Objectives: We examined racial/ethnic disparities in highly active antiretroviral therapy (HAART) use and whether differences are moderated by substance use or insurance status, using data from the Women's Interagency HIV Study (WIHS). Methods: Logistic regression examined HAART use in a longitudinal cohort of women for whom HAART was clinically indicated in 2005 (N = 1354). Results: Approximately 3 of every 10 eligible women reported not taking HAART. African American and Hispanic women were less likely than were White women to use HAART. After we adjusted for potential confounders, the higher likelihood of not using HAART persisted for African American but not for Hispanic women. Uninsured and privately insured women, regardless of race/ethnicity, were less likely than were Medicaid enrollees to use HAART. Although alcohol use was related to HAART nonuse, illicit drug use was not. Conclusions: These findings suggest that expanding and improving insurance coverage should increase access to antiretroviral therapy across racial/ethnic groups, but it is not likely to eliminate the disparity in use of HAART between African American and White women with HIV/AIDS.

Objective: To assess knowledge of and attitudes towards human papillomavirus (HPV), Pap testing, and the HPV vaccine. Methods: In a multicenter U.S. cohort study, women with the human immunodeficiency virus (HIV) and at-risk comparison women completed 44-item standardized self-report questionnaires exploring their knowledge of cervical cancer prevention, HPV, and HPV vaccination. Results were correlated with demographic variables, measures of education and attention, and medical factors. Data were clustered using principal component analysis. Significant associations were assessed in multivariable models. Results: Among 1588 women, HIV seropositive women better understood facts about cervical cancer prevention and HPV than seronegative women, but both had substantial knowledge deficits. Almost all women considered Pap testing important, although 53% of HIV seropositive and 48% of seronegative women considered cervical cancer not preventable (P=0.21). Only 44% of HIV seropositive women knew Paps assess the cervix, versus 42% of HIV seronegative women (P=0.57). Both groups understood that HPV causes genital warts and cervical cancer (67% of HIV seropositive vs. 55% of seronegative women, P=0.002). About half of both groups considered HPV vaccination extremely important for cervical cancer prevention. HIV seronegative women were more likely to report learning of HPV vaccination through advertising than from clinicians (81% vs. 64%, P<0.0001). Conclusion: High risk women need effective education about cervical cancer prevention, HPV, and HPV vaccination.

Objective: To compare sexual problems among HIV-positive and HIV-negative women and describe clinical and psychosocial factors associated with these problems. Design: Data were collected during a study visit of the Women's Interagency HIV Study (WIHS). The WIHS studies the natural and treated history of HIV among women in the United States. Methods: Between October 01, 2006, and March 30, 2007, 1805 women (1279 HIV positive and 526 HIV negative) completed a study visit that included administration of the Female Sexual Function Index. In addition, the visit included completion of standardized interviewer-administered surveys, physical and gynecological examinations, and blood sample collection. Results: Women with HIV reported greater sexual problems than did those without HIV. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship. CD4 cell count was associated with Female Sexual Function Index scores, such that those with CD4 <or=199 cells per microliter reported lower functioning as compared with those whose cell count was 200 or higher. Conclusions: Given research documenting relationships between self-reported sexual problems and both clinical diagnoses of sexual dysfunction and women's quality of life, greater attention to this issue as a potential component of women's overall HIV care is warranted.

To generate insights into how migration shapes sexual risk and protection, we interviewed 36 female and 20 male West Indian immigrants attending a public sexually transmitted disease clinic in Brooklyn, New York, between 2004 and 2005. Migration theory suggests that shifts in sexual partnership patterns, bi-directional travel and changes in sexual norms may alter risk. We found evidence of sexual mixing across ethnic groups: a large proportion of participants' partners were not born in the West Indies, despite what is expected among first generation immigrants. Recent travel 'home', another potential source of risk, was uncommon. In open-ended interviews, two themes around sexual and social networks emerged. First, immigrants believed that access to wider, more anonymous sexual networks in New York City (NYC) and the weakening of social controls that limit multiple partnerships (especially for women) promoted greater risk. Second, immigrants experienced greater opportunities for protection in NYC, both through exposure to safer sex messages and availability of condoms. Reported changes in their own condom use, however, were not attributed to migration. West Indian immigrants' risk in NYC may be driven by access to wider sexual networks but failure to alter reliance on 'networks of knowledge' for protection.

