to non-Christian) and reporting stronger homophobic beliefs were associated with reduced odds of discussing PrEP with patients. In the multivariable model, only homophobia remained statistically significant (OR, 0.24; 95% CI: 0.07-0.63). CONCLUSION The findings suggest that physicians in Jamacia may be willing to prescribe PrEP; however, homophobia is a barrier to discussions, underscoring the need for the Ministry of Health and Wellness to recognize the role that homophobia plays in the national HIV program to further reduce HIV incidence in Jamaica.
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Affiliation(s)
- Melonie M Walcott
- School of Public Health, University at Albany, Rensselaer, New York, USA
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Meghan Tipre
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vijay Nandi
- Laboratory of Data Analytics, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Alissa Davis
- Social Intervention Group, Columbia School of Social Work, New York, NY, USA
| | - Elwin Wu
- Social Intervention Group, Columbia School of Social Work, New York, NY, USA
| | | | - Victoria Frye
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
- Community Health and Social Medicine (CSOM), City University of New York, New York, NY, USA
| | - J Peter Figueroa
- Department of Columbia, University School of Social Work, New York, NY, USA
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Tieu HV, Karuna S, Huang Y, Sobieszczyk ME, Zheng H, Tomaras GD, Montefiori DC, Shen M, DeRosa S, Cohen K, Isaacs MB, Regenold S, Heptinstall J, Seaton KE, Sawant S, Furch B, Pensiero M, Corey L, Bar KJ. Safety and immunogenicity of a recombinant oligomeric gp145 subtype C Env protein (gp145 C.6980) HIV vaccine candidate in healthy, HIV-1-uninfected adult participants in the US. Vaccine 2023; 41:6309-6317. [PMID: 37679276 DOI: 10.1016/j.vaccine.2023.07.046] [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: 01/23/2023] [Revised: 06/21/2023] [Accepted: 07/23/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND An approach to a preventive HIV vaccine is induction of effective broadly neutralizing antibodies (bnAbs) and effector binding antibodies (bAbs). Preclinical studies suggest that trimeric envelope (Env) proteins may elicit nAbs, which led to the development of the recombinant gp145 subtype C Env protein (gp145 C.6980) immunogen. HVTN 122 was a Phase 1 trial that evaluated the safety, tolerability, and immunogenicity of gp145 C.6980 in adults. METHODS Healthy, HIV-1 seronegative adults received three intramuscular injections of gp145 C.6980 with aluminum hydroxide (alum) at months 0, 2, and 6 at either 300 mcg (high dose, n = 25) or 100 mcg (low dose, n = 15), or placebo/saline (placebo, n = 5). Participants were followed for 12 months. RESULTS Forty-five participants were enrolled. High and low doses of the study protein were well-tolerated, with mild or moderate reactogenicity commonly reported. Only one adverse event (mild injection site pruritis) in one participant (low dose) was considered product-related; there were no dose-limiting toxicities. High and low dose recipients demonstrated robust bAb responses to vaccine-matched consensus gp140 Env and subtype-matched gp120 Env proteins two weeks post-last vaccination (response rates >90 %), while no responses were detected to a heterologous subtype-matched V1V2 antigen. No significant differences were seen between high and low dose groups. Participants in both experimental arms demonstrated nAb response rates of 76.5 % to a tier 1 virus (MW9635.26), but no responses to tier 2 isolates. Env-specific CD4 + T-cell responses were elicited in 36.4 % of vaccine recipients, without significant differences between groups; no participants demonstrated CD8 + T-cell responses. CONCLUSIONS Three doses of novel subtype C gp145 Env protein with alum were safe and well-tolerated. Participants demonstrated bAb, Env-specific CD4 + T-cell, and tier 1 nAb responses, but the regimen failed to induce tier 2 or heterologous nAb responses. CLINICAL TRIALS REGISTRATION NCT03382418.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, USA; Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, USA
| | - Shelly Karuna
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Yunda Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA
| | - Magdalena E Sobieszczyk
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, USA
| | - Hua Zheng
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Georgia D Tomaras
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Mingchao Shen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Stephen DeRosa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kristen Cohen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Margaret Brewinski Isaacs
- Division of Refugee Health, Administration for Children and Families, Department of Health and Human Services, USA
| | - Stephanie Regenold
- Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | | | | | | | - Brianna Furch
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Michael Pensiero
- Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Katharine J Bar
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Darlington CK, Lipsky RK, Teitelman AM, Koblin BA, Davis A, Walcott M, Compton PA, Tieu HV. HIV risk perception, pre-exposure prophylaxis (PrEP) awareness, and PrEP initiation intention among women who use drugs. J Subst Use Addict Treat 2023; 152:209119. [PMID: 37451517 PMCID: PMC10529693 DOI: 10.1016/j.josat.2023.209119] [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] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/16/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Women who use drugs (WWUD) are prime candidates for pre-exposure prophylaxis (PrEP) due to their elevated risk of acquiring HIV through biological, behavioral, and contextual factors. However, PrEP uptake among WWUD remains low. The relationship between unhealthy drug use and correlates of PrEP uptake in this vulnerable population is not well defined. The purpose of this study is to characterize the relationships between specific types and routes of drug use and several precursors of PrEP uptake among WWUD. METHODS The study collected data via a computer-based survey from 233 women living in New York City and Philadelphia who participated in a study designed to develop and pilot a women-focused intervention for PrEP uptake. The sample of cisgender, HIV-negative women were not currently taking PrEP but considered PrEP eligible. This analysis is focused on women's HIV risk perception, PrEP awareness, PrEP initiation intention, and any use of the following drugs: barbiturates, benzodiazepines, crack cocaine, powder cocaine, hallucinogens, heroin, methamphetamines, and prescription opioids. RESULTS Within the three months prior to study enrollment, 63.1 % of participants reported any drug use; 42 % reported polydrug use; 19.8 % had injected drugs; 75 % reported getting high or drunk before sex; and 44 % had been enrolled in drug treatment. Of our total sample, 41.2 % perceived themselves at risk for HIV infection, 41.6 % were aware of PrEP prior to the study, and 62.7 % intended to initiate PrEP after they were informed. When compared to other PrEP-eligible women, women who reported prescription opioid use and polydrug use perceived themselves at higher risk for HIV infection and had higher intention to start PrEP. However, they and women who reported injecting drugs also reported lower awareness of PrEP. CONCLUSION These findings have implications for increasing education about PrEP and the various modes of HIV exposure to support PrEP uptake in this vulnerable population.
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Affiliation(s)
| | | | - Anne M Teitelman
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA; Thomas Jefferson University, College of Nursing, Philadelphia, PA, USA
| | | | - Annet Davis
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Melonie Walcott
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Peggy A Compton
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA; Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Teitelman AM, Tieu HV, Chittamuru D, Shaw PA, Nandi V, Davis A, Lipsky RK, Darlington CK, Fiore D, Koblin BA. A Randomized Controlled Pilot Study of Just4Us, a Counseling and Navigation Intervention to Promote Oral HIV Prophylaxis Uptake Among PrEP-Eligible Cisgender Women. AIDS Behav 2023; 27:2944-2958. [PMID: 36869921 PMCID: PMC10475488 DOI: 10.1007/s10461-023-04017-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/05/2023]
Abstract
HIV pre-exposure prophylaxis (PrEP) uptake among cisgender women in the United States is low. Just4Us, a theory-based counseling and navigation intervention, was evaluated in a pilot randomized controlled trial among PrEP-eligible women (n = 83). The comparison arm was a brief information session. Women completed surveys at baseline, post-intervention, and at three months. In this sample, 79% were Black, and 26% were Latina. This report presents results on preliminary efficacy. At 3 months follow-up, 45% made an appointment to see a provider about PrEP; only 13% received a PrEP prescription. There were no differences in PrEP initiation by study arm (9% Info vs. 11% Just4Us). PrEP knowledge was significantly higher in the Just4Us group at post-intervention. Analysis revealed high PrEP interest with many personal and structural barriers along the PrEP continuum. Just4Us is a promising PrEP uptake intervention for cisgender women. Further research is needed to tailor intervention strategies to multilevel barriers.Clinicaltrials.gov registration NCT03699722: A Women-Focused PrEP Intervention (Just4Us).
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Affiliation(s)
- Anne M Teitelman
- Department of Family and Community Health, School of Nursing, Fagin Hall, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA.
| | - Hong-Van Tieu
- New York Blood Center, New York, NY, USA
- Columbia University Irving Medical Center, New York, NY, USA
| | - Deepti Chittamuru
- Department of Family and Community Health, School of Nursing, Fagin Hall, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Pamela A Shaw
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Annet Davis
- Department of Family and Community Health, School of Nursing, Fagin Hall, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Rachele K Lipsky
- Department of Family and Community Health, School of Nursing, Fagin Hall, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Caroline K Darlington
- Department of Family and Community Health, School of Nursing, Fagin Hall, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Danielle Fiore
- Department of Family and Community Health, School of Nursing, Fagin Hall, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
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Gunaratne SH, Taylor BS, Wilkin TJ, Tieu HV. CROI 2023: Advances in Antiviral Therapy in HIV and Viral Hepatitis. Top Antivir Med 2023; 31:445-467. [PMID: 37315511 PMCID: PMC10266865] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Several innovative methods were presented at the 2023 Conference on Retroviruses and Opportunistic Infections (CROI) targeting different aspects of the HIV care continuum to improve testing, linkage to care, and viral suppression. Some of these approaches were directed at more vulnerable groups, such as pregnant women, adolescents, and individuals who inject drugs. In contrast was the devastating impact of the COVID-19 pandemic, with negative outcomes on HIV viral load suppression and retention in care. Data were presented on hepatitis B virus (HBV) suppression showing that tenofovir alafenamide (TAF)/emtricitabine (FTC)/bictegravir (BIC) may be superior to tenofovir disoproxil fumarate/FTC plus dolutegravir in suppressing HBV in HIV/HBV-coinfected individuals. A pilot study examining a 4-week trial of direct-acting antiviral therapy to treat hepatitis C in recently infected individuals showed lower rates of sustained virologic response at 12 weeks than longer courses. Additional data were presented on the use of long-acting cabotegravir/rilpivirine, comparing this regimen with oral TAF/FTC/BIC and the use of long-acting cabotegravir/rilpivirine in those with viremia. Data were presented on a novel strategy of lenacapavir with 2 broadly neutralizing antibodies given every 6 months as maintenance antiretroviral therapy (ART). Data were presented on improving HIV care outcomes in adolescents, interventions to prevent mother-to-child transmission, and HIV reservoirs in children and adolescents. Data were also presented on interactions between ART and hormonal contraception, as well as ART-related weight gain and impact on pregnancy. A study examining BIC pharmacokinetics in pregnancy was presented, as well as retrospective data on outcomes of adolescents receiving TAF/FTC/BIC.
