Effect of ageing on neurocognitive function by stage of HIV infection: evidence from the Multicenter AIDS Cohort Study.

Background: The demographics of the HIV epidemic in the USA have shifted towards older age. We aimed to establish the relationship between the processes of ageing and HIV infection in neurocognitive impairment.

Methods: With longitudinal data from the Multicenter AIDS Cohort Study, a long-term prospective cohort study of the natural and treated history of HIV infection among men who have sex with men in the USA, we examined the effect of ageing, HIV infection (by disease stage), and their interaction on five neurocognitive domains: information processing speed, executive function, episodic memory, working memory, and motor function.

Stimulant use and progression to AIDS or mortality after the initiation of highly active antiretroviral therapy.

Background: HIV-positive persons who use stimulants (eg, methamphetamine) experience profound health disparities, but it remains unclear whether these persist after highly active antiretroviral therapy (HAART) initiation. Conducted within the Multicenter AIDS Cohort Study, this investigation examined whether stimulant use is associated with progression to AIDS or all-cause mortality after the initiation of HAART.

Methods: Using marginal structural modeling, the cumulative proportion of visits where any stimulant use was reported (ie, 0%, 1%-49%, 50%-99%, and 100%) was examined as a time-varying predictor of (1) all-cause mortality and (2) AIDS or all-cause mortality.

Sexual risk trajectories among MSM in the United States: implications for pre-exposure prophylaxis delivery.

Background: Despite evidence supporting pre-exposure prophylaxis (PrEP) efficacy, there are concerns regarding the feasibility of widespread PrEP implementation among men who have sex with men (MSM). To inform the development of targeted PrEP delivery guidelines, sexual risk trajectories among HIV-negative MSM were characterized.

Methods: At semiannual visits from 2003 to 2011, HIV-negative MSM (N = 419) participating in the Multicenter AIDS Cohort Study provided data on sexual risk behaviors (SRBs) since their last visit.

Uptake and predictors of anal cancer screening in men who have sex with men.

Objectives: We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM).

Methods: Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression.

It gets better: resolution of internalized homophobia over time and associations with positive health outcomes among MSM.

Health disparities research among gay and bisexual men has focused primarily on risk and deficits. However, a focus on resiliencies within this population may greatly benefit health promotion. We describe a pattern of resilience (internalized homophobia (IHP) resolution) over the life-course and its associations with current health outcomes.

Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach.

Objectives: We tested a theory of syndemic production among men who have sex with men (MSM) using data from a large cohort study.

Methods: Participants were 1551 men from the Multicenter AIDS Cohort Study enrolled at 4 study sites: Baltimore, Maryland-Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania. Participants who attended semiannual visits from April 1, 2008, to March 31, 2009, completed an additional survey that captured data about events throughout their life course thought to be related to syndemic production.

Network mixing and network influences most linked to HIV infection and risk behavior in the HIV epidemic among black men who have sex with men.

Objectives: We evaluated network mixing and influences by network members upon Black men who have sex with men.

Methods: We conducted separate social and sexual network mixing analyses to determine the degree of mixing on risk behaviors (e.g.

Labor force participation and health-related quality of life in HIV-positive men who have sex with men: the Multicenter AIDS Cohort Study.

Too many people with HIV have left the job market permanently and those with reduced work capacity have been unable to keep their jobs. There is a need to examine the health effects of labor force participation in people with HIV. This study presents longitudinal data from 1,415 HIV-positive men who have sex with men taking part in the Multicenter AIDS Cohort Study.

HIV health center affiliation networks of black men who have sex with men: disentangling fragmented patterns of HIV prevention service utilization.

Background: In the United States, black men who have sex with men (BMSM) are at highest risk for HIV infection and are at high risk for limited health service utilization. We describe HIV health center (HHC) affiliation network patterns and their potential determinants among urban BMSM.

Methods: The Men's Assessment of Social and Risk Network instrument was used to elicit HHC utilization, as reported by study respondents recruited through respondent-driven sampling.

Application of syndemic theory to black men who have sex with men in the Multicenter AIDS Cohort Study.

This study analyzed data from a large prospective epidemiologic cohort study among men who have sex with men (MSM), the Multicenter AIDS Cohort Study, to assess syndemic relationships among black MSM in the cohort (N = 301). We hypothesized that multiple interconnections among psychosocial health conditions would be found among these men, defining syndemic conditions. Constituents of syndemic conditions measured included reported depression symptoms, sexual compulsiveness, substance use, intimate partner violence (IPV), and stress.

The cumulative effects of medication use, drug use, and smoking on erectile dysfunction among men who have sex with men.

Introduction: Erectile dysfunction (ED) is highly prevalent among human immunodeficiency virus-seropositive (HIV+) men who have sex with men (MSM). There is a need for additional research to determine the correlates of HIV+ and HIV-seronegative (HIV-) MSM, especially regarding nonantiretroviral medication use.

Aims: This study examined the prevalence of ED and the sociodemographic, medical conditions, medication use, and substance use correlates of ED among HIV+ and HIV- MSM.

Assessing response to therapy in idiopathic pulmonary arterial hypertension: a consensus survey of Canadian pulmonary hypertension physicians.

Background: Many treatment options are now available for patients with idiopathic pulmonary arterial hypertension (IPAH). Data regarding the optimal combination of therapies are lacking, as is consensus on how to assess response to therapy and when to change therapeutic regimens.

Objectives: To gather the opinions of Canadian pulmonary hypertension (PH) experts regarding standard practice in the care of IPAH patients after therapy is initiated.

The mediating role of pain in substance use and depressive symptoