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[PMID]:27771206
[Au] Autor:Whittle HJ; Palar K; Seligman HK; Napoles T; Frongillo EA; Weiser SD
[Ad] Endereço:Global Health Sciences, University of California, San Francisco (UCSF), Mission Hall/Global Health and Clinical Sciences Building, 550 16th Street, 3rd Floor, San Francisco, CA 94158-2549, United States. Electronic address: henry.whittle.14@ucl.ac.uk.
[Ti] Título:How food insecurity contributes to poor HIV health outcomes: Qualitative evidence from the San Francisco Bay Area.
[So] Source:Soc Sci Med;170:228-236, 2016 12.
[Is] ISSN:1873-5347
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Food-insecure people living with HIV/AIDS (PLHIV) consistently exhibit worse clinical outcomes than their food-secure counterparts. This relationship is mediated in part through non-adherence to antiretroviral therapy (ART), sub-optimal engagement in HIV care, and poor mental health. An in-depth understanding of how these pathways operate in resource-rich settings, however, remains elusive. OBJECTIVE: We aimed to understand the relationship between food insecurity and HIV health among low-income individuals in the San Francisco Bay Area using qualitative methods. METHODS: Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance from a non-profit organization. Interviews explored experiences with food insecurity and its perceived effects on HIV-related health, mental health, and health behaviors including taking ART and attending clinics. Thematic content analysis of transcripts followed an integrative inductive-deductive approach. RESULTS: Food insecurity was reported to contribute to poor ART adherence and missing scheduled clinic visits through various mechanisms, including exacerbated ART side effects in the absence of food, physical feelings of hunger and fatigue, and HIV stigma at public free-meal sites. Food insecurity led to depressive symptoms among participants by producing physical feelings of hunger, aggravating pre-existing struggles with depression, and nurturing a chronic self-perception of social failure. Participants further explained how food insecurity, depression, and ART non-adherence could reinforce each other in complex interactions. CONCLUSION: Our study demonstrates how food insecurity detrimentally shapes HIV health behavior and outcomes through complex and interacting mechanisms, acting via multiple socio-ecological levels of influence in this setting. The findings emphasize the need for broad, multisectoral approaches to tackling food insecurity among urban poor PLHIV in the United States.
[Mh] Termos MeSH primário: Abastecimento de Alimentos/normas
Infecções por HIV/economia
Avaliação de Resultados (Cuidados de Saúde)
[Mh] Termos MeSH secundário: Adulto
Idoso
Antirretrovirais/efeitos adversos
Antirretrovirais/economia
Antirretrovirais/uso terapêutico
Feminino
Assistência Alimentar/utilização
Infecções por HIV/epidemiologia
Infecções por HIV/psicologia
Seres Humanos
Masculino
Adesão à Medicação/psicologia
Adesão à Medicação/estatística & dados numéricos
Meia-Idade
Organizações sem Fins Lucrativos/estatística & dados numéricos
Pesquisa Qualitativa
São Francisco/epidemiologia
Fatores Socioeconômicos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Retroviral Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28448905
[Au] Autor:Bluthenthal RN; Wenger L; Chu D; Bourgois P; Kral AH
[Ad] Endereço:Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90033, USA. Electronic address: rbluthen@usc.edu.
[Ti] Título:Drug use generations and patterns of injection drug use: Birth cohort differences among people who inject drugs in Los Angeles and San Francisco, California.
[So] Source:Drug Alcohol Depend;175:210-218, 2017 06 01.