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Affiliation(s)
| | | | | | - Hong-Van Tieu
- Columbia University Irving Medical Center, New York, New York
- New York Blood Center, New York
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Gunaratne SH, Tieu HV, Wilkin TJ, Taylor BS. CROI 2022: advances in antiviral therapy for HIV, COVID-19, and viral hepatitis. Top Antivir Med 2022; 30:490-521. [PMID: 36347057 PMCID: PMC9473894] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The 2022 Conference on Retroviruses and Opportunistic Infections provided a rich source of new data and comprehensive reviews on antiviral therapy. For COVID-19, intramuscular sotrovimab was noninferior to intravenous sotrovimab, serostatus did not predict the efficacy of sotrovimab, and molnupiravir appeared safe and modestly effective in decreasing hospitalization rates. Trials from low- and middle-income countries provided data to support transitioning those on first-line therapy with or without virologic suppression and those virologically suppressed on second-line therapy to dolutegravir-based regimens. Additional data supported the use of lenacapavir as a long-acting antiretroviral drug. Data across the United States demonstrate the negative impact of the COVID-19 pandemic on the HIV care continuum, although enhanced outreach efforts and decentralization of antiretroviral therapy delivery were associated with improvements in care engagement outcomes. Researchers described potential mechanisms for the emergence of integrase strand transfer inhibitor resistance. Studies on proviral genotyping high-lighted the limitations of its use in predicting clinically significant resistance. Several studies looked at the epidemiology and treatment of hepatitis C and B and the status of current hepatitis C virus elimination efforts. Data presented on HIV, COVID-19, and maternal and pediatric health included 2-year virologic outcome data of very early antiretroviral therapy in potentially reducing the latent HIV reservoir in infants with HIV. Data presented on COVID-19 and HIV therapeutics in children included SARS-CoV-2-neutralizing monoclonal antibodies in children younger than 12 years of age, remdesivir in hospitalized infants and children, and long-acting therapies for HIV treatment in children.
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Sobieszczyk ME, Maaske J, Falsey AR, Sproule S, Robb ML, Frenck RW, Tieu HV, Mayer KH, Corey L, Neuzil KM, Tong T, Brewinski Isaacs M, Janes H, Bansal H, Edwards LM, Green JA, Kelly EJ, Shoemaker K, Takas T, White T, Bhuyan P, Villafana T, Hirsch AI. Durability of protection and immunogenicity of AZD1222 (ChAdOx1 nCoV-19) COVID-19 vaccine over 6 months. J Clin Invest 2022; 132:e160565. [PMID: 36106642 PMCID: PMC9479753 DOI: 10.1172/jci160565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/30/2022] [Indexed: 01/06/2023] Open
Abstract
BackgroundWe report updated safety, efficacy, and immunogenicity of AZD1222 (ChAdOx1 nCoV-19) from an ongoing phase 3 trial.MethodsAdults at increased risk of SARS-CoV-2 infection were randomized (2:1), stratified by age, to receive 2 doses of AZD1222 or placebo. The primary efficacy end point was confirmed SARS-CoV-2 reverse-transcriptase PCR-positive (RT-PCR-positive) symptomatic COVID-19 at 15 or more days after a second dose in baseline SARS-CoV-2-seronegative participants. The 21,634 and 10,816 participants were randomized to AZD1222 and placebo, respectively.FindingsData cutoff for this analysis was July 30, 2021; median follow-up from second dose was 78 and 71 days for the double-blind period (censoring at unblinding or nonstudy COVID-19 vaccination) and 201 and 82 days for the period to nonstudy COVID-19 vaccination (regardless of unblinding) in the AZD1222 and placebo groups, respectively. For the primary efficacy end point in the double-blind period (141 and 184 events; incidence rates: 39.2 and 118.8 per 1,000 person years), vaccine efficacy was 67.0% (P < 0.001). In the period to nonstudy COVID-19 vaccination, incidence of events remained consistently low and stable through 6 months in the AZD1222 group; for the primary efficacy end point (328 and 219 events; incidence rates: 36.4, 108.4) and severe/critical disease (5 and 13 events; incidence rates: 0.6, 6.4), respective vaccine efficacy estimates were 65.1% and 92.1%. AZD1222 elicited humoral immune responses over time, with waning at day 180. No emergent safety issues were seen.ConclusionAZD1222 is safe and well tolerated, demonstrating durable protection and immunogenicity with median follow-up (AZD1222 group) of 6 months.Trial registrationClinicalTrials.gov NCT04516746.FundingAstraZeneca; US government.
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Affiliation(s)
- Magdalena E. Sobieszczyk
- Division of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, New York–Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Jill Maaske
- Clinical Development, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Ann R. Falsey
- University of Rochester School of Medicine and Dentistry, Rochester Regional Health, Rochester, New York, USA
| | - Stephanie Sproule
- Biometrics, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Merlin L. Robb
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Robert W. Frenck
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Hong-Van Tieu
- Division of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, New York–Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Kenneth H. Mayer
- Fenway Health, The Fenway Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Lawrence Corey
- University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Tina Tong
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | | | - Holly Janes
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Himanshu Bansal
- Biometrics, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | | | - Justin A. Green
- Clinical Development, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Elizabeth J. Kelly
- Translational Medicine, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Kathryn Shoemaker
- Biometrics, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Therese Takas
- Clinical Development, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Tom White
- Data Sciences and AI, BioPharmaceuticals R&D and
| | - Prakash Bhuyan
- Clinical Development, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Tonya Villafana
- Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - and Ian Hirsch
- Biometrics, Vaccines, & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
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10
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Jackson GY, Darlington CK, Tieu HV, Brawner BM, Flores DD, Bannon JA, Davis A, Frye V, Chittamuru D, Gugerty P, Koblin BA, Teitelman AM. Women's views on communication with health care providers about pre-exposure prophylaxis (PrEP) for HIV prevention. Cult Health Sex 2022; 24:642-656. [PMID: 33535887 PMCID: PMC8567214 DOI: 10.1080/13691058.2021.1877824] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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] [Indexed: 05/03/2023]
Abstract
Since the beginning of the HIV epidemic in the USA, effective interventions to reduce HIV risk among cisgender women have been lacking. Although oral HIV pre-exposure prophylaxis (PrEP) is effective in pharmacologically preventing HIV infection, there is a gap between the recommended use of PrEP and PrEP uptake among eligible women. This study aimed to identify the role of patient-provider communication in PrEP decision-making among women considering PrEP. Semi-structured in-depth interviews were conducted with 41 PrEP-eligible women in Philadelphia and New York City. A thematic analysis of the responses was conducted, and a conceptual model developed and confirmed as analysis continued. Of the women interviewed, 53.6% were African American and 29.3% were Latina. Women noted that having a trusting relationship with their health care provider, receiving a tailored recommendation for PrEP based upon their specific needs and using their health care provider as support were crucial facilitators of PrEP decision-making. Lack of provider knowledge about PrEP, perceived health care provider stigma about their drug use and sexual activity, and lack of care continuity were all identified as barriers to effective communication. Study findings can inform future interventions to enhance patient-provider communication about PrEP and increase PrEP uptake among women.
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Affiliation(s)
| | - Caroline K. Darlington
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Corresponding Author: Caroline K. Darlington
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | | | | | | | - Annet Davis
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria Frye
- School of Medicine, The City University of New York, New York, NY, USA
| | - Deepti Chittamuru
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Paige Gugerty
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Anne M. Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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11
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Teitelman AM, Tieu HV, Flores D, Bannon J, Brawner BM, Davis A, Gugerty P, Koblin B. Individual, social and structural factors influencing PrEP uptake among cisgender women: a theory-informed elicitation study. AIDS Care 2022; 34:273-283. [PMID: 33719816 PMCID: PMC8426410 DOI: 10.1080/09540121.2021.1894319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 10/21/2022]
Abstract
The underutilization of pre-exposure prophylaxis (PrEP) among cisgender women in the U.S. limits this population's ability to reduce their risk for HIV infection, especially within the unique individual, social and structural systems they navigate. There is a need to identify the relevant multi-level barriers and facilitators to PrEP use among cisgender women to inform theory-guided efforts that address HIV disparities by race/ethnicity among cisgender women. Guided by the Integrated Behavioral Model and the Behavioral Model of Vulnerble Populations we conducted 41 interviews with PrEP eligible cisgender women in New York City and Philadelphia. Directed content analysis identified 11 modal behavioral beliefs crucial to PrEP uptake, including anticipated negative social consequences, 5 normative beliefs centered on available social supports, and 9 control beliefs such as anticipated barriers such as cost. Awareness and knowledge of PrEP as a biobehavioral HIV prevention method is limited for this sample. Through conventional content analysis we identified interpersonal and structural barriers to PrEP uptake including lack of partner support, transportation, mental health challenges, and challenges in accessing PrEP care. Potential solutions to structural barriers were enumerated along with implications for future intervention work and public health programming.
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Affiliation(s)
- Anne M. Teitelman
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Hong-Van Tieu
- Lab of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center; Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center
| | - Dalmacio Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jacqueline Bannon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Annet Davis
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Paige Gugerty
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Beryl Koblin
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA,Independent Consultant, Metuchen, NJ
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12
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Sobieszczyk M, Falsey AR, Robb ML, Tieu HV, McElrath J, Corey L, Neuzil K, Tong T, Isaacs MB, Maaske J, Jepson B, Sproule S, Kelly E. LB6. Asymptomatic Infection and Duration of Viral Shedding in Symptomatic Breakthrough Infections in a Phase 3 Study of AZD1222 (ChAdOx1 nCoV-19). Open Forum Infect Dis 2021. [PMCID: PMC8644203 DOI: 10.1093/ofid/ofab466.1637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
SARS-CoV-2 vaccine efficacy (VE) against asymptomatic infection and impact on viral shedding during breakthrough infections have critical implications for pandemic control. AZD1222 (ChAdOx1 nCoV-19; 2 doses, 4 weeks apart) demonstrated VE of 74.0% (95% CI 65.3, 80.5) against the primary endpoint of symptomatic RT-PCR-confirmed COVID-19 and safety in a Phase 3, 2:1 randomized, placebo-controlled study in the US, Chile and Peru (n=32,451). Here we present exploratory analyses on asymptomatic infections determined by nucleocapsid (N) seroconversion and time to viral clearance in participants with symptomatic infections determined by N seroconversion (primary data cut, March 5, 2021).
Methods
N seroconversion was assessed at all scheduled and illness visits in the fully vaccinated analysis set (Table). In this analysis, symptomatic infections are defined as N seroconversion ≥ 15 days post second dose in participants who attended an illness visit with ≥ 1 qualifying COVID-19 symptom and had ≥ 1 positive RT-PCR result for SARS-CoV-2. Asymptomatic infections are defined as N seroconversion ≥ 15 days post second dose in participants who did not meet the criteria for symptomatic infections. In participants with symptomatic infections, viral shedding in saliva was assessed for 28 days and cumulative incidence of viral clearance was determined.
Table. AZD1222 VE against symptomatic and potentially asymptomatic SARS-CoV-2 infections as determined by N seroconversion
Results
Overall, 358 participants had SARS-CoV-2 infections as determined by N seroconversion (Table). Incidences per 1000 person-years of symptomatic infections were 25.62 for AZD1222 vs 103.42 for placebo (VE 75.23%; 95% CI 65.33, 82.31) and of asymptomatic infections were 51.24 vs 111.95 (VE 54.24%; 95% CI 39.99, 65.10) (Table). Sensitivity analyses for N seroconversion using the primary endpoint and CDC criteria for defining symptomatic/asymptomatic status were supportive. Median time to viral clearance in saliva in participants with symptomatic infections was 11 days (AZD1222, n=52) vs 16 days (placebo, n=92) (Figure).
Figure. Viral clearance in saliva samples in participants with symptomatic infections as determined by N seroconversion
Conclusion
AZD1222 resulted in lower yet meaningful VE against asymptomatic compared to symptomatic infections, as determined by N seroconversion, and shortened viral shedding in symptomatic SARS-CoV-2 breakthrough infections vs placebo, highlighting its potential contribution to reducing viral transmission.
