Photodermatoses in skin of colour.

Photodermatoses represent a heterogeneous collection of disorders unified by the characteristic of being provoked through exposure to ultraviolet radiation. Generally, these conditions are classified into the following categories: immunologically mediated photodermatoses, chemical- and drug-induced photosensitivity, photoaggravated dermatoses and photosensitivity associated with defective DNA repair mechanisms or chromosomal instabilities. The list of photodermatoses is extensive, and each individual photodermatosis is understood to a different extent. Regardless, there exists a paucity of information with regards to the clinical presentation among those with skin of colour. With ever-changing global demographics, recognition of photosensitive disorders in a diverse population is essential for accurate diagnoses and therapeutic guidance. The scope of this article seeks to review the epidemiology and clinical variability in presentation of such photodermatoses in patients with skin of colour.

Legal intervention for non-adherent patients in the treatment of tuberculosis.

BACKGROUND: The Philadelphia Department of Public Health Tuberculosis (TB) Control Program has a progressively severe, stepwise legal process for managing non-adherent TB patients, potentially culminating in incarceration. OBJECTIVE: To review the application of legal procedures and to evaluate their effectiveness in the management of non-adherent TB patients. METHODS: We evaluated this process by reviewing patients' records from 2001 to 2005 to identify all non-adherent patients and determine their treatment outcomes. RESULTS: In this period, we initiated the legal process for 39 non-adherent patients. One patient died, and nine patients were lost. Twenty-nine patients became adherent after the use of a legal intervention. Our final completion percentage was 76.3%. CONCLUSION: Our legal process improved the treatment completion rate for patients who would otherwise have been non-adherent. Increasing treatment completion rates reduce the risk of relapse and disease transmission as well as the growing rate of anti-tuberculosis drug resistance.

Unprotected intercourse among people living with HIV/AIDS: The importance of partnership characteristics.

The purpose of this study was to determine the relative importance and interactive effects of partnership characteristics in unprotected intercourse among people living with HIV/AIDS (PLWHA). An interview study was conducted among a convenience sample of PLWHA in care. Of all the demographic, health status, risk history and behaviors and partnership covariates explored, only the partnership covariates were significantly associated with unprotected intercourse. Significant covariates included having a steady partner (OR and 95%CI = 4.2; 1.3, 13.5), HIV-positive (OR and 95%CI = 2.7; 1.0, 6.9 versus HIV-negative partner) or unknown serostatus partner (OR and 95%CI = 4.6; 1.1, 18.3 versus HIV-negative partner) and men who have sex with men (MSM) partnerships (OR and 95%CI = 3.0; 1.2, 7.3). Partnership covariates explained 23% of the variance in unprotected intercourse; other groups of covariates did not significantly improve model fit. Significant interaction terms between reported partner HIV status, partnership type and sexual orientation revealed the greatest likelihood of unprotected intercourse in two groups of individuals: those in steady relationships with HIV-positive partners and MSM in relationships with partners of unknown serostatus. Prevention interventions for PLWHA should focus on partnership characteristics.