[Is] ISSN:1879-0046
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: A robust literature documents generational trends in drug use. We examined the implications of changing national drug use patterns on drug injection histories of diverse people who inject drugs (PWID). METHODS: Drug use histories were collected from 776 active PWID in 2011-13. Using descriptive statistics, we examine drug use initiation by year and birth cohort (BC) differences in drug first injected. A multivariate linear regression model of time to injection initiation ([TTII] (year of first injection minus year of first illicit drug use) was developed to explore BC differences. RESULTS: The first drug injected by BC changed in tandem with national drug use trends with heroin declining from 77% for the pre-1960's BC to 58% for the 1960's BC before increasing to 71% for the 1990's BC. Multivariate linear regression modeling found that shorter TTII was associated with the 1980's/1990's BC (-3.50 years; 95% Confidence Interval [CI]=-0.79, -6.21) as compared to the 1970's BC. Longer TTII was associated with being female (1.65 years; 95% CI=0.40, 2.90), African American (1.69 years; 95% CI=0.43, 2.95), any substance use treatment prior to injection (4.22 years; 95% CI=2.65, 5.79), and prior non-injection use of drug that was first injected (3.29 years; 95% CI=2.19, 4.40). CONCLUSION: National drug trends appear to influence injection drug use patterns. The prescription opiate drug era is associated with shorter TTII. Culturally competent, demographically and generationally-targeted prevention strategies to combat transitions to drug injection are needed to prevent or shorten upstream increases in risky drug use practices on a national level.
[Mh] Termos MeSH primário: Fatores Etários
Abuso de Substâncias por Via Intravenosa/epidemiologia
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Heroína
Seres Humanos
Modelos Lineares
Los Angeles/epidemiologia
Masculino
Meia-Idade
Análise Multivariada
São Francisco/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
70D95007SX (Heroin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


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[PMID]:28332945
[Au] Autor:Arayasirikul S; Pomart WA; Raymond HF; Wilson EC
[Ad] Endereço:a Center for Public Health Research , San Francisco Department of Public Health , San Francisco , California , USA.
[Ti] Título:Unevenness in Health at the Intersection of Gender and Sexuality: Sexual Minority Disparities in Alcohol and Drug Use Among Transwomen in the San Francisco Bay Area.
[So] Source:J Homosex;65(1):66-79, 2018.
[Is] ISSN:1540-3602
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Research on the health of transwomen is largely focused on heterosexual HIV risk. Little is known about the health of sexual minority transwomen. We conducted a secondary cross-sectional analysis of data from a HIV risk and resilience study of transwomen aged 16 to 24 years in the San Francisco Bay Area (N = 259). Prevalence and demographic characteristics of sexual minority transwomen was assessed and logistic regression models were used to examine the relationship between sexual minority status and alcohol and drug use. In logistic regression models, sexual minority transwomen had greater fold odds of heavy episodic drinking and illicit prescription drug use compared to their heterosexual counterparts, controlling for race/ethnicity, age, income, nativity, hormone status, and history of feminization procedures. These results suggest that sexual minority status may be an important social determinant of health among gender minorities. Populations of transwomen are heterogeneous; effective interventions must consider sexual minority status.
[Mh] Termos MeSH primário: Alcoolismo/psicologia
Transtornos Relacionados ao Uso de Substâncias/psicologia
Pessoas Transgênero/psicologia
[Mh] Termos MeSH secundário: Adolescente
Alcoolismo/epidemiologia
Grupos de Populações Continentais
Estudos Transversais
Feminino
Heterossexualidade
Seres Humanos
Modelos Logísticos
Masculino
Prevalência
São Francisco/epidemiologia
Comportamento Sexual
Minorias Sexuais e de Gênero
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.1080/00918369.2017.1310552


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[PMID]:28463769
[Au] Autor:Tipple BJ; Jameel Y; Chau TH; Mancuso CJ; Bowen GJ; Dufour A; Chesson LA; Ehleringer JR
[Ad] Endereço:Department of Biology, University of Utah, 257 S 1400 E, Salt Lake City, UT 84112, USA; IsoForensics, Inc., 421 Wakara Way, Suite 100, Salt Lake City, UT 84108, USA. Electronic address: brett.tipple@utah.edu.
[Ti] Título:Stable hydrogen and oxygen isotopes of tap water reveal structure of the San Francisco Bay Area's water system and adjustments during a major drought.
[So] Source:Water Res;119:212-224, 2017 08 01.