Funding Statement
Disclosures
Ann R. Falsey, MD, AstraZeneca (Individual(s) Involved: Self): Grant/Research Support; BioFire Diagnostics (Individual(s) Involved: Self): Grant/Research Support; Janssen (Individual(s) Involved: Self): Grant/Research Support; Merck, Sharpe and Dohme (Individual(s) Involved: Self): Grant/Research Support; Novavax (Individual(s) Involved: Self): Other Financial or Material Support, Paid DSMB member; Pfizer (Individual(s) Involved: Self): Grant/Research Support Merlin L. Robb, M.D., Henry M. Jackson Foundation (Other Financial or Material Support, This work was conducted under a funding agreement with the USG through an INteragency Personnel Agreement) Hong-Van Tieu, M.D, M.S., National Institutes of Health (Grant/Research Support) Lawrence Corey, MD, NIH (Grant/Research Support) Kathleen Neuzil, MD, MPH, NIH (Grant/Research Support, Other Financial or Material Support, Dr. Neuzil is the CoVPN co-chair with testing of COVID-19 vaccines with salary support from NIH.)Pfizer (Grant/Research Support) Jill Maaske, M.D., AstraZeneca (Employee, Shareholder) Brett Jepson, n/a, AstraZeneca (Other Financial or Material Support, On assignment to AstraZeneca)Cytel, Inc. (Employee) Stephanie Sproule, n/a, AstraZeneca (Other Financial or Material Support, Fees for statistical consulting.) Elizabeth Kelly, n/a, AstraZeneca (Employee, Shareholder)
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Affiliation(s)
| | | | - Merlin L Robb
- Walter Reed Army Institute of Research, Silver Spring, MD, Silver Spring, Maryland
| | - Hong-Van Tieu
- Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY and Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, New York, New York
| | | | | | - Kathleen Neuzil
- University of Maryland School of Medicine, Baltimore, Maryland
| | - Tina Tong
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, Bethesda, Maryland
| | - Margaret Brewinski Isaacs
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, Bethesda, Maryland
| | - Jill Maaske
- AstraZeneca Pharmaceuticals LP, Gaithersburg, MD, Gaithersburg, Maryland
| | - Brett Jepson
- AstraZeneca Pharmaceuticals LP, Gaithersburg, MD and Cytel, Inc., Cambridge, MA, Bethesda, Maryland
| | - Stephanie Sproule
- AstraZeneca Pharmaceuticals LP, Gaithersburg, MD, Gaithersburg, Maryland
| | - Elizabeth Kelly
- AstraZeneca Pharmaceuticals LP, Gaithersburg, MD, Gaithersburg, Maryland
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13
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Lemos MP, Nandi V, Dragavon J, Fleming I, Krishnan K, Musuruana M, Kramer M, Glantz H, Andrasik M, Coombs RW, McElrath MJ, Tieu HV. HIV-1 Nucleic Acids Identify Rectal HIV Exposures in Self-Collected Rectal Swabs, Whereas Y-Chromosome Single Tandem Repeat Mixtures Are Not Reliable Biomarkers of Condomless Receptive Anal Intercourse. J Acquir Immune Defic Syndr 2021; 88:138-148. [PMID: 34506358 PMCID: PMC8439546 DOI: 10.1097/qai.0000000000002748] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND To focus interventions, biomarkers of HIV-1 exposure could help in identifying subpopulations at highest risk of acquisition. We assessed whether Y-chromosome single tandem repeat (YSTR) mixtures obtained from rectal swabs could serve as a biomarker of condomless receptive anal intercourse (CRAI) among men who have sex with men and transgender women and evaluated the feasibility of detecting HIV-1 virions to assess exposures. METHODS Twenty-nine sexually active HIV-seronegative men who have sex with men and one transgender woman from New York City answered on-site and mobile app sexual behavior questionnaires. They were randomized to collecting self-administered rectal swabs every morning or after receptive anal intercourse (RAI). YSTR profiles were assessed from blood sample and swabs; HIV-1 exposure was measured by conducting quantitative polymerase chain reaction in swabs. RESULTS After 2 months, the daily mobile survey had 135%-201% more instances of anal sex acts and 170%-193% more RAI than on-site surveys. Daily mobile reporting had 11%-35% less CRAI events than those reported on-site (Pdaily = 0.001; Pper-sex = 0.047). The daily swabbing arm reported less RAI (P < 0.001) and CRAI (P < 0.038) and had 2.95 lower odds of detecting YSTR mixtures (P = 0.021) than the per-sex-event arm. Surprisingly, YSTR detection was not significantly modified by report of bowel movements and lubricant, enema, or condom use. No participant became HIV-1 infected, yet HIV-1 total nucleic acids were detected in 6 independent episodes of CRAI in 2 participants taking pre-exposure prophylaxis. CONCLUSIONS YSTR mixtures demonstrated 80% specificity but only 30% sensitivity as a biomarker of CRAI in self-collected rectal swabs. However, detection of HIV-1 exposures in self-collected swabs may help in identifying those needing further HIV risk reduction strategies.
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Affiliation(s)
- Maria P. Lemos
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Vijay Nandi
- Laboratory of Data Analytics, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY
| | - Joan Dragavon
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Ira Fleming
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Keertana Krishnan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Martin Musuruana
- Laboratory of Data Analytics, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY
| | - Madeline Kramer
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Hayley Glantz
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Michele Andrasik
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Robert W. Coombs
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
- Department of Pathology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - M. Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY
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14
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Astronomo RD, Lemos MP, Narpala SR, Czartoski J, Fleming LB, Seaton KE, Prabhakaran M, Huang Y, Lu Y, Westerberg K, Zhang L, Gross MK, Hural J, Tieu HV, Baden LR, Hammer S, Frank I, Ochsenbauer C, Grunenberg N, Ledgerwood JE, Mayer K, Tomaras G, McDermott AB, McElrath MJ. Rectal tissue and vaginal tissue from intravenous VRC01 recipients show protection against ex vivo HIV-1 challenge. J Clin Invest 2021; 131:e146975. [PMID: 34166231 DOI: 10.1172/jci146975] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 12/16/2020] [Accepted: 06/22/2021] [Indexed: 11/17/2022] Open
Abstract
BackgroundVRC01, a potent, broadly neutralizing monoclonal antibody, inhibits simian-HIV infection in animal models. The HVTN 104 study assessed the safety and pharmacokinetics of VRC01 in humans. We extend the clinical evaluation to determine intravenously infused VRC01 distribution and protective function at mucosal sites of HIV-1 entry.MethodsHealthy, HIV-1-uninfected men (n = 7) and women (n = 5) receiving VRC01 every 2 months provided mucosal and serum samples once, 4-13 days after infusion. Eleven male and 8 female HIV-seronegative volunteers provided untreated control samples. VRC01 levels were measured in serum, secretions, and tissue, and HIV-1 inhibition was determined in tissue explants.ResultsMedian VRC01 levels were quantifiable in serum (96.2 μg/mL or 1.3 pg/ng protein), rectal tissue (0.11 pg/ng protein), rectal secretions (0.13 pg/ng protein), vaginal tissue (0.1 pg/ng protein), and cervical secretions (0.44 pg/ng protein) from all recipients. VRC01/IgG ratios in male serum correlated with those in paired rectal tissue (r = 0.893, P = 0.012) and rectal secretions (r = 0.9643, P = 0.003). Ex vivo HIV-1Bal26 challenge infected 4 of 21 rectal explants from VRC01 recipients versus 20 of 22 from controls (P = 0.005); HIV-1Du422.1 infected 20 of 21 rectal explants from VRC01 recipients and 12 of 12 from controls (P = 0.639). HIV-1Bal26 infected 0 of 14 vaginal explants of VRC01 recipients compared with 23 of 28 control explants (P = 0.003).ConclusionIntravenous VRC01 distributes into the female genital and male rectal mucosa and retains anti-HIV-1 functionality, inhibiting a highly neutralization-sensitive but not a highly resistant HIV-1 strain in mucosal tissue. These findings lend insight into VRC01 mucosal infiltration and provide perspective on in vivo protective efficacy.FundingNational Institute of Allergy and Infectious Diseases and Bill & Melinda Gates Foundation.
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Affiliation(s)
- Rena D Astronomo
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Maria P Lemos
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Sandeep R Narpala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Julie Czartoski
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Lamar Ballweber Fleming
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Kelly E Seaton
- Department of Surgery, Duke University, Durham, North Carolina, USA
| | - Madhu Prabhakaran
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Yunda Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Yiwen Lu
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Katharine Westerberg
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Lily Zhang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Mary K Gross
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - John Hural
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Lindsey R Baden
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Scott Hammer
- Columbia University Medical Center, New York, New York, USA
| | - Ian Frank
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Nicole Grunenberg
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | | | - Georgia Tomaras
- Department of Surgery, Duke University, Durham, North Carolina, USA.,Department of Immunology and Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina, USA
| | - Adrian B McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - M Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, Washington, USA
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15
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Gunaratne SH, Tieu HV, Wilkin TJ, Taylor BS. CROI 2021: Advances in Antiretroviral Therapy for HIV and Antiviral Therapy for COVID-19. Top Antivir Med 2021; 29:361-378. [PMID: 34370418 PMCID: PMC8384088] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The 2021 Conference on Retroviruses and Opportunistic Infections included advances in therapy for HIV as well as for SARS-CoV-2. Data presented on COVID-19 therapies included trials showcasing the use of monoclonal antibodies for prevention and treatment of COVID-19. Promising new data were presented on lenacapavir, an investigational HIV capsid inhibitor given as a subcutaneous injection every 6 months. Although encouraging data from settings across the globe reported achievement of 90-90-90 HIV care cascade targets, disparities exist in care engagement and viral suppression, particularly for people of color and young people with HIV. Several interventions were associated with improved care cascade outcomes. The COVID-19 pandemic has impacted HIV care engagement, but mitigation strategies can allow programs to continue to serve people with HIV during the pandemic. Studies examining the resistance patterns of existing antiretroviral therapy (ART) agents were presented, as were resistance mechanisms of novel agents such as lenacapavir and resistance patterns among individuals who seroconverted while on preexposure prophylaxis. Data from large observational cohorts were presented on patterns of ART uptake and trends in mortality and in virologic failure. Pertinent findings relating to pediatric and maternal health issues included data on dolutegravir-based ART in children and adolescents with HIV; safety and tolerability of dolutegravir-based ART in children and pregnant women; similarly high maternal viral suppression at 50 weeks postpartum in women receiving certain ART regimens; weight gain in pregnant women receiving dolutegravir plus tenofovir alafenamide/emtricitabine; and viral suppression with dolutegravir-based ART when started during the third trimester of pregnancy.
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Affiliation(s)
- Shauna H. Gunaratne
- Send correspondence to Dr Shauna Gunaratne, 180 Ft Washington Ave, 6th floor, New York, NY, 10032 or
| | - Hong-Van Tieu
- Assistant Professor of Clinical Medicine at Columbia University Irving Medical Center in New York, New York
| | - Timothy J. Wilkin
- Professor of Medicine at Weill Cornell Medicine in New York, New York
| | - Barbara S. Taylor
- Associate Professor of Infectious Diseases at UT Health San Antonio in Texas
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16
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Teitelman AM, Koblin BA, Brawner BM, Davis A, Darlington C, Lipsky RK, Iwu E, Bond KT, Westover J, Fiore D, Tieu HV. Just4Us: Development of a Counselor-Navigator and Text Message Intervention to Promote PrEP Uptake Among Cisgender Women at Elevated Risk for HIV. J Assoc Nurses AIDS Care 2021; 32:188-204. [PMID: 33427767 PMCID: PMC10375596 DOI: 10.1097/jnc.0000000000000233] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT In the United States, pre-exposure prophylaxis (PrEP) uptake among eligible cisgender women has been slow, despite the availability of oral PrEP since 2012. Although women make up nearly 20% of those living with HIV, there are currently few PrEP uptake interventions for cisgender women at elevated risk for acquiring HIV. Here we describe the process used to design and pre-pilot test Just4Us, a theory-based behavioral intervention to promote PrEP initiation and adherence among PrEP-eligible cisgender women. This work was part of a multiphase study conducted in New York City and Philadelphia, two locations with HIV rates higher than the national average. The counselor-navigator component of the intervention was designed to be delivered in a 60- to 90-min in-person session in the community, followed by several phone calls to support linkage to care. An automated text messaging program was also designed for adherence support. Just4Us addressed personal and structural barriers to PrEP uptake using an empowerment framework by building on women's insights and resources to overcome barriers along the PrEP cascade. Usability pre-pilot testing results were favorable and provided valuable feedback used to refine the intervention.
