Are HIV Prevention Services Reaching all LGBTQ+ Youth? An Intersectional Analysis in a National Sample.

Although research has examined disparities in HIV prevention behaviors, intersectional research is needed to understand who may be underserved. This study examines disparities in consistent condom use, HIV testing, and PrEP awareness and use across assigned sex, gender identity, sexual orientation, and racial/ethnic identity in a large sample of sexually active LGBTQ+ youth (mean age = 16.5) who completed the 2022 LGBTQ National Teen Survey. Four social identities were included as indicators in Chi-Square Automated Interaction Detection models to uncover disparate rates of HIV preventive behaviors. Generally, HIV testing and PrEP services were higher among gay/lesbian and queer youth assigned male, and lower among those assigned female. Certain LGBTQ+ youth may be systematically missed by these services, (e.g., those assigned female; those assigned male who also identify as bisexual, pansexual, asexual, questioning, or straight (and trans/gender diverse)). Providers should strive to serve populations who are not being reached by HIV prevention services.

RESUMEN: Aunque las investigaciones han examinado disparidades en los comportamientos de prevención del VIH, la aplicación de un esquema interseccional es necesario para entender quienes tienen menos acceso a los cuidados de la salud. Este estudio examina disparidides en el uso del condón, las pruebas de VIH y el conocimiento y el uso de profilaxis preexposición (PrEP) entre el sexo asignado, la identidad del género, la orientación sexual, la identidad racial/étnica) en una muestra nacional de jovenes (edad promedia = 16.5), LGBTQ+. Cuatro identidades sociales estuvieron incluidas como indicadores en el modelo de la Detección de la Interacción Automática de Chi-Square para detectar diferencias de comportamientos de prevención. Generalmente, el uso de las pruebas de VIH y los servicios de PrEP estaban mas alto entre los jovenes gay/lesbiana y queer asignados masculinos y mas bajo entre jóvenes asignadas femeninas. Es posible que ciertos jovenes LGBTQ+ estén omitidos de los servicios de las pruebas de VIH y PrEP, incluyendo jóvenes que fueron asignadas feminidas, ovenes bisexuales, pansexuales, asexuales, cuestionando, o heterosexuales (transgénero/a/e o de diversos géneros) que fueron asignados masculinos. Los profesionales de salud deben luchar para servir a las poblaciones que están fuera del alcance de los servicios preventivos del VIH.

Are We Meeting Their Needs? Well-child, Dental, and Mental Health Care for Youth in Juvenile Correctional Facilities in Minnesota.

Compared with the general population, justice-involved youth have substantially higher rates of several health conditions. Less is known about their use of health services to address these conditions. Using data from a statewide survey of 217 youth in juvenile correctional facilities and 164,832 youth in public schools, we examined selfreported health (health overall, weight status, disability, asthma, allergy, mental health) and receipt of care. Justice-involved youth reported a high number of physical health concerns; however, physical health conditions were not related to receipt of care. Youth who reported experiencing depressive symptoms with or without suicidal ideation, and those who had attempted suicide, were more likely than their peers without these mental health issues to have received mental health treatment in the past year. However, many youth with serious mental health concerns had not received treatment. Results from this study demonstrate unmet health care needs among a sample of youth in juvenile correctional facilities.

Applying Trauma-Informed Practices to the Care of Refugee and Immigrant Youth: 10 Clinical Pearls.

Immigrant and refugee youth have higher rates of trauma than youth who are not transnational. While youth are incredibly resilient, trauma and toxic stress can result in poor health outcomes that persist throughout life. However, clinical interventions can promote resilience and decrease the negative impact of trauma. This article will review the principles of trauma-informed care and its application for the care of immigrant and refugee youth and their families by sharing concrete and feasible strategies for primary care providers and systems.

Intracellular expression patterns of the human papillomavirus type 59 E1/E4 protein in COS cells, keratinocytes, and genital epithelium.

OBJECTIVE: To compare and contrast the intracellular distribution pattern of the human papillomavirus type 59 (HPV 59) E1/E4 protein in COS cells, human keratinocytes, and naturally infected genital epithelium. METHODS: The HPV 59 E1/E4 protein was expressed in COS cells and NIKS cells (immortalized human keratinocytes). A subset of NIKS cells was induced to differentiate. The intracellular distribution pattern of E1/E4 and the effects of E1/E4 expression on the cytoskeleton network were compared for COS and NIKS cells. Expression of E1/E4 was examined in HPV 59-infected foreskin xenografts grown in athymic mice and in a natural HPV 59-infected genital lesion. RESULTS: The HPV 59 E1/E4 protein formed dense perinuclear inclusions in COS cells, similar to those reported for the HPV 16 E1/E4 protein. In contrast, the E1/E4 protein was diffusely cytoplasmic in undifferentiated NIKS cells, co-localizing with an intact cytokeratin filament network. The E1/E4 protein was concentrated in the region of the cornified cell envelope (CCE) of differentiated NIKS cells, co-localizing with involucrin, a CCE component. A similar distribution in the region of the CCE was observed for E1/E4 protein in HPV 59-infected human epithelial tissues. CONCLUSIONS: The HPV 59 E1/E4 protein is cytoplasmic and co-localizes with an intact cytokeratin filament network in undifferentiated keratinocytes. The E1/E4 protein is distributed in the region of the CCE and co-localizes with involucrin in differentiated human keratinocytes, consistent with the intracellular distribution pattern observed in HPV 59-infected epithelium.

Human papillomavirus type 59 immortalized keratinocytes express late viral proteins and infectious virus after calcium stimulation.

Human papillomavirus type 59 (HPV 59) is an oncogenic type related to HPV 18. HPV 59 was recently propagated in the athymic mouse xenograft system. A continuous keratinocyte cell line infected with HPV 59 was created from a foreskin xenograft grown in an athymic mouse. Cells were cultured beyond passage 50. The cells were highly pleomorphic, containing numerous abnormally shaped nuclei and mitotic figures. HPV 59 sequences were detected in the cells by DNA in situ hybridization in a diffuse nuclear distribution. Southern blots were consistent with an episomal state of HPV 59 DNA at approximately 50 copies per cell. Analysis of the cells using a PCR/reverse blot strip assay, which amplifies a portion of the L1 open reading frame, was strongly positive. Differentiation of cells in monolayers was induced by growth in F medium containing 2 mM calcium chloride for 10 days. Cells were harvested as a single tissue-like sheet, and histologic analysis revealed a four-to-six cell-thick layer. Transcripts encoding involucrin, a cornified envelope protein, and the E1/E4 and E1/E4/L1 viral transcripts were detected after several days of growth in F medium containing 2 mM calcium chloride. The E1/E4 and L1 proteins were detected by immunohistochemical analysis, and virus particles were seen in electron micrographs in a subset of differentiated cells. An extract of differentiated cells was prepared by vigorous sonication and was used to infect foreskin fragments. These fragments were implanted into athymic mice. HPV 59 was detected in the foreskin xenografts removed 4 months later by DNA in situ hybridization and PCR/reverse blot assay. Thus, the complete viral growth cycle, including production on infectious virus, was demonstrated in the HPV 59 immortalized cells grown in a simple culture system.