Key Populations Research Articles

Abstract 2536: In vivo label-free imaging reveals distinct CD8 T cell metabolic changes during effective radio-immunotherapy in cold murine melanoma versus hot colon carcinoma

Abstract In vivo multiphoton autofluorescence microscopy provides label-free, single-cell imaging of metabolic changes. These metabolic changes are quantified via the metabolic coenzymes NAD(P)H and FAD which are autofluorescent molecules endogenous to all cells. Metabolic reprogramming is a hallmark of cancer. Immune cells also change their metabolism during cancer progression and this metabolic switch correlates to immune cell phenotype and function. Here, we study metabolic changes during administration of a potent radio-immunotherapy regimen in murine melanoma and colon carcinoma. This therapy includes external beam radiation, hu14.18-IL2 immunocytokine (anti-GD2 mAb fused to IL2) or free IL2, and anti-CTLA-4, leading to in situ vaccination and cure of established murine tumors. We created a transgenic mCherry-labeled T cell mouse to study the critical T cell response. We implanted syngeneic B78 (GD2+) melanoma or MC38 (GD2-) colon carcinoma cells into the flanks of mCherry-labeled CD8 T cell reporter mice to induce tumors. Under anesthesia, skin flap surgery was performed, and tumors were imaged at multiple timepoints during therapy. Multiphoton imaging was performed to collect NAD(P)H, FAD, and mCherry signal. Fluorescence lifetime images were collected using time correlated single photon counting electronics. Tissues were also harvested and analyzed via flow cytometry, single-cell RNA sequencing, and multiplex immunofluorescence to corroborate imaging findings and characterize the immune infiltrate. Our in vivo label-free imaging revealed that CD8 T cells from treated versus control tumors exhibit different metabolic phenotypes including changes in NAD(P)H and FAD protein binding and redox balance across these two solid tumors. In cold B78 melanoma tumors, in vivo metabolic imaging revealed that CD8 T cells are activated early but maintain an oxidative metabolic state consistent with exhaustion or a memory phenotype. In hot MC38 colon carcinoma, in vivo metabolic imaging revealed that CD8 T cells are activated early and then quickly transition to a glycolytic state that fuels their cytotoxic function. scRNAseq confirmed the metabolic changes we observed within our B78 model and provided additional insight into CD8 T and tumor cell changes during therapy. Flow cytometry illustrated significant changes in the immune infiltrates of both tumor types over time and treatment. These results show that label-free in vivo imaging enables single-cell quantification of metabolic changes during therapy - across multiple solid tumors. Combined with other traditional assays, we can elucidate key immune cell populations and the crucial timepoints during therapy where changes are occurring. This imaging platform may be leveraged to help develop new immunotherapy combinations and study other cancer types where cures have not been realized. Citation Format: Alexa R. Heaton, Anna Hoefges, Nathaniel J. Burkard, Arika S. Feils, Noah W. Tsarovsky, Garrett M. Lublin, Alina A. Hampton, Samantha K. Burkard, Aurora D'Amato, Mildred A. Felder, Anqi Gao, Huy Q. Dinh, Amy K. Erbe-Gurel, Alexander L. Rakhmilevich, Paul M. Sondel, Melissa C. Skala. In vivo label-free imaging reveals distinct CD8 T cell metabolic changes during effective radio-immunotherapy in cold murine melanoma versus hot colon carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2536.

Abstract 5775: Direct prediction of tumor cellular phenotypic composition from multi-parametric MRI in neuroblastoma murine models