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Affiliation(s)
- Anne M Teitelman
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Beryl A Koblin
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Bridgette M Brawner
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Annet Davis
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Caroline Darlington
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Rachele K Lipsky
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Emilia Iwu
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Keosha T Bond
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Julie Westover
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Danielle Fiore
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Hong-Van Tieu
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
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Tieu HV, Koblin BA, Latkin C, Curriero FC, Greene ER, Rundle A, Frye V. Neighborhood and Network Characteristics and the HIV Care Continuum among Gay, Bisexual, and Other Men Who Have Sex with Men. J Urban Health 2020; 97:592-608. [PMID: 29845586 PMCID: PMC7560681 DOI: 10.1007/s11524-018-0266-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In order for treatment as prevention to work as a national strategy to contain the HIV/AIDS epidemic in the United States (US), the HIV care continuum must become more robust, retaining more individuals at each step. The majority of people living with HIV/AIDS (PLWHA) in the US are gay, bisexual, and other men who have sex with men (MSM). Within this population, there are distinct race- and ethnicity-based disparities in rates of HIV infection, engagement, and retention in HIV care, and viral suppression. Compared with White MSM, HIV-infected Black MSM are less likely to be on anti-retroviral therapy (ART), adhere to ART, and achieve viral suppression. Among MSM living in urban areas, falling off the continuum may be influenced by factors beyond the individual level, with new research identifying key roles for network- and neighborhood-level characteristics. To inform multi-level and multi-component interventions, particularly to support Black MSM living in urban areas, a clearer understanding of the pathways of influence among factors at various levels of the social ecology is required. Here, we review and apply the empirical literature and relevant theoretical perspectives to develop a series of potential pathways of influence that may be further evaluated. Results of research based on these pathways may provide insights into the design of interventions, urban planning efforts, and assessments of program implementation, resulting in increased retention in care, ART adherence, and viral suppression among urban-dwelling, HIV-infected MSM.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily R Greene
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Andrew Rundle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA.
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Diaz JE, Schrimshaw EW, Tieu HV, Nandi V, Koblin BA, Frye V. Acculturation as a Moderator of HIV Risk Behavior Correlates Among Latino Men Who Have Sex with Men. Arch Sex Behav 2020; 49:2029-2043. [PMID: 31858309 PMCID: PMC7302998 DOI: 10.1007/s10508-019-01604-x] [Citation(s) in RCA: 4] [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: 09/21/2018] [Revised: 10/16/2019] [Accepted: 12/03/2019] [Indexed: 05/18/2023]
Abstract
Acculturation is associated with increased sexual risk behaviors among heterosexual Latinos, but its influence among Latino gay, bisexual, and other men who have sex with men (MSM) remains less clear. Elements of acculturation may create distinct lived experiences among sexual minority Latinos, moderating how beneficial and adverse influences contribute to their sexual risk behaviors. Latino MSM living in New York City (n = 412) were recruited using a modified time-space venue- and web-based sampling method. Negative binomial regression models estimated associations between indicators of acculturation (i.e., language use, nativity status, ethnic identification), sexual minority stressors (i.e., internalized homophobia, sexual orientation-based discrimination), peer condom use norms, and the number of serodiscordant condomless anal intercourse (SDCAI) encounters. Acculturation indicators were then tested as simultaneous moderators of the influence of each predictor variable on the outcome. The association between internalized homophobia and SDCAI was significant only among English language speakers (aIRR = 3.05 [2.13, 4.37]) and those born outside of the U.S. (foreign-born = 0, aIRR = 0.17 [0.08, 0.36]). Sexual orientation-based discrimination and SDCAI were also positively associated among both English-speaking (aIRR = 1.82 [1.22, 2.72]) and foreign-born men (aIRR = 0.34 [0.14, 0.84]). Stronger ethnic identification also moderated the protective effects of peer condom use norms on SDCAI (aIRR = 0.28 [0.15, 0.52]). Results suggest that different dimensions of acculturation help shape how both stressors and protective factors influence HIV risk among Latino MSM. Future research is needed to examine the mechanisms through which these differences in acculturation may act on sexual risk behaviors among Latino MSM.
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Affiliation(s)
- José E Diaz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York, NY, USA
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19
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Teitelman AM, Chittamuru D, Koblin BA, Davis A, Brawner BM, Fiore D, Broomes T, Ortiz G, Lucy D, Tieu HV. Beliefs Associated with Intention to Use PrEP Among Cisgender U.S. Women at Elevated HIV Risk. Arch Sex Behav 2020; 49:2213-2221. [PMID: 32270399 PMCID: PMC7321894 DOI: 10.1007/s10508-020-01681-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/26/2019] [Revised: 02/26/2020] [Accepted: 03/07/2020] [Indexed: 05/16/2023]
Abstract
Women comprise 19% of those newly diagnosed with HIV in the U.S. There is a wide gap between recommended use of pre-exposure prophylaxis (PrEP) and actual uptake among women who are eligible for PrEP. In order to identify women's beliefs and intentions about starting PrEP, a survey, informed by the reasoned action approach, was administered to 160 cisgender PrEP-eligible women, age 18-55, in Philadelphia and New York City. The mean age was 40.2 years (SD = 11.78), 44% had completed high school, 75% were unemployed, and 85% experienced financial instability in the past 3 months. Multivariate linear regression analyses identified sets of behavioral and normative beliefs associated with intention to start PrEP in the next 3 months. Behavioral beliefs reflected views about PrEP benefits such as preventing HIV, and normative beliefs reflected perceptions of support or lack thereof from others including partners, friends, mother, and children. These findings can be used to inform interventions to foster greater PrEP uptake among women.
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Affiliation(s)
- Anne M Teitelman
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA.
| | - Deepti Chittamuru
- Public Health Department, University of California-Merced, Merced, CA, USA
| | | | - Annet Davis
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Danielle Fiore
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Tarashon Broomes
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Geneva Ortiz
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Debbie Lucy
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
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20
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Taylor NK, Young MR, Williams VD, Benitez J, Usher D, Hammer SM, Tieu HV, Sobieszczyk ME. Assessing Knowledge of HIV Vaccines and Biomedical Prevention Methods Among Transgender Women in the New York City Tri-State Area. Transgend Health 2020; 5:116-121. [PMID: 32656354 PMCID: PMC7347014 DOI: 10.1089/trgh.2019.0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To lower the HIV risk of transgender women, it is imperative to understand their unique HIV prevention needs and design biomedical prevention interventions that are responsive to the psychosocial, behavioral, and clinical needs of these communities. Preventive HIV vaccines are an important modality under investigation in diverse study participants. We sought to assess the knowledge of HIV vaccine research and the most common barriers and facilitators to participation in HIV vaccine studies among HIV-negative transgender women living in New York City. Methods: Six focus groups were conducted among 29 participants recruited in the New York City tri-state area from December 2014 to July 2015. Prefocus group quantitative questionnaire assessed demographic, behavioral information, knowledge of preventive vaccine research, and reasons for potential participation in prevention studies. Results: Median age of participants was 29 years and 41.4% identified as white. Over half of participants have heard of preventive vaccine research and majority indicated that an important factor in participating in HIV prevention research is to help the community collective effort. Key barriers that emerged were fear of side effects, feelings of exclusion from biomedical research. Facilitators to participation in prevention studies included trusting relationships with providers. Conclusions: These barriers and facilitators are important to consider in the design of studies inclusive of trans communities and transgender-specific prevention strategies. Barriers may be overcome by disseminating accurate information via social media or health providers.
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Affiliation(s)
- Nicholas Kenji Taylor
- Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, USA.,Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, USA
| | - Maria R Young
- Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Van Don Williams
- Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Jorge Benitez
- Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | | | - Scott M Hammer
- Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | | | - Magdalena E Sobieszczyk
- Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, USA
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Rouphael NG, Morgan C, Li SS, Jensen R, Sanchez B, Karuna S, Swann E, Sobieszczyk ME, Frank I, Wilson GJ, Tieu HV, Maenza J, Norwood A, Kobie J, Sinangil F, Pantaleo G, Ding S, McElrath MJ, De Rosa SC, Montefiori DC, Ferrari G, Tomaras GD, Keefer MC. DNA priming and gp120 boosting induces HIV-specific antibodies in a randomized clinical trial. J Clin Invest 2020; 129:4769-4785. [PMID: 31566579 PMCID: PMC6819112 DOI: 10.1172/jci128699] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/24/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND RV144 is the only preventive HIV vaccine regimen demonstrating efficacy in humans. Attempting to build upon RV144 immune responses, we conducted a phase 1, multicenter, randomized, double-blind trial to assess the safety and immunogenicity of regimens substituting the DNA-HIV-PT123 (DNA) vaccine for ALVAC-HIV in different sequences or combinations with AIDSVAX B/E (protein). METHODS One hundred and four HIV-uninfected participants were randomized to 4 treatment groups (T1, T2, T3, and T4) and received intramuscular injections at 0, 1, 3, and 6 months (M): T1 received protein at M0 and M1 and DNA at M3 and M6; T2 received DNA at M0 and M1 and protein at M3 and M6; T3 received DNA at M0, M1, M3, and M6 with protein coadministered at M3 and M6; and T4 received protein and DNA coadministered at each vaccination visit. RESULTS All regimens were well tolerated. Antibodies binding to gp120 and V1V2 scaffold were observed in 95%–100% of participants in T3 and T4, two weeks after final vaccination at high magnitude. While IgG3 responses were highest in T3, a lower IgA/IgG ratio was observed in T4. Binding antibodies persisted at 12 months in 35%–100% of participants. Antibody-dependent cell-mediated cytotoxicity and tier 1 neutralizing-antibody responses had higher response rates for T3 and T4, respectively. CD4+ T cell responses were detectable in all treatment groups (32%–64%) without appreciable CD8+ T cell responses. CONCLUSION The DNA/protein combination regimens induced high-magnitude and long-lasting HIV V1V2–binding antibody responses, and early coadministration of the 2 vaccines led to a more rapid induction of these potentially protective responses. TRIAL REGISTRATION ClinicalTrials.gov NCT02207920. FUNDING National Institute of Allergy and Infectious Diseases (NIAID) grants UM1 AI068614, UM1 AI068635, UM1 AI068618, UM1 AI069511, UM1 AI069470, UM1 AI069534, P30 AI450008, UM1 AI069439, UM1 AI069481, and UM1 AI069496; the National Center for Advancing Translational Sciences, NIH (grant UL1TR001873); and the Bill & Melinda Gates Foundation (grant OPP52845).