[Is] ISSN:1879-2448
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Water availability and sustainability in the Western United States is a major flashpoint among expanding communities, growing industries, and productive agricultural lands. This issue came to a head in 2015 in the State of California, when the State mandated a 25% reduction in urban water use following a multi-year drought that significantly depleted water resources. Water demands and challenges in supplying water are only expected to intensify as climate perturbations, such as the 2012-2015 California Drought, become more common. As a consequence, there is an increased need to understand linkages between urban centers, water transport and usage, and the impacts of climate change on water resources. To assess if stable hydrogen and oxygen isotope ratios could increase the understanding of these relationships within a megalopolis in the Western United States, we collected and analyzed 723 tap waters across the San Francisco Bay Area during seven collection campaigns spanning 21 months during 2013-2015. The San Francisco Bay Area was selected as it has well-characterized water management strategies and the 2012-2105 California Drought dramatically affected its water resources. Consistent with known water management strategies and previously collected isotope data, we found large spatiotemporal variations in the δ H and δ O values of tap waters within the Bay Area. This is indicative of complex water transport systems and varying municipality-scale management decisions. We observed δ H and δ O values of tap water consistent with waters originating from snowmelt from the Sierra Nevada Mountains, local precipitation, ground water, and partially evaporated reservoir sources. A cluster analysis of the isotope data collected in this study grouped waters from 43 static sampling sites that were associated with specific water utility providers within the San Francisco Bay Area and known management practices. Various management responses to the drought, such as source switching, bringing in new sources, and water conservation, were observed in the isotope data. Finally, we estimated evaporative loss from one utility's reservoir system during the 2015 water year using a modified Craig-Gordon model to estimate the consequences of the drought on this resource. We estimated that upwards of 6.6% of the water in this reservoir system was lost to evaporation.
[Mh] Termos MeSH primário: Secas
Hidrogênio
Isótopos de Oxigênio
Água
[Mh] Termos MeSH secundário: Baías
Cidades
Mudança Climática
Monitoramento Ambiental
Nevada
São Francisco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Oxygen Isotopes); 059QF0KO0R (Water); 7YNJ3PO35Z (Hydrogen)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28922420
[Au] Autor:Eerkens JW; Hull B; Goodman J; Evoy A; Kapp JD; Hussain S; Green RE
[Ad] Endereço:Department of Anthropology, University of California Davis, Davis, California, United States of America.
[Ti] Título:Stable C and N isotope analysis of hair suggest undernourishment as a factor in the death of a mummified girl from late 19th century San Francisco, CA.
[So] Source:PLoS One;12(9):e0184921, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The chance discovery of a 1.5-3.5 years old mummified girl presents a unique opportunity to further our understanding of health and disease among children in 19th Century San Francisco. This study focuses on carbon and nitrogen stable isotope signatures in serial samples of hair that cover the last 14 months of her life. Results suggest an initial omnivorous diet with little input from marine resources or C4 plants. Around six months before death δ15N starts a steady increase, with a noticeable acceleration just two months before she died. The magnitude of δ15N change, +1.5‰ in total, is consistent with severe undernourishment or starvation. Cemetery records from this time period in San Francisco indicate high rates of infant and child mortality, mainly due to bacterial-borne infectious diseases, about two orders of magnitude higher than today. Taken together, we hypothesize that the girl died after a prolonged battle with such an illness. Results highlight the tremendous impacts that modern sanitation and medicine have had since the 1800s on human health and lifespan in the United States.
[Mh] Termos MeSH primário: Cabelo
Mortalidade Infantil/história
Transtornos da Nutrição do Lactente
Múmias
[Mh] Termos MeSH secundário: Isótopos de Carbono/análise
Isótopos de Carbono/metabolismo
Pré-Escolar
Feminino
Cabelo/química
Cabelo/metabolismo
História do Século XIX
Seres Humanos
Lactente
Transtornos da Nutrição do Lactente/história
Transtornos da Nutrição do Lactente/metabolismo
Isótopos de Nitrogênio/análise
Isótopos de Nitrogênio/metabolismo
São Francisco
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Carbon Isotopes); 0 (Nitrogen Isotopes)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170919
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184921


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[PMID]:28891237
[Au] Autor:Dall'Era M; Cisternas MG; Snipes K; Herrinton LJ; Gordon C; Helmick CG
[Ad] Endereço:University of California, San Francisco.
