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Zhang G.,International Laboratory Branch | Cai F.,Duke University | Zhou Z.,International Laboratory Branch | DeVos J.,International Laboratory Branch | And 14 more authors.
Journal of Clinical Microbiology | Year: 2013

High-throughput, sensitive, and cost-effective HIV drug resistance (HIVDR) detection assays are needed for large-scale monitoring of the emergence and transmission of HIVDR in resource-limited settings.Using suspension array technology, we have developed a multiplex allele-specific (MAS) assay that can simultaneously detect major HIVDR mutations at 20 loci.Forty-five allele-specific primers tagged with unique 24-base oligonucleotides at the 5= end were designed to detect wild-type and mutant alleles at the 20 loci of HIV-1 subtype C.TheMASassay was first established and optimized with three plasmid templates (C-wt, C-mut1, and C-mut2) and then evaluated using 148 plasma specimens from HIV-1 subtype C-infected individuals.All the wild-type and mutant alleles were unequivocally distinguished with plasmid templates, and the limits of detection were 1.56% for K219Q and K219E, 3.13% for L76V, 6.25% for K65R, K70R, L74V, L100I, K103N, K103R, Q151M, Y181C, and I47V, and 12.5% for M41L, K101P, K101E, V106A, V106M, Y115F, M184V, Y188L, G190A, V32I, I47A, I84V, and L90M.Analyses of 148 plasma specimens revealed that theMASassay gave 100% concordance with conventional sequencing at eight loci and>95% (range, 95.21% to 99.32%) concordance at the remaining 12 loci.The differences observed were caused mainly by 24 additional low-abundance alleles detected by theMASassay.Ultradeep sequencing analysis confirmed 15 of the 16 low-abundance alleles.This multiplex, sensitive, and straightforward result-reporting assay represents a new efficient genotyping tool for HIVDR surveillance and monitoring.© 2013, American Society for Microbiology.All Rights Reserved. Source

Lanier Y.,NCHHSTP | Castellanos T.,NCHHSTP | Barrow R.Y.,Centers for Disease Control and Prevention | Jordan W.C.,HIV AIDS Advisory Committee | And 2 more authors.
AIDS Patient Care and STDs | Year: 2014

Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts. © 2014, Mary Ann Liebert, Inc. Source

Knopf J.A.,Community Guide Branch | Finnie R.K.C.,Community Guide Branch | Peng Y.,Community Guide Branch | Hahn R.A.,Community Guide Branch | And 9 more authors.
American Journal of Preventive Medicine | Year: 2016

Context Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision and hearing - obstacles to lifetime educational achievement and predictors of adult morbidity and premature mortality. If school-based health centers (SBHCs) can overcome educational obstacles and increase receipt of needed medical services in disadvantaged populations, they can advance health equity. Evidence acquisition A systematic literature search was conducted for papers published through July 2014. Using Community Guide systematic review methods, reviewers identified, abstracted, and summarized available evidence of the effectiveness of SBHCs on educational and health-related outcomes. Analyses were conducted in 2014-2015. Evidence synthesis Most of the 46 studies included in the review evaluated onsite clinics serving urban, low-income, and racial or ethnic minority high school students. The presence and use of SBHCs were associated with improved educational (i.e., grade point average, grade promotion, suspension, and non-completion rates) and health-related outcomes (i.e., vaccination and other preventive services, asthma morbidity, emergency department use and hospital admissions, contraceptive use among females, prenatal care, birth weight, illegal substance use, and alcohol consumption). More services and more hours of availability were associated with greater reductions in emergency department overuse. Conclusions Because SBHCs improve educational and health-related outcomes in disadvantaged students, they can be effective in advancing health equity. © 2016 American Journal of Preventive Medicine. Source

Pitasi M.A.,Emory University | Smith A.J.,NCHHSTP | Teshale E.H.,NCHHSTP
AIDS and Behavior | Year: 2014

Men who have sex with men (MSM) bear a disproportionate burden of hepatitis B virus (HBV) infections. We used serologic data from the National HIV Behavioral Surveillance (NHBS) system to determine the prevalence and correlates of HBV infection, immunization, and susceptibility in a sample of Los Angeles County MSM. Approximately 19 % (95 % CI 15-24 %) had serologic evidence of current or past infection, while 35 % (95 % CI 30-40 %) were susceptible. Compared with the youngest age group, MSM ages 40-49 years had a lower prevalence of immunization (aPR 0.28, 95 % CI 0.17-0.45) and a higher prevalence of infection (aPR 8.53, 95 % CI 3.95-18.4) and susceptibility (aPR 2.02, 95 % CI 1.13-3.63). We also observed poor concordance between self-reported and serologic measures of vaccination. Our results indicate the possibility of missed opportunities to vaccinate MSM. Gaps in implementing existing vaccination strategies must be addressed to increase hepatitis B vaccination coverage for MSM, especially in older age groups. © 2013 Springer Science+Business Media New York. Source

Hills S.L.,National Center for Emerging and Zoonotic Infectious Diseases | Russell K.,Epidemic Intelligence Service | Russell K.,National Center for Immunization and Respiratory Diseases | Hennessey M.,National Center for Emerging and Zoonotic Infectious Diseases | And 5 more authors.
Morbidity and Mortality Weekly Report | Year: 2016

What is already known about this topic? Zika virus is spread primarily by Aedes species mosquitoes, though recent reports have described two instances of sexual transmission of Zika virus, and replicative virus has been isolated from semen of one man with hematospermia. CDC released interim guidance for prevention of sexual transmission of Zika virus on February 5, 2016. What is added by this report? This report provides information on six confirmed and probable cases of sexual transmission of Zika virus from male travelers to female nontravelers. This suggests that sexual transmission of Zika virus might be more common than previously reported. What are the implications for public health practice? Men who reside in or have traveled to an area of ongoing Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) with their pregnant partner for the duration of the pregnancy. © 2016, Department of Health and Human Services. All rights reserved. Source

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