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Ohsuga T, Egawa M, Takahashi Y, Ikeda Y, Tsuyuki K, Kanatani K, Niwa F, Hirabayashi K, Nakayama T, Mandai M. Association between low MCV in early pregnancy and perinatal mental health in the Japan Environment and Children's Study and the possible effect of iron deficiency. J Affect Disord 2024; 356:34-40. [PMID: 38583601 DOI: 10.1016/j.jad.2024.04.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Postpartum anemia and iron deficiency are associated with postpartum depression. This study investigated the association between a low mean corpuscular volume (MCV) without anemia (which implies early-stage iron deficiency) in early pregnancy and perinatal mental health outcomes. METHODS The fixed data from the Japan Environment and Children's Study (JECS), a Japanese nationwide birth cohort, were used. Perinatal mental health was assessed using the Kessler 6-item psychological distress scale (K6) in mid-pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at 1- and 6-months postpartum. RESULTS Among the 3635 women with MCVs <85 fL in early pregnancy, the proportions of women with K6 scores ≥13 in mid-pregnancy and EPDS scores ≥9 at 1- and 6-months postpartum were 2.7 %, 12.8 %, and 9.9 %, respectively, compared with the 33,242 women with MCVs ≥85 fL at 1.9 %, 11.9 %, and 9.0 %, respectively. Multivariate logistic regression models showed that an MCV <85 in early pregnancy was associated with a K6 score ≥ 13 in mid-pregnancy and an EPDS score ≥ 9 at 1- and 6-months postpartum (adjusted odds ratio (95 % confidence interval): 1.48 (1.16-1.87), 1.14 (1.01-1.28), and 1.09 (0.95-1.24), respectively). LIMITATIONS Low MCV values do not necessarily represent iron deficiency. Ferritin, currently the best indicator of iron deficiency, was not measured in the JECS. CONCLUSIONS This study results suggest that a low MCV without anemia in early pregnancy is associated with a slightly increased risk of perinatal mental health deterioration.
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Affiliation(s)
- T Ohsuga
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - M Egawa
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
| | - Y Ikeda
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - K Tsuyuki
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Kanatani
- Kyoto Unit Centre for Japan Environment and Children's Study, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - F Niwa
- Kyoto Unit Centre for Japan Environment and Children's Study, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Hirabayashi
- Kyoto Unit Centre for Japan Environment and Children's Study, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan; Kyoto Unit Centre for Japan Environment and Children's Study, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - M Mandai
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Tesfai Y, Lucea MB, Chan E, Asuquo T, Zhu H, Gaines TL, Campbell JC, Stockman JK, Tsuyuki K. Cumulative Lifetime Violence and Bacterial Vaginosis Infection in Sexually Transmitted Infections: Findings From a Retrospective Cohort Study Among Black Women at Risk for HIV. AJPM Focus 2024; 3:100180. [PMID: 38445027 PMCID: PMC10912451 DOI: 10.1016/j.focus.2023.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Introduction Bacterial vaginosis is the most common vaginal condition among women of reproductive age and has been associated with sexually transmitted infections. This study examines the association between cumulative lifetime violence exposure, bacterial vaginosis, and sexually transmitted infections among Black women at risk for HIV. Methods HIV-negative Black women in a retrospective cohort study (N=230) completed survey questions on cumulative violence (exposure to sexual or physical abuse before age 18 years and exposure to intimate partner violence or sexual violence [partner or other] after age 18 years and past year), bacterial vaginosis (lifetime and past year), and sexually transmitted infection diagnosis (lifetime and past year). Logistic regression models estimated the associations between cumulative violence, bacterial vaginosis, and sexually transmitted infections. Bacterial vaginosis was examined as a moderator in the association between cumulative violence and sexually transmitted infections. Results Many women reported cumulative violence exposure (40%), lifetime bacterial vaginosis diagnosis (53%), and lifetime sexually transmitted infection diagnosis (73%). Cumulative violence experience was significantly associated with increased adjusted odds of lifetime bacterial vaginosis diagnosis (AOR=1.98; 95% CI=1.10, 3.54). Lifetime bacterial vaginosis diagnosis (AOR=2.76; 95% CI=1.45, 5.22) and past-year bacterial vaginosis diagnosis (AOR=2.16; 95% CI=1.14, 4.10) were significantly associated with increased odds of lifetime sexually transmitted infection diagnosis. Lifetime bacterial vaginosis diagnosis (AOR=2.10; 95% CI=1.19, 3.70) and past-year bacterial vaginosis diagnosis (AOR=3.00; 95% CI=1.70, 5.31) were significantly associated with past-year sexually transmitted infection diagnosis. Lifetime bacterial vaginosis infection significantly increased the odds of lifetime sexually transmitted infection diagnosis with increasing cumulative violence exposure. Conclusions Our findings support educating and screening Black women who experience cumulative violence for bacterial vaginosis to reduce the risk of untreated bacterial vaginosis and sexually transmitted infections.
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Affiliation(s)
- Yordanos Tesfai
- Family Medicine and Public Health, University of California, San Diego, La Jolla, California
| | - Marguerite B. Lucea
- Department of Nursing, College of Health Professions, Towson University, Towson, Maryland
| | - Erica Chan
- Family Medicine and Public Health, University of California, San Diego, La Jolla, California
| | - Theresa Asuquo
- Program in Medical Education - Health Equity (PRIME-HEQ), Department of Medicine, University of California, San Diego, La Jolla, California
| | - Helen Zhu
- Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California
| | - Tommi L. Gaines
- Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California
| | | | - Jamila K. Stockman
- Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California
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Stockman JK, Anderson KM, Fernandez DeSoto A, Campbell DM, Tsuyuki K, Horvath KJ. A Trauma-Informed HIV Intervention (LinkPositively) to Improve HIV Care Among Black Women Affected by Interpersonal Violence: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e46325. [PMID: 37405824 DOI: 10.2196/46325] [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: 03/05/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Black women bear a disproportionate burden of HIV, accounting for nearly 60% of new diagnoses among US women. Black women living with HIV often experience mutually reinforcing epidemics, known as syndemics, including interpersonal violence and substance use. Syndemics are associated with decreased HIV care engagement and treatment adherence and worsening HIV outcomes. Few HIV services and resources are tailored to be culturally and gender-responsive and trauma informed for Black women living with HIV. Technology-based, psychoeducational, and peer navigation programs offer promising pathways to tailored HIV support and improved HIV care outcomes. Therefore, the web-based, trauma-informed intervention LinkPositively was developed in collaboration with Black women living with HIV to promote uptake of HIV care and ancillary support services. OBJECTIVE This study primarily determines the feasibility and acceptability of the LinkPositively intervention among Black women living with HIV affected by interpersonal violence. The secondary aim is to examine the preliminary impact of the LinkPositively intervention on retention in HIV care, antiretroviral therapy adherence, and viral suppression while evaluating the role of mechanism of change variables (eg, social support) in the associations. METHODS The LinkPositively trial is a pilot randomized controlled trial conducted in California, United States, among 80 adult Black women living with HIV who have experienced interpersonal violence. Core components of LinkPositively include one-on-one peer navigation with phone and SMS text message check-ins; 5 weekly one-on-one video sessions to build coping and care navigation skills; and a mobile app that contains a peer support social networking platform, an educational database with healthy living and self-care tips, a GPS-enabled HIV and ancillary care resource locator, and a medication self-monitoring and reminder system. Participants are randomly assigned to the intervention (n=40) or control (Ryan White standard of care; n=40) arm, with follow-up at 3 and 6 months. At each assessment, participants complete an interviewer-administered survey and submit hair samples for the assessment of HIV medication adherence. All research staff and investigators adhere to ethical principles and guidelines for conducting research activities. Data will be analyzed using generalized estimating equations. RESULTS Final development and testing of the LinkPositively app were completed in July 2021. As of May 2023, we have screened 97 women for eligibility. Of the 97 women screened, 27 (28%) were eligible and have been enrolled in the study. The dissemination of preliminary results will occur in 2024. CONCLUSIONS This trial will advance HIV prevention science by harnessing technology to promote engagement in HIV care while improving social support through peers and social networking-all while being trauma informed for Black women living with HIV with experiences of interpersonal violence. If shown to be feasible and acceptable, LinkPositively has the potential to improve HIV care outcomes among Black women, a marginalized key population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46325.
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Affiliation(s)
- Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Katherine M Anderson
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Alexandra Fernandez DeSoto
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Danielle M Campbell
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, United States
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Tsuyuki K, Chan E, Lucea MB, Cimino A, Rudolph AE, Tesfai Y, Campbell JC, Catabay CJ, Stockman JK. Characterising a syndemic among black women at risk for HIV: the role of sociostructural inequity and adverse childhood experiences. Sex Transm Infect 2023; 99:7-13. [PMID: 35595503 PMCID: PMC9887352 DOI: 10.1136/sextrans-2021-055224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/13/2022] [Indexed: 02/03/2023] Open
Abstract
Objectives Black women disproportionately experience STIs (including HIV/AIDS), gender-based violence, substance misuse and mental health conditions. Addressing a gap in syndemic research, we characterised comorbidity overlap within the context of sociostructural inequities and adverse childhood experiences (ACEs) among black women in Baltimore, Maryland. Methods Between 2015 and 2018, black women (n=305) were recruited from STI clinics in Baltimore, Maryland. Among those with complete survey data (n=230), we conducted a latent class analysis to differentiate women based on their profile of the following syndemic comorbidities: STIs, adult sexual victimisation, substance misuse and mental health disorders. We then examined the association between ACEs and syndemic latent class membership. Results Thirty-three percent of women experienced three to nine ACEs before age 18 years, and 44% reported four to six comorbidities. The two-class latent class solution demonstrated the best fit model, and women were categorised in either class 1 (past-year STI; 59%) or class 2 (syndemic comorbidities; 41%). Women in class 2 were more likely to report unstable housing (10% vs 3%) and identify as bisexual/gay (22% vs 10%) than women in class 1. ACEs were significantly associated with an increased likelihood of class 2 membership. Conclusions This study reinforces the importance of screening for ACEs and offering trauma-informed, integrated care for black women with syndemic comorbidities. It also highlights the critical nature of tailoring interventions to improve sociostructural equity, preventing and reducing syndemic development.
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Affiliation(s)
- Kiyomi Tsuyuki
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Erica Chan
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Andrea Cimino
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Yordanos Tesfai
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Christina J Catabay
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Jamila K Stockman
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Sherman ADF, Cimino AN, Balthazar M, Johnson KB, Burns DD, Verissimo ADO, Campbell JC, Tsuyuki K, Stockman JK. Discrimination, Sexual Violence, Depression, Post-traumatic Stress Disorder, and Social Support among Black Women. J Health Care Poor Underserved 2023; 34:35-57. [PMID: 37464480 PMCID: PMC10356991 DOI: 10.1353/hpu.2023.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND Black Americans face significant discrimination associated with mental health disorder, which may be exacerbated among sexually victimized people. Social support may buffer that relationship. METHODS Cross-sectional data from a retrospective cohort study were analyzed to examine if discrimination and sexual victimization overlap to exacerbate symptoms of depression and post-traumatic stress disorder (PTSD) and to determine the extent to which social support moderated that association among Black women living in Baltimore, Maryland [138 non-abused (no physical/sexual victimization) and 98 abused (sexually victimized) since age 18]. RESULTS Symptoms of depression and PTSD were independently associated with discrimination. Multilinear regression showed social support from friends moderated the association between discrimination and depressive symptoms among sexually abused participants only. CONCLUSION Discrimination may exacerbate symptoms of depression and PTSD more for sexually victimized Black women, but sources of informal social support may attenuate adverse effects of discrimination on depressive symptoms among members of that group.