[Ti] Título:The Incidence and Prevalence of Systemic Lupus Erythematosus in San Francisco County, California: The California Lupus Surveillance Project.
[So] Source:Arthritis Rheumatol;69(10):1996-2005, 2017 Oct.
[Is] ISSN:2326-5205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Estimates of the incidence and prevalence of systemic lupus erythematosus (SLE) in the US have varied widely. The purpose of this study was to conduct the California Lupus Surveillance Project (CLSP) to determine credible estimates of SLE incidence and prevalence, with a special focus on Hispanics and Asians. METHODS: The CLSP, which is funded by the Centers for Disease Control and Prevention, is a population-based registry of individuals with SLE residing in San Francisco County, CA, from January 1, 2007 through December 31, 2009. Data sources included hospitals, rheumatologists, nephrologists, commercial laboratories, and a state hospital discharge database. We abstracted medical records to ascertain SLE cases, which we defined as patients who met ≥4 of the 11 American College of Rheumatology classification criteria for SLE. We estimated crude and age-standardized incidence and prevalence, which were stratified by sex and race/ethnicity. RESULTS: The overall age-standardized annual incidence rate was 4.6 per 100,000 person-years. The average annual period prevalence was 84.8 per 100,000 persons. The age-standardized incidence rate in women and men was 8.6 and 0.7 per 100,000 person-years, respectively. This rate was highest among black women (30.5), followed by Hispanic women (8.9), Asian women (7.2), and white women (5.3). The age-standardized prevalence in women per 100,000 persons was 458.1 in blacks, 177.9 in Hispanics, 149.7 in Asians, and 109.8 in whites. Capture-recapture modeling estimated 33 additional incident cases and 147 additional prevalent cases. CONCLUSION: Comprehensive methods that include intensive case-finding provide more credible estimates of SLE in Hispanics and Asians, and confirm racial and ethnic disparities in SLE. The disease burden of SLE is highest in black women, followed by Hispanic women, Asian women, and white women.
[Mh] Termos MeSH primário: Grupos Étnicos/estatística & dados numéricos
Lúpus Eritematoso Sistêmico/epidemiologia
Sistema de Registros
[Mh] Termos MeSH secundário: Adulto
Afroamericanos/estatística & dados numéricos
Nativos do Alasca/estatística & dados numéricos
Americanos Asiáticos/estatística & dados numéricos
California/epidemiologia
Monitoramento Epidemiológico
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Feminino
Hispano-Americanos/estatística & dados numéricos
Seres Humanos
Incidência
Índios Norte-Americanos/estatística & dados numéricos
Lúpus Eritematoso Sistêmico/etnologia
Masculino
Meia-Idade
Grupo com Ancestrais Oceânicos/estatística & dados numéricos
Prevalência
São Francisco/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1002/art.40191


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[PMID]:28799200
[Au] Autor:Strawbridge WJ; Wallhagen MI
[Ad] Endereço:Institute for Health and Aging, University of California, San Francisco, San Francisco, California.
[Ti] Título:Simple Tests Compare Well with a Hand-held Audiometer for Hearing Loss Screening in Primary Care.
[So] Source:J Am Geriatr Soc;65(10):2282-2284, 2017 Oct.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To compare hearing loss screening results of four simple tests with those of hand-held audiometry. DESIGN: Cross-sectional study of individuals screened during intake for physicals and other routine procedures. SETTING: Two primary care clinics in the San Francisco Bay area. PARTICIPANTS: Older adults not wearing hearing aids (N = 125, mean age 72.9, 63% female). MEASUREMENTS: Direct question about hearing loss, indirect question, finger-rub test, whisper test, and audiometric results using a hand-held audiometer. RESULTS: Sensitivity was 91% for the finger-rub test compared with 89% for the direct question, 85% for the indirect question, and 79% for the whisper test. For specificity, the whisper test was highest, followed by the finger rub, indirect, and direct. CONCLUSION: Simple screening procedures can be used to identify older adults with hearing loss in primary care and facilitate early referral for additional testing and treatment.