Abstract Introduction. The clinical prognosis for children with high-risk neuroblastoma, a cancer of the sympathetic nervous system, remains poor. Non-invasive imaging biomarkers of treatment response are essential for precision medicine. Here, we evaluated a supervised machine learning model trained on co-registered MRI-histology maps to predict density maps of key neuroblastoma cell populations (undifferentiated, differentiating, apoptotic) directly from multi-parametric mpMRI in murine models of neuroblastoma. Methods. Tumour MRI parametric maps for spin-lattice relaxation time (T1, sensitive to undifferentiated cells), transverse relaxation rate (R2*, sensitive to red blood cells), and apparent diffusion coefficient (ADC, sensitive to cell density) were co-registered with digitized H&E slides (20x, 0.46μm resolution) from 11 Th-MYCN mice. Automated cell segmentation/classification into 6 categories allowed for the generation of density maps at MRI resolution. Classical ML models were trained to simultaneously predict 5 histological labels using a supervised regression approach on 9095 MRI voxels (n=4 mice), each represented by 5 normalized input features: R2*, T1, and ADC, along with median values of the pixels’ square neighbourhood (2px wide). Model performance was evaluated using 10-fold cross-validation and the negative mean-squared-error metric before application to remaining tumours. Results/Discussion. The random forest classifier achieved the lowest mean-squared-error and smallest variation during the 10-fold cross-validation and was selected as the best model. Extra trees, XGBoost and light-gradient-boosting machines also performed well. The similarity of the entire MRI-generated maps (for all 11 mice in the dataset) was compared to the histology maps using the mean squared error (MSE) and structural similarity index (SSIM) metrics. The model achieved an average MSE of 0.0037, 0.0089, 0.0016, 0.0014, and 0.0008 for cellular density, undifferentiated neuroblasts, apoptotic neuroblasts, differentiating neuroblasts and red blood cells density respectively. The SSIM indexes were 0.90, 0.88, 0.90, 0.88 and 0.92 for cellular density, undifferentiated neuroblasts’, apoptotic neuroblasts’, differentiating neuroblasts’ and red blood cells density respectively. Conclusion. This proof-of-concept study demonstrates that mpMRI can characterize neuroblastoma phenotypes and generate quantitative data previously accessible only through digital histology analysis, including cellular density maps. Validation in more diverse datasets could enable “non-invasive” or “virtual” biopsies, capturing entire tumour volume to enhance diagnostic precision, guide surgical planning, and refine response assessment. Citation Format: Konstantinos Zormpas-Petridis, Matthew Blackledge, Louis Chesler, Yinyin Yuan, Simon P. Robinson, Yann Jamin. Direct prediction of tumor cellular phenotypic composition from multi-parametric MRI in neuroblastoma murine models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5775.

Abstract 4787: BGB-A3055, an afucosylated anti-CCR8 antibody, preferentially depletes intratumoral regulatory T cells and inhibits tumor growth in preclinical models

Abstract Background: Regulatory T cells (Tregs) is a well-known key immune suppressive cell population enriched in tumor microenvironment (TME) that inhibits the anti-tumor immunity. Accordingly, specific depletion of Tregs in TME is considered as an attractive strategy to enhance the efficacy of immunotherapy such as PD-(L)1 treatment. C-C motif chemokine receptor 8 (CCR8), a G-protein coupled receptor, is predominately upregulated in intratumoral Tregs while CCR8 level in peripheral Tregs is relatively low. Therefore, CCR8 is widely explored as a promising therapeutic target for intratumoral Treg depletion. BGB-A3055 is a novel humanized afucosylated immunoglobulin G (IgG) 1 monoclonal antibody against human CCR8 (hCCR8). Here, we present the in vitro and in vivo data of BGB-A3055 in preclinical models. Methods: The cellular binding of BGB-A3055 was determined by fluorescence-activated cell sorting (FACS) on 293T cells that overexpress hCCR8 or primary human Treg cells. The blocking activity of BGB-A3055 on CCL1-CCR8 induced signaling was determined by Path Hunter eXpress HuCCR8 CHO-K1ß-Arrestin GPCR Assay kit. Antibody-dependent cellular cytotoxicity (ADCC) effect was evaluated on primary Treg cells. In vivo intratumoral Treg depletion and anti-tumor efficacy was assessed in GL261 and MC38 syngeneic models using hCCR8 knock-in mice. Results: BGB-A3055 exhibited a potent cellular binding to hCCR8 overexpressing cells and primary human Treg cells. BGB-A3055 can also efficiently block CCL1-CCR8 signaling and induce potent ADCC effect against CCR8 expressing primary Treg cells. Furthermore, in preclinical in vivo models, BGB-A3055 preferentially depleted Tregs in TME, demonstrated potent single agent and synergistic anti-tumor effect in combination with PD-1 antibody. Conclusions: BGB-3055 is a novel fully humanized afucosylated antibody that has high binding affinity to hCCR8, strong CCL1-CCR8 blocking capacity and potent ADCC effect. BGB-A3055 demonstrated strong anti-tumor activity as single agent or in combination with PD-1 antibody. A Ph1 study evaluating BGB-A3055 alone and in combination with Tislelizumab in participants with solid tumor is ongoing (NCT05935098). Citation Format: Xitao Wang, Yannan Xu, Ming Fang, Ming Jiang, Haolan Li, Mingchao Kang, Xiaomin Song. BGB-A3055, an afucosylated anti-CCR8 antibody, preferentially depletes intratumoral regulatory T cells and inhibits tumor growth in preclinical models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4787.