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Affiliation(s)
- Nadine G Rouphael
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA
| | - Cecilia Morgan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Shuying S Li
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Ryan Jensen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Brittany Sanchez
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Shelly Karuna
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Edith Swann
- Division of AIDS, NIH, Bethesda, Maryland, USA
| | | | - Ian Frank
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Janine Maenza
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,University of Washington, Seattle, Washington, USA
| | | | - James Kobie
- Department of Medicine, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Faruk Sinangil
- Global Solutions for Infectious Diseases, South San Francisco, California, USA
| | - Giuseppe Pantaleo
- Division of Immunology and Allergy, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Song Ding
- EuroVacc Foundation, Lausanne, Switzerland
| | - M Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Stephen C De Rosa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - David C Montefiori
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Guido Ferrari
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Georgia D Tomaras
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael C Keefer
- Department of Medicine, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
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22
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Chittamuru D, Frye V, Koblin BA, Brawner B, Tieu HV, Davis A, Teitelman A. PrEP Stigma, HIV Stigma, and Intention to Use PrEP among Women in New York City and Philadelphia. Stigma Health 2019; 5:240-246. [PMID: 33184608 DOI: 10.1037/sah0000194] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/27/2022]
Abstract
Background Stigma is an important contributor to the continued HIV epidemic in the United States (US). In 2016, women made up nearly one in five of all new infections. Pre-exposure HIV Prophylaxis or PrEP is a medication that can be taken to prevent HIV acquisition; however, PrEP is significantly underutilized by women at risk for infection. How PrEP stigma relates to PrEP initiation among women is not well understood. Methods Surveys were completed by 160 PrEP-eligible women aged 18-55 in Philadelphia, PA and New York City, NY. Associations between PrEP stigma, HIV stigma, and PrEP initiation intention were modeled using multinomial logistic regression, controlling for sociodemographic and theoretically-relevant variables. Results Participants ranged in age from 18 to 55 years (M = 40.2; SD = 11.78). Most (79%) identified as Black or African-American and/or Latina and 36% had completed high-school or less. Higher PrEP stigma was significantly associated with lower PrEP initiation intention, while controlling for other theoretically-relevant and sociodemographic variables. HIV stigma was not related to PrEP initiation intention. Conclusions HIV prevention interventions seeking to increase PrEP initiation among PrEP-eligible, urban women need to address the role that PrEP stigma plays in PrEP uptake.
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Affiliation(s)
- Deepti Chittamuru
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, Merced, CA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY
| | - Beryl A Koblin
- School of Nursing, University of Pennsylvania, Philadelphia, PA
| | | | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY
| | - Annet Davis
- School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Anne Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA
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23
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Hermanstyne KA, Green HD, Tieu HV, Hucks-Ortiz C, Wilton L, Shoptaw S. The Association Between Condomless Anal Sex and Social Support Among Black Men Who Have Sex With Men (MSM) in Six U.S. Cities: A Study Using Data from the HIV Prevention Trials Network BROTHERS Study (HPTN 061). AIDS Behav 2019; 23:1387-1395. [PMID: 30377980 DOI: 10.1007/s10461-018-2315-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We assessed how egocentric (i.e., self-generated descriptions of a person's social contacts) network structure and composition corresponded with reported instances of condomless receptive and insertive anal intercourse with men who were reportedly HIV-infected or of unknown HIV serostatus in a sample of black men who have sex with men (MSM) in six U.S. cities. Ratings showing a higher percentage of network members who provided social participation and medical support were positively associated with reporting condomless sex. There were also significant positive associations between stimulant use and condomless insertive and receptive anal sex. Future research should examine the social processes that underlie these associations and explore ways that social support can affect HIV prevention efforts for black MSM.
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Affiliation(s)
- Keith A Hermanstyne
- Department of Psychiatry, UCSF Weil Institute for Neurosciences, University of California, 1930 Market Street, San Francisco, CA, 94102, USA.
| | - Harold D Green
- Indiana University Network Science Institute, Bloomington, IN, USA
- Center for Applied Network Analysis and Systems Science, RAND Corporation, Santa Monica, CA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | | | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA, USA
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24
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Taylor BS, Tieu HV, Jones J, Wilkin TJ. CROI 2019: advances in antiretroviral therapy. Top Antivir Med 2019; 27:50-68. [PMID: 31137003 PMCID: PMC6550357] [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] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/17/2019] [Indexed: 06/09/2023]
Abstract
The 2019 Conference on Retroviruses and Opportunistic Infections included many exciting advances in antiretroviral therapy (ART). Investigators presented a case report of a second patient possibly cured of HIV through an allogeneic hematopoietic stem cell transplant from a CC chemokine receptor 5-delta 32 donor. Two clinical trials of long-acting injectable cabotegravir and rilpivirine showed promising safety, efficacy, and tolerability as maintenance ART. Test-and-treat and rapid-ART-start strategies show promise in advancing progress toward the HIV care cascade 90-90-90 Joint United Nations Programme on HIV/AIDS/World Health Organization targets. However, late diagnosis and mortality after ART initiation remain high, even in the context of HIV service scale-up, and mortality from unintentional opioid overdose in people living with HIV in the United States is on the rise. In vitro studies were presented that identified and evaluated the effect of resistance-associated mutations on ART susceptibility and elucidated mechanisms of resistance. Epidemiologic data were reported on the prevalence, impact, regional variation, and changes over time of resistance-associated mutations. Decreasing regional and national rates of resistance may be a benefit of increasing use of integrase strand transfer inhibitors (InSTIs). New findings were presented on maternal and fetal health outcomes in women of reproductive potential, drug-drug interactions between hormonal contraception and ART, and further exploration of the association between InSTIs and birth defects.
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Affiliation(s)
- Barbara S. Taylor
- Send correspondence to Barbara S. Taylor, MD, MS, 7703 Floyd Curl Dr, MSC 7881, San Antonio, TX 78229, or , 210-567-4661 (phone), 210-567-4670 (fax)
| | - Hong-Van Tieu
- Associate Member at New York Blood Center and Assistant Professor of Clinical Medicine at Columbia University Medical Center in New York, New York
| | - Joyce Jones
- Assistant Professor at Johns Hopkins University School of Medicine in Baltimore, Maryland
| | - Timothy J. Wilkin
- Associate Professor of Medicine at Weill Cornell Medicine in New York, New York
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25
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Hirshfield S, Teran RA, Downing MJ, Chiasson MA, Tieu HV, Dize L, Gaydos CA. Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study. JMIR Public Health Surveill 2018; 4:e10847. [PMID: 30389648 PMCID: PMC6238105 DOI: 10.2196/10847] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 04/23/2018] [Revised: 08/10/2018] [Accepted: 08/16/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Suboptimal antiretroviral therapy (ART) adherence and disengagement in care present significant public health challenges because of the increased probability of HIV transmission. In the United States, men who have sex with men (MSM) continue to be disproportionately affected by HIV, highlighting a critical need to engage high-risk MSM living with HIV who are not engaged or retained in care. OBJECTIVE The aim of the study was to assess the feasibility of at-home blood self-collection and laboratory quantification of HIV-1 RNA viral load (VL) to report laboratory-based VL outcomes and compare self-reported and laboratory-reported VL. METHODS Between 2016 and 2017, 766 US HIV-positive MSM enrolled in a Web-based behavioral intervention were invited to participate in an at-home dried blood spot (DBS) collection study using HemaSpot-HF kits (Spot On Sciences, Inc, Austin, TX) for laboratory-quantified VL. RESULTS Of those invited to participate, 72.3% (554/766) enrolled in the DBS study. Most (79.2%, 439/554) men enrolled reported attempting to collect their blood, 75.5% (418/554) of participants mailed a DBS specimen to the research laboratory, and 60.8% (337/554) had an adequate blood sample for VL testing. Of the 337 specimens tested for VL by the laboratory, 52.5% (177/337) had detectable VL (median: 3508 copies/mL; range: 851-1,202,265 copies/mL). Most men (83.9%, 135/161) who returned a DBS specimen with laboratory-quantified detectable VL self-reported an undetectable VL during their last clinical visit. CONCLUSIONS Home collection of DBS samples from HIV-positive MSM is feasible and has the potential to support clinical VL monitoring. Discrepant laboratory HIV-1 RNA values and self-reported VL indicate a need to address perceived VL status, especially in the era of treatment as prevention. Most participants were willing to use an at-home DBS kit in the future, signaling an opportunity to engage high-risk MSM in long-term HIV care activities.
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Affiliation(s)
- Sabina Hirshfield
- Research and Evaluation, Public Health Solutions, New York, NY, United States
| | - Richard A Teran
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | | | - Mary Ann Chiasson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, United States
| | - Hong-Van Tieu
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, United States
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, United States
| | - Laura Dize
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, United States
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, United States
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26
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Koblin BA, Usher D, Nandi V, Tieu HV, Bravo E, Lucy D, Miles L, Ortiz G, Kindlon MJ, Parisi DM, Frye V. Post-exposure Prophylaxis Awareness, Knowledge, Access and Use Among Three Populations in New York City, 2016-17. AIDS Behav 2018; 22:2718-2732. [PMID: 29858737 DOI: 10.1007/s10461-018-2175-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Post-exposure prophylaxis (PEP) is a cost-effective, but underused HIV prevention strategy. PEP awareness, knowledge, access, and usage was assessed among young men of color who have sex with men (YMSMOC; n = 177), transgender women (TW; n = 182), and cisgender women of color (CWOC; n = 170) in New York City. 59% were aware of PEP: 80% among YMSMOC, 63% among TW and 34% among CWOC (p < 0.001). 13% had ever used PEP. PEP awareness was higher among YMSMOC with a recent HIV test and lower among those with ≥ 4 partners. PEP awareness was lower among TW who anticipated stigma and reported barriers to taking PEP, and higher among TW who exchanged sex for resources. Among CWOC, more barriers to taking PEP reduced the odds of PEP awareness. PEP education and outreach needs to be deliberate about population-specific campaigns, with a need to focus on reducing PEP stigma and other barriers which impede PEP access.
