Transgender women in Kenya experience greater stigma, depressive symptoms, alcohol and drug use and risky sexual practices than cis-gendered men who have sex with men.

BACKGROUND: Worldwide, sexual and gender minority individuals have disproportionate burden of HIV. There are limited quantitative data from sub-Saharan Africa on the intersection of risks experienced by transgender women (TGW) in comparison to cis-men who have sex with men (MSM). This analysis addresses this gap by comparing reported stigma, psychosocial measures of health, and sexual risk practices between TGW and cis-MSM in Kenya. METHODS: We analyzed data from the baseline visit of an ongoing prospective cohort study taking place in three diverse metropolitan areas. Eligible participants were HIV-negative, assigned male at birth, ages 18-29 years, and reported anal intercourse in the past 3 months with a man or TGW. Data collected by audio computer assisted self-interview included sociodemographic measures, and sexual practices occurring in the past 3 months. Multivariable regressions assessed differences between TGW and cis-MSM in selected sexual practices, depressive symptoms, alcohol and drug use, and stigma. RESULTS: From September, 2019, through May, 2021, 838 participants were enrolled: 108 (12.9%) TGW and 730 (87.1%) cis-MSM. Adjusting for sociodemographic variables, TGW were more likely than cis-MSM to report: receptive anal intercourse (RAI; adjusted prevalence ratio [aPR] = 1.59, 95% CI: 1.32 - 1.92), engaging in group sex (aPR = 1.15, 95% CI: 1.04 - 1.27), 4 or more male sex partners (aPR = 3.31, 95% CI: 2.52 - 4.35), and 3 or more paying male sex partners (aPR = 1.58, 95% CI: 1.04 - 2.39). TGW were also more likely to report moderate to severe depressive symptoms (aPR = 1.42, 95% CI: 1.01 - 1.55), and had similar alcohol and drug abuse scores as cis-MSM. In sensitivity analysis, similar to TGW, male-identifying individuals taking feminizing gender affirming therapy had an increased likelihood of reporting RAI and group sex, and greater numbers of male sex partners and paying male sex partners relative to cis-MSM. CONCLUSIONS: Across three metropolitan areas in Kenya, TGW were more likely to report depressive symptoms and increased sexual risk taking. We identified a need for research that better characterizes the range of gender identities. Our analysis affirms the need for programmatic gender-affirming interventions specific to transgender populations in Kenya and elsewhere in Africa.

Sexually Transmitted Disease-Related Reddit Posts During the COVID-19 Pandemic: Latent Dirichlet Allocation Analysis.

BACKGROUND: Sexually transmitted diseases (STDs) are common and costly, impacting approximately 1 in 5 people annually. Reddit, the sixth most used internet site in the world, is a user-generated social media discussion platform that may be useful in monitoring discussion about STD symptoms and exposure. OBJECTIVE: This study sought to define and identify patterns and insights into STD-related discussions on Reddit over the course of the COVID-19 pandemic. METHODS: We extracted posts from Reddit from March 2019 through July 2021. We used a topic modeling method, Latent Dirichlet Allocation, to identify the most common topics discussed in the Reddit posts. We then used word clouds, qualitative topic labeling, and spline regression to characterize the content and distribution of the topics observed. RESULTS: Our extraction resulted in 24,311 total posts. Latent Dirichlet Allocation topic modeling showed that with 8 topics for each time period, we achieved high coherence values (pre-COVID-19=0.41, prevaccination=0.42, and postvaccination=0.44). Although most topic categories remained the same over time, the relative proportion of topics changed and new topics emerged. Spline regression revealed that some key terms had variability in the percentage of posts that coincided with pre-COVID-19 and post-COVID-19 periods, whereas others were uniform across the study periods. CONCLUSIONS: Our study's use of Reddit is a novel way to gain insights into STD symptoms experienced, potential exposures, testing decisions, common questions, and behavior patterns (eg, during lockdown periods). For example, reduction in STD screening may result in observed negative health outcomes due to missed cases, which also impacts onward transmission. As Reddit use is anonymous, users may discuss sensitive topics with greater detail and more freely than in clinical encounters. Data from anonymous Reddit posts may be leveraged to enhance the understanding of the distribution of disease and need for targeted outreach or screening programs. This study provides evidence in favor of establishing Reddit as having feasibility and utility to enhance the understanding of sexual behaviors, STD experiences, and needed health engagement with the public.