Unplanned shunt readmission: what does it really look like?

Readmission after an operation has garnered considerable attention within the neurosurgical literature. In this study, the authors sought to analyze the reasons why children are readmitted after shunt surgery and to identify key population characteristics and potential drivers. The authors' single-institution shunt surgery administrative database was used to identify procedures performed from January 1, 2018, to December 31, 2021. Only de novo or revision cranial shunt operations were included. Each surgery within the database represents an index case, and each patient was followed for a 90-day period. The authors categorized an unplanned readmission after shunt surgery as falling into one of 4 groups: 1) definitely unrelated to the index surgery; 2) possibly related but ultimately deemed unrelated; 3) directly related but no return to the operating room; and 4) directly related and requiring repeat surgery. Groups 3 and 4 were combined for statistical purposes. A total of 715 shunt operations were performed with 148 (20.7%) unplanned readmissions within 90 days in 139 patients. The median age was 3.2 years with 58%, 53%, and 58% being male, Caucasian, and having some form of public health insurance, respectively. The majority of African-American children had government insurance (80%) compared to Caucasian (41%) and Hispanic/other (55%) children (p < 0.001). The proportion of new versus revision surgical procedures was 45% versus 55%. Surgeon C did the most operations (n = 52 [37%]). The median number of days to readmission and length of readmission were 26.5 (IQR 9.5-47.0) days and 3.0 (IQR confidence interval 1.0-5.0) days, respectively. Multinomial analysis found that public insurance, revision surgery, and prior admission to the neonatal intensive care unit (NICU) were associated with definitely unrelated readmissions. Private insurance, no prior NICU admission, and an individual surgeon were associated with directly related readmissions. Survival analyses showed no differences in time to readmission among all patients and among only those who had prior NICU admission. The 90-day readmission rate after index shunt surgery was 21%. Drivers of readmission-including socioeconomic status and hydrocephalus severity-were a function of the type of readmission.

Impact of Global Climate Change in the Distribution and the Range Dynamics of Endemic Orchid Habenaria suaveolens Dalzell in Northern Western Ghats of India

Climate change and human activity have significantly contributed to the decline of biodiversity worldwide. Orchids, in particular, are sensitive to disturbances and may respond rapidly to the impacts of climate change than many other plant species. Due to their complex biology and the pressures placed on their habitats, orchids are considered a highly vulnerable group of plants. The lateritic plateaus of northern Western Ghats support a variety of life forms and are quite fragile in nature. The slightest pressure on the habitat affects all the flora and fauna thriving in these microhabitats. Habenaria suaveolens is one of the endemic orchids that can be found growing in these habitats only. In the present study, we examine the effect of climate change on the distribution of threatened H. suaveolens utilizing ecological niche modeling for present and future climatic scenarios (SSP 2-4.5 &amp; SSP 5-8.5) to identify key environmental determinants and population parameters. A total of 25 occurrence records were used to study the SDM model using the MIROC6 global climatic model. The result revealed that only 19.50% (7921 km2) is highly suitable for the species in the current period. The highly suitable area reduces from 57.99% (SSP245) to 74.12% (SSP585) in 2090. Moreover, the total suitable habitat gets confined to less than 1000 km2 in future climatic conditions. The major environmental variable that predicts the distribution of the species are Bio17 (Precipitation of driest quarter), Bio1 (Annual Mean Temperature), Bio2 (Mean Diurnal Range), and aspect. Recently, the species is becoming less in population due to man-made activities like quarrying, tourism, grazing, trampling, etc., in and around the lateritic plateaus, leading to disturbances in the habitat. This study has provided a baseline data about the contiguous distribution of the species and its potentially suitable habitats in the future for conservationists to take precautionary steps for the protection of the species. Hence, a strategic plan can be compiled based on this to conserve these highly habitat specific plants.