Objectives: This study assessed the prevalence of insomnia symptoms among women with and without HIV-infection and examined factors associated with insomnia. Design: Participants (n = 1682) were enrolled in the Women's Interagency HIV Study (WIHS); 69% were infected with HIV. This was a cross-sectional analysis of data from standardized interviewer-administered instruments and physical/gynecological exams. Analysis focused on sociodemographics, sleep measures, depressive symptoms, drug use, alcohol consumption, medications, and HIV-related clinical variables. Women were classified as having symptoms of insomnia if they reported either difficulty initiating sleep, difficulty maintaining sleep, or early morning awakening ≥ 3 times a week in the past 2 weeks. Results: Overall, HIV-infected women were 17% more likely to endorse insomnia symptoms than uninfected women (OR = 1.17, 95% CI: 1.04-1.34, P < 0.05). The adjusted prevalence of insomnia symptoms varied by HIV status and age groups. Among women ages 31-40 years, those with HIV infection were 26% more likely to endorse insomnia symptoms than their counterparts (OR = 1.26, 95% CI: 1.01-1.59, P < 0.05). No significant differences were observed in the likelihood of reporting insomnia symptoms based on HIV treatment type. Multivariate-adjusted regression analyses showed that depression was the most consistent and significant independent predictor of the likelihood of reporting insomnia symptoms across all age strata. Conclusions: Insomnia symptoms are common among both HIV-infected and uninfected women. Prevalence of insomnia did not vary significantly by HIV status, except among younger women. Younger women with HIV infection are at greater risk for experiencing insomnia symptoms.

Background: Retention in care for human immunodeficiency virus (HIV)-infected patients is a National HIV/AIDS Strategy priority. We hypothesized that retention could be improved with coordinated messages to encourage patients' clinic attendance. We report here the results of the first phase of the Centers for Disease Control and Prevention/Health Resources and Services Administration Retention in Care project. Methods: Six HIV-specialty clinics participated in a cross-sectionally sampled pretest-posttest evaluation of brochures, posters, and messages that conveyed the importance of regular clinic attendance. 10,018 patients in 2008-2009 (preintervention period) and 11,039 patients in 2009-2010 (intervention period) were followed up for clinic attendance. Outcome variables were the percentage of patients who kept 2 consecutive primary care visits and the mean proportion of all primary care visits kept. Stratification variables were: new, reengaging, and active patients, HIV RNA viral load, CD4 cell count, age, sex, race or ethnicity, risk group, number of scheduled visits, and clinic site. Data were analyzed by multivariable log-binomial and linear models using generalized estimation equation methods. Results: Clinic attendance for primary care was significantly higher in the intervention versus preintervention year. Overall relative improvement was 7.0% for keeping 2 consecutive visits and 3.0% for the mean proportion of all visits kept (P < .0001). Larger relative improvement for both outcomes was observed for new or reengaging patients, young patients and patients with elevated viral loads. Improved attendance among the new or reengaging patients was consistent across the 6 clinics, and less consistent across clinics for active patients. Conclusion: Targeted messages on staying in care, which were delivered at minimal effort and cost, improved clinic attendance, especially for new or reengaging patients, young patients, and those with elevated viral loads.

Background: Despite the major benefits of effective antiretroviral therapy on HIV-related survival, there is an ongoing need to help alleviate medication side effects related to antiretroviral therapy use. Initial studies suggest that marijuana use may reduce HIV-related symptoms, but medical marijuana use among HIV-infected individuals has not been well described.

s the part of the paper in which we should provide a brief synopsis of the entirety, that is the whole and complete, reason for and information contained within the paper so that a person could quickly decide whether it was worth wasting any of their valuable time (that is, time during which they would be scrolling social media, swiping left or right, or engaging in highly ritualistic slaughter fests of the online hyper-realistic variety).

In this study, I will explore how Sneaker culture came to be and how the marketing of sneakers to the youth became both a fun lifestyle which in the beginning embraced community and promoted individualism to a problematic hobby that has claimed a number of lives and boasts wealth to the have-nots. By learning the history and current advertising of sneakers we can get a glimpse into what the average sneaker consumer and enthusiast may be thinking and feeling regarding what some may deem as a way of life.