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27
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Tieu HV, Laeyendecker O, Nandi V, Rose R, Fernandez R, Lynch B, Hoover DR, Frye V, Koblin BA. Prevalence and mapping of hepatitis C infections among men who have sex with men in New York City. PLoS One 2018; 13:e0200269. [PMID: 30020960 PMCID: PMC6051624 DOI: 10.1371/journal.pone.0200269] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/23/2018] [Indexed: 12/13/2022] Open
Abstract
Emerging sexually transmitted hepatitis C virus (HCV) epidemics among men who have sex with men (MSM) have been reported worldwide, with higher HCV infection rates among those who are HIV-infected. This study aims to determine prevalence of recent and chronic HCV infections among community-recruited MSM in New York City (NYC), map HCV infections by home, social, and sexual neighborhoods, and identify clusters of genetically linked HCV variants using phylogenetic analysis. The NYC M2M study recruited MSM via modified time-space, venue-based sampling and internet/mobile app-based recruitment during 2010–13. Participants completed a Google Earth map on neighborhoods of where they lived, socialized, and had sex in the last 3 months, an ACASI questionnaire, and a sexual network inventory about their sex partners. The men received HIV testing and provided serum samples. Testing on stored serum samples included HCV antibody and RNA viral load, HCV antibody avidity assay (avidity index <30% with positive viral load is considered recently infected), and HCV RNA extraction and amplification to generate a 432 base-pair region of Core/E1 for sequencing and phylogenetic analysis. Historic local controls were included in the phylogenetic analysis. Of 1,028 MSM, 79.7% were HIV-negative and 20.3% HIV-positive. Twenty nine MSM (2.8%) were HCV antibody-positive. MSM who were HCV antibody-positive reported a median of 2 male sex partners in last 3 months, with 6.9% aged 18–24, 17.2% 25–29, 13.8% 30–39, and 62.1% 40 and over. 8.1% of HIV-positive MSM were HCV antibody-positive vs. 1.5% of HIV-negative men (p<0.0001). Of 29 HCV-antibody positive MSM, 12 (41%) were HCV RNA-positive (11 subtype 1a and 1 subtype 1b). Two of 12 HCV RNA-positive participants had low antibody avidity values, suggesting recent HCV infection. HCV antibody seropositivity was significantly associated with older age >40 years, adjusted odds ratio (aOR) 3.56 (95% CI 1.57, 8.08), HIV-positive serostatus, aOR 3.18 (95% CI 1.40, 7.22), any sexually transmitted infection (STI) in the last 3 months, aOR 2.81 (95% CI 1.11, 7.13), and injection drug use (IDU) ever, aOR 4.34 (95% CI 1.69, 11.17). Mapping of HCV infections differed slightly by home, social, and sexual neighborhoods. Based on phylogenetic analysis from 12 HCV RNA-positive samples, no evidence of a clustered HCV epidemic was found. Overall HCV seroprevalence was 2.8% among community-recruited MSM in NYC, with higher prevalence among HIV-positive MSM compared to HIV-negative MSM. Only two participants were found to have recent HCV infection, with no evidence of a clustered HCV epidemic based on phylogenetic analysis. Our results support testing of HCV infection among HIV-negative MSM if they report having a recent STI and IDU in the past rather than universal HCV testing in all HIV-negative MSM.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, United States of America
- Columbia University Medical Center, Division of Infectious Diseases, Department of Medicine, New York, United States of America
- * E-mail:
| | - Oliver Laeyendecker
- National Institute of Allergy and Infectious Diseases, Baltimore, United States of America
- School of Medicine, Johns Hopkins University, Baltimore, United States of America
| | - Vijay Nandi
- Laboratory of Data Analytics, New York Blood Center, New York, United States of America
| | - Rebecca Rose
- BioInfoExperts, LLC, Thibodaux, United States of America
| | - Reinaldo Fernandez
- School of Medicine, Johns Hopkins University, Baltimore, United States of America
| | - Briana Lynch
- National Institute of Allergy and Infectious Diseases, Baltimore, United States of America
| | - Donald R. Hoover
- Rutgers the State University of New Jersey, Department of Statistics, Piscataway, United States of America
| | - Victoria Frye
- City University of New York School of Medicine, New York, United States of America
| | - Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, United States of America
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28
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Tieu HV, Taylor BS, Jones J, Wilkin TJ. CROI 2018: Advances in Antiretroviral Therapy. Top Antivir Med 2018; 26:40-53. [PMID: 29727296 PMCID: PMC5963936] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The 2018 Conference on Retroviruses and Opportunistic Infections (CROI) showcased exciting data on new investigational agents including MK-8591 and tri-specific antibody targeting 3 highly conserved epitopes on HIV-1 in a single antibody. Clinical trials of initial antiretroviral therapy (ART) and switch studies involving bictegravir/emtricitabine/tenofovir alafenamide were presented. Intensification of initial ART with integrase strand transfer inhibitors did not increase the risk of immune reconstitution inflammatory syndrome. Pharmacokinetic issues were discussed, including the substantial drug-drug interactions between efavirenz-based ART and hormonal contraception delivered via a vaginal ring. Studies on pre-ART drug resistance and emergence of drug resistance after initial and second-line ART in different settings and populations were highlighted. Novel technologies to identify drug resistance included a free, cloud-based web service for HIV genotyping analysis and a promising technology for point-of-care drug resistance mutations testing. New strategies to improve the HIV care continuum included home-based testing with initiation of same-day ART and stratified care with specialized clinics to serve those disengaged in care, but the data on financial incentives were not encouraging. Several studies provided insights into the impact of early ART on decreasing the size of the HIV reservoir in HIV-infected infants. Pertinent conference findings relating to women's health issues included similar clinical outcomes between breastfeeding and formula feeding HIV-infected women, the problem of viral rebound and ART nonadherence in pregnancy and postpartum.
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Affiliation(s)
- Hong-Van Tieu
- Send correspondence to Hong-Van Tieu, MD, MS, 310 E. 67th Street Suite 3-110, New York, NY 10065,
| | - Barbara S. Taylor
- Associate Professor of Infectious Diseases at UT Health San Antonio in San Antonio, Texas
| | - Joyce Jones
- Clinical Associate at Johns Hopkins University School of Medicine in Baltimore, Maryland
| | - Timothy J. Wilkin
- Associate Professor of Medicine at Weill Cornell Medicine in New York, New York
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Levy ME, Phillips G, Magnus M, Kuo I, Beauchamp G, Emel L, Hucks-Ortiz C, Hamilton EL, Wilton L, Chen I, Mannheimer S, Tieu HV, Scott H, Fields SD, Del Rio C, Shoptaw S, Mayer K. A Longitudinal Analysis of Treatment Optimism and HIV Acquisition and Transmission Risk Behaviors Among Black Men Who Have Sex with Men in HPTN 061. AIDS Behav 2017; 21:2958-2972. [PMID: 28352984 PMCID: PMC5623129 DOI: 10.1007/s10461-017-1756-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Little is known about HIV treatment optimism and risk behaviors among Black men who have sex with men (BMSM). Using longitudinal data from BMSM in the HPTN 061 study, we examined participants' self-reported comfort with having condomless sex due to optimistic beliefs regarding HIV treatment. We assessed correlates of treatment optimism and its association with subsequent risk behaviors for HIV acquisition or transmission using multivariable logistic regression with generalized estimating equations. Independent correlates of treatment optimism included age ≥35 years, annual household income <$20,000, depressive symptoms, high HIV conspiracy beliefs, problematic alcohol use, and previous HIV diagnosis. Treatment optimism was independently associated with subsequent condomless anal sex with a male partner of serodiscordant/unknown HIV status among HIV-infected men, but this association was not statistically significant among HIV-uninfected men. HIV providers should engage men in counseling conversations to assess and minimize willingness to have condomless sex that is rooted in optimistic treatment beliefs without knowledge of viral suppression.
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Affiliation(s)
- Matthew E Levy
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA.
| | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Manya Magnus
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA
| | - Irene Kuo
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA
| | - Geetha Beauchamp
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lynda Emel
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Christopher Hucks-Ortiz
- Division of HIV Prevention and Care, John Wesley Community Health Institute, Los Angeles, CA, USA
| | | | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Iris Chen
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sharon Mannheimer
- Department of Medicine, Harlem Hospital and Columbia University Medical Center, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Hyman Scott
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Sheldon D Fields
- Nicole Weirtheim College of Nursing and Health Sciences, Florida International University, Miami, FL, USA
| | - Carlos Del Rio
- Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kenneth Mayer
- Fenway Health, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, MA, USA
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30
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Richardson S, Seekaew P, Koblin B, Vazquez T, Nandi V, Tieu HV. Barriers and facilitators of HIV vaccine and prevention study participation among Young Black MSM and transwomen in New York City. PLoS One 2017; 12:e0181702. [PMID: 28723970 PMCID: PMC5517061 DOI: 10.1371/journal.pone.0181702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 07/04/2017] [Indexed: 11/23/2022] Open
Abstract
Background Black men who have sex with men (MSM), and Transwomen (TW) shoulder disproportionate burden of HIV. However, they are unrepresented in HIV vaccine trials. We investigated the perceptions of that factors associated with HIV vaccine trials participation among Black MSM and TW in New York. Methods Self-administered online questionnaires were administered to 18–29 years of NYC residents who identified as Black MSM and TW, assessing demographics, awareness and willingness to participate in HIV vaccine trials, barriers and facilitators associated with willingness, and sexual behaviors. Frequency summation was performed to determine barriers and facilitators, and logistic regression analysis was performed to determine factors association with expressed willingness. Results Black MSM and TW who reported engaging in risk behaviors had a 61% lower likelihood of participating in HIV vaccine trials when compared to those who did not report engaging in any risk behavior. Facilitators associated with trial participation were: cash compensation, confidentiality regarding participation, public transportation vouchers, gift cards, and food or grocery vouchers as potential facilitators for trial participation. Conversely, fear of side effects from the vaccine, concerns about testing positive on routine HIV testing due to an HIV vaccine, limited knowledge of research trials, and fear of being judged as HIV-positive were perceived as barriers. Conclusions These findings provided insights into the considerations and perceptions of Black MSM and TW towards HIV vaccine trials. However, further studies are needed to delineate the complex mechanisms underlying the decision-making process and establish approaches to increase study participation in this population.
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Affiliation(s)
- Sharise Richardson
- University of Miami School of Medicine, Miami, Florida, United States of America
| | - Pich Seekaew
- Department of Prevention, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- * E-mail:
| | - Beryl Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Tasha Vazquez
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
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Chen I, Zhang Y, Cummings V, Cloherty GA, Connor M, Beauchamp G, Griffith S, Rose S, Gallant J, Scott HM, Shoptaw S, del Rio C, Kuo I, Mannheimer S, Tieu HV, Hurt CB, Fields SD, Wheeler DP, Mayer KH, Koblin BA, Eshleman SH. Analysis of HIV Integrase Resistance in Black Men Who Have Sex with Men in the United States. AIDS Res Hum Retroviruses 2017; 33:745-748. [PMID: 28384058 DOI: 10.1089/aid.2017.0005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/13/2022] Open
Abstract
Resistance to reverse transcriptase and protease inhibitors was frequently detected in HIV from black men who have sex with men (MSM) enrolled in the HIV prevention trials network (HPTN) 061 study. In this study, integrase strand transfer inhibitor (INSTI) resistance was analyzed in black MSM enrolled in HPTN 061 (134 infected at enrollment and 23 seroconverters) and a follow-up study, HPTN 073 (eight seroconverters). The ViroSeq HIV-1 Integrase Genotyping Kit (Abbott Molecular) was used for analysis. Major INSTI resistance mutations were not detected in any of the samples. HIV from 14 (8.4%) of the 165 men, including 4 (12.9%) of 31 seroconverters, had accessory or polymorphic INSTI-associated mutations. The most frequently detected mutation was E157Q. These findings are promising because INSTI-based regimens are now recommended for first-line antiretroviral treatment and because long-acting cabotegravir is being evaluated for pre-exposure prophylaxis.
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Affiliation(s)
- Iris Chen
- Bureau of Primary Health Care, Health Resources and Services Administration, Rockville, Maryland
| | - Yinfeng Zhang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vanessa Cummings
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gavin A. Cloherty
- Infectious Disease Research, Abbott Diagnostics, Abbott Park, Illinois
| | - Matthew Connor
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Geetha Beauchamp
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Sam Griffith
- Science Facilitation Department, FHI 360, Durham, North Carolina
| | - Scott Rose
- Science Facilitation Department, FHI 360, Durham, North Carolina
| | | | - Hyman M. Scott
- Bridge HIV, San Francisco Department of Public Health, San Francisco, California
| | - Steven Shoptaw
- Department of Family Medicine, University of California Los Angeles, Los Angeles, California
| | - Carlos del Rio
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Irene Kuo
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, District of Columbia
| | - Sharon Mannheimer
- Department of Medicine, Harlem Hospital, Columbia University, Mailman School of Public Health, New York, New York
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York
| | - Christopher B. Hurt
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sheldon D. Fields
- School of Health Professions, New York Institute of Technology, Old Westbury, New York
| | - Darrell P. Wheeler
- School of Social Welfare, University at Albany, State University of New York, Albany, New York
| | - Kenneth H. Mayer
- Fenway Health/Infectious Disease Division, The Fenway Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York
| | - Susan H. Eshleman
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Koblin BA, Egan JE, Nandi V, Sang JM, Cerdá M, Tieu HV, Ompad DC, Hoover DR, Frye V. Congruence of Home, Social and Sex Neighborhoods among Men Who Have Sex with Men, NYCM2M Study. J Urban Health 2017; 94:364-374. [PMID: 27646852 PMCID: PMC5481209 DOI: 10.1007/s11524-016-0074-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Substantial literature demonstrates the influence of the neighborhood environment on health behaviors and outcomes. But limited research examines on how gay and bisexual men experience and exist in various geographic and virtual spaces and how this relates to their sexual behavior. New York City Men 2 Men (NYCM2M) was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use, and depression among men who have sex with men (MSM) living in NYC. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. Whether key neighborhoods of human activity, where a participant resided (termed home), socialized (termed social), or had sex most often (termed sex), were the same or different was evaluated. "Congruence" (or the sameness) of home, social, and most often sex neighborhood was reported by 17 % of men, while 30 % reported that none of their neighborhoods were the same. The largest group of men (39 %) reported that their home and sex neighborhoods were the same but their social neighborhood was different while 10 % reported that their home neighborhood was different than their social and sex neighborhood; 5 % men reported same home and social neighborhoods with a different sex neighborhood. Complete neighborhood incongruence was highest among men who were Black and/or Latino, had lower education and personal income levels, and had greater financial insecurity. In adjusted analysis, serodiscordant condomless anal intercourse and condomless anal intercourse with partners from the Internet or mobile applications were significantly associated with having the same social and sex (but not home) neighborhoods. Understanding the complexity of how different spaces and places relate to the health and sexual behavior of MSM is essential for focusing interventions to best reach various populations of interest.
