Childhood Exposure to Religions With High Prevalence of Members Who Discourage Homosexuality Is Associated With Adult HIV Risk Behaviors and HIV Infection in Black Men Who Have Sex With Men

Exposure to childhood religious affiliations where the majority of members discourage homosexuality may have negative psychological impacts for Black men who have sex with men. This study tested the hypothesis that exposures to these environments during childhood were associated with adulthood human immunodeficiency virus (HIV)/sexually transmitted infection (STI) behavioral risk and HIV infection, because these exposures influenced HIV/STI risk by undermining race/sexual identity congruence and increasing internalized homophobia and interpersonal anxiety. Structural equation modeling as well as logistic and Poisson regressions were performed using baseline data from HIV Prevention Trials Network 061 ( N = 1,553). Childhood religion affiliations that were more discouraging of homosexuality were associated with increased likelihood of HIV infection; however, the association was no longer significant after adjusting for age, income, and education. Having a childhood religion affiliation with high prevalence of beliefs discouraging homosexuality was associated with increased numbers of sexual partners (adjusted odds ratio = 4.31; 95% confidence interval [3.76, 4.94], p < .01). The hypothesized path model was largely supported and accounted for 37% of the variance in HIV infection; however, interpersonal anxiety was not associated with HIV/STI risk behaviors. Structural interventions are needed that focus on developing affirming theologies in religious institutions with Black men who have sex with men congregants.

Co-Parenting Relationship Experiences of Black Adolescent Mothers in Active Romantic Partnerships With the Fathers of Their Children

We conducted an interpretive description of co-parenting relationship experiences of romantically involved Black adolescent mothers and fathers with shared biological children. The study was conducted in Brooklyn, New York, using data from individual in-depth interviews with adolescent mothers and fathers (n = 10). Four themes were identified: (a) putting our heads together; (b) balancing childhood and parenthood; (c) less money, more problems; and (d) if we use condoms, it is for contraception. The co-parenting couples managed very complex relationships, but their mutual interest in the welfare of their children was a relational asset. Co-parents had sparse financial resources but used a moral economy strategy to provide mutual support. Future research is needed that focuses on identifying other co-parent relationship assets and integrating and evaluating their utility for enhancing interventions for adolescent families.

The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa

Ghanaian men who have sex with men (MSM) have a high HIV seroprevalence, but despite a critical need to address this public health concern, research evidence has been extremely limited on influences on sexual risk behavior among MSM in Ghana. To investigate associations between HIV/STD knowledge, HIV stigma, and sexual behaviors in a sample of MSM in Ghana, we conducted a secondary data analysis of cross-sectional survey data from a non-probability sample of Ghanaian MSM (N = 137). Nearly all the men (93%) had more than one current sex partner (M = 5.11, SD = 7.4). Of those reported partners, the average number of current female sexual partners was 1.1 (SD = 2.6). Overall, knowledge levels about HIV and STDs were low, and HIV stigma was high. There was no age-related difference in HIV stigma. Younger MSM (≤25 years) used condoms less often for anal and vaginal sex than did those over 25. Relative frequency of condom use for oral sex was lower in younger men who had higher STD knowledge and also was lower in older men who reported high HIV stigma. Knowledge and stigma were not associated with condom use for anal or vaginal sex in either age group. These descriptive data highlight the need for the development of intervention programs that address HIV/STD prevention knowledge gaps and reduce HIV stigma in Ghanaian communities. Intervention research in Ghana should address age-group-specific HIV prevention needs of MSM youth.

Gender equity predicts condom use among adolescent and young adult parents in Toronto, Canada

Adolescents and young adults have higher rates of sexually transmitted infections (STI) than any other age cohort in Toronto, Ontario, Canada. The sub-population of young parents is at even higher risk for acquiring STIs than the general population of adolescents and young adults. The purpose of this study was to determine whether and how co-parenting relationship functioning and gender equitable attitudes were associated with condom use among adolescent and young adult parents. We conducted a cross-sectional survey with 102 non-married adolescent and young adult parents in Toronto. Study participants used iPads to self-administer the co-parenting relationship scale, gender equitable men scale, and a sexual behaviour battery regarding their condom use during the last episode of sexual intercourse (including vaginal and anal). Logistic regression was used to determine whether scale scores predicted condom use at last intercourse, adjusting for age and sex. t-tests were performed to assess group mean differences in gender equitable attitudes and co-parenting relationship functioning between condom users and nonusers and between mothers and fathers. We observed that co-parenting relationship functioning was not associated with condom use behaviours. Instead, gender equitable attitudes predicted condom use in the overall sample (AOR=1.13; 95% CI 1.03, 1.25, p<0.05). Fathers who used condoms at last intercourse had higher gender equitable attitude scores than fathers who did not use condoms (M=58 vs. 53, p=0.02). Mothers' gender equitable attitude scores were not associated with condom use behaviours. Attitudes that support gender equity attitudes predict condom use among young parents, particularly among young fathers. Sexual risk reduction programs targeting young parents may benefit from incorporating components that promote gender equity norms.