[Mh] Termos MeSH primário: Audiometria/instrumentação
Perda Auditiva/diagnóstico
Programas de Rastreamento/instrumentação
Atenção Primária à Saúde/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Audiometria/métodos
Estudos Transversais
Feminino
Seres Humanos
Masculino
Programas de Rastreamento/métodos
Meia-Idade
Reprodutibilidade dos Testes
São Francisco
Sensibilidade e Especificidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.15044


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[PMID]:28768851
[Au] Autor:Devinsky O; Friedman D; Cheng JY; Moffatt E; Kim A; Tseng ZH
[Ad] Endereço:From the Department of Neurology (O.D., D.F., J.Y.C.), Epilepsy Center, NYU School of Medicine; and Department of Pathology (E.M.), Department of Neurology (A.K.), and Electrophysiology and Arrhythmia Service (Z.H.T.), Department of Medicine, UCSF School of Medicine. od4@nyu.edu.
[Ti] Título:Underestimation of sudden deaths among patients with seizures and epilepsy.
[So] Source:Neurology;89(9):886-892, 2017 Aug 29.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the definite and potential frequency of seizures and epilepsy as a cause of death (COD) and how often this goes unrecognized. METHODS: Prospective determination of seizures or epilepsy and final COD for individuals aged 18-90 years with out-of-hospital sudden cardiac deaths (SCDs) from the population-based San Francisco POST SCD Study. We compared prospective seizure or epilepsy diagnosis and final COD as adjudicated by a multidisciplinary committee (pathologists, electrophysiologists, and a vascular neurologist) vs retrospective adjudication by 2 epileptologists with expertise in seizure-related mortality. RESULTS: Of 541 SCDs identified during the 37-month study period (mean age 62.8 years, 69% men), 525 (97%) were autopsied; 39/525 (7.4%) had seizures or epilepsy (mean age: 58 years, range: 27-92; 67% men), comprising 17% of 231 nonarrhythmic sudden deaths. The multidisciplinary team identified 15 cases of epilepsy, 6 sudden unexpected deaths in epilepsy (SUDEPs), and no deaths related to acute symptomatic seizures. The epileptologists identified 25 cases of epilepsy and 8 definite SUDEPs, 10 possible SUDEPs, and 5 potential cases of acute symptomatic seizures as a COD. CONCLUSIONS: Among the 25 patients identified with epilepsy by the epileptologists, they found definite or possible SUDEP in 72% (18/25) vs 24% (6/25) by the multidisciplinary group (6/15 cases they identified with epilepsy). The epileptologists identified acute symptomatic seizures as a potential COD in 5/14 patients with alcohol-related seizures. Epilepsy is underdiagnosed among decedents. Among patients with seizures and epilepsy who die suddenly, seizures and SUDEP often go unrecognized as a potential or definite COD.
[Mh] Termos MeSH primário: Morte Súbita Cardíaca/epidemiologia
Epilepsia/mortalidade
Convulsões/mortalidade
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Autopsia
Causas de Morte
Interpretação Estatística de Dados
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Estudos Retrospectivos
São Francisco/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004292


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[PMID]:28650229
[Au] Autor:Truong HM; Fatch R; Raymond HF; McFarland W
[Ad] Endereço:University of California, San Francisco.
[Ti] Título:HIV Treatment and Re-infection Beliefs Predict Sexual Risk Behavior of Men Who Have Sex With Men.
[So] Source:AIDS Educ Prev;29(3):218-227, 2017 Jun.