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Affiliation(s)
- Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA.
| | - James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA
| | - Jordan M Sang
- College of Global Public Health, New York University, New York, NY, USA
| | - Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Danielle C Ompad
- College of Global Public Health, New York University, New York, NY, USA.,Center for Drug Use and HIV Research, NYU Rory Meyers College of Nursing, New York, NY, USA
| | - Donald R Hoover
- Department of Statistics and Biostatistics and Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA.,Department of Community Health and Social Medicine, City College of New York, CUNY Medical School, City University of New York, New York, NY, USA
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Hickson DA, Mena LA, Wilton L, Tieu HV, Koblin BA, Cummings V, Latkin C, Mayer KH. Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities. Am J Epidemiol 2017; 185:786-800. [PMID: 28402405 DOI: 10.1093/aje/kww144] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/15/2016] [Indexed: 12/24/2022] Open
Abstract
The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis.
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Affiliation(s)
- DeMarc A Hickson
- Department of Epidemiology and Biostatistics, Jackson State University, School of Public Health, Jackson, MS
| | - Leandro A Mena
- Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39213, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Hong-Van Tieu
- New York Blood Center and Columbia University Medical Center, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Vanessa Cummings
- National Institute of Water and Atmospheric Research (NIWA), Wellington, New Zealand
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kenneth H Mayer
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Jones J, Taylor BS, Tieu HV, Wilkin TJ. CROI 2017: Advances in Antiretroviral Therapy. Top Antivir Med 2017; 25:51-67. [PMID: 28598790 PMCID: PMC5677043] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The 2017 Conference on Retroviruses and Opportunistic Infections (CROI) featured exciting preclinical data on investigational antiretroviral agents with good in vitro efficacy and long half-lives. Investigational medications, including bictegravir, demonstrated excellent efficacy and tolerability, as did dual-agent therapy with dolutegravir paired with rilpivirine or with lamivudine. Dolutegravir monotherapy proved inadvisable due to virologic failure and resistance. The gap between high- and low-income settings along the HIV care continuum is narrowing, with Zimbabwe, Malawi, and Zambia approaching the 90-90-90 targets established by the joint United Nations Programme on HIV/AIDS (UNAIDS), whereas communities in the Southern United States are falling behind. Innovative strategies to improve outcomes include 2-way text messaging, home-based HIV testing, peer navigation, and New York City's realignment of services into comprehensive sexual health programs. A high prevalence of resistance was documented in low- and middle-income settings and policy considerations were modeled to address increasing resistance rates. Novel resistance mutations to integrase strand transfer inhibitors and nucleoside analogue reserve transcriptase inhibitors were identified, but the clinical implications are unclear and require further investigation. Several studies provided insights on dosing and safety of antiretroviral therapy to prevent mother-to-child transmission through pharmacokinetic analysis. A special session devoted to Zika virus included a study of its effects on the central nervous system and a promising animal study of a Zika vaccine.
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Affiliation(s)
- Joyce Jones
- Send correspondence to Joyce Jones, MD, 1800 Orleans Street, Carnegie 158, Baltimore, MD 21287, or
| | - Barbara S. Taylor
- Associate Professor of Infectious Diseases at the University of Texas Health Science Center at San Antonio
| | - Hong-Van Tieu
- Associate Member of the New York Blood Center and Assistant Professor of Clinical Medicine at Columbia University Medical Center in New York, New York
| | - Timothy J. Wilkin
- Associate Professor of Medicine at Weill Cornell Medicine in New York, New York
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35
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Chen I, Huang W, Connor MB, Frantzell A, Cummings V, Beauchamp GG, Griffith S, Fields SD, Scott HM, Shoptaw S, Del Rio C, Magnus M, Mannheimer S, Tieu HV, Wheeler DP, Mayer KH, Koblin BA, Eshleman SH. CXCR4-using HIV variants in a cohort of Black men who have sex with men: HIV Prevention Trials Network 061. HIV Clin Trials 2016; 17:158-64. [PMID: 27300696 DOI: 10.1080/15284336.2016.1180771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate factors associated with HIV tropism among Black men who have sex with men (MSM) in the United States enrolled in a clinical study (HIV Prevention Trials Network 061). METHODS HIV tropism was analyzed using a phenotypic assay (Trofile assay, Monogram Biosciences). Samples were analyzed from 43 men who were HIV infected at enrollment and reported either exclusive insertive intercourse or exclusive receptive intercourse; samples were also analyzed from 20 men who were HIV uninfected at enrollment and seroconverted during the study. Clonal analysis of individual viral variants was performed for seroconverters who had dual/mixed (DM) viruses. RESULTS DM viruses were detected in samples from 11 (26%) of the 43 HIV-infected men analyzed at the enrollment visit; HIV tropism did not differ between those reporting exclusive insertive vs receptive intercourse. DM viruses were also detected in five (25%) of the 20 seroconverters. DM viruses were associated with lower CD4 cell counts. Seroconverters with DM viruses had dual-tropic viruses only or mixed populations of CCR5- and dual-tropic viruses. CONCLUSIONS DM viruses were frequently detected among Black MSM in this study, including seroconverters. Further studies are needed to understand factors driving transmission and selection of CXCR4- and dual-tropic viruses among Black MSM.
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Affiliation(s)
- Iris Chen
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Wei Huang
- b Monogram Biosciences , South San Francisco , CA , USA
| | - Matthew B Connor
- c Vaccine and Infectious Disease Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | | | - Vanessa Cummings
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Geetha G Beauchamp
- c Vaccine and Infectious Disease Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | - Sam Griffith
- d Science Facilitation Department , FHI 360 , Durham , NC , USA
| | - Sheldon D Fields
- e Mervyn M. Dymally School of Nursing , Charles R. Drew University of Medicine and Science , Los Angeles , CA , USA
| | - Hyman M Scott
- f Bridge HIV , San Francisco Department of Public Health , San Francisco , CA , USA
| | - Steven Shoptaw
- g Department of Family Medicine , University of California Los Angeles , Los Angeles , CA , USA
| | - Carlos Del Rio
- h Department of Global Health , Emory University Rollins School of Public Health , Atlanta , GA , USA
| | - Manya Magnus
- i Department of Epidemiology and Biostatistics , The George Washington University , Washington , DC , USA
| | - Sharon Mannheimer
- j Department of Medicine, Harlem Hospital , Columbia University Mailman School of Public Health , New York , NY , USA
| | - Hong-Van Tieu
- k Laboratory of Infectious Disease Prevention , Lindsley F. Kimball Research Institute, New York Blood Center , New York , NY , USA
| | - Darrell P Wheeler
- l School of Social Welfare , University at Albany, State University of New York , Albany , NY , USA
| | - Kenneth H Mayer
- m The Fenway Institute , Fenway Health , Boston , MA , USA.,n Infectious Disease Division , Beth Israel Deaconess Medical Center , Boston , MA , USA.,o Department of Medicine , Harvard Medical School , Boston , MA , USA
| | - Beryl A Koblin
- k Laboratory of Infectious Disease Prevention , Lindsley F. Kimball Research Institute, New York Blood Center , New York , NY , USA
| | - Susan H Eshleman
- a Department of Pathology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
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Taylor BS, Olender SA, Tieu HV, Wilkin TJ. CROI 2016: Advances in Antiretroviral Therapy. Top Antivir Med 2016; 24:59-81. [PMID: 27398863 PMCID: PMC6148924] [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] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 05/16/2016] [Indexed: 06/06/2023]
Abstract
The 2016 Conference on Retroviruses and Opportunistic Infections highlighted exciting advances in antiretroviral therapy, including important data on investigational antiretroviral drugs and clinical trials. Clinical trials demonstrated benefits from a long-acting injectable coformulation given as maintenance therapy, examined intravenous and subcutaneous administration of a monoclonal antibody directed at the CD4 binding site of HIV-1, and provided novel data on tenofovir alafenamide. Several studies focused on the role of HIV drug resistance, including the significance of minority variants, transmitted drug resistance, use of resistance testing, and drug class-related resistance. Novel data on the HIV care continuum in low- and middle-income settings concentrated on differentiated HIV care delivery models and outcomes. Data on progress toward reaching World Health Organization 90-90-90 targets as well as outcomes related to expedited initiation of HIV treatment and adherence strategies were presented. Results from a trial in Malawi showed reduced rates of mother-to-child transmission among HIV-infected women who initiated antiretroviral therapy prior to pregnancy, and several studies highlighted the effect of antiretroviral therapy in pediatric populations. A special session was dedicated to the findings of studies of Ebola virus disease and treatment during the outbreak in West Africa.
