Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study.

BACKGROUND: HIV pre-exposure prophylaxis (PrEP) is highly effective in men who have sex with men (MSM) at the individual level, but data on population-level impact are lacking. We examined whether rapid, targeted, and high-coverage roll-out of PrEP in an MSM epidemic would reduce HIV incidence in the cohort prescribed PrEP and state-wide in Australia's most populous state, New South Wales. METHODS: The Expanded PrEP Implementation in Communities-New South Wales (EPIC-NSW) study is an implementation cohort study of daily co-formulated tenofovir disoproxil fumarate and emtricitabine as HIV PrEP. We recruited high-risk gay men in a New South Wales-wide network of 21 clinics. We report protocol-specified co-primary outcomes at 12 months after recruitment of the first 3700 participants: within-cohort HIV incidence; and change in population HIV diagnoses in New South Wales between the 12-month periods before and after PrEP roll-out. The study is registered with ClinicalTrials.gov, number NCT02870790. FINDINGS: We recruited 3700 participants in the 8 months between March 1, 2016, and Oct 31, 2016. 3676 (99%) were men, 3534 (96%) identified as gay, and 149 (4%) as bisexual. Median age was 36 years (IQR 30-45 years). Overall, 3069 (83%) participants attended a visit at 12 months or later. Over 4100 person-years, two men became infected with HIV (incidence 0·048 per 100 person-years, 95% CI 0·012-0·195). Both had been non-adherent to PrEP. HIV diagnoses in MSM in New South Wales declined from 295 in the 12 months before PrEP roll-out to 221 in the 12 months after (relative risk reduction [RRR] 25·1%, 95% CI 10·5-37·4). There was a decline both in recent HIV infections (from 149 to 102, RRR 31·5%, 95% CI 11·3 to 47·3) and in other HIV diagnoses (from 146 to 119, RRR 18·5%, 95% CI -4·5 to 36·6). INTERPRETATION: PrEP implementation was associated with a rapid decline in HIV diagnoses in the state of New South Wales, which was greatest for recent infections. As part of a combination prevention approach, rapid, targeted, high-coverage PrEP implementation is effective to reduce new HIV infections at the population level. FUNDING: New South Wales Ministry of Health, Gilead Sciences.

Software for real-time localization of baleen whale calls using directional sonobuoys: A case study on Antarctic blue whales.

Directional frequency analysis and recording (DIFAR) sonobuoys can allow real-time acoustic localization of baleen whales for underwater tracking and remote sensing, but limited availability of hardware and software has prevented wider usage. These software limitations were addressed by developing a module in the open-source software PAMGuard. A case study is presented demonstrating that this software provides greater efficiency and accessibility than previous methods for detecting, localizing, and tracking Antarctic blue whales in real time. Additionally, this software can easily be extended to track other low and mid frequency sounds including those from other cetaceans, pinnipeds, icebergs, shipping, and seismic airguns.

Low-frequency vocalizations of sei whales (Balaenoptera borealis) in the Southern Ocean.

Simultaneous sightings and acoustic detections of sei whales (Balaenoptera borealis) are scarce, and there are few published data describing their vocalizations. Analysis of recordings from directional frequency analysis and recording sonobuoys in the presence of sei whales in the Southern Ocean in March 2013 identified both downsweep and upsweep calls. Sound frequencies within all calls were between 34 and 87 Hz with an average call duration of 1.1 s. These very low-frequency sounds share characteristics with sei whale calls recorded near the Hawaiian Islands and off Cape Cod in winter and summer, respectively, but are the first documented sei whale calls in the Southern Ocean that are clearly less than 100 Hz.

Blue whale vocalizations recorded around New Zealand: 1964-2013.

Previous underwater recordings made in New Zealand have identified a complex sequence of low frequency sounds that have been attributed to blue whales based on similarity to blue whale songs in other areas. Recordings of sounds with these characteristics were made opportunistically during the Southern Ocean Research Partnership's recent Antarctic Blue Whale Voyage. Detections of these sounds occurred all around the South Island of New Zealand during the voyage transits from Nelson, New Zealand to the Antarctic and return. By following acoustic bearings from directional sonobuoys, blue whales were visually detected and confirmed as the source of these sounds. These recordings, together with the historical recordings made northeast of New Zealand, indicate song types that persist over several decades and are indicative of the year-round presence of a population of blue whales that inhabits the waters around New Zealand. Measurements of the four-part vocalizations reveal that blue whale song in this region has changed slowly, but consistently over the past 50 years. The most intense units of these calls were detected as far south as 53°S, which represents a considerable range extension compared to the limited prior data on the spatial distribution of this population.

The influence of behavioural context on Weddell seal (Leptonychotes weddellii) airborne mother-pup vocalisation.

Previous mammalian studies have demonstrated that varying levels of signaller arousal are frequently expressed through vocal behaviour. The potential for callers to convey their motivational state may ensure that recipient responses are appropriate to their needs. The current study investigated the influence of behavioural context on Weddell seal mother-pup vocalisation. Mother and pup call rates were calculated within five and seven behavioural contexts, respectively, and the acoustic characteristics of 69 pup calls were measured within four contexts (total calls = 276). Context significantly influenced the temporal patterning of calls, with reuniting mothers and pups and lone active pups emitting more calls than during mother-pup contact periods. Reuniting and lone pup calls were also characterised by longer durations, higher fundamental frequencies, and increased energy in upper harmonics. Results suggest that reunion events and lone pup searching are characterised by calls reflective of heightened arousal, compared with mother-pup contact periods.