Patient-centered evaluation of integrated care and health equity: evidence from county medical alliances in Henan province

BackgroundIntegrated care services have been initiated in China for several years, yet there remains a dearth of substantial evidence and research elucidating the service’s efficacy, particularly in underdeveloped areas. This study aims to address this gap by evaluating the effectiveness of integrated care from the patients’ perspective, thereby offering practical strategies to improve service effectiveness and promote health equity within county medical alliances.MethodsThe Patient Perceptions of Integrated Care (PPIC) and European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5 L) scales were employed to gather information on patients’ perceptions of integrated care and their self-rated health status. A total of 1093 respondents from two pilot areas were selected for data collection. T-tests and one-way analysis of variance (ANOVA) were recruited, additionally, the study utilized multiple linear regression models to examine the specific impact of various factors on the effectiveness of integrated care services.ResultsThe average score for the effectiveness of integrated healthcare services from the patients’ perspective was 67.72 (SD = 14.443, n = 1093). Statistical analysis revealed that as the respondents’ age increased and their self-rated health declined, the PPIC scores showed an upward trend. Regression analysis found that factors such as age, education level, income, health status, and level of healthcare intervention significantly influenced PPIC scores. Overall, there is a trend where respondents with higher health needs tend to have higher perceptions of the service, while those with relatively higher socioeconomic status are more likely to provide lower ratings. Additionally, increasing the frequency and duration of healthcare interventions can improve respondents’ evaluations of the services.ConclusionsThis study analyzes the effectiveness of integrated services in China’s county-level medical alliance from the patients’ perspective. It finds progress in resource integration and efficiency but identifies limitations in implementation, particularly in balancing equity. Socio-economic factors continue to affect the fairness of service utilization and patient satisfaction. Constraints in finance, human capital, and technology hinder the provision of more targeted services for vulnerable groups. To promote health equity, future services need to focus more on key populations and provide more targeted services, accelerate the integration of information technology, and expand service coverage to address the diverse needs of marginalized communities.

Willingness of female sex workers to use HIV self-testing in Burkina Faso: analysis of cross-sectional respondent-driven sampling data

BackgroundHIV self-testing (HIVST) is an approach that allows individuals to test for HIV and obtain results in their homes or other private settings. It is recommended by the World Health Organization (WHO), particularly for key populations, to help achieve the first 95. The objective of this study was to evaluate the willingness to use HIVST among female sex workers (FSWs) in Burkina Faso.MethodsWe performed a biobehavioral cross-sectional study conducted in five regions in Burkina Faso. FSWs were recruited using the respondent-driven sampling (RDS) method. To evaluate FSW’s willingness to use HIVST, each participant was invited to answer a “Yes” or “No” question: “If you were offered an HIV self-test, would you use it?.” The determinants of willingness to use HIVST were identified using Poisson-modified generalized estimating equation models.ResultsA total of 1,338 FSWs were included in this study. The mean age was 28.1 years (standard deviation: 7.71 years), and 47.9% of FSWs had attended at least secondary school. Nearly 21.1% had good knowledge of HIV transmission modes. One-third (28.8%) of FSWs reported not using a condom during their last sexual intercourse with a non-paying partner. Among the study participants, 89.5% (95% CI: 87.0; 91.6) were willing to use HIVST. The main determinants of FSW’s willingness to use HIVST were being married (adjusted prevalence ratio (aPR): 1.10 (95%CI: 1.01; 1.20) p = 0.034), having first sex at the age greater than 18 years (aPR: 1.14 (95%CI: 1.02; 1.29) p = 0.024), being member of an association (aPR: 1.10 (95%CI: 1.02; 1.18) p = 0.014), and being no current alcohol consumer (aPR: 1.06 (95%CI 1.01; 1.12) p = 0.026).ConclusionThis study revealed a good willingness to use HIVST among FSWs. This is a promising means to increase HIV testing coverage and knowledge of HIV status among FSWs and would then strengthen HIV prevention and care services.

Modeling the potential impact of viral load monitoring on vertical transmission of HIV in Kenya.