Association of angiotensinogen gene SNPs and haplotypes with risk of hypertension in eastern Indian population.

BACKGROUND: Angiotensinogen (AGT) enzyme comprises a vital module of RAAS system that effectively controls the blood pressure and related cardiovascular functions. Ample association studies have reported the importance of AGT variants in cardiovascular and non-cardiovascular adversities. But lately, owing to the complexity of the many anomalies, the haplotype based examination of genetic variation that facilitates the identification of polymorphic sites which are located in the vicinity of the causative polymorphic site, gets greater appreciation. METHODS: In the present study, we have done genotype and haplotype analysis of AGT gene in reference to hypertension to confirm the association of the two in an Indian population. To accomplish this, we performed candidate SNPs analysis and construct possible haplotypes across the AGT promoter and gene region in 414 subjects (256 Hypertensive cases and 158 controls). RESULTS: We found four SNPs (rs11568020: A-152G and rs5050: A-20C in promoter; rs4762 and rs699 in exon2) and 3 haplotypes (H4, H7 and H8) that showed a stronger positive association with hypertension. The haplotype H2 was showing protective association with hypertension. CONCLUSION: The results of the present study confirmed and reestablished the role of AGT gene variants and their haplotypes in the causation of hypertension in Indian population and showed that haplotypes can provide stronger evidence of association.

Absence of p53 gene mutations in exons 5 - 7 among breast cancer patients of Bengalee Hindu caste females, West Bengal, India.

BACKGROUND: The high incidence and relatively good prognosis of breast cancer has made it the most prevalent cancer in the world today. A large number of distinct mutations and polymorphisms in the p53 gene have been reported worldwide, but there is no report regarding the role of this inherited susceptibility gene in breast cancer risk among the Bengalee Hindu Caste females of West Bengal, India. AIM OF THE STUDY: We investigated the distribution and the nature of p53 gene mutations and polymorphisms in exons 5-7 in a cohort of 110 Bengalee Hindu breast cancer patients and 127 age, sex and caste matched controls by direct sequencing. RESULTS: We did not observe any mutations and polymorphisms in our studied individuals. CONCLUSION: We therefore conclude that mutations in exons 5-7 of p53 gene are rare causes of breast cancer among Bengalee Hindu caste females, and therefore of little help for genetic counseling and diagnostic purposes.

Menstrual characteristics: a study of the adolescents of rural and urban West Bengal, India.

BACKGROUND: It has been observed that menstrual characteristics are generally influenced by lifestyle, socio-cultural and biological factors. AIM: The present study examines: (a) variation in menstrual characteristics between rural and urban adolescents; and (b) whether these characteristics can be predicted from various socio-economic variables related to place of residence. SUBJECTS AND METHODS: The sample of the present study constituted 715 adolescent girls from rural (325) and urban (390) areas of West Bengal, a State of India. These girls belong to a Bengali-speaking Hindu ethnic group. Data on socio-economic variables and menstrual characteristics were collected using pretested questionnaires. RESULTS: Rural and urban adolescents differed significantly (p < or = 0.05) with respect to age at menarche, skipped and irregular cycles, premenstrual syndrome, duration of menstrual discharge, mean number of days of peak discharge and problems related to menstrual discharge. Place of residence was found to be a significant predictor of age at menarche (beta = 0.27, p < 0.01). Significant association was observed between some of the socio-economic variables and various menstrual characteristics among the study participants. CONCLUSIONS: Menstrual characteristics differ significantly between rural and urban adolescents. Moreover, various socio-economic variables pertaining to place of residence significantly affect the menstrual characteristics among adolescents.