[Is] ISSN:1943-2755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We examined whether beliefs about antiretroviral (ART) efficacy and reinfection prospectively predicted subsequent condomless anal intercourse (CAI). Men who have sex with men in San Francisco (N = 773) were recruited for a longitudinal study using time-location sampling. HIV-negative men were more likely to have sero-discordant receptive CAI and HIV-positive men were more likely to have sero-discordant insertive CAI if they previously reported these behaviors at baseline and reported less concern about HIV transmission due to ART. HIV-positive men were more likely to report sero-concordant CAI at follow-up if they reported this behavior at baseline. Previous sexual behavior was consistently the strongest predictor of future sexual behavior. Previous sexual behavior and optimistic beliefs about ART for treatment and prevention predicted subsequent sexual behavior with sero-discordant partners. Since individual-level and population-level benefits of ART depend on persons maintaining adequate drug concentrations, prevention messages should continue emphasizing treatment adherence and practicing a combination of risk-reduction strategies.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Infecções por HIV/transmissão
Conhecimentos, Atitudes e Prática em Saúde
Homossexualidade Masculina/psicologia
Cooperação do Paciente/psicologia
Comportamento Sexual/psicologia
Sexo sem Proteção/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Infecções por HIV/diagnóstico
Infecções por HIV/tratamento farmacológico
Infecções por HIV/prevenção & controle
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Estudos Prospectivos
Risco
Assunção de Riscos
São Francisco
Parceiros Sexuais
Carga Viral
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170627
[St] Status:MEDLINE
[do] DOI:10.1521/aeap.2017.29.3.218


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[PMID]:28609485
[Au] Autor:Carlson S; Borrell LN; Eng C; Nguyen M; Thyne S; LeNoir MA; Burke-Harris N; Burchard EG; Thakur N
[Ad] Endereço:School of Medicine, University of California, San Francisco, San Francisco, California, United States of America.
[Ti] Título:Self-reported racial/ethnic discrimination and bronchodilator response in African American youth with asthma.
[So] Source:PLoS One;12(6):e0179091, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:IMPORTANCE: Asthma is a multifactorial disease composed of endotypes with varying risk profiles and outcomes. African Americans experience a high burden of asthma and of psychosocial stress, including racial discrimination. It is unknown which endotypes of asthma are vulnerable to racial/ethnic discrimination. OBJECTIVE: We examined the association between self-reported racial/ethnic discrimination and bronchodilator response (BDR) among African American youth with asthma ages 8 to 21 years (n = 576) and whether this association varies with tumor necrosis factor alpha (TNF-α) level. MATERIALS AND METHODS: Self-reported racial/ethnic discrimination was assessed by a modified Experiences of Discrimination questionnaire as none or any. Using spirometry, BDR was specified as the mean percentage change in forced expiratory volume in one second before and after albuterol administration. TNF-α was specified as high/low levels based on our study population mean. Linear regression was used to examine the association between self-reported racial/ethnic discrimination and BDR adjusted for selected characteristics. An interaction term between TNF-α levels and self-reported racial/ethnic discrimination was tested in the final model. RESULTS: Almost half of participants (48.8%) reported racial/ethnic discrimination. The mean percent BDR was higher among participants reporting racial/ethnic discrimination than among those who did not (10.8 versus 8.9, p = 0.006). After adjustment, participants reporting racial/ethnic discrimination had a 1.7 (95% CI: 0.36-3.03) higher BDR mean than those not reporting racial/ethnic discrimination. However, we found heterogeneity of this association according to TNF-α levels (p-interaction = 0.040): Among individuals with TNF-α high level only, we observed a 2.78 higher BDR mean among those reporting racial/ethnic discrimination compared with those not reporting racial/ethnic discrimination (95%CI: 0.79-4.77). CONCLUSIONS: We found BDR to be increased in participants reporting racial/ethnic discrimination and this association was limited to African American youth with TNF-α high asthma, an endotype thought to be resistant to traditional asthma medications. These results support screening for racial/ethnic discrimination in those with asthma as it may reclassify disease pathogenesis.
[Mh] Termos MeSH primário: Asma/tratamento farmacológico
Broncodilatadores/uso terapêutico
Racismo/estatística & dados numéricos
Autorrelato
[Mh] Termos MeSH secundário: Adolescente
Afroamericanos/estatística & dados numéricos
Albuterol/uso terapêutico
Asma/etnologia
Asma/metabolismo
Estudos de Casos e Controles
Criança
Feminino
Seres Humanos
Modelos Lineares
Masculino
Avaliação de Resultados (Cuidados de Saúde)/métodos
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Racismo/etnologia
São Francisco
Fator de Necrose Tumoral alfa/metabolismo
Saúde da População Urbana/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Tumor Necrosis Factor-alpha); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179091



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