Viral load (VL) monitoring among pregnant and breastfeeding women (PBFW) can reduce vertical transmission (VT) by identifying PBFW with unsuppressed VL and promoting re-suppression. However, the impact of varying degrees of adherence to VL monitoring guidelines on the prevention of vertical transmission (PVT) is unknown. We developed a microsimulation model of HIV progression and PVT care for PBFW living with recently acquired HIV in Kenya. We used this model to evaluate VL monitoring in two key maternal populations: 1) newly positive (NP) pregnant women who initiate ART during antenatal care and 2) known positive (KP) women who are diagnosed and initiate ART prior to conception. For each population, we simulated three levels of adherence to Kenyan VL monitoring guidelines during pregnancy and 18 months of breastfeeding: 1) No testing (NT); 2) 50% adherence to indicated VL tests (VL-50%); 3) 100% adherence (VL-100%). We evaluated VL monitoring in each population by comparing live births, maternal deaths, and VT under VL-50% and VL-100% to NT. Under NT, infants acquired HIV at a rate of 619 vs. 505 per 10,000 live births in the NP vs. KP populations, respectively. VL monitoring reduced VT by 1.6-2.7% in NP women vs. 9.1%-14.3% in KP women, and it reduced maternal deaths by 1.2-1.8% vs. 1.6-2.3%. Maternal VL monitoring in Kenya has considerably greater potential for achieving relative reductions in VT among KP women than among NP women. In KP women, even imperfect adherence to guidelines may achieve substantial relative reductions in VT.

Predictors of unsuppressed viral load among men who have sex with men living with HIV in South Africa.

South Africa has the largest HIV epidemic of the world, but predictors of unsuppressed viral load among MSM are scarce. We did a cross-sectional study to assess socio-demographic characteristics, year of antiretroviral therapy (ART) initiation, and viral load data from 1385 MSM registered in five key population clinics in five districts in South Africa in 2023 and 2024. We used logistic regression to assess predictors of unsuppressed viral load (≥200 copies/ml). We then conducted a case--control study involving 57 cases (viral load≥200 copies/ml) and 57 matched controls (viral load<200 copies/ml; matched on age, ART start date, clinic, and outreach vs. facility attendance) drawn from the cross-sectional study to explore additional differences between groups. In the cross-sectional study, predictors for unsuppressed viral load included on ART for 1-2 years [odds ratio (OR) 3.53; 1.77-7.69] or 3-5 years (OR 2.33; 1.18-5.04) vs. more than 5 years, being an outreach vs. facility-based client (OR: 2.64; 1.79-3.94), and enrolled at Johannesburg (OR: 3.53; 2.25-5.64), or Durban (OR: 0.36; 0.84-0.70), vs. Pretoria. The case-control study identified predictors for unsuppressed viral load, which included missing more than four ART dosages per month (OR: 5.55; 1.19-41,03), having moderate to severe anxiety (OR: 3.90; 1.34-12,52), hazardous alcohol use (OR: 2.70; 1.14-6.81), and Christian vs. no religion (OR: 3.89; 1.34-12.29). We identified regional differences and key predictors of unsuppressed viral load among MSM living with HIV in South Africa. Screening for risk factors for unsuppressed viral load at ART continuation may inform where adherence support and other health services are needed.

Bridging the gap: Enhancing HIV care pathways for young key populations in Chad.

Young key populations-sex workers and men who have sex with men (MSM)-face significant barriers to accessing HIV care in Chad due to stigma, discrimination, and socio-economic challenges. Although legal protections exist, gaps in enforcement continue to undermine care efforts. This study explored care pathways for young key populations in Chad to identify their specific challenges and propose targeted strategies to strengthen the HIV care continuum. Conducted in April 2025 in N'Djamena Chad, the qualitative study involved ten in-depth interviews with sex workers and MSM, aged 15-24 years, recruited through snowball sampling. Framework analysis revealed key themes across the HIV care continuum, specifically in testing, linkage to care, and retention in antiretroviral therapy (ART). Three major themes and 13 sub-themes emerged: (1) HIV testing and diagnosis, (2) linkage to care and ART initiation, and (3) retention in care and adherence to ART. Stigma-both externalized and internalized-was a significant barrier at every stage. Fear of disclosure, discrimination in healthcare settings, and financial constraints further hindered care engagement. Conversely, community-based awareness programs in faith-based institutions, and peer support networks were crucial in facilitating access to services. Addressing these challenges requires a comprehensive, multi-level approach that includes stigma-reduction training for healthcare workers, enforcement of anti-discrimination laws, targeted financial aid mechanisms, and integrated psychosocial counseling. Strengthening community-based interventions and peer-led outreach can further enhance engagement and retention, thereby improving health outcomes and reducing new infections among young key populations in Chad while aligning with global HIV targets.