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Stockman JK, Lucea MB, Cimino AN, Wood BA, Tsuyuki K, Granger DA, Campbell JC. Discrimination, resilience, and HIV testing frequency among black women seeking services from STD clinics. Soc Sci Med 2023; 316:115344. [PMID: 36115729 DOI: 10.1016/j.socscimed.2022.115344] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/06/2021] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE In the United States, Black women are disproportionately affected by HIV, accounting for most new HIV infections diagnosed among women. Socio-structural barriers to HIV testing include stigma and discrimination but may be mitigated by resilience. OBJECTIVE We aimed to examine the effect of discrimination and resilience on HIV testing behaviors among Black women. METHODS Between 2016 and 2018, we conducted The ESSENCE Project, a retrospective cohort study on the role of physiological and environmental factors on the association between sexual assault and HIV risk among Black women in Baltimore, Maryland, USA. Black women aged 18-44 were recruited from public health STD clinics and completed an audio-computer-assisted self-interview survey. Hierarchical multiple negative binomial regression models were used to examine the associations of everyday discrimination (subtle and overt) and resilience on HIV testing frequency; resilience and its subscales (relational maintenance, personal fortitude, positive coping, independence and insight) were also examined as moderators. RESULTS Among 236 Black women reporting HIV testing history, the median number of lifetime HIV tests was 4 (IQR = 2, 6). Mean everyday discrimination was 2.3 (SD = 1.2). Mean resilience was 5.3 (SD = 0.8). Everyday discrimination and its subscales (overt and subtle) were negatively associated with lifetime HIV testing frequency, while overall resilience was not associated with lifetime HIV testing frequency. Accounting for demographics, overall resilience moderated the association of subtle discrimination and lifetime HIV testing frequency. For the resilience subscales, more specifically: (1) associations of subtle discrimination and HIV testing frequency were significant at the lowest relational maintenance and lowest positive coping resilience; and (2) the association of subtle discrimination and HIV testing frequency was significant at the highest resilience for all four subscales. CONCLUSIONS These findings highlight the need for provider- and community-level interventions addressing the deleterious effects of everyday discrimination and more specifically subtle everyday discrimination to encourage HIV testing.
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Affiliation(s)
- Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, USA.
| | | | - Andrea N Cimino
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Brittany A Wood
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, USA
| | - Douglas A Granger
- School of Social Ecology, University of California, Irvine, Irvine, CA, USA
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Mancus GC, Cimino AN, Hasan MZ, Campbell JC, Sharps P, Winch PJ, Tsuyuki K, Stockman JK. Greenness and the Potential Resilience to Sexual Violence: "Your Neighborhood Is Being Neglected Because People Don't Care. People With Power Don't Care". J Interpers Violence 2022; 37:NP17344-NP17368. [PMID: 34210177 DOI: 10.1177/08862605211028009] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is increasing evidence that green space in communities reduces the risk of aggression and violence, and increases wellbeing. Positive associations between green space and resilience have been found among children, older adults and university students in the United States, China and Bulgaria. Little is known about these associations among predominately Black communities with structural disadvantage. This study explored the potential community resilience in predominately Black neighborhoods with elevated violent crime and different amounts of green space. This embedded mixed-methods study started with quantitative analysis of women who self-identified as "Black and/or African American." We found inequality in environments, including the amount of green space, traffic density, vacant property, and violent crime. This led to 10 indepth interviews representing communities with elevated crime and different amounts of green space. Emergent coding of the first 3 interviews, a subset of the 98 in the quantitative analysis, led to a priori coding of barriers and facilitators to potential green space supported community resilience applied to the final 7 interview data. Barriers were a combination of the physical and social environment, including traffic patterns, vacant property, and crime. Facilitators included subjective qualities of green space. Green spaces drew people in through community building and promoting feelings of calmness. The transformation of vacant lots into green spaces by community members affords space for people to come together and build community. Green spaces, a modifiable factor, may serve to increase community resilience and decrease the risk of violence.
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Affiliation(s)
| | | | - Md Zabir Hasan
- The University of British Columbia, Vancouver, British Columbia, BC, Canada
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Tsuyuki K, Stockman JK, Stadnick NA, Moore V, Zhu H, Torres V, Cano R, Penninga K, Aldous JL. Proyecto Compadre: Using Implementation Science to Tailor Peer Navigation for Latino Men in the US-Mexico Border Region. J Acquir Immune Defic Syndr 2022; 90:S98-S104. [PMID: 35703761 PMCID: PMC9220980 DOI: 10.1097/qai.0000000000002985] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Latino men who have sex with men (MSM) in San Diego have poor HIV testing and prevention outcomes compared with non-Latino White men. Peer navigation (PN) is a promising evidence-based intervention to reduce disparities but needs tailoring for Latino MSM. SETTINGS Health centers near the US-Mexico border. METHODS Using the Exploration, Preparation, Implementation, Sustainment Framework, we conducted mixed-methods implementation science study. In phase I, we conducted interviews with Latino men (n = 15), focus groups with staff (n = 7), and surveys with all to understand the Exploration, Preparation, Implementation, Sustainment factors associated with HIV testing and care linkage. In phase II, we conducted 31 web-based surveys with Latino men and staff to rank intervention and implementation strategies from phase I. Quantitative data were analyzed descriptively, integrated with qualitative data, and reviewed by our community-academic partnership to develop an implementation model. RESULTS Latino men (N = 15) were 94% Spanish speaking, 67% gay identified, 27% US born, and their suggestions were to have navigators use peer referral to address barriers such as stigma; use the Latino social network to expand reach, leverage social media for peer-led intervention, and disseminate HIV information. Staff (N = 26) were 77% Spanish speaking, 35% gay-identified, 96% trained in cultural competency, and suggested including culturally appropriate HIV educational materials in Spanish, status and identity neutral programs, administrative/supervisorial/training structure for PNs, and PN compensation and team integration. Overall, results emphasized a need for a formalized PN model centered on referrals and using existing Latino community social networks. CONCLUSIONS Findings can be packaged for future implementation of PN programs for Latino MSM.
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Affiliation(s)
- Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego (9500 Gilman Drive, La Jolla, CA, 92093-0507, USA)
| | - Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego (9500 Gilman Drive, La Jolla, CA, 92093-0507, USA)
| | | | | | - Helen Zhu
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego (9500 Gilman Drive, La Jolla, CA, 92093-0507, USA)
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Anderson KM, Tsuyuki K, Fernandez DeSoto A, Stockman JK. The Effect of Adverse Mental Health and Resilience on Perceived Stress by Sexual Violence History. Int J Environ Res Public Health 2022; 19:ijerph19084796. [PMID: 35457663 PMCID: PMC9029884 DOI: 10.3390/ijerph19084796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
Sexual violence, including nonconsensual sexual initiation and rape, remains pervasive, with impacts including adverse mental health and dysregulated stress response. Resilience is a promising interventional target. To advance the science, we examined the potential for resilience as an interventional tool by estimating associations between resilience, adverse mental health, and perceived stress among women by sexual violence history and partner perpetration. We analyzed 2018−2020 baseline survey data from 65 women enrolled in a prospective case-control study of sexual violence and HIV susceptibility in San Diego, CA. Multiple linear regressions were performed to examine associations, stratified by sexual violence history. About half of women experienced nonconsensual sexual initiation and/or rape; half of rapes were partner-perpetrated. Post-traumatic stress disorder (PTSD) was significantly associated with perceived stress among survivors (in regressions with depression and resilience, nonconsensual initiation: β = 6.514, p = 0.003, R2 = 0.616; rape: β = 5.075, p = 0.030, R2 = 0.611). Resilience was associated with lower perceived stress for all women; the effect appeared stronger among survivors of sexual violence (nonconsensual initiation: β = −0.599, p < 0.001 vs. β = −0.452, p = 0.019; rape: β = −0.624, p < 0.001 vs. β = −0.421, p = 0.027). Partner perpetration of rape was not associated with perceived stress. Our findings support leveraging resilience and addressing PTSD to reduce perceived stress among women with lifetime experiences of sexual violence.
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Affiliation(s)
- Katherine M. Anderson
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, San Diego, CA 92093, USA; (K.T.); (A.F.D.); (J.K.S.)
- Correspondence:
| | - Kiyomi Tsuyuki
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, San Diego, CA 92093, USA; (K.T.); (A.F.D.); (J.K.S.)
| | - Alexandra Fernandez DeSoto
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, San Diego, CA 92093, USA; (K.T.); (A.F.D.); (J.K.S.)
| | - Jamila K. Stockman
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, San Diego, CA 92093, USA; (K.T.); (A.F.D.); (J.K.S.)
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Stockman JK, Anderson KM, Tsuyuki K, Horvath KJ. LinkPositively: A Trauma-Informed Peer Navigation and Social Networking WebApp to Improve HIV Care among Black Women Affected by Interpersonal Violence. J Health Care Poor Underserved 2021; 32:166-188. [PMID: 34934301 PMCID: PMC8687146 DOI: 10.1353/hpu.2021.0056] [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: 01/20/2023]
Abstract
In the U.S., Black women living with HIV/AIDS (WLHA) are affected disproportionately by interpersonal violence, which often co-occurs with adverse mental health and/or substance use, and exacerbates existing poor HIV care outcomes. Peer navigation has been successful in improving HIV care; however, HIV clinics often lack resources for sustainability and may not account for socio-structural barriers unique to Black WLHA. To address this gap, we developed LinkPositively, a culturally-tailored, trauma-informed WebApp for Black WLHA affected by interpersonal violence to improve HIV care outcomes. Using focus group data from nine Black WLHA and peer navigators, we developed LinkPositively. Core components include: virtual peer navigation to facilitate skill-building to cope with barriers and navigate care; social networking platform for peer support; educational and self-care tips; GPS-enabled resource locator for HIV care and support service agencies; and medication self-monitoring/reminder system. If efficacious, LinkPositively will shift the HIV prevention and care paradigm for Black WLHA.
