Prevalence of High Risk Behaviors in HIV Infected Persons Aged ≥50 Years in Selected Counties of Yunnan Province

OBJECTIVE:

To understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODS:

Face to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTS:

Among the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9%(28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32(7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents(4.5%, 9/198), the difference was statistically significant (χ(2)=11.715,P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONS:

Risk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

Purchase full article [in Chinese] at:  http://goo.gl/VIjwes

By:  Zhai J1, Niu J2, Song LJ2, Mei JY2, Xiao MY2, Luo HB2, Ma YL2, Zhang JM3, Li WH4, Yang QW5, Jia MH2.

• 1Kunming Medical University, Kunming 650000, China.
• 2AIDS/STD Department, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China.
• 3Jianshui County Center for Disease Control and Prevention, Jianshui 654300, China.
• 4Gejiu County Center for Disease Control and Prevention, Gejiu 661000, China.
• 5Mengzi County Center for Disease Control and Prevention, Mengzi 661100, China. 
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Mar 10;37(3):371-4. doi: 10.3760/cma.j.issn.0254-6450.2016.03.016.

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Factors Associated with High-Risk Behaviors among People Newly Diagnosed with HIV Through Heterosexual Contact Before & After Diagnosis in Some Areas in Henan Province

OBJECTIVE:

To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province, and evaluate the risk of secondary transmission.

METHODS:

A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.

RESULTS:

Among 361 HIV infected persons, the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3%(279/361) and 28.5%(103/361) before diagnosis to 13.6% (49/361) and 2.5%(9/361) after diagnosis, the difference was significant (χ(2)=16.66,P<0.001;χ(2)= 4.80,P=0.03). The subjects surveyed always had more commercial heterosexual behaviors in Henan, Guangdong and Zhejiang provinces before and after diagnosis. After HIV infection confirmation, the condom use rates were 51.0%(25/49) for commercial heterosexual behaviors, 88.5% (184/208) for sex with regular partners and 88.9%(8/9) for sex with irregular partners, respectively. Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors, previous HIV detection and age of 35 years or older.

CONCLUSIONS:

Extramarital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread. It is necessary to inform the HIV test results, improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.

Purchase full article [Article in Chinese] at:   http://goo.gl/jj3npC

By:  Fan PY1, Bai YJ2, Yang WJ1, Li N1, Sun DY1, Zhu Q1, Wang Z1.

• 1Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.
• 2Zhoukou Prefecture Centre for Disease Control and Prevention, Zhoukou 466000, China.
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Mar 10;37(3):367-70. doi: 10.3760/cma.j.issn.0254-6450.2016.03.015. 

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Examining the Sociocultural Context of HIV-related Risk Behaviors among Kathoey (Male-to-female Transgender Women) Sex Workers in Bangkok, Thailand

Kathoey (male-to-female transgender) sex workers (KSW) in Thailand are at high risk for sexually transmitted infections; however, few qualitative studies have been conducted to understand the sociocultural context of engaging in HIV risk behaviors. 

A total of 24 participants were purposively sampled in Bangkok based on KSW work venues and substance use. Results revealed the importance of participants' understanding of the self in relation to establishing economic independence through sex work, which could then be used to re-establish support from family, who often have not accepted a son's gender transition. 

Participants linked being kathoey to a belief in fate but did not view engagement in sex work in the same way. Different sex work venues exposed KSW to different risky situations. 

HIV prevention programs for kathoey must address the importance of economic security and its relation to social support and gender transition within a cultural- and work-environment-specific framework.

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By:  Nemoto T, Cruz T, Iwamoto M, Trocki K, Perngparn U, Areesantichai C, Suzuki S, Roberts C.

J Assoc Nurses AIDS Care. 2016 Mar-Apr;27(2):153-65. doi: 10.1016/j.jana.2015.11.003. Epub 2015 Nov 14.

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Information, Motivation, and Behavioral Skills of High-Risk Young Adults to Use the HIV Self-Test

HIV self tests (HIVST) have the potential to increase testing among young adults. However, little is known about high-risk young adults' perception of the HIVST as a risk reduction tool and how they would use the HIVST in their everyday lives. 