HIV home testing in Poland – an underappreciated approach despite huge potential : an implementation study

ABSTRACT HIV testing faces barriers worldwide and little progress in systematically implementing new approaches has been made so far, especially in Europe. Testing sites (VCTs) and clubs have been the only large-scale venues in Poland to offer anonymous tests for key populations. They are located exclusively in large cities leaving large areas without any real access. We wanted to see if home tests might fill the gaps. Between November 2022 and February 2023 free Simplitude ByMe HIV home-tests were sent out to parcel lockers with orders made opportunistically by patients on the TyToTu.pl webpage. The clients were asked to fill out a short epidemiological online questionnaire (age, gender, sexual orientation, nationality, residence: provincial city/smaller city/village, previous testing) before the order and were asked to give e-feedback afterwards. Statistical analysis was performed for 887 returned questionnaires. 1473 home tests were dispensed. 76.6% of recipients reported heterosexual, 11.7% homosexual and 10.6% bisexual contacts. 57% came were from large provincial cities (p < 0.0001) and for 80% of them it was their first test ever, especially if they reported heterosexual contacts (p < 0.0001) or were older (OR 0.9736; 95% CI: 0.9507, 0.9971). If heterosexual clients had tested before then in the more distant past by 745 days (95% CI: 411-1096). Five tests were reported back as positive (all among heterosexual clients) translating to 0.34% prevalence, 91 negative (6.17% return rate) and 9 invalid (0.61%). Home testing has been underutilized in Poland despite huge interest. Barriers still exist especially for clients reporting heterosexual contacts. HIV home tests should be freely available, especially among older and heterosexual clients as well as immigrants. We urge local and national bodies to fund such testing as it may help include more people in treatment earlier.

Prevalence of HIV/syphilis co-infection among men who have sex with men in China: a systematic review and meta-analysis

BackgroundMen who have sex with men (MSM) are key populations for HIV and syphilis infection, and co-infection with both diseases significantly increases health risks. However, the co-infection of HIV/syphilis among this population in China has not been systematically evaluated. We aimed to conduct a meta-analysis to ascertain the prevalence of HIV/syphilis co-infection among MSM in China.MethodsWe conducted a systematic literature search involving PubMed, Web of Science, CNKI and Wanfang to identify publications reporting HIV/syphilis co-infection among MSM in China. Our search encompassed articles available from the establishment of these databases up to December 31, 2022. Additionally, we examined the references of retrieved articles to identify additional relevant records. The random-effects model fitting Freeman-Tukey double arcsine transformation was employed to estimate the prevalence of HIV/syphilis co-infection and its 95% confidence interval (CI). Heterogeneity was assessed utilizing the I2 statistics and Cochran’s Q test. To explore the potential sources of heterogeneity, we conducted subgroup and meta-regression analyses.ResultsA total of 46 studies were included, with a total sample size of 50,187 MSM, including1,459 co-infected individuals. The pooled prevalence of HIV/syphilis co-infection among MSM in China was 2.7% (95% CI: 2.2-3.4%), with significant heterogeneity (I2 = 90.5%, Q = 474.65, P < 0.01). Across China’s four regions, the Central region exhibited the highest co-infection prevalence (4.5%, 95% CI: 0.0-17.7%), followed by the Eastern region (3.1%, 95% CI: 2.4-3.9%) and Western region (2.4%, 95% CI: 1.8-3.1%). In contrast, the Northeast region reported the lowest co-infection prevalence (0.6%, 95% CI: 0.3-1.0%). Studies utilizing multiple sampling methods (4.7%, 95% CI: 3.6-6.0%) and recruiting MSM from sexually transmitted disease (STD) clinics (9.1%, 95% CI: 3.2-17.6%) showed higher prevalence of co-infection. Furthermore, the co-infection prevalence among MSM in China demonstrated a progressive increase with age.ConclusionThe prevalence of HIV/syphilis co-infection among MSM in China was elevated, with certain regional disparities. Notably, the STD clinics attendees and older MSM were more likely to be co-infected. Urgent and targeted measures are needed to enhance interventions for these vulnerable populations to control HIV/syphilis co-infection.