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Affiliation(s)
- Jamila K Stockman
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| | - Katherine M Anderson
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| | - Kiyomi Tsuyuki
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
| | - Keith J Horvath
- is an Associate Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and Director of the Disparities Core of the UC San Diego Center for AIDS Research. is a Clinical Research Coordinator at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health and a PhD Student at Emory University, Rollins School of Public Health in the Department of Behavioral, Social, and Health Education Sciences. is an Assistant Professor at the University of California, San Diego in the School of Medicine, Department of Medicine, Division of Infectious Diseases and Global Public Health. is an Associate Professor at San Diego State University in the Department of Psychology
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11
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Chan E, Catabay CJ, Campbell JC, Rudolph AE, Stockman JK, Tsuyuki K. Feminine gender norms and syndemic harmful drinking, sexual violence, and sexually transmitted infections among Black women at risk for HIV. Drug Alcohol Depend 2021; 221:108566. [PMID: 33581345 PMCID: PMC8026659 DOI: 10.1016/j.drugalcdep.2021.108566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 07/08/2020] [Revised: 01/03/2021] [Accepted: 01/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study examined the associations between feminine gender ideologies (i.e., socially constructed attitudes and beliefs of women's appropriate behavior and roles) and the syndemic comorbidities of harmful alcohol use, sexual violence, and sexually transmitted infections (STI), which disproportionately affect Black women. METHODS Black women, aged 18-44 (n = 305) were recruited from STI clinics in Baltimore, MD into a retrospective cohort study. A survey assessed feminine gender ideologies using a measure of hyperfemininity and sexual hyperfemininity (subscale of sexual domains), harmful drinking (AUDIT), lifetime STI (Y/N and count), and syndemic burden (no burden [0-1 morbidity] and syndemic burden [2-3 comorbidities]). Multivariable regression models identified correlates of harmful drinking, STI, and syndemic burden. The analytic sample included (n = 231) women with complete data. RESULTS Nearly half of our sample reported high hyperfemininity and high sexual hyperfemininity, 23% reported harmful drinking, 39% experienced sexual violence as an adult, and 74% reported a lifetime STI. High sexual hyperfemininity (Adjusted Odds Ratio [AOR] = 1.94, 95% Confidence Interval [CI]: 1.00-3.76) and sexual violence (AOR = 2.82, 95%CI: 1.43-5.58) were associated with greater odds of harmful drinking. Experiencing sexual violence in adulthood was associated with an increased count of lifetime STIs (Adjusted Incidence Rate Ratio [AIRR] = 1.33, 95%CI: 1.06-1.68). Syndemic burden affected 41% of our sample. High sexual hyperfemininity was associated with experiencing syndemic burden in unadjusted models (OR = 1.98, 95%CI: 1.16-3.37), but was not significant after controlling for confounders. CONCLUSIONS Interventions to reduce harmful drinking and STIs among Black women in the U.S. should address sexual gender ideologies and sexual violence.
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Affiliation(s)
- Erica Chan
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA
| | - Christina J Catabay
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA
| | - Jacquelyn C Campbell
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B Moore Avenue, Ritter Annex 905, Philadelphia, PA, 19122, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA.
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12
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Stockman JK, Syvertsen JL, Hayashi HD, Ludwig-Barron N, Tsuyuki K, Morris MD, Palinkas LA. "Violence and love and drugs…it all goes hand in hand": A mixed methods analysis of the substance abuse, violence, and HIV/AIDS syndemic among women who use methamphetamine. Subst Abus 2021; 42:821-831. [PMID: 33492198 PMCID: PMC8442613 DOI: 10.1080/08897077.2020.1865242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/22/2022]
Abstract
Background: The synergistic epidemics of substance use, violence, and HIV/AIDS, also known as the SAVA syndemic, disproportionately affects vulnerable women in the United States. Methamphetamine use is closely linked with physical and sexual violence, including intimate partner violence (IPV), which heightens women's vulnerability to HIV. This mixed methods study examined the prevalence and correlates of violence among women who use methamphetamine, (n = 209) enrolled in an HIV intervention study in San Diego, California. Methods: At baseline, 209 women completed an interviewer-administered computer-assisted survey. A sub set of women who reported lifetime IPV (n = 18) also participated in qualitative interviews to contextualize our understanding of patterns of violence over time. Results: In the overall cohort, reports of lifetime (66.0%) and past 2-month (19.6%) IPV were prevalent. Moreover, women reported lifetime physical only (27.3%), sexual only (6.2%), or both forms of violence (50.7%) by multiple perpetrators. Factors independently associated with lifetime IPV were having unprotected sex with a steady partner (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.04, 6.00) and being high on methamphetamine during unprotected sex with a steady partner (OR: 2.56, 95% CI: 1.30, 5.09) within the past 2 months. Our qualitative narratives illuminated how IPV in women's steady relationships often reflects a culmination of violent victimization throughout their lifetime which is further exacerbated by methamphetamine use and sexual risk through gendered power dynamics. Conclusions: HIV prevention interventions should address the SAVA syndemic in a holistic manner, including the role of methamphetamine use in the context of women's abusive steady relationships.
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Affiliation(s)
- Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | - Hitomi D. Hayashi
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, USA
| | - Natasha Ludwig-Barron
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Meghan D. Morris
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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13
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Talla C, Itanyi IU, Tsuyuki K, Stadnick N, Ogidi AG, Olakunde BO, Patel D, Oko JO, Aarons G, Onoka CA, Ezeanolue EE. Hepatitis B infection and risk factors among pregnant women and their male partners in the Baby Shower Programme in Nigeria: a cross-sectional study. Trop Med Int Health 2020; 26:316-326. [PMID: 33247862 DOI: 10.1111/tmi.13531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To determine the population prevalence and determinants of hepatitis B (Hep B) status, and status discordance, among pregnant women and their male partners in Nigeria. METHODS Cross-sectional study assessing the seroprevalence of Hep B virus in a cohort of 16 920 pregnant women and their male partners in northcentral Nigeria. Rapid HBsAg antibody test was used for Hep B diagnosis. Demographic, socio-economic and behavioural information was collected through interviewer-administered questionnaires and evaluated as determinants of Hep B status and couple status discordance using logistic regression. RESULTS Of 16 920 participants who had a Hep B test result, 6750 couples and 1316 discordant couples were identified. The prevalence of Hep B among all participants was 10.9%, with lower prevalence among pregnant women (10.2%) than their male partners (11.9%), P < 0.001. The prevalence of Hep B sero-discordance among couples was 19.5% (1316/6750). Younger age, prior Hep B testing and a prior positive Hep B test increased the odds of Hep B infection while being a woman decreased the odds of Hep B among all participants, and among couples. Furthermore, polygamy (adjusted odds ratio [AOR]: 1.49, 95% confidence interval [CI]: 1.19-1.87), prior Hep B testing (AOR: 2.38, 95% CI: 1.14-4.97) and a prior positive Hep B test result were significant determinants of status discordance among the participating couples. CONCLUSION The prevalence of Hep B among pregnant women and their male partners in northcentral Nigeria is high. A large-scale intervention is required to reduce Hep B prevalence in this setting.
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Affiliation(s)
- Carol Talla
- Caritas Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California, San Diego, CA, USA
| | - Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, CA, USA.,UC San Diego Dissemination and Implementation Science Center, San Diego, CA, USA
| | - Amaka Grace Ogidi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Babayemi Oluwaseun Olakunde
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,National Agency for the Control of AIDS, Abuja, Nigeria
| | - Dina Patel
- Healthy Sunrise Foundation, Las Vegas, NV, USA
| | | | - Gregory Aarons
- Department of Psychiatry, University of California, San Diego, CA, USA.,UC San Diego Dissemination and Implementation Science Center, San Diego, CA, USA
| | - Chima Ariel Onoka
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.,Healthy Sunrise Foundation, Las Vegas, NV, USA
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14
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Stockman JK, Anderson KM, Karris MY, Benson CA, Tsuyuki K, Granger DA, Weber A, Ghosh M. The Role of Stress and Genital Immunity in Sexual Trauma and HIV Susceptibility Among Adolescent Girls and Adult Women (The THRIVE Study): Protocol for a Longitudinal Case-Control Study. JMIR Res Protoc 2020; 9:e18190. [PMID: 32903198 PMCID: PMC7752525 DOI: 10.2196/18190] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The relationship between sexual violence and HIV risk has been extensively documented through social and behavioral research; however, the underlying biological mechanisms are poorly understood. OBJECTIVE The purpose of the THRIVE (Trauma and HIV Risk: Investigating Stress and the Immune Disruption of the Vaginal Environment) Study is to examine the impact of sexual trauma due to sexual violence on HIV susceptibility through dysregulation of soluble inflammatory and anti-inflammatory and anti-HIV biomarkers in the female genital tract and dysregulation of the hypothalamic-pituitary-adrenal axis among adolescent girls and adult women. METHODS The THRIVE Study is a longitudinal case-control study conducted in San Diego, CA, among a racially diverse sample. Cases are adolescent girls (aged 14-19 years) or adult women (aged 20-45 years) who have experienced forced vaginal penetration by a phallus perpetrated by a man within the past 15 days. Controls are adolescent girls or adult women who have engaged in consensual vaginal sex with a man within the past 15 days. At baseline and 1- and 3-month follow-up study visits, participants undergo a urine-based pregnancy test; venipuncture blood draw for HIV, C-reactive protein, adrenocorticotropic hormone, and progesterone testing; a 45-min interviewer-administered computer survey; and cervicovaginal lavage to measure proinflammatory and anti-inflammatory and anti-HIV soluble immune biomarkers. After each study visit, participants self-collect saliva specimens (upon waking, 30 min after waking, and 45 min after waking) at home for 3 consecutive days, which are later assayed for cortisol and dehydroepiandrosterone sulfate. Participants receive compensation at each study visit and for the return of saliva specimens, and a list of local medical and support services. Study procedures use trauma-informed care methods, given the sensitive nature of the study and enrollment of women in the acute phase after sexual trauma. All research staff and investigators adhere to ethical principles and guidelines in the conduct of research activities. Data will be analyzed for descriptive and inferential analyses. RESULTS The recruitment of participants is ongoing. The publication of the first results is expected by late 2021. CONCLUSIONS The THRIVE Study will provide foundational knowledge on how sexual trauma due to sexual violence increases susceptibility to HIV acquisition via alterations in cervicovaginal immune regulation and the psychobiology of the stress responses. These findings will inform future research on mechanistic models of in vitro and in vivo injury and cervicovaginal wound healing processes, which may lead to the development of nonvaccine biomedical HIV prevention products for girls and women. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/18190.