Our study sought to examine these factors. Twenty-one ethnically diverse participants (ages 18-24) used the HIVST at our study site, completed surveys, and underwent an in-depth interview. Descriptive statistics were used to analyze the survey responses, and interview data were coded using constructs from the information-motivation-behavioral skills model. Information deficits included: how to use the HIVST and the "window period" for sero-conversion. 

Motivations supporting HIVST use included: 

• not needing to visit the clinic, 
• fast results, 
• easy access, and 
• use in non-monogamous relationships. 

Behavioral skills discussed included: 

• coping with a positive test, 
• handling partner violence after a positive test, and 
• accessing HIV services. 

These findings can inform the use of the HIVST for improving HIV testing rates and reducing HIV risk behavior.

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By:  Brown W 3rd1,2, Carballo-Diéguez A1,3, John RM4, Schnall R5.

• 1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA.
• 2Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, USA.
• 3Psychiatry, Mailman School of Public Health, Columbia University, New York, USA.
• 4School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA.
• 5School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA. rb897@columbia.edu. 

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Intervention Caused Changes in High Risk Sex Behaviors among Female Sex Workers from Vietnam in Yunnan, 2009-2013

OBJECTIVE:

To understand the prevalence of high risk sex behaviors and HIV infection status among the female sex workers (FSWs) from Vietnam in Yunnan province during a 5 year intervention project and provide evidence for the improvement of the behavior intervention among this population.

METHODS:

The survey was conducted annually among Vietnamese FSWs sampled in a county near China-Vietnam border to collect the information about their demographic characteristics, high risk sex behaviors and HIV test results through questionnaire and in-depth interview by bilingual outreach team. The behavior intervention included peer advise, training, lectures, interactive games, free condom distribution. The database was set up with Excel 2003 and the results were analyzed with SPSS 16.0.

RESULTS:

The condom use rates among the Vietnamese FSWs at commercial sex in last month were 1.5%, 36.0%, 67.7%, 86.5% and 90.3% (P<0.05) respectively; and the condom use rates at the latest sex were 89.5%,44.8%, 86.6%,92.5% and 99.0% respectively (P<0.05) . The HIV antibody positive rates were 7.5%, 3.6%, 5.9%, 4.0% and 3.1% respectively (P>0.05).

CONCLUSION:

The condom use rate of Vietnamese FSWs at commercial sex increased by more than 90% after the 5 year intervention project. However, the HIV-infection rate was still high. It is necessary to promote condom use among FSWs from Vietnam and their regular sex partners and strengthen the health education among clients.

Purchase full article at [Article in Chinese]:  http://goo.gl/ryYQDF

By:  Xue H1, Luo Z1, Zhu Z2, Yang X2, Yang L1, Yang J1, Duo L3, Liu W4.

• 1Kunming Yundi Behavior and Health Research Center, Kunming 650228, China.
• 2Hekou County Center for Didease Control and Prevention.
• 3The Second People's Hospital of Yunnan Province; Email: duolin@hotmail.com.
• 4School of Public Health, Kunming Medical University. 

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Missed Opportunities to Offer HIV Tests to High-Risk Groups During General Practitioners' STI-Related Consultations

BACKGROUND:

The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa.

OBJECTIVE:

To establish the risk factors for incident HIV infection among antenatal clients aged 18-49 years attending public antenatal clinics in rural Eastern Cape, South Africa.

DESIGN:

This was an unmatched case-control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant.

RESULTS:

The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol.

CONCLUSIONS:

Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.

Below:  HIV testing in STI-related consultations among the two common high-risk groups at the Dutch general practice, 2008–2013

Full article at:   http://goo.gl/jNlE8a

By:  Joore IK1, Reukers DF2, Donker GA3, van Sighem AI4, Op de Coul EL2, Prins JM5, Geerlings SE5, Barth RE6, van Bergen JE7, van den Broek IV2.

• 1Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands.
• 2Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
• 3Department of Sentinel Practices, NIVEL Primary Care Database, Utrecht, The Netherlands.
• 4Stichting HIV Monitoring, Amsterdam, The Netherlands On behalf of the ATHENA National Observational HIV Cohort, Amsterdam, The Netherlands.
• 5Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands.
• 6On behalf of the ATHENA National Observational HIV Cohort, Amsterdam, The Netherlands University Medical Center Utrecht, Utrecht, The Netherlands.
• 7Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands STI AIDS Netherlands (Soa Aids Nederland), Amsterdam, The Netherlands. 
• BMJ Open. 2016 Jan 21;6(1):e009194. doi: 10.1136/bmjopen-2015-009194.