Prevalence of stigma in people living with HIV, its effect on treatment adherence and psychiatric comorbid disease

ABSTRACT HIV has become a rising healthcare issue in Pakistan in recent years with new outbreaks and spillover to traditionally low-risk groups. We studied the stigma around HIV, its relation to psychiatric comorbidities such as depression and anxiety, and adherence to treatment in people living with HIV (PLHIV). A hospital-based cross-sectional study was conducted over six months at a tertiary care hospital in Karachi, Pakistan. Self-administered digital questionnaires containing basic demographics, PHQ9, GAD7, HSS12, and GMAS scales were used to assess depression, anxiety, stigma, and medical adherence respectively. A total of 66 participants were included, with a mean age of 39.97 ± 14.32 years. The mean stigma score was 25.67 ± 9.46, with 9 participants (13.85%) experiencing severe stigma. Among the different stigma components, disclosure concerns had the highest mean score (7.91 ± 2.91). Most participants had no depression and a no-to-low risk for anxiety. No relationship was found between medical adherence and either stigma scores or psychiatric comorbidities. Patients identified as from key populations (n = 35) had significantly increased risk of depression (p = 0.0493), anxiety (p = 0.023), and HIV-associated stigma (p = 0.0166). Stigma continues to affect mental well-being and hinders early diagnosis and treatment of PLHIV. A comprehensive approach, cannot be complete without addressing this stigma and its effect on disease burden, diagnosis, and treatment.

Higher prevalence of pulmonary tuberculosis revealed by Xpert MTB/RIF ultra among drug users in Kinshasa, Democratic Republic of Congo

IntroductionThe Democratic Republic of Congo (DRC) is one of the eight countries with the highest burden of tuberculosis (TB) in the world. The public health system is inadequate and the screening for TB in the key and vulnerable population (KVP), including drug users (DU) is not currently done. The present study aimed to determine the prevalence of pulmonary TB among DU in Kinshasa by comparing molecular tests with microscopic techniques.MethodsA cross-sectional study covering 22 townships (out of 24) of Kinshasa was conducted from October to December 2023. Sputum samples were collected from DUs aged ≥ 18 years, clinically suspected of TB, and attending drug consumption sites. The samples were analyzed by both the Acid-fast bacilli (AFB)-Nelseen hot staining and Xpert MTB/RIF Ultra for TB and rifampin-resistance diagnosis.ResultsFor 399 DUs included in the study, the age range was from 18 to 77 years old, with a median of 31 (IQR: 25–39). Among these DUs, 359 (89%; 95% CI: 86.64– 92.55%) were male. TB prevalence was 3.5% (95% CI: 1.9-5.8%) when the AFB-Nelseen hot staining was used for diagnosis. However, the prevalence was significantly higher at 13.8% (95% CI: 10.6-17.6%) with the Xpert MTB/RIF test (p = 0.000). Xpert MTB-RIF Ultra contributed with an added value of 82% (95% IC: 79.25– 86.47%) to the diagnosis of TB in DUs. The KAPPA test showed a low concordance at 25%. Alcohol, diazepam and tobacco consumption have been identified as practical risks associated with the onset of pulmonary TB (p < 0.05).ConclusionDUs are a population at risk of TB that should not be neglected among all KVPs in Kinshasa. In this specific population, the determination of TB prevalence was significantly improved with the use of Xpert MTB/RIF Ultra compared to hot AFB-Neelsen staining. Among the DU included in the present study, those who habitually consumed alcohol in its different forms, diazepam for non-medical purposes, and tobacco, were significantly more infected than the others. DUs should be considered for systemic screening for pulmonary TB alongside other key populations such as people living with HIV and Xpert should be maintained as a first-line test instead of microscopy. Further studies also including asymptomatic participants are needed to assess the burden due to pulmonary TB in DUs as well as in their living environment.