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Affiliation(s)
- Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Katherine M Anderson
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Maile Y Karris
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Constance A Benson
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States.,School of Nursing, Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Akilah Weber
- Rady Children's Hospital San Diego, San Diego, CA, United States.,Department of Obstetrics and Gynecology, University of California San Diego Health, San Diego, CA, United States
| | - Mimi Ghosh
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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15
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Adeyemi OA, Itanyi IU, Ozigbu CE, Stadnick N, Tsuyuki K, Olayiwola O, Ogidi AG, Eze C, Aarons GA, Onoka CA, Ezeanolue EE. Sero-prevalence and determinants of Hepatitis B among a cohort of HIV-infected women of reproductive age in Nigeria. PLoS One 2020; 15:e0236456. [PMID: 32941424 PMCID: PMC7498243 DOI: 10.1371/journal.pone.0236456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/05/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sub-Saharan Africa houses over two-thirds of the 37 million people living with human immunodeficiency virus (HIV) globally and of this, 5-20% are co-infected with Hepatitis B virus (HBV). This is double jeopardy, especially for women of reproductive age in these settings, who can transmit both viruses vertically as well as horizontally to their children. The objectives of this study were to investigate the prevalence and determinants of HBV among women of reproductive age living with HIV. METHODS This was a cross-sectional study of HIV-infected women of reproductive age in Benue State, Nigeria. Participants were eligible for the study if they were HIV-infected women (ages 18-45 years) receiving care from any of the selected study sites. A global rapid hepatitis B surface antigen (HBsAg) antibody test strip was used to test for HBsAg in plasma. A pretested questionnaire was used to collect data on sociodemographic, clinical and lifestyle characteristics of participants. We estimated prevalence of HBV infection and used multivariable logistic regression to determine factors associated with the infection at a significance level of <0.05. RESULTS A total of 6577 women were screened for HBsAg. The prevalence of HBV was 10.3% (95% CI: 9.5-10.9%). Age, parity and male partner's HIV status were found to be associated with having HBV infection. Compared to women older than 40 years, the odds of HBV infection increased significantly with increasing age until age 35 years and decreased significantly with increasing parity (versus no parity). Women with HIV-infected partners and those without a partner had higher odds of HBV infection compared to women with HIV-negative partners. CONCLUSION HBV is hyperendemic among HIV-infected women of reproductive age in North Central Nigeria. Specific programs targeting HBV testing, vaccination and treatment of all women of reproductive age need to be developed in this resource-limited, high-need setting.
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Affiliation(s)
- Olusegun Adewale Adeyemi
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Department of Epidemiology and Public Health, Graduate Program In Life Sciences, University of Maryland, School of Medicine, Baltimore, MD, United States of America
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Chamberline Ekene Ozigbu
- Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina, United States of America
| | - Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, California, United States of America
- UC San Diego Dissemination and Implementation Science Center, San Diego, California, United States of America
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California, San Diego, California, United States of America
| | | | - Amaka Grace Ogidi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Chuka Eze
- Vitira Health, Arlington, Virginia United States of America
| | - Gregory Alan Aarons
- Department of Psychiatry, University of California, San Diego, California, United States of America
- UC San Diego Dissemination and Implementation Science Center, San Diego, California, United States of America
| | - Chima Ariel Onoka
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Las Vegas, Nevada, United States of America
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16
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Tsuyuki K, Stockman JK, Knauth D, J Catabay C, He F, Al-Alusi NA, Pilecco FB, Jain S, Barbosa RM. Typologies of violence against women in Brazil: A latent class analysis of how violence and HIV intersect. Glob Public Health 2020; 15:1639-1654. [PMID: 32515274 DOI: 10.1080/17441692.2020.1767675] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We address the limited understanding around the overlap between violence and HIV in Brazil. Data was from two clinic-based samples of HIV-positive (n = 1534) and HIV-negative women (n = 1589) in São Paulo and Porto Alegre. We conducted latent class analysis and identified violence typologies by type of violence, life course timing, frequency, and perpetrator, stratified by city and HIV-status. Overall, HIV-positive women experienced more lifetime physical and sexual violence than HIV-negative women. Twelve unique violence latent classes were identified. In São Paulo, HIV-positive women were likely to have endured physical violence several times (Conditional Probability [CP]: 0.80) by an intimate partner (CP: 0.85), and sexual violence several times (CP: 0.46) by an intimate partner (CP: 0.62). In Porto Alegre, HIV-positive women endured physical violence several times (CP: 0.80) by an intimate partner (CP: 0.70) during childhood/adolescence (CP: 0.48), and sexual violence several times (CP: 0.54) by an intimate partner (CP: 0.60). Findings inform interventions to educate around gender equity, violence, and the health effects of violence including HIV, integrate HIV and violence services, and improve the provision of bio-medical HIV prevention among HIV-negative women who experience violence.
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Affiliation(s)
- Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Daniela Knauth
- Department of Social Medicine, University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Christina J Catabay
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Feng He
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Noor A Al-Alusi
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Flavia Bulegon Pilecco
- Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sonia Jain
- Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
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17
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Tsuyuki K, Donta B, Dasgupta A, Fleming PJ, Ghule M, Battala M, Nair S, Silverman J, Saggurti N, Raj A. Masculine Gender Ideologies, Intimate Partner Violence, and Alcohol Use Increase Risk for Genital Tract Infections Among Men. J Interpers Violence 2020; 35:2316-2334. [PMID: 29294709 PMCID: PMC5756145 DOI: 10.1177/0886260517700619] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Masculine gender ideologies are thought to underlie alcohol use, intimate partner violence (IPV) perpetration, and sexual risk of HIV and other sexually transmitted infections (STIs). We extend on studies in the Indian context by examining the roles of masculine gender ideologies, alcohol use, and IPV on three outcomes of HIV risk (condom use, genital tract infection [GTI] symptoms, and GTI diagnosis). We applied logistic regression models to cross-sectional data of men and their wives in rural Maharashtra, India (n = 1,080 couples). We found that men with less masculine gender ideologies demonstrated greater odds of condom use (i.e., lower odds no condom use, odds ratio [OR] = 0.96, 95% confidence interval [CI] = [0.93, 0.98]). IPV perpetration was associated with increased odds of reporting ≥1 GTI symptom (adjusted OR [AOR] = 1.56, 95% CI = [1.07, 2.26]) and decreased GTI diagnosis (AOR = 0.28, 95% CI = [0.08, 0.97]). Moderate alcohol consumption was associated with increased odds of reporting ≥1 GTI symptom (AOR = 1.51, 95% CI = [1.01, 2.25]). Our findings have direct implications for men's and women's health in rural India, including targeted GTI diagnosis and treatment, integrated violence prevention in STI clinics, and targeted intervention on masculine gender ideologies.
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Affiliation(s)
- Kiyomi Tsuyuki
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
| | - Balaiah Donta
- National Institute for Research in Reproductive Health, Mumbai, India
| | - Anindita Dasgupta
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
- Center for Gender Equity and Health, University of California, San Diego
| | - Paul J. Fleming
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
| | - Mohan Ghule
- National Institute for Research in Reproductive Health, Mumbai, India
| | | | - Saritha Nair
- National Institute for Research in Reproductive Health, Mumbai, India
| | - Jay Silverman
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
- Center for Gender Equity and Health, University of California, San Diego
- Department of Society, Human Development and Health, Harvard School of Public Health, Harvard University, Boston, MA, USA
| | | | - Anita Raj
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
- Center for Gender Equity and Health, University of California, San Diego
- Clinical Addiction Research and Education, Section of General, Internal Medicine, Department of Medicine, Boston University, School of Medicine/Boston Medical Center, Boston, MA, USA
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18
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Catabay CJ, Stockman JK, Campbell JC, Tsuyuki K. Perceived stress and mental health: The mediating roles of social support and resilience among black women exposed to sexual violence. J Affect Disord 2019; 259:143-149. [PMID: 31445340 PMCID: PMC6791774 DOI: 10.1016/j.jad.2019.08.037] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/01/2019] [Accepted: 08/17/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Black women disproportionately suffer from violence and its subsequent mental health outcomes. Increasing levels of perceived stress are associated with greater symptoms of depression and post-traumatic stress disorder (PTSD). Social support and resilience can potentially mediate the negative consequences of perceived stress on women's mental health. This study assesses the association between perceived stress and mental health outcomes among Black women. In addition, this study examines social support and resilience as mediators of association between perceived stress and mental health. METHODS Black women residing in Baltimore, MD (n = 310) were recruited from STD clinics into a retrospective cohort study (2013-2018) on sexual assault and HIV risk. Social support and resilience served as coping variables and were assessed as mediators in the associations between perceived stress and mental health. Analyses were stratified by exposure to sexual violence in adulthood. RESULTS Almost half of our sample (46%) experienced severe depression and about one-third (27%) experienced severe PTSD. Resilience partially mediated the association between perceived stress and severe depressive symptoms among exposed women. Social support partially mediated the association between perceived stress and severe PTSD symptoms among exposed women. LIMITATIONS Since this is a cross-sectional analysis, we are unable to determine the temporal relationship between outcome and exposure variables. The CES-D-10 and NSESSS are scales that measure the severity of depressive and PTSD symptoms, respectively, and are not clinical diagnoses. CONCLUSION There is a critical need to develop interventions focused on reducing the burden of stress on mental health.
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Affiliation(s)
- Christina J Catabay
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, United States
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, United States
| | - Jacquelyn C Campbell
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD 21205-2110, United States
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, United States.
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Tsuyuki K, Al-Alusi NA, Campbell JC, Murry D, Cimino AN, Servin AE, Stockman JK. Adverse childhood experiences (ACEs) are associated with forced and very early sexual initiation among Black women accessing publicly funded STD clinics in Baltimore, MD. PLoS One 2019; 14:e0216279. [PMID: 31063469 PMCID: PMC6504039 DOI: 10.1371/journal.pone.0216279] [Citation(s) in RCA: 13] [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: 07/10/2018] [Accepted: 04/17/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To examine the association between adverse childhood experiences (ACEs) and early sexual initiation. METHODS We analyzed retrospective data of (n = 241) Black women recruited from public STD clinics in Baltimore, MD. Multinomial logistic and linear regression models estimated associations between ACEs and early sexual initiation; contextual variables at initiation were examined as mediators. RESULTS Twelve percent of our sample reported very early sexual initiation (11-12 years) and 29% reported early sexual initiation (13-14 years). Each additional ACE reported was associated with greater risk of very early sexual initiation (RRR = 1.49; 95%CI:1.23,1.80). Specifically, emotional abuse (RRR = 3.71; 95%CI:1.55,8.89), physical abuse (RRR = 9.45; 95%CI:3.56,25.12), sexual abuse (RRR = 8.60; 95%CI:3.29,22.51), witnessing maternal abuse (RRR = 5.56; 95%CI:2.13,14.52), and household substance misuse (RRR = 3.21; 95%CI:1.38,7.47) at or before the age of 18 were associated with very early sexual initiation. As for context of initiation, age at sexual initiation was younger if the man at initiation was a non-partner (ß = -0.88; 95%CI:-1.36,-0.40), was ≥3 years older (ß = -1.30; 95%CI:-1.82,-0.77), had pressured or forced sexual intitiation (ß = -1.09; 95%CI:-1.58,-0.59), and was under the influence of drugs/alcohol (ß = -0.97; 95%CI:-1.62,-0.32). Contextual variables at first sex, including being pressured or forced, and the man being ≥3 years older fully mediated the association between ACEs and early sexual initiation. CONCLUSIONS This study highlights the critical need to develop interventions that reduce the impact of ACEs on women's health and delay age at sexual initiation. Health education efforts are needed for clinicians and parents to identify and prevent childhood abuse and to identify and report sexual coercion and abuse for girls and adolescents.