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A 'Test & Treat' Prevention Strategy in Australia Requires Innovative HIV Testing Models

OBJECTIVES:

HIV diagnoses among men who have sex with men (MSM) in several high-income countries, including Australia, have increased substantially over recent years. Australia, in line with global prevention strategies, has emphasised a 'test and treat' HIV prevention strategy which relies on timely detection of HIV through frequent testing by those at risk. We examined trends in repeat testing among MSM defined as 'high-risk' according to Australian testing guidelines.

METHODS:

HIV test records from MSM attending high caseload clinics in Melbourne 2007-2013 and classified as high-risk were analysed. Binary outcomes of 'test within 3 months' and 'test within 6 months' were assigned to tests within individuals' panel of records. Negative binomial regressions assessed trends in overall HIV testing and returning within 3 and 6 months. Annualised proportions of return tests (2007-2012) were compared using two-sample z tests.

RESULTS:

Across 18 538 tests among 7117 high-risk MSM attending primary care clinics in Melbourne (2007-2013), the number of annual HIV tests increased (p<0.01). Between 2007 and 2012 annualised proportions of tests with a subsequent test within 3 and 6 months also increased (p<0.01); however, by 2012 only 36.4% and 15.1% of tests were followed by another test inside 6 and 3 months, respectively.

CONCLUSIONS:

Repeat testing among high-risk MSM in Australia remains unacceptably low, with recent modest increases in testing unlikely to deliver meaningful prevention impact. Removing known barriers to HIV testing is needed to maximise the potential benefit of test and treat-based HIV prevention.

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Sex Transm Infect. 2016 Jan 22. pii: sextrans-2015-052421. doi: 10.1136/sextrans-2015-052421.

By:  Wilkinson AL1, El-Hayek C2, Spelman T2, Fairley CK3, Leslie D4, McBryde ES5, Hellard M6, Stoové M1.

• 1Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
• 2Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia.
• 3Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia Central Clinical School, Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
• 4Victorian Infectious Disease Reference Laboratory, Melbourne, Victoria, Australia.
• 5Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
• 6Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia Department of Infectious Disease, Alfred Health, Alfred Hospital, Melbourne, Victoria, Australia. 

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Immune Activation in the Female Genital Tract: Expression Profiles of Soluble Proteins in Women at High Risk for HIV Infection

Soluble cervicovaginal biomarkers of inflammation, immune activation and risk of HIV acquisition are needed to reliably assess the safety of new biomedical prevention strategies including vaccines and microbicides. However, a fuller understanding of expression profiles in women at high risk for HIV infection is crucial to the effective use of these potential biomarkers in Phase 3 trial settings. 

We have measured 45 soluble proteins and peptides in cervicovaginal lavage samples from 100 HIV negative women at high risk for HIV infection. Women were followed over one menstrual cycle to investigate modulation by hormonal contraception, menstrual cycle phase, recent sexual exposure and intravaginal practices. 

Women using injectable DMPA had increased concentration of several soluble proteins of the innate and adaptive immune system, including IL-1α, IL-1β, IL-2, MIP-1β, IP-10, IL-8, TGF-β, HBD4, IgA, IgG1, and IgG2. Women using combined oral contraceptives had a similar signature. There were differences in concentrations among samples from post-ovulation compared to pre-ovulation, notably increased immunoglobulins. Increased prostate-specific antigen, indicative of recent sexual exposure, was correlated with increased IL-6, MCP-1, and SLPI, and decreased GM-CSF and HBD3. 

The identified signature profiles may prove critical in evaluating the potential safety and impact on risk of HIV acquisition of different biomedical intervention strategies.