Infectious disease-specific health literacy and its influencing factors: Research results based on a cross-sectional design study carried out in Shandong Province's rural areas.

Rural residents face a higher risk of infectious diseases, and infectious disease-specific health literacy (IDSHL) is a crucial means of managing these risks. This study intended to survey the levels of IDSHL among rural residents in Shandong Province, China, and explore the influencing factors of IDSHL. In 2022, a cross-sectional design investigation was carried out in Shandong Province of China, involving 2283 participants recruited through a multistage sampling approach in rural regions. A cognitive questionnaire was used to assess participants' levels of IDSHL. Pearson χ2 test was performed to compare the differences in the distribution of categorical variables between the adequate and inadequate IDSHL groups. Multicollinearity diagnosis analysis was utilized to evaluate multicollinearity. Multiple logistic regression was used to detect the possible influencing factors of IDSHL. Among the participants, 31.80% had adequate IDSHL. Multiple logistic regression demonstrated that education (odds ratio (OR)junior high school = .71, 95% confidence interval (CI) of OR: 0.51-0.99, P = .04; ORuniversity or above = 2.62, 95% CI of OR: 1.67-4.11, P < .01), occupation (ORbusiness = 2.19, 95% CI of OR: 1.34-3.57, P < .01; ORothers = 1.46, 95% CI of OR: 1.02-2.10, P = .04), family income (OR1-3 10,000 RMB = 2.83, 95% CI of OR: 1.98-4.05, P < .01; OR3-6 10,000 RMB = 1.75, 95% CI of OR: 1.21-2.53, P < .01), "whether the participant used a smartphone in daily life" (OR = 2.02, 95% CI of OR: 1.32-3.09, P < .01) and "whether knowledge of infectious disease prevention and control could be acquired" (OR = 11.77, 95% CI of OR: 6.44-21.54, P < .01) were associated with adequate IDSHL. The rural residents' level of adequate IDSHL in China's Shandong Province, was unsatisfactory. Special health education is needed to be implemented to enhance rural residents' IDSHL and should target key populations with low levels of IDSHL.

Use of self-test to increase HIV testing among men who have sex with men and transgender women-overview of systematic reviews

ABSTRACT Human Immunodeficiency Virus (HIV) infection is stigmatizing, especially for key populations, who are disproportionately affected by Sexually Transmitted Infections (STIs). The stigma and discrimination suffered by these groups are among the main obstacles to HIV prevention, treatment and care, which is why the World Health Organization recommends the use of self-tests to increase HIV testing and achieve the 95-95-95 target by 2030 proposed by the United Nations. We conducted an overview of systematic reviews and meta-analyses, searching for free and indexed terms in nine databases, and using the acronym PICO as an inclusion criterion. Two independent reviewers performed the selection in two stages, and disagreements were resolved by consensus with a third reviewer. Quality analysis was performed using the Assessing the Methodological Quality of Systematic Reviews, version 2 (AMSTAR 2) tool. Four studies were included, one evaluating men who have sex with men (MSM), one evaluating MSM and another key population, and two evaluating MSM and transgender women (TGW). HIVST was effective in increasing testing frequency and uptake and was considered as good as or better in detecting new HIV infections. However, the presence of more than one critical weakness and multiple non-critical flaws reduced the overall confidence.

COVID-19 vaccination integration, innovations and key populations: Results from a global survey.

COVID-19 vaccination integration, innovations and key populations: Results from a global survey.

Dietary self-management behavior and associated factors among breast cancer patients receiving chemotherapy: A latent profile analysis.

Dietary self-management behavior and associated factors among breast cancer patients receiving chemotherapy: A latent profile analysis.

Is Southeast Asia and the Western Pacific ready for potential monkeypox virus outbreaks?

Is Southeast Asia and the Western Pacific ready for potential monkeypox virus outbreaks?

Transcriptome analysis reveals the different toxic mechanism of three HBCD diastereoisomers to Brachionus plicatilis based on chemical defensome.

Transcriptome analysis reveals the different toxic mechanism of three HBCD diastereoisomers to Brachionus plicatilis based on chemical defensome.