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Affiliation(s)
- Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, La Jolla, California, United States of America
- * E-mail:
| | - Noor A. Al-Alusi
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, La Jolla, California, United States of America
| | - Jacquelyn C. Campbell
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - DeMarjion Murry
- Philander Smith College, Little Rock, Arkansas, United States of America
| | - Andrea N. Cimino
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Argentina E. Servin
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, La Jolla, California, United States of America
| | - Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, La Jolla, California, United States of America
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Tsuyuki K, Shoptaw SJ, Ransome Y, Chau G, Rodriguez-Diaz CE, Friedman RK, Srithanaviboonchai K, Li S, Mimiaga MJ, Mayer KH, Safren SA. The Longitudinal Effects of Non-injection Substance Use on Sustained HIV Viral Load Undetectability Among MSM and Heterosexual Men in Brazil and Thailand: The Role of ART Adherence and Depressive Symptoms (HPTN 063). AIDS Behav 2019; 23:649-660. [PMID: 30725397 DOI: 10.1007/s10461-019-02415-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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
The effect of non-injection substance use on HIV viral load (VL) is understudied in international settings. Data are from HPTN063, a longitudinal observational study of HIV-infected individuals in Brazil, Thailand, and Zambia, with focus on men with VL data (Brazil = 146; Thailand = 159). Generalized linear mixed models (GLMM) assessed whether non-injection substance use (stimulants, cannabis, alcohol, polysubstance) was associated with VL undetectability. ART adherence and depressive symptoms were examined as mediators of the association. In Thailand, substance use was not significantly associated with VL undetectability or ART adherence, but alcohol misuse among MSM was associated with increased odds of depression (AOR = 2.75; 95% CI 1.20, 6.32, p = 0.02). In Brazil, alcohol misuse by MSM was associated with decreased odds of undetectable VL (AOR = 0.34; 95% CI 0.13, 0.92, p = 0.03). Polysubstance use by heterosexual men in Brazil was associated with decreased odds of ART adherence (AOR = 0.25; 95% CI 0.08, 0.78, p = 0.02). VL suppression appears attainable among non-injection substance users. Substance use interventions among HIV-positive men should address depression, adherence, and VL undetectability.
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Tsuyuki K, Cimino AN, Holliday CN, Campbell JC, Al-Alusi NA, Stockman JK. Physiological Changes from Violence-Induced Stress and Trauma Enhance HIV Susceptibility Among Women. Curr HIV/AIDS Rep 2019; 16:57-65. [PMID: 30762216 PMCID: PMC6420839 DOI: 10.1007/s11904-019-00435-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 12/11/2022]
Abstract
PURPOSE OF REVIEW This theoretical review identifies physiological mechanisms by which violence against women (VAW) may increase women's susceptibility to HIV through trauma, stress, and immune dysfunction. RECENT FINDINGS Research documents systemic and local immune responses are related to stress and trauma from abuse across the life course (i.e., childhood, IPV, adulthood re-victimization). Findings are interpreted within a theoretical framework grounded in the Social Stress Theory and the concept of toxic stress, and highlight the current state of the science connecting: (1) VAW to the physiological stress response and immune dysfunction, and (2) the physiological stress response and inflammation to HIV susceptibility and infection in the female reproductive tract. Despite a dearth of research in human subjects, evidence suggests that VAW plays a significant role in creating a physiological environment conducive to HIV infection. We conclude with a discussion of promising future steps for this line of research.
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Affiliation(s)
- Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
| | - Andrea N Cimino
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Charvonne N Holliday
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacquelyn C Campbell
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Noor A Al-Alusi
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
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Ransome Y, Mayer KH, Tsuyuki K, Mimiaga MJ, Rodriguez-Diaz CE, Srithanaviboonchai K, Friedman RK, Limbada M, Safren SA. The Role of Religious Service Attendance, Psychosocial and Behavioral Determinants of Antiretroviral Therapy (ART) Adherence: Results from HPTN 063 Cohort Study. AIDS Behav 2019; 23:459-474. [PMID: 29956116 DOI: 10.1007/s10461-018-2206-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Early and sustained antiretroviral therapy (ART) adherence can suppress the HIV virus in individuals and reduce onward transmission of HIV in the population. Religiosity has been associated with better HIV clinical outcomes. Data are from a longitudinal, observational study of 749 HIV-infected individuals from Brazil, Zambia, and Thailand (HPTN 063). Ordered logistic regression assessed whether religious service attendance was associated with ART adherence (self-reported and plasma HIV-RNA) and moderated the association between alcohol problems and ART adherence. In each country, > 80% of participants reported high self-reported ART adherence (good/very good/excellent). Religious service attendance exceeded 85% but was statistically unrelated to adherence. In combined-country models, (p = 0.03) as alcohol problems increased, the probability of high self-reported ART adherence, as well as viral-load, became weaker at higher compared to low service attendance frequency. Future studies should evaluate spirituality variables and replicate the moderation analyses between religious attendance and alcohol problems.
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Cimino AN, Yi G, Patch M, Alter Y, Campbell JC, Gundersen KK, Tang JT, Tsuyuki K, Stockman JK. The Effect of Intimate Partner Violence and Probable Traumatic Brain Injury on Mental Health Outcomes for Black Women. J Aggress Maltreat Trauma 2019; 28:714-731. [PMID: 31929719 PMCID: PMC6953753 DOI: 10.1080/10926771.2019.1587657] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Severe intimate partner violence (IPV) including loss of consciousness from head injuries and/or strangulation can result in traumatic brain injury (TBI), a brain pathology characterized by altered brain function, cognitive impairment, and mental health disorders, including depression and posttraumatic stress disorder (PTSD). This study examines the prevalence of probable TBI (defined as loss of consciousness from a blow to the head and/or strangulation) and its association with comorbid PTSD and depression among Black women, who experience both higher rates of IPV and greater mental health burden than White and Latina women. Data come from a retrospective cohort study of 95 Black women with abuse history including IPV, forced sex, and childhood maltreatment. About one-third of women (n=32) had probable TBI. Among them, 38% (n=12) were hit on the head, 38% (n=12) were strangled to unconsciousness, and 25% (n=8) were strangled and hit on the head. Women with IPV history and probable TBI had significantly greater odds of various physical injuries including those that required medical care compared to other abused women. Probable TBI significantly increased comorbid PTSD and depression by 8.93 points (SE=3.40), after controlling for past violence (F (4, 90)=3.67, p<.01). Findings from this study reinforce the need to screen women who lost unconsciousness due to IPV for TBI and facilitate referrals to IPV interventions and mental health treatment.
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Affiliation(s)
- Andrea N Cimino
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Grace Yi
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michelle Patch
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Yasmin Alter
- US Army's Sexual Harassment and Assault Response and Prevention (SHARP) Program
| | - Jacquelyn C Campbell
- Johns Hopkins University School of Nursing, Department of Community Public Health, Baltimore, MD, USA
| | - Kristin K Gundersen
- University of California San Diego, Division of Infectious Diseases and Global Public Health, Department of Medicine La Jolla, CA, USA
| | - Judy T Tang
- University of California San Diego, Division of Infectious Diseases and Global Public Health, Department of Medicine La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- University of California San Diego, Division of Infectious Diseases and Global Public Health, Department of Medicine La Jolla, CA, USA
| | - Jamila K Stockman
- Vice Chief University of California San Diego, Division of Infectious Diseases and Global Public Health, Department of Medicine La Jolla, CA, USA
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Tsuyuki K, Gipson JD, Barbosa RM, Urada LA, Morisky DE. Preventing syndemic Zika virus, HIV/STIs and unintended pregnancy: dual method use and consistent condom use among Brazilian women in marital and civil unions. Cult Health Sex 2018; 20:1006-1022. [PMID: 29231077 PMCID: PMC5997495 DOI: 10.1080/13691058.2017.1406535] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Syndemic Zika virus, HIV and unintended pregnancy call for an urgent understanding of dual method (condoms with another modern non-barrier contraceptive) and consistent condom use. Multinomial and logistic regression analysis using data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), a nationally representative household survey of reproductive-aged women in Brazil, identified the socio-demographic, fertility and relationship context correlates of exclusive non-barrier contraception, dual method use and condom use consistency. Among women in marital and civil unions, half reported dual protection (30% condoms, 20% dual methods). In adjusted models, condom use was associated with older age and living in the northern region of Brazil or in urban areas, whereas dual method use (versus condom use) was associated with younger age, living in the southern region of Brazil, living in non-urban areas and relationship age homogamy. Among condom users, consistent condom use was associated with reporting Afro-religion or other religion, not wanting (more) children and using condoms only (versus dual methods). Findings highlight that integrated STI prevention and family planning services should target young married/in union women, couples not wanting (more) children and heterogamous relationships to increase dual method use and consistent condom use.
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Affiliation(s)
- Kiyomi Tsuyuki
- Department of Community Health Sciences, UCLA Fielding School of Public Health, USA
| | - Jessica D. Gipson
- Department of Community Health Sciences, UCLA Fielding School of Public Health, USA
| | - Regina Maria Barbosa
- Núcleo de Estudos de População “Elza Berquó”, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Lianne A. Urada
- School of Social Work, San Diego State University (SDSU), San Diego, USA
| | - Donald E. Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, USA
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Tsuyuki K, Pitpitan EV, Levi-Minzi MA, Urada LA, Kurtz SP, Stockman JK, Surratt HL. Substance Use Disorders, Violence, Mental Health, and HIV: Differentiating a Syndemic Factor by Gender and Sexuality. AIDS Behav 2017; 21:2270-2282. [PMID: 28669024 DOI: 10.1007/s10461-017-1841-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 12/28/2022]
Abstract
This paper measures syndemic substance use disorder, violence, and mental health and compares the syndemic among HIV-infected heterosexual men, heterosexual women, and men who have sex with men (MSM). Data were from a sample of high needs substance-using, HIV-infected people in South Florida between 2010 and 2012 (n = 481). We used confirmatory factor analysis to measure a syndemic latent variable and applied measurement invariance models to identify group differences in the data structure of syndemic co-morbidities among heterosexual men, heterosexual women, and MSM. We found that variables used to measure the syndemic fit each sub-group, supporting that substance use disorder, violence, and mental health coincide in HIV-infected individuals. Heterosexual men and MSM demonstrated similar syndemic latent variable factor loadings, but significantly different item intercepts, indicating that heterosexual men had larger mean values on substance use disorder, anxiety, and depression than MSM. Heterosexual men and heterosexual women demonstrated significantly different syndemic variable factor loadings, indicating that anxiety and depression contribute more (and substance use contributes less) to the syndemic in heterosexual men compared to heterosexual women. MSM and heterosexual women demonstrated similar syndemic latent variable factor loadings and intercepts, but had significantly different factor residual variances indicating more variance in violent victimization and depression for MSM and more variance in stress for heterosexual women than what is captured by the observed syndemic indicators. Furthermore, heterosexual women had a larger syndemic factor mean than MSM, indicating that the syndemic burden is greater among heterosexual women than MSM. Our findings support that measurement invariance can elucidate differences in the syndemic to tailor interventions to sub-group needs.