Cationic nanoparticles disrupt cellular signaling in a cholesterol dependent manner

In this study, we investigate the interaction of charged polystyrene particles with respiratory epithelial cells. Experiments were designed to reveal the effect of cellular interaction with particles of varying size and charge and how such interactions could alter cytokine induced cellular processes. A549 cells, containing a stably transfected Interleukin-8 (IL-8) Luciferase promoter construct, were cultured in the presence of the proinflammatory cytokine tumor necrosis factor-α (TNF-α) and polystyrene particles for 4.5h. Several endpoints were measured: IL-8 gene expression, IL-6 protein, IL-8 protein, and NF-кB translocation. At 4.5h, cellular viability was maintained for the particle exposed cells. Interestingly, we found that only the cationic nanoparticles have the ability to disrupt the TNF-α stimulated cellular signaling by reducing the IL-8 promoter activity, IL-6 and IL-8 protein. Cationic nanoparticles reduce these processes through interfering with NF-κB translocation. However, the activity of the cationic nanoparticles on the IL-8 promoter and NF-κB translocation is lost when cholesterol is depleted from A549 cells before particle exposure, which suggests that cationic nanoparticles rely on membrane cholesterol integrity to disrupt cellular signaling.

The relationship between hemodynamics and inflammatory activation in women at risk for preeclampsia

OBJECTIVE

This study evaluated: 1) whether women with risk factors for preeclampsia had a hyperdynamic circulation and increased markers of endothelial and inflammatory activation; and 2) whether hemodynamically directed therapy was associated with a change in markers.

METHODS

A controlled experimental study was performed for two groups: 1) women at risk for preeclampsia (high risk); and 2) women at low risk (controls). Tumor necrosis factor-alpha (TNF-alpha), TNF-alpha receptors 1 and 2, vascular cell adhesion molecule-1, cellular fibronectin, and cardiac output were measured at or before 24 weeks' gestation and at 6-8 week intervals. High-risk subjects with cardiac output greater than 7.4 L/minute were treated with atenolol. Atenolol therapy was not randomized. Therefore, the longitudinal data were descriptive. Data were analyzed by the t test, Wilcoxon rank sum test, chi(2) test, multivariable linear regression, and the standard two-stage test.

RESULTS

There were 46 high-risk subjects and 25 controls. Maternal age, gestational age, and parity did not differ between the groups. Cardiac output (P <.001) and vascular cell adhesion molecule-1 (P =.02) at baseline were significantly increased in the high-risk group. A total of 42 women in the high-risk group received atenolol for high cardiac output. There was a slower rise in TNF-alpha receptor 1 in the treated group compared with the controls (P <.001).

CONCLUSION

Women with risk factors for preeclampsia had a hyperdynamic circulation and endothelial activation. Hemodynamically directed therapy in women at risk was associated with a slower rise in TNF-alpha receptor 1 compared with low-risk women who were not treated, suggesting a relationship between hemodynamics and inflammatory activation.

Aspirin for primary prevention of cardiovascular events

OBJECTIVE

The use of aspirin for primary prevention of cardiovascular events in the general population is controversial. The purpose of this study was to create a versatile model to evaluate the effects of aspirin in the primary prevention of cardiovascular events in patients with different risk profiles.

DESIGN

A Markov decision-analytic model evaluated the expected length and quality of life for the cohort's next 10 years as measured by quality-adjusted survival for the options of taking or not taking aspirin.

SETTING

Hypothetical model of patients in a primary care setting.

PATIENTS

Several cohorts of patients with a range of risk profiles typically seen in a primary care setting were considered. Risk factors considered included gender, age, cholesterol levels, systolic blood pressure, smoking status, diabetes, and presence of left ventricular hypertrophy. The cohorts were followed for 10 years. Outcomes were myocardial infarction, stroke, gastrointestinal bleed, ulcer, and death.

MAIN RESULTS

For the cases considered, the effects of aspirin varied according to the cohort's risk profile. By taking aspirin, the lowest-risk cohort would be the most harmed with a loss of 1.8 quality-adjusted life days by taking aspirin; the highest risk cohort would achieve the most benefit with a gain of 11.3 quality-adjusted life days. Results without quality adjustment favored taking aspirin in all the cohorts, with a gain of 0.73 to 8.04 days. The decision was extremely sensitive to variations in the utility of taking aspirin and to aspirin's effects on cardiovascular mortality. The model was robust to other probability and utility changes within reasonable parameters.

CONCLUSIONS

The decision of whether to take aspirin as primary prevention for cardiovascular events depends on patient risk. It is a harmful intervention for patients with no risk factors, and it is beneficial in moderate and high-risk patients. The benefits of aspirin in this population are comparable to those of other widely accepted preventive strategies. It is especially dependent on the patient's risk profile, patient preferences for the adverse effects of aspirin, and on the level of beneficial effects of aspirin on cardiovascular-related mortality.