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Affiliation(s)
| | | | - Hong-Van Tieu
- Columbia University Medical Center and New York Blood Center, New York, NY, USA
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Tieu HV, Nandi V, Hoover DR, Lucy D, Stewart K, Frye V, Cerda M, Ompad D, Latkin C, Koblin BA. Do Sexual Networks of Men Who Have Sex with Men in New York City Differ by Race/Ethnicity? AIDS Patient Care STDS 2016; 30:39-47. [PMID: 26745143 DOI: 10.1089/apc.2015.0237] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The United States HIV epidemic disproportionately affects Black and Hispanic men who have sex with men (MSM). This disparity might be partially explained by differences in social and sexual network structure and composition. A total of 1267 MSM in New York City completed an ACASI survey and egocentric social and sexual network inventory about their sex partners in the past 3 months, and underwent HIV testing. Social and sexual network structure and composition were compared by race/ethnicity of the egos: black, non-Hispanic (N = 365 egos), white, non-Hispanic (N = 466), and Hispanic (N = 436). 21.1% were HIV-positive by HIV testing; 17.2% reported serodiscordant and serostatus unknown unprotected anal/vaginal intercourse (SDUI) in the last 3 months. Black MSM were more likely than white and Hispanic MSM to report exclusively having partners of same race/ethnicity. Black and Hispanic MSM had more HIV-positive and unknown status partners than white MSM. White men were more likely to report overlap of social and sex partners than black and Hispanic men. No significant differences by race/ethnicity were found for network size, density, having concurrent partners, or having partners with ≥10 years age difference. Specific network composition characteristics may explain racial/ethnic disparities in HIV infection rates among MSM, including HIV status of sex partners in networks and lack of social support within sexual networks. Network structural characteristics such as size and density do not appear to have such an impact. These data add to our understanding of the complexity of social factors affecting black MSM and Hispanic MSM in the U.S.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York City, New York
| | - Vijay Nandi
- Laboratory of Analytical Sciences, New York Blood Center, New York City, New York
| | - Donald R. Hoover
- Department of Biostatistics, Rutgers University, New Brunswick, New Jersey
| | - Debbie Lucy
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York City, New York
| | - Kiwan Stewart
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York City, New York
| | - Victoria Frye
- Laboratory of Behavioral and Social Sciences, New York Blood Center, New York City, New York
| | - Magdalena Cerda
- Department of Emergency Medicine, University of California, Davis, California
| | - Danielle Ompad
- New York University Steinhardt School of Culture, Education, and Human Development, New York City, New York
| | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York City, New York
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Tieu HV, Liu TY, Hussen S, Connor M, Wang L, Buchbinder S, Wilton L, Gorbach P, Mayer K, Griffith S, Kelly C, Elharrar V, Phillips G, Cummings V, Koblin B, Latkin C. Sexual Networks and HIV Risk among Black Men Who Have Sex with Men in 6 U.S. Cities. PLoS One 2015; 10:e0134085. [PMID: 26241742 PMCID: PMC4524662 DOI: 10.1371/journal.pone.0134085] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sexual networks may place U.S. Black men who have sex with men (MSM) at increased HIV risk. METHODS Self-reported egocentric sexual network data from the prior six months were collected from 1,349 community-recruited Black MSM in HPTN 061, a multi-component HIV prevention intervention feasibility study. Sexual network composition, size, and density (extent to which members are having sex with one another) were compared by self-reported HIV serostatus and age of the men. GEE models assessed network and other factors associated with having a Black sex partner, having a partner with at least two age category difference (age difference between participant and partner of at least two age group categories), and having serodiscordant/serostatus unknown unprotected anal/vaginal intercourse (SDUI) in the last six months. RESULTS Over half had exclusively Black partners in the last six months, 46% had a partner of at least two age category difference, 87% had ≤5 partners. Nearly 90% had sex partners who were also part of their social networks. Among HIV-negative men, not having anonymous/exchange/ trade partners and lower density were associated with having a Black partner; larger sexual network size and having non-primary partners were associated with having a partner with at least two age category difference; and having anonymous/exchange/ trade partners was associated with SDUI. Among HIV-positive men, not having non-primary partners was associated with having a Black partner; no sexual network characteristics were associated with having a partner with at least two age category difference and SDUI. CONCLUSIONS Black MSM sexual networks were relatively small and often overlapped with the social networks. Sexual risk was associated with having non-primary partners and larger network size. Network interventions that engage the social networks of Black MSM, such as interventions utilizing peer influence, should be developed to address stable partnerships, number of partners, and serostatus disclosure.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States of America
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
- * E-mail:
| | - Ting-Yuan Liu
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Sophia Hussen
- Division of Infectious Diseases, Emory School of Medicine, Atlanta, GA, United States of America
| | - Matthew Connor
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Lei Wang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Susan Buchbinder
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, United States of America
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Pamina Gorbach
- Department of Epidemiology, School of Public Health, Division of InfectiousDiseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America
| | - Kenneth Mayer
- Fenway Community Health Center, Boston, MA, United States of America
| | - Sam Griffith
- FHI 360, Research Triangle Park, NC, United States of America
| | - Corey Kelly
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Vanessa Elharrar
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Gregory Phillips
- The George Washington University School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington, DC, United States of America
| | - Vanessa Cummings
- Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Beryl Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States of America
| | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Tieu HV, Suntarattiwong P, Puthanakit T, Chotpitayasunondh T, Chokephaibulkit K, Sirivichayakul S, Buranapraditkun S, Rungrojrat P, Chomchey N, Tsiouris S, Hammer S, Nandi V, Ananworanich J. Comparing interferon-gamma release assays to tuberculin skin test in Thai children with tuberculosis exposure. PLoS One 2014; 9:e105003. [PMID: 25121513 PMCID: PMC4133381 DOI: 10.1371/journal.pone.0105003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/16/2014] [Indexed: 11/18/2022] Open
Abstract
Background Data on the performance of interferon-gamma release assays (IGRAs), QuantiFERON TB Gold In-tube (QFNGIT) and T-Spot.TB, in diagnosing tuberculosis (TB) are limited in Southeast Asia. This study aims to compare the performances of the two IGRAs and TST in Thai children with recent TB exposure. Methods This multicenter, prospective study enrolled children with recent exposure to active TB adults. Children were investigated for active TB. TST was performed and blood collected for T-Spot.TB and QFNGIT. Results 158 children were enrolled (87% TB-exposed and 13% active TB, mean age 7.2 years). Only 3 children had HIV infection. 66.7% had TST≥10 mm, while 38.6% had TST≥15 mm. 32.5% had positive QFNGIT; 29.9% had positive T-Spot.TB. QFNGIT and T-Spot.TB positivity was higher among children with active TB compared with TB-exposed children. No indeterminate IGRA results were detected. No statistically significant differences between the performances of the IGRAs and TST at the two cut-offs with increasing TB exposure were detected. Concordance for positive IGRAs and TST ranged from 42–46% for TST≥10 mm and 62–67% for TST≥15 mm. On multivariable analyses, exposure to household primary/secondary caregiver with TB was associated with positive QFNGIT. Higher TB contact score and active TB were associated with positive T-Spot.TB. Conclusions Both QFNGIT and T-Spot.TB performed well in our Thai pediatric study population. No differences in the performances between tests with increasing TB exposure were found. Due to accessibility and low cost, using TST may more ideal than IGRAs in diagnosing latent and active TB in healthy children in Thailand and other similar settings.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America
- * E-mail:
| | | | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | | | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunee Sirivichayakul
- Department of Medicine, Faculty of Medicine, Chulalonglongkorn University, Bangkok, Thailand
| | | | | | - Nitiya Chomchey
- SEARCH, The Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Simon Tsiouris
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America
| | - Scott Hammer
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Jintanat Ananworanich
- HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, Chulalonglongkorn University, Bangkok, Thailand
- SEARCH, The Thai Red Cross AIDS Research Center, Bangkok, Thailand
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
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Koblin BA, Egan JE, Rundle A, Quinn J, Tieu HV, Cerdá M, Ompad DC, Greene E, Hoover DR, Frye V. Methods to measure the impact of home, social, and sexual neighborhoods of urban gay, bisexual, and other men who have sex with men. PLoS One 2013; 8:e75878. [PMID: 24146785 PMCID: PMC3797712 DOI: 10.1371/journal.pone.0075878] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/16/2013] [Indexed: 11/18/2022] Open
Abstract
Men who have sex with men (MSM) accounted for 61% of new HIV diagnoses in the United States in 2010. Recent analyses indicate that socio-structural factors are important correlates of HIV infection. NYCM2M was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use and depression among MSM living in New York City. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. This paper describes novel methodological approaches used to improve the quality of data collected for analysis of the impact of neighborhoods on MSM health. Previous research has focused predominately on residential neighborhoods and used pre-determined administrative boundaries (e.g., census tracts) that often do not reflect authentic and meaningful neighborhoods. This study included the definition and assessment of multiple neighborhoods of influence including where men live (home neighborhood), socialize (social neighborhood) and have sex (sexual neighborhood). Furthermore, making use of technological advances in mapping, we collected geo-points of reference for each type of neighborhood and identified and constructed self-identified neighborhood boundary definitions. Finally, this study collected both perceived neighborhood characteristics and objective neighborhood conditions to create a comprehensive, flexible and rich neighborhood-level set of covariates. This research revealed that men perceived their home, social and sexual neighborhoods in different ways. Few men (15%) had the same home, social and sexual neighborhoods; for 31%, none of the neighborhoods was the same. Of the three types of neighborhoods, the number of unique social neighborhoods was the lowest; the size of sexual neighborhoods was the smallest. The resultant dataset offers the opportunity to conduct analyses that will yield context-specific and nuanced understandings of the relations among neighborhood space, and the well-being and health of urban MSM.
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Affiliation(s)
- Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- * E-mail:
| | - James E. Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - James Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- Division of Infectious Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, United States of America
| | - Magdalena Cerdá
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Danielle C. Ompad
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS) and Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, New York, New York, United States of America
| | - Emily Greene
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Donald R. Hoover
- Department of Statistics and Biostatistics and Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, Piscataway, New Jersey, United States of America
| | - Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
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Affiliation(s)
- Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F Kimball Research Institute, New York Blood Center, New York, NY 10065, USA.
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Tieu HV, Spikes P, Patterson J, Bonner S, Egan JE, Goodman K, Stewart K, Frye V, Xu G, Hoover DR, Koblin BA. Sociodemographic and risk behavior characteristics associated with unprotected sex with women among black men who have sex with men and women in New York City. AIDS Care 2012; 24:1111-9. [PMID: 22533637 DOI: 10.1080/09540121.2012.672723] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objectives of this cross-sectional study were to compare sociodemographic and risk behavior characteristics between black men who have sex with both men and women (MSMW) and those who have sex with men only (MSMO) and assess factors associated with having any unprotected vaginal and/or anal intercourse (UVAI) with women in the last 3 months. Data from 326 black men who reported recent unprotected anal intercourse with a man in an HIV behavioral intervention study in New York City were analyzed. Baseline characteristics were compared between MSMW and MSMO, and factors associated with having any UVAI in the past 3 months with women among MSMW were evaluated. In total, 26.8% reported having sex with both men and women in the last 3 months. MSMW were less likely to be HIV infected, use amyl nitrates, and have unprotected receptive anal sex with most recent male partner. MSMW were more likely to be over 40 years old and use heroin. A total of 55.6% of MSMW reported having UVAI with women in the last 3 months. Compared to MSMW having only protected sex, MSMW having any UVAI with women were less likely to be HIV infected and to disclose having sex with men to female partners; they were more likely to have greater than four male sex partners in the last 3 months. In conclusion, HIV prevention interventions among black MSMW should directly address the risk of HIV transmission to both their female and male partners. Disclosure of bisexuality to female partners may be an important component of future prevention efforts.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA.
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Cuc NTK, Simianer H, Eding H, Tieu HV, Cuong VC, Wollny CBA, Groeneveld LF, Weigend S. Assessing genetic diversity of Vietnamese local chicken breeds using microsatellites. Anim Genet 2011; 41:545-7. [PMID: 20394606 DOI: 10.1111/j.1365-2052.2010.02039.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study aimed to assess genetic diversity within and between nine Vietnamese local chicken breeds and two Chinese breeds included for comparison. Genotyping 29 microsatellites revealed high diversity of both Vietnamese and Chinese breeds. Cluster analysis using the STRUCTURE software suggested six clusters as the most likely grouping of the 11 breeds studied. These groups encompassed four homogeneous clusters, one formed by the two Chinese breeds and the other three representing a single breed each: the Mekong Delta breed Ac, the South Central Coast breed Choi, and the Red River Delta breed Dong Tao. The six remaining breeds formed two additional admixed clusters.
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Affiliation(s)
- N T K Cuc
- Department of Animal Sciences, Animal Breeding and Genetics Group, Georg-August-Universität Göttingen, Göttingen, Germany
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Edwards-Jackson N, Kerr SJ, Tieu HV, Ananworanich J, Hammer SM, Ruxrungtham K, Phanuphak P, Avihingsanon A. Cardiovascular risk assessment in persons with HIV in the developing world: comparing three risk equations in a cohort of HIV-infected Thais. J Int AIDS Soc 2010. [PMCID: PMC3112855 DOI: 10.1186/1758-2652-13-s4-o40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wilkin TJ, Shalev N, Tieu HV, Hammer SM. Advances in antiretroviral therapy. Top HIV Med 2010; 18:66-92. [PMID: 20516526] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The 17th Conference on Retroviruses and Opportunistic Infections maintained its tradition of being the preeminent forum for detailing the state-of-the-art of antiretroviral therapy. Abundant new and updated information was presented on investigational drugs, approaches to the management of treatment-naive and -experienced patients, the use of drugs for prevention of mother-to-child HIV-1 transmission, and HIV resistance to antiretroviral drugs. Of particular note were the continued advances in antiretroviral treatment and research emanating from resource-limited settings and from large clinical trials to determine the optimal initial antiretroviral drug regimen. Several interesting smaller studies were focused on HIV-1 pathogenesis and persistent viremia.
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