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Affiliation(s)
- Kiyomi Tsuyuki
- Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
| | - Eileen V Pitpitan
- Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Maria A Levi-Minzi
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL, USA
| | - Lianne A Urada
- School of Social Work, San Diego State University (SDSU), San Diego, USA
| | - Steven P Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL, USA
| | - Jamila K Stockman
- Department of Medicine, University of California San Diego (UCSD), 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Hilary L Surratt
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL, USA
- Center for Health Services Research, University of Kentucky, Lexington, KY, USA
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Urada LA, Simmons J, Wong B, Tsuyuki K, Condino-Enrera G, Hernandez LI, Simbulan NP, Raj A. A human rights-focused HIV intervention for sex workers in Metro Manila, Philippines: evaluation of effects in a quantitative pilot study. Int J Public Health 2016; 61:945-957. [PMID: 27600733 DOI: 10.1007/s00038-016-0875-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 12/03/2015] [Revised: 07/20/2016] [Accepted: 08/12/2016] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES This study evaluated a brief human rights-focused HIV community mobilization intervention for sex workers in the Philippines, a country with one of the fastest rising number of HIV cases worldwide. METHODS Five single-session group interventions to reduce sexual risk and increase HIV testing among 86 sex workers in Manila were evaluated with pre-post-test data via Wilcoxon's signed-ranks and Mann-Whitney tests. The 4-h intervention, Kapihan (August-November, 2013), integrated human rights with HIV skill-building. Demographic data, violence/trafficking victimization, human rights knowledge, and intentions to HIV test and treat were collected. RESULTS Participants were median aged 23; female (69 %); had children (55; 22 % had 3+ children); used drugs (past 3 months: 16 %); sexually/physically abused by clients (66 %); 20 % street sex workers ever took an HIV test. Pre-post-test scores significantly improved in knowledge of HIV (z = -8.895, p < 0.001), reproductive health (z = -3.850, p < 0.001), human rights (z = -4.391, p < 0.001), ethical rights of research participants (z = -5.081, p < 0.001), and intentions to HIV test (z = -4.868, p < 0.001). CONCLUSIONS Integrating human rights into HIV interventions may empower sex workers to address their health and human rights and test for HIV.
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Affiliation(s)
- Lianne A Urada
- Department of Medicine/Division of Global Public Health, Center on Gender Equity and Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA. .,College of Health and Human Services, School of Social Work, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA.
| | - Janie Simmons
- National Development and Research Institutes, Inc., 71 W 23rd St, New York, NY, 10010, USA
| | - Betty Wong
- Department of Medicine/Division of Global Public Health, Center on Gender Equity and Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Kiyomi Tsuyuki
- Department of Medicine/Division of Global Public Health, Center on Gender Equity and Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Gerlita Condino-Enrera
- Woodwater Center for Healing, 8 Nicanor Reyes St, Loyola Heights, Quezon City, Philippines
| | - Laufred I Hernandez
- Department of Behavioral Sciences, University of the Philippines, Manila, Rizal Hall, Padre Faura Street, Ermita, Manila, Philippines
| | - Nymia Pimentel Simbulan
- College of Arts and Science and College of Public Health, University of the Philippines, Manila, Rizal Hall, Padre Faura Street, Ermita, Manila, Philippines
| | - Anita Raj
- Department of Medicine/Division of Global Public Health, Center on Gender Equity and Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
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Tsuyuki K, Gipson JD, Urada LA, Barbosa RM, Morisky DE. Dual protection to address the global syndemic of HIV and unintended pregnancy in Brazil. ACTA ACUST UNITED AC 2016; 42:271-279. [PMID: 26880759 DOI: 10.1136/jfprhc-2015-101175] [Citation(s) in RCA: 7] [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] [Received: 01/09/2015] [Revised: 09/29/2015] [Accepted: 11/23/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Syndemic HIV and unintended pregnancy is prevalent in Brazil, where 79% of female HIV cases occur in women of reproductive age and 55% of all pregnancies are unintended. Although increasing condom use to prevent HIV may decrease non-barrier contraception and increase unintended pregnancy, few studies focus on dual protection or dual methods (condoms with another modern contraceptive). AIM To describe the correlates of dual method use and consistent condom use in women of reproductive age in Brazil. METHOD Data are from the 2006 Pesquisa Nacional de Demografia e Saúde da Mulher e da Criança, a decennial nationally representative household survey of women of reproductive age in Brazil. Multivariate logistic regression models identify the socio-demographic, sexual debut, fertility and relationship factors associated with dual method use and consistent condom use. RESULTS Two-thirds of contracepting women in Brazil used dual protection (40% exclusive condoms, 27% dual methods). Consistent condom use in the past year occurred among 61% of exclusive condom users and 27% of dual method users. Dual methods (vs exclusive condoms) was associated with some high school education [relative risk ratio (RRR)=1.69, p<0.05], living in the Southern region (RRR=1.59, p<0.01), and number of children (RRR=1.22, p<0.01), net of other factors. Consistent condom use was associated with condom use at sexual debut [adjusted odds ratio (AOR)=1.84, p<0.001], wants no (more) children (AOR=1.86, p<0.001), single/separated relationship status (AOR=2.77/2.45, p<0.001) and using exclusive condoms (vs dual methods: AOR=0.19, p<0.001). CONCLUSIONS Findings highlight that targeting and delivering integrated HIV and family planning services should focus on completed/large families. single/separated individuals, and promoting dual protection at sexual debut.
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Affiliation(s)
- Kiyomi Tsuyuki
- NIDA Post-doctoral Fellow, Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Jessica D Gipson
- Assistant Professor, Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), USA
| | - Lianne A Urada
- Assistant Professor, Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Regina Maria Barbosa
- Professor, Population Studies Center (NEPO), University of Campinas (UNICAMP), Campinas, Brazil
| | - Donald E Morisky
- Professor, Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), USA
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Urada LA, Halterman S, Raj A, Tsuyuki K, Pimentel-Simbulan N, Silverman JG. Socio-structural and behavioral risk factors associated with trafficked history of female bar/spa entertainers in the sex trade in the Philippines. Int J Gynaecol Obstet 2015; 132:55-9. [PMID: 26434671 DOI: 10.1016/j.ijgo.2015.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 12/29/2014] [Revised: 06/25/2015] [Accepted: 09/11/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore factors associated with trafficking (deceptive/coercive entry to sex trade) among female bar/spa entertainers who traded sex in the Philippines. METHOD Female bar/spa entertainers who traded sex in the past 6months were recruited from 25bar/spa venues in Metro Manila (April 2009-January 2010) and assessed via cross-sectional survey data collection for HIV-risk-related socio-structural factors associated with deceptive/coercive entry into the sex trade. The study employed hierarchical linear modeling. RESULTS Of 166bar/spa entertainers assessed, 19 (11.4%) reported being deceived/coerced (i.e. trafficked) into their first jobs. Trafficking history was independently associated with current drug use (adjusted odds ratio [AOR] 2.05; 95% confidence interval [CI] 1.00-3.97) decreased availability of condoms at venues for entertainers (AOR 0.18; 95% CI 0.05-0.71) and, conversely, increased peer support for practicing safer sex behaviors (AOR 3.08; 95% CI 1.63-5.09). Those deceived/coerced into their positions were more likely than non-trafficked women to have been recruited by an agency who came to their rural province (AOR 12.07; 95% CI 1.77-82.25) as opposed to getting the job from advertisement (AOR 0.10; 95% CI 0.02-0.65) or a friend/acquaintance (AOR 0.02; 95% CI 0.00-0.48). CONCLUSION The findings have implications for designing interventions to prevent and target trafficked women in the Philippines who may be more vulnerable to substance use and, potentially, HIV infection.
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Affiliation(s)
- Lianne A Urada
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
| | - Sonja Halterman
- School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Anita Raj
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Nymia Pimentel-Simbulan
- Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines, Manila, Philippines
| | - Jay G Silverman
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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Tsuyuki K, Surratt HL, Levi-Minzi MA, O'Grady CL, Kurtz SP. The Demand for Antiretroviral Drugs in the Illicit Marketplace: Implications for HIV Disease Management Among Vulnerable Populations. AIDS Behav 2015; 19:857-68. [PMID: 25092512 PMCID: PMC4318775 DOI: 10.1007/s10461-014-0856-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 10/24/2022]
Abstract
The diversion of antiretroviral medications (ARVs) has implications for the integrity and success of HIV care, however little is known about the ARV illicit market. This paper aimed to identify the motivations for buying illicit ARVs and to describe market dynamics. Semi-structured interviews (n = 44) were conducted with substance-involved individuals living with HIV who have a history of purchasing ARVs on the street. Grounded theory was used to code and analyze interviews. Motivations for buying ARVs on the illicit market were: to repurchase ARVs after having diverted them for money or drugs; having limited access or low quality health care; to replace lost or ruined ARVs; and to buy a back-up stock of ARVs. This study identified various structural barriers to HIV treatment and ARV adherence that incentivized ARV diversion. Findings highlight the need to improve patient-provider relationships, ensure continuity of care, and integrate services to engage and retain high-needs populations.
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Affiliation(s)
- Kiyomi Tsuyuki
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 2 NE 40th Street, Suite 404, Miami, FL, 33137, USA,
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Surratt HL, Kurtz SP, Levi-Minzi MA, Cicero TJ, Tsuyuki K, O'Grady CL. Pain treatment and antiretroviral medication adherence among vulnerable HIV-positive patients. AIDS Patient Care STDS 2015; 29:186-92. [PMID: 24984142 DOI: 10.1089/apc.2014.0104] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pain represents a significant source of morbidity, function loss, and decreased quality of life among people living with HIV. The present study examined the associations among pain, pain treatment, and ARV adherence among indigent, HIV-positive substance abusers. Participants were recruited via targeted sampling strategies, and completed a one-time computer-assisted personal interview. ANOVA and chi-square tests were used to analyze differences in demographics, health and psychological status, health behaviors, by pain and pain treatment status; a multivariate logistic regression model was constructed to examine the contribution of pain/treatment status to recent ARV adherence. Results indicated that those with untreated pain had lower odds of achieving gold-standard 95% ARV adherence as compared to the pain-free and treated pain groups; higher substance dependence symptoms were also associated with significantly lower odds of 95% ARV adherence. Findings suggest that pain management is critical to the health of people living with HIV, specifically those with high levels of co-morbid health and psychological problems. The prevalence of untreated pain was elevated among this group, and contributed to reduced ARV adherence. Providers of clinical care to disadvantaged HIV-positive patients should emphasize routine assessment and appropriate treatment of pain in order to provide comprehensive HIV care.
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Affiliation(s)
- Hilary L. Surratt
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Steven P. Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Maria A. Levi-Minzi
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Theodore J. Cicero
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kiyomi Tsuyuki
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Catherine L. O'Grady
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
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Sato S, Nagao R, Hujioka T, Suzuki K, Tsuyuki K, Hoshika A. A case of food-dependent exercise-induced anaphylaxis due to ingestion of peach. J Investig Allergol Clin Immunol 2009; 19:337. [PMID: 19639742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- S Sato
- Department of Pediatrics, Tokyo Medical University, Tokyo, Japan.
