Comparison of a Wearable Accelerometer/Gyroscopic, Portable Gait Analysis System (LEGSYS+TM) to the Laboratory Standard of Static Motion Capture Camera Analysis.

Examination of gait patterns has been used to determine severity, intervention triage and prognostic measures for many health conditions. Methods that generate detailed gait data for clinical use are typically logistically constrained to a formal gait laboratory setting. This has led to an interest in portable analysis systems for near clinical or community-based assessments. The following study assessed with the wearable accelerometer/gyroscopic, gait analysis system (LEGSYS+TM) and the standard of static motion capture camera (MOCAP) analysis during a treadmill walk at three different walking speeds in healthy participants (n = 15). To compare each speed, 20 strides were selected from the MOCAP data and compared with the LEGSYS+ strides at the same time point. Both scatter and bland-Altman plots with accompanying linear regression analysis for each of the parameters. Each stride parameter showed minimal or a consistent difference between the LEGSYS+ and MOCAP, with the phase parameters showing inconsistencies between the systems. Overall, LEGSYS+ stride parameters can be used in the clinical setting, with the utility of phase parameters needing to be taken with caution.

Delivery of TDF/FTC for Pre-exposure Prophylaxis to Prevent HIV-1 Acquisition in Young Adult Men Who Have Sex With Men and Transgender Women of Color Using a Urine Adherence Assay.

BACKGROUND: Pre-exposure prophylaxis (PrEP) for HIV prevention with daily tenofovir and emtricitabine is effective when taken consistently. Currently, there is no objective way to monitor PrEP adherence. Urine has been shown to be highly correlated with plasma tenofovir levels, with urine tenofovir levels >1000 ng/mL demonstrating recent (1-2 days) adherence to PrEP. SETTING: This study was conducted at an urban community health center in Philadelphia, Pennsylvania. METHODS: PrEP was administered to 50 young men who have sex with men and transgender women of color using weekly, biweekly, and/or monthly dispensation schedules. Primary objectives were retention at 48 weeks (in care at week 48 and completing ≥50% of medication pickups) and adherence assessed by urine tenofovir levels. Risk behaviors and sexually transmitted infection diagnoses were also collected. RESULTS: Seventy percent of participants were retained in care at 48 weeks. The proportion of subjects with urine tenofovir consistent with recent adherence was 80, 74.4, 82.4, 82.4, and 69.7% at weeks 4, 12, 24, 36, and 48, respectively. Sixty-one sexually transmitted infections were diagnosed over 231 screenings throughout 48 weeks, with no significant change between the first and second 24-week periods (P = 0.43; 0 seroconversions). At week 48, more than half of subjects reported an increase or no change in condom use, an increase in their ability to discuss HIV with partners, and no change in number of sexual partners from baseline. CONCLUSIONS: These data demonstrate PrEP can be successfully delivered to a high-risk population with high program retention and medication adherence measured by urine tenofovir levels.

A case study of chewed Truvada® for PrEP maintaining protective drug levels as measured by a novel urine tenofovir assay.

Emtricitabine/tenofovir disoproxil fumarate (FTC/TDF; Truvada®) given as pre-exposure prophylaxis (PrEP) successfully blocks HIV when taken once daily prior to potential HIV exposure. A 22-year-old male reported difficulty swallowing FTC/TDF for PrEP and subsequently began chewing the FTC/TDF tablets. Monthly urine samples assessed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) indicated tenofovir levels >1,000 ng/ml, indicative of protection from HIV acquisition, over a 48-week period. Data from observational studies of HIV-positive patients details the successful treatment of HIV using crushed FTC/TDF delivered via feeding and gastronomy tubes while small, randomized trials of healthy volunteers demonstrate bioequivalence between whole and crushed FTC/TDF.

"I definitely want grandbabies": Caregivers of adolescents with perinatally-acquired HIV reflect on dating and childbearing.

INTRODUCTION: Parents and caregivers of typically developing teens are often a source of information about sexual health and relationships. However, little is known about the information offered to adolescents with perinatally acquired HIV (APHIV) by caregivers who may provide support and guidance to their teen as they explore sexuality and childbearing. METHOD: This qualitative exploratory study involved the in-depth interviews of 18 caregivers (17 females), including biological mothers (9), relatives (5), and adoptive/foster mothers (4), who care for APHIV. Interviews explored views regarding their adolescent's engagement in romantic relationships, sexual behaviors, and childbearing. The guardian's knowledge of mother-to-child-transmission (MTCT) was also assessed for accuracy. Transcribed interviews were coded for emergent themes. RESULTS: Analyses indicated that the majority of caregivers discussed sexual health and dating with their adolescent. However, guidance regarding disclosure to partners of the adolescent's HIV status varied. Some biological mothers and all relatives cautioned against disclosure, contrary to foster/adoptive mothers. Most caregivers wanted their adolescent to experience parenthood. Reasons affirming childbearing included the belief their child would be a good parent and wanted to experience parenthood, childbearing as a normative experience, and decreased HIV-related stigma. Biological mothers and most relatives did not know the risk of MTCT, as opposed to all foster/adoptive mothers who accurately stated the risk was 1% to 2%. DISCUSSION: The type of guardian influenced the nature of shared information related to disclosure and risk of MTCT. Sexual and reproductive health education should be provided to caregivers because they could be an important source of information for APHIV. (PsycINFO Database Record