Retest and retreat: a review of national HIV retesting guidelines to inform elimination of mother-to-child HIV transmission efforts
High maternal HIV incidence contributes substantially to mother-to-child HIV transmission (MTCT) in some settings. Since 2006, HIV retesting during the third trimester and breastfeeding has been recommended by the World Health Organization in higher prevalence (≥5%) settings to reduce MTCT. However, many countries lack clarity on when and how often to retest pregnant and postpartum women to optimize resources and service delivery. This study reviewed and characterized national guidelines on maternal retesting based on timing and frequency.
Developing an epidemiologic study to investigate risk factors for colorectal cancer among Alaska Native people
Alaska Native (AN) people have among the highest rates of colorectal cancer (CRC) recorded globally. Preventing CRC is an important health priority of AN tribal health leaders and communities. Lifestyle and genetic risk and protective factors for CRC among AN people remain understudied. This paper works to establish a tribally led, community-based, comprehensive investigation of lifestyle and genetic risk and protective factors for CRC among AN people. This description is intended to provide guidance to other researchers working to establish community-based studies of cancer risk, particularly among tribal communities.
Effect of Human Papillomavirus vaccine to interrupt recurrence of vulvar and anal neoplasia (VIVA): a trial protocol
Human papillomavirus (HPV), particularly HPV type 16, causes most anal and vulvar high-grade squamous intraepithelial lesions (HSIL), which are precursors to cancer. After initial treatment of HSIL, more than 30% of patients will have disease recurrence, with even higher recurrence among HIV-positive individuals and men who have sex with men. Recurrences can be debilitating and lead to significant morbidity and medical expense. The objective of this study was to test whether the licensed prophylactic HPV vaccine (Gardasil-9) can reduce the risk of HSIL recurrence by 50% in previously unvaccinated individuals recently treated for anal or vulvar HSIL.
An economic gap between the recommended healthy food patterns and existing diets of minority groups in the US National Health and Nutrition Examination Survey 2013-14
The US Department of Agriculture has identified three Healthy Food Patterns as ways to implement the 2015-2020 Dietary Guidelines for Americans. This study estimated the daily cost of the Healthy Vegetarian, US-Style, and Mediterranean Food Patterns (at 2,000 kcal/d) using national food prices adjusted for inflation. Furthermore, it also estimated the cost of existing dietary intakes in $/2,000 kcal/d for persons ≥2 years in the National Health and Nutrition Examination Survey (NHANES 2013-2014) using the same national food prices.
Reasons for differences in the incidence of venous thromboembolism in black versus white americans
Venous thromboembolism incidence rates are 30-100% higher in American blacks than whites. This study examined (a) the degree to which differences in the frequencies of socioeconomic, lifestyle, and medical risk factors, and genetic variants explain the excess venous thromboembolism risk in blacks and (b) whether some risk factors are more strongly associated with venous thromboembolism in blacks compared with whites.
A time-based objective measure of exposure to the food environment
Exposure to food environments has mainly been limited to counting food outlets near participants' homes. This study considers food environment exposures in time and space using global positioning systems records and fast food restaurants as the environment of interest.
NT-pro BNP as a mediator of the racial difference in incident atrial fibrillation and heart failure
Blacks harbor more cardiovascular risk factors than whites, but experience less atrial fibrillation (AF). Conversely, whites may have a lower risk of heart failure (CHF). N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels are higher in whites, predict incident AF, and have diuretic effects in the setting of increased ventricular diastolic pressures, potentially providing a unifying explanation for these racial differences.
Associations of circulating very-long-chain saturated fatty acids and incident type 2 diabetes: a pooled analysis of prospective cohort studies
Saturated fatty acids (SFAs) of different chain lengths have unique metabolic and biological effects, and a small number of recent studies suggest that higher circulating concentrations of the very-long-chain SFAs (VLSFAs) arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) are associated with a lower risk of diabetes. Confirmation of these findings in a large and diverse population is needed. The objective of this study was to investigate the associations of circulating VLSFAs 20:0, 22:0, and 24:0 with incident type 2 diabetes in prospective studies.
Multi-ancestry genome-wide gene-smoking interaction study of 387,272 individuals identifies new loci associated with serum lipids
The concentrations of high- and low-density-lipoprotein cholesterol and triglycerides are influenced by smoking, but it is unknown whether genetic associations with lipids may be modified by smoking. To study this, investigators conducted a multi-ancestry genome-wide gene-smoking interaction study in 133,805 individuals with follow-up in an additional 253,467 individuals. Additionally, this study demonstrates the importance of including diverse populations, particularly in studies of interactions with lifestyle factors, where genomic and lifestyle differences by ancestry may contribute to novel findings.
Implementation of a comprehensive safer conception intervention for HIV-serodiscordant couples in Kenya: uptake, use and effectiveness
Safer conception strategies minimize HIV risk during condomless sex to become pregnant. Gaps remain in understanding the acceptability, feasibility and choices HIV-serodiscordant couples make when multiple safer conception options are available. Researchers conducted a pilot study of a comprehensive safer conception package for HIV-serodiscordant couples with immediate fertility desires in Kenya.