Below:  Distribution of analyte concentrations in cervicovaginal lavage samples for 370 healthy visits

Full article at:   http://goo.gl/QLQAIc

By:  

Suzanna C. Francis, Kathy Baisley, Trong T. Ao, Saidi Kapiga, Richard J. Hayes

MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom

Suzanna C. Francis, Deborah Watson-Jones, Trong T. Ao, Kaballa Maganja, Aura Andreasen, Saidi Kapiga

Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania

Yanwen Hou, Gary R. Coulton

Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom

Janneke van de Wijgert

Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom

Carolina Herrera, Robin J. Shattock

Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom

Deborah Watson-Jones, Aura Andreasen

Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom

  

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Towards Preparedness for PrEP: PrEP Awareness & Acceptability among MSM at High Risk of HIV Transmission Who Use Sociosexual Media in Four Celtic Nations: Scotland, Wales, Northern Ireland & the Republic of Ireland: An Online Survey

OBJECTIVE:

To assess the awareness and acceptability of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) and use sociosexual media at high risk of HIV infection in four Celtic nations.

DESIGN:

Cross-sectional study.

METHODS:

Online self-complete survey of 386 HIV-negative/status unknown MSM who reported condomless anal intercourse (CAI) with ≥2 men in the last year, recruited from gay sociosexual media.

RESULTS:

One-third (34.5%, 132/386) of the participants were aware of PrEP but over half (58.5%, 226/356) reported that they would be willing to use PrEP if it were available to them. Only men who regularly tested for HIV every 6 months were more likely to be aware of PrEP. PrEP acceptability was only associated with reporting ≥5 CAI partners in the last year.

CONCLUSIONS:

Low levels of PrEP awareness were reported across these Celtic nations. Only one-third of high-risk MSM had heard of PrEP but over one-half would be willing to take a daily pill to prevent HIV infection. Sociodemographic factors, commercial gay scene proximity and social network use were unrelated to considering PrEP use. However, those reporting most CAI partners were more likely to consider PrEP use.

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By:  Frankis JS1, Young I2, Lorimer K1, Davis M3, Flowers P1.

• 1School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
• 2MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
• 3School of Social Sciences, Monash University, Melbourne, Victoria, Australia. 
• Sex Transm Infect. 2016 Jan 22. pii: sextrans-2015-052101. doi: 10.1136/sextrans-2015-052101.

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Experimentals, Bottoms, Risk-Reducers & Clubbers: Exploring Diverse Sexual Practice in an Internet-Active High-Risk Behaviour Group of Men Who Have Sex with Men in Sweden

This study aimed to identify sub-groups of men who have sex with men at high risk of HIV infection. Data from the Swedish MSM2013 survey were analysed with a focus on respondents (n = 714) who reported having had unprotected anal intercourse with male casual partner(s) in the past 12 months. 

Weighted Latent Class Analysis with covariates and distal outcomes was conducted to identify sub-groups of men sharing the same sexual practice characteristics. Four latent classes emerged: experimentals, bottoms, risk-reducers and clubbers. 

Experimentals appeared to differ most from the other classes. They had extensive experience of barebacking, the use of poppers and fisting. Higher number of casual male sex partners and reporting having HIV were predictors for belonging to experimentals. 

No evidence for an association between self-rated HIV prevention knowledge and taking less part in risky practices was found. Hence, knowledge-intensive interventions may not be the best fit for reducing HIV transmission. 

This diversity of men based on similar sexual practice patterns should be taken into account when designing future HIV prevention interventions.

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By:  Persson KI1,2, Tikkanen R3, Bergström J4, Berglund T5, Thorson A1, Forsberg BC1.

• 1 Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
• 2 Department of Knowledge Development, Unit for Health and Sexuality , Public Health Agency of Sweden , Solna , Sweden.
• 3 Department of Social Work , University of Gothenburg , Göteborg , Sweden.
• 4 Department of Monitoring and Evaluation, Unit for Statistics and Surveillance , Public Health Agency of Sweden , Solna , Sweden.
• 5 Department of Monitoring and Evaluation, Unit for Epidemiology and Health Economics , Public Health Agency of Sweden , Solna , Sweden.

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Low Prevalence of Hepatitis C Co-Infection in Recently HIV-Infected Minority Men Who Have Sex with Men in Los Angeles

Background

Geographic and sociodemographic characterization of hepatitis C virus (HCV) transmission amongst men who have sex with men (MSM) has been limited. Our aim was to characterize HCV prevalence, risk factors for HCV co-infection, and patterns of HIV and HCV co-transmission and transmitted drug resistance mutations (DRMs) in newly HIV-diagnosed Los Angeles MSM.