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Sudo S, Tsuyuki K, Yano T, Takagi K. A magnetic fluid microdevice using insect wings. J Phys Condens Matter 2008; 20:204142. [PMID: 21694271 DOI: 10.1088/0953-8984/20/20/204142] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A magnetic fluid microdevice using Diptera insect wings is proposed and constructed. The magnetic fluid device is composed of insect wings, a small permanent magnet, coil, and kerosene-based magnetic fluid. First, the structural properties of insect wings are studied through measurements of certain morphological parameters. Secondly, the novel type of microwind energy converter is constructed. Thirdly, the power generation characteristics of the magnetic fluid microdevice using insect wings are examined. It is found that the output power is roughly proportional to the cube of the airflow velocity.
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Affiliation(s)
- S Sudo
- Department of Machine Intelligence and Systems Engineering, Akita Prefectural University, Yurihonjo 015-0055, Japan
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Baba R, Tsuyuki K, Kimura Y, Ninomiya K, Aihara M, Ebine K, Tauchi N, Nishibata K, Nagashima M. Oxygen uptake efficiency slope as a useful measure of cardiorespiratory functional reserve in adult cardiac patients. Eur J Appl Physiol Occup Physiol 1999; 80:397-401. [PMID: 10502072 DOI: 10.1007/s004210050610] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In this study we aimed to elucidate the validity and usefulness of the oxygen uptake efficiency slope (OUES) in the evaluation of adult cardiac patients. Cardiopulmonary exercise tests were performed on a treadmill by 50 adult patients with chronic heart failure. The OUES was calculated from data for the first 75%, 90%, and 100% of exercise duration. The OUES is derived from the following equation: VO(2)=ax logV(E)+b, where VO(2) is oxygen uptake (ml/kg/min), V(E) is minute ventilation (l/kg/min), and the constant "a" represents OUES. We also determined the ventilatory anaerobic threshold (VAT). The correlation coefficient of the logarithmic curve-fitting model was [mean (SD)] 0.986 (0.009). The OUES could be used to discriminate effectively between New York Heart Association functional classes (P < 0.001). OUES and maximum VO(2) were significantly correlated (r=0.78, P < 0.01). Agreement between the OUES values for the first 90%, 75%, and 100% of the exercise was excellent (intraclass correlation coefficient = 0.99). Our results suggest that OUES is applicable to adult cardiac patients as an objective, effort-independent estimation of cardiorespiratory functional reserve.
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Affiliation(s)
- R Baba
- Research Institute of Sports Medical Science Tokai University, 1117 Kitakaname, Hiratsuka, Kanagawa, 259-12, Japan.
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Abstract
alpha-Glucosyltransferase was purified from Pseudomonas mesoacidophila MX-45. The molecular weight was estimated to be 63,000 by SDS-PAGE, and the isoelectric point was pI 5.4. For enzyme activity based on sucrose decomposition, the optimum pH and the optimum temperature were pH 5.8 and 40 degrees C, respectively. The ranges of stable pH and temperature were pH 5.1-6.7 and below 40 degrees C, respectively. The purified enzyme of MX-45 converted sucrose into trehalulose (1-O-alpha-D-glucopyranosyl- D-fructose) and isomaltulose (palatinose, 6-O-alpha-D-glucopyranosyl-D-fructose) simultaneously, and the ratio of trehalulose to isomaltulose increased at lower reaction temperatures. Therefore, optimum conditions for trehalulose production were pH 5.5-6.5 at 20 degrees C. The yield of trehalulose from sucrose (20-40% solution) was 91%. The Km for sucrose was 19.2 +/- 3.3 mM estimated by the Hanes-Woolf plot. Product inhibition was observed, and the product inhibition constant was 0.17 M. Hg2+, Fe3+, Cu2+, Mg2+, Ag+, Pb2+, glucono-1,5-lactone, and Tris(hydroxymethyl)aminomethane inhibited the reaction.
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Affiliation(s)
- Y Nagai
- Food Laboratory, Mitsui Sugar Co., Ltd., Kanagawa, Japan
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Tsuyuki K, Arisawa Y, Yokoyama I, Matsumoto K, Ogiwara T, Fukagawa H, Tomita C, Wakamatsu K, Nouga K. [Studies on the efficacy and safety of panipenem/betamipron in infections in surgical domain and the safety when mixed with lactate containing infusion]. Jpn J Antibiot 1992; 45:188-96. [PMID: 1613972] [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: 12/27/2022]
Abstract
Studies were done on the effectiveness and safety of panipenem/betamipron, a new carbapenem antibiotic, in infections in the surgical domain and its safety when dissolved in infusions containing lactate. The obtained results are summarized as follows. The preparation, 0.5 g/0.5 g or 1.0 g/1.0 g, was administered by intravenous drip infusion 2 to 3 times a day to 31 cases of patients with infections in the surgical domain. A physiological saline solution was used as the solvent in 21 cases (group A) of them and Solita T3, an infusion containing lactate, was used as the solvent in the 10 remaining cases (group B). As for its clinical effects, results were rated as "excellent" in 20, "good" in 7, "fair" in 3 and "no response" in 1 out of the 31 cases, and the efficacy rate was 87.1%. Regarding its bacteriological effects, results were rated as "disappeared" in 22, "decreased" in 2, "unchanged" in 1 and "unknown" in 1 out of 26 cases from which bacteria were isolated, hence the bacteria-clearance rate was 88.0%. As for side effects, skin rash was seen in 1 case and slight increases of GOT and GPT were noted as abnormal changes in laboratory data in 2 cases. These side effects were all observed among the cases in group A but not at all in group B where a lactate containing infusion was used as the solvent.
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Affiliation(s)
- K Tsuyuki
- Department of Surgery, Kawasaki City, Kawasaki Hospital
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Hase H, Nakamura R, Inishi Y, Degawa T, Yabuki S, Machii K, Tsuyuki K. [Prediction of severity of coronary artery disease by treadmill exercise testing]. Kokyu To Junkan 1991; 39:1159-64. [PMID: 1775747] [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: 12/28/2022]
Abstract
Coronary angiography was performed in 250 patients with a significant ischemic ST segment change detected by symptom-limited maximum treadmill exercise testing, and relationship between anatomical severity of coronary artery disease and parameters in exercise testing was studied. The age of the patients ranged from 34 to 76 years (188 men, 62 women). One-vessel disease (1VD) was presented in 82 patients, two-vessel disease (2VD) in 42, three-vessel disease or left main coronary disease (3VD) in 26, and no significant stenosis was presented in 100 subjects (Normal). Functional aerobic impairement (FAI) was evaluated in each group as a parameter of exercise capacity, myocardial aerobic impairment (MAI) and heart rate impairment (HRI) were also evaluated as a parameter of maximum myocardial oxygen requirements and maximum heart rate, respectively. Using these parameters, discriminant analysis was performed to compare the group with significant coronary artery disease and the Normal group. Also, to compare the group with multi-vessel disease and the group with less than 2VD. Also, the 3VD group and the group with less than 3VD. FAI, MAI and HRI were significantly different (p less than 0.0001) in each group. The discriminant formula to separate the group of significant coronary artery disease from the Normal group was Z = -1.049 + 0.02 [FAI] +0.08 [MAI] +0.03 [HRI]. According to this formula, sensitivity was 92.5% and specificity was 71.5%. The discriminant formula to separate the group with multi-vessel disease from the group with less than 2VD was Z = -4.731 + 0.07 [FAI] +0.106 [MAI] +0.02 [HRI]. According to this formula, sensitivity was 96.3% and specificity was 78.8%.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Hase
- Third Department of Internal Medicine, Toho University Ohashi Hospital
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Takekuma K, Tsuyuki K, Honda T. [Clinical investigation of cefdinir in the pediatric field]. Jpn J Antibiot 1990; 43:1806-12. [PMID: 2086818] [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: 12/30/2022]
Abstract
We performed pharmacokinetic, bacteriological and clinical studies on cefdinir granules (CFDN, FK482), and obtained the results summarized below. 1. Serum levels of CFDN when granular form was given in a single dose of 6 mg/kg before meal peaked at 0.81 micrograms/ml 6 hours after dosing. The serum half-life of the drug was 2.45 hours. 2. CFDN was administered to 18 patients with bacterial infections which consisted mainly of respiratory tract infections in doses of 1.3-7.4 mg/kg three times daily for 3-9 days. Clinical efficacies were "excellent" in 10 patients, "good" in 7, and "poor" in one, with an overall efficacy rate of 94.4%. 3. As for bacteriological effects on 20 strains of causative organisms, all the 10 strains of Gram-positive organisms were eradicated, with an eradication rate of 100%. Meanwhile, the eradication rate on 10 strains of Gram-negative organisms was 87.5%. Overall, bacteriological effect was "eradicated" in 17 strains, "decreased" in one, and "unknown" in 2, with an eradication rate of 94.4%. 4. No side effects nor abnormal laboratory test values were noted in any of the patients. We have concluded that cefdinir is useful in the treatment of infection in the pediatric field.
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Affiliation(s)
- K Takekuma
- Department of Pediatrics, Tokyo Medical College
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Nakatsu T, Yokoyama I, Tsuyuki K, Soh Y, Hanai G, Matsumoto H, Kubo H, Matsumoto K, Nohga K, Koyanagi H. [Clinical reevaluation of continuous intravenous infusion of 5-fluorouracil--plasma concentrations and clinical dose by continuous intravenous and 60-min infusions]. Gan To Kagaku Ryoho 1990; 17:253-8. [PMID: 2301952] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Daily and intermittent continuous intravenous infusions [by gravity drip, (IVG) or infusion pump, (IVP)] and intermittent short-time intravenous drip infusion of 5-FU were carried out on advanced cancer patients. The MTD and dose-limiting toxicity were investigated in relation to the plasma concentrations of 5-FU determined by HPLC. Responses in eleven patients receiving IVG administration daily at 8-21 mg/kg/day were NC, but those given 5-FU alone showed no adverse reactions. Plasma concentrations were too low to be determined. In 9 patients receiving IVG or IVP administration weekly at 60 mg/kg for 24 hr, 1 of the 5 evaluable patients showed reduced hepatic metastatic lesions. One of 4 patients receiving IVP administration weekly at 120 mg/kg for 48 hr showed a disappearance of metastatic lesions in the skeletal muscle, but bone marrow suppression was observed as dose-limiting toxicity. Pharmacokinetics were more stable in IVP than in IVG with less individual difference in the plasma concentrations. Among the outpatients receiving short-time iv, IVG administration once or twice a week, 2 patients given weekly administrations at 20 mg/kg for 60 min showed slight adverse reactions. In 6 patients given high-dose administrations, bone marrow suppression was observed. When pharmacokinetics in the patients given 5-FU for 60 min were compared between the IVG and IVP groups, there were individual differences in plasma concentrations, but the differences were not significant. It was concluded from above results that the following practical dose schedules would be recommendable: 60 mg/kg for 24hr/week by IVP for inpatients and 20 mg/kg for 60 min/week by IVG for outpatients.