Methods

Viral RNA was extracted from stored plasma samples from a Los Angeles cohort of newly diagnosed HIV-infected MSM with well-characterized substance use and sexual behavioral characteristics via computer-assisted self-interviewing surveys. Samples were screened for HCV by qPCR. HCV E1, E2, core, NS3 protease and NS5B polymerase and HIV-1 protease and reverse transcriptase regions were amplified and sequenced. Phylogenetic analysis was used to determine relatedness of HCV and HIV-1 isolates within the cohort and viral sequences were examined for DRMs.

Results

Of 185 newly HIV-diagnosed MSM, the majority (65 %) were of minority race/ethnicity and recently infected (57.8 %), with median age of 28.3 years. A minority (6.6 %) reported injection drug use (IDU), whereas 96 (52.8 %) reported recent substance use, primarily cannabis or stimulant use. High risk sexual behaviors included 132 (74.6 %) with unprotected receptive anal intercourse, 60 (33.3 %) with group sex, and 10 (5.7 %) with fisting. Forty-five (24.3 %) had acute gonorrhea or chlamydia infection. Only 3 (1.6 %) subjects had detectable HCV RNA. Amongst these subjects, HIV and HCV isolates were unrelated by phylogenetic analysis and none possessed clinically relevant NS3 or NS5B HCV DRMs.

Conclusions

Prevalence of HCV co-infection was low and there was no evidence of HIV-HCV co-transmission in this cohort of relatively young, predominantly minority, newly HIV-diagnosed MSM, most with early HIV infection, with high rates of high risk sexual behaviors, STI, and non-IDU. The low HCV prevalence in a group with high-risk behaviors for non-IDU HCV acquisition suggests an opportune time for targeted HCV prevention measures.

Below:  a Phylogenetic analysis of Hepatitis C virus (HCV) isolates. Consensus sequences of an 857 nucleotide (nt) fragment of the HCV NS3 protease from the three HCV isolates from the cohort were aligned with the Los Alamos National Laboratory HCV Database consensus sequences for HCV genotype (gt) 1a and 3a, along with additional reference sequences from subjects living in Los Angeles, to make a neighbor-joining tree. The consensus sequences for gt 1a and 3a are labeled as “CON” with the corresponding genotype. The Los Angeles HCV sequences are labeled as “LA” with the corresponding subject number. The HCV-positive subject samples are labeled A, B, and C. The tree is rooted with the HCV genotype 1a consensus sequence and the genetic distance scale bar is located at the center of the figure. b Phylogenetic analysis of HIV-1 pol. A 1302 nt fragment of pol covering the HIV-1 protease and reverse transcriptase (HXB2 reference location nt 2254–3555) from N = 148 isolates from the cohort was aligned with the Clade B consensus and used to build a neighbor-joining tree. Each sequence is labeled with a unique subject identifier, and the HCV-positive subjects are labeled A, B, and C. The tree is rooted with the Clade B consensus sequence. The genetic distance scale bar is located at the lower left of the figure

Full article at:  http://goo.gl/WjeAsD

By: Kara W. Chew^1*, Martha L. Blum²³, Marjan Javanbakht⁴, Laurel E. Clare², Lorelei D. Bornfleth², Robert Bolan⁵, Debika Bhattacharya² and Pamina M. Gorbach⁴⁶

¹Department of Medicine, David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd, Suite 100, Los Angeles 90025, CA, USA

²Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 37-121 CHS, Los Angeles 90095, CA, USA

³Present Address: Community Hospital of the Monterey Peninsula, Infectious Diseases Division, 23625 Holman Highway, Monterey 93942, CA, USA

⁴Department of Epidemiology, UCLA Fielding School of Public Health, 71-235E CHS, Los Angeles 90095, CA, USA

⁵Los Angeles LGBT Center, 1625 N. Schrader Blvd, Los Angeles 90028, CA, USA

⁶Department of Medicine, David Geffen School of Medicine at UCLA, 41-295 CHS, Los Angeles 90095, CA, USA

 

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