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Affiliation(s)
- T Nakatsu
- Dept. of Surgery Kawasaki Municipal Hospital
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Kubota T, Nakada M, Tsuyuki K, Inada T, Asanuma F, Ishibiki K, Abe O. Cell kinetics and chemosensitivity of human carcinomas serially transplanted into nude mice. Jpn J Cancer Res 1986; 77:502-7. [PMID: 3089982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Six human carcinoma xenografts serially transplanted into nude mice were used for the study of chemosensitivity and cell kinetics. Three gastric carcinomas (St-4, St-40 and H-111), two colon carcinomas (Co-3 and Co-4) and one breast carcinoma (MX-1) were inoculated into the subcutaneous tissue of BALB/cA nude mice. The maximum tolerable doses of mitomycin C (MMC), adriamycin (ADM), cyclophosphamide (CPA) and 5-fluorouracil (5-FU) were administered when the tumor weights reached 100-300 mg. The response rates of the tumor to these drugs were found to be 3/6 for MMC, 2/6 for 5-FU and 1/6 for ADM and CPA. Percent labeled mitosis curves obtained from 3H-thymidine pulse labeling were analyzed by the method of Quastler and Sherman. It was found that the antitumor effect of MMC was closely correlated with the growth fractions of the tumors (r = -0.98, P less than 0.001), and it appeared that the tumor cells were more sensitive to MMC in the resting stages during the proliferating phase than in the other cell cycle phases. Cell kinetics is considered to be an important factor in determining chemosensitivity, and the system of human tumor xenografts-nude mice seems to be a suitable experimental model for investigating the correlation between cell kinetics and chemosensitivity in vivo.
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Tsuyuki K, Akaike M, Chang K, Hase H, Lee M, Ebine K. [Studies of circulatory responses during submaximal continuous and intermittent exercise in patients with coronary heart disease]. Kokyu To Junkan 1985; 33:1485-9. [PMID: 3832211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Chang K, Akaike M, Tsuyuki K, Hase H, Ebine K. [Evaluation of exercise training with exercise intensity below anaerobic threshold in coronary artery disease patients]. Kokyu To Junkan 1985; 33:1347-53. [PMID: 4095389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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42
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Hase H, Watanabe S, Nakamura R, Yabuki S, Machii K, Lee M, Ebine K, Akaike M, Tsuyuki K, Chang K. [Effect of exercise training on functional aerobic capacity, cardiac function and peripheral circulatory function in chronic hemodialysis patients]. Nihon Jinzo Gakkai Shi 1985; 27:1429-36. [PMID: 4094167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kubota T, Inada T, Nakada M, Tsuyuki K, Ishibiki K, Abe O. [Cell kinetics of human lung small cell carcinomas transplanted into nude mice]. Gan To Kagaku Ryoho 1985; 12:1775-81. [PMID: 2994575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Three human lung small cell carcinoma (SCC) xenografts serially transplanted into BALB/c nude mice were used for cell kinetic analysis. SCC strains, Lu-24, Lu-130 and Lu-134, were inoculated into the backs of nude mice, and when each tumor reached more than 300 mg, 50 microCi of 3H-thymidine per mouse was administered ip. The percentage labeled mitosis curve was obtained from the autoradiographic specimens which were labeled by the pulse-chase method. Cell cycle phase, growth fraction (GF) and cell loss factor (CL) were assessed by the methods of Quastler, Fujita and Steel, respectively. These cell kinetic parameters were compared with those of six control human gastrocolic and breast carcinoma xenografts which were previously reported by us. It was noticed that the cell cycle times (Tc) of SCC were statistically shorter than those of controls and this short Tc was found to be dependent on their short post-mitotic resting phases. GFs and labeling indices of SCC were observed to be statistically lower than those of controls, suggesting an incomplete adaptation of SCC xenografts to the host nude mice. Whereas some modifications by the host mice on the cell kinetics were supposed, the characteristics of SCC cell kinetics were thought to be essentially preserved in nude mice and these kinetic parameters were observed to be stable throughout the serial transfers. Accordingly, the SCC xenograft-nude mouse system was considered to be useful as an experimental therapeutic model of human lung small cell carcinomas.
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Tsuyuki K, Kubota T, Hanatani Y, Nakada M, Kubouchi K, Asanuma F, Ishibiki K, Abe O. [Experimental combination chemotherapy against a human breast carcinoma (MX-1) transplanted into nude mice with special reference to the cell kinetics]. Nihon Gan Chiryo Gakkai Shi 1984; 19:770-7. [PMID: 6436411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Tsuyuki K. [Experimental combination chemo-radiotherapy on human breast carcinoma (MX-1) transplanted into nude mice]. Nihon Geka Gakkai Zasshi 1984; 85:421-32. [PMID: 6431259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Experimental combination chemo-radiotherapy of mitomycin C (MMC) and Linac irradiation was performed on human breast carcinoma transplanted into nude mice. The treatment was started on 2 wks. after tumor inoculations and the effects were evaluated by T/C ratio of the tumor weight. Cell kinetic analysis was studied by flow cytometry, 3H-thymidine uptake labeling index (L.I.) and mitotic index (M.I.) on 24 hrs. after treatments. Effect of MMC (0.5, 1 and 2 mg/kg) and irradiation (500, 1000 and 2000 rads/mouse) revealed exponential linear dose response curves against T/C ratio which was significantly correlated with L.I. In combination therapy, the synergistic action was observed when 500 rads/mouse and 1 mg/kg were combined, and the effect was found to be more excellent when the radiation was performed 24 hrs. before MMC administration than the reversed sequence. By MMC and radiation, 2n and 3n cells increased with decrease of 4n cells. Whereas no change of M.I. was observed, L.I. was depressed. Increased 3n cells with depressed L.I. was supposed to be caused by S phase prolongation. As this change was more remarkable by radiation, the combination therapy was thought to be more effective when the radiation was performed before MMC administration. This nude mice-human tumor system was thought to be useful to analyze the combination chemoradiotherapy.
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Yamaka T, Chang K, Akaike M, Tsuyuki K, Nomura M, Hase H, Ebine K. [Effects of exercise training on hemodialysis-induced hypotension and subjective complaints during hemodialysis therapy in hemodialysis patients]. Nihon Jinzo Gakkai Shi 1984; 26:399-406. [PMID: 6471582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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47
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Kurihara H, Kubota T, Okazaki M, Maruyama K, Tsuyuki K, Nakada M, Asanuma F, Konno H, Ishibiki K, Abe O. [Effect of chemotherapy on the interstitial tissue of a malignant human tumor transplanted into nude mice, with reference to microvessels]. Gan To Kagaku Ryoho 1983; 10:2016-22. [PMID: 6614936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Experimental chemotherapy of cyclophosphamide (CPA) was performed on a human malignant hemangiopericytoma serially transplanted into nude mice with a genetic background of BALB/c and the changes or histological findings and microangiograms (MAG) were investigated. The treatment was performed 2 weeks after tumor inoculation. Either 120 mg/kg or 240 mg/kg of CPA, dissolved in 0.2 ml of physiological saline, was administered once intraperitoneally. On days 1, 2, 4 and 7 after the treatment, mice were sacrificed and each tumor was examined in terms of histological findings and MAG. Although the tumors treated with 120 mg/kg of CPA were suppressed temporarily, the regrowth of the tumors were observed. The tumors treated with 240 mg/kg of CPA regressed without any regrowth. From the observations of MAG, the former showed an avascular area on day 4 after the treatment and the tumor vessels regenerated on day 7 after the treatment. On the other hand, in the latter group, it was found that the normal vascular network developed after the formation of an avascular area 2 days after the treatment. From the histological findings, the former showed to reduce mitotic indeces of 1 or 2 days after the treatment, however the mitotic indeces were found to recover 7 days after the treatment. Mitotic indeces of tumors treated with 240 mg/kg of CPA were observed to be depressed after the treatment. These results suggested that the changes of interstitial tissue were closely correlated well with the destruction and regrowth of tumor cells observed by the growth curve and histological findings. Tumor vessels were thought to play an important role in the cancer chemotherapy, not only as the transport systems of drugs but also as the target of antitumor agents.
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Tsuyuki K, Kubota T, Yamada Y, Hanatani Y, Nakada M, Ishibiki K, Abe O. [Role of host immunity in experimental radiotherapy]. Nihon Gan Chiryo Gakkai Shi 1983; 18:1108-15. [PMID: 6663165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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49
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Kubota T, Hanatani Y, Tsuyuki K, Nakada M, Ishibiki K, Abe O, Kamataki T, Kato R. Antitumor effect and metabolic activation of cyclophosphamide and 4-hydroperoxycyclophosphamide in the human breast carcinoma (MX-1)-nude mouse system. Gan 1983; 74:437-44. [PMID: 6884701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The effects of cyclophosphamide (CPA) and its active form, 4-hydroperoxy-CPA, against human breast carcinoma transplanted into nude mice (BALB/c nu/nu) were evaluated in terms of the decreases of hepatic drug-metabolizing enzymes in nude mice. A human breast carcinoma, MX-1, was implanted into the subcutaneous tissue of nude mice and a drug was administered intravenously once at a dose of 0.05, 0.1 or 0.15 mmol/kg, 1 or 3 weeks after tumor inoculation. 4-Hydroperoxy-CPA was more effective than CPA as regards inhibition of tumor growth, and the difference in effect was greater when the drugs were administered 3 weeks after tumor inoculation. The activity of CPA was depressed by the decrease of the hepatic drug-metabolizing enzymes in proportion to the tumor-bearing period. Therefore, the effects of masked derivatives of CPA may correlate with the changes in drug-metabolizing activities of tumor-bearing mice. The human tumor xenografts-nude mice system is considered to be suitable for chemosensitivity tests with masked compounds.
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Konno H, Kubota T, Tsuyuki K, Nakada M, Kubouchi K, Yoshizumi Y, Asanuma F, Kurihara H, Koh J, Ishibiki K, Abe O. [Immunological competence of nude mice on the growth of transplantable human tumors--with reference to natural killer cells]. Gan To Kagaku Ryoho 1983; 10:775-80. [PMID: 6881996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Influences of natural killer cells on the transplantable human tumors was evaluated by using anti-asialo GM1 antibody. Two human gastric adenocarcinomas designated as St-4 (poorly differentiated) and St-40 (well differentiated) were inoculated into nude mice. The effects of anti-asialo GM1 antibody were assessed in terms of tumor doubling time (Td) and 3H-thymidine (3H-TdR) uptake labeling index (L.I.). Whereas the Td of St-4 was significantly shortened by administration of anti-asialo GM1 antibody, no noticeable changes were observed in St-40. This enhanced growth of St-4 was also supported by the elevation of L.I. both in flashing and repeating methods. On the other hand, as the repeated L.I. of St-40 was almost 100% in control tumors, repeated L.I. was not increased by the administration of anti-asialo GM1 antibody. It was supported that natural killer activity of nude mice regulated the growth of transplantable human tumors concerning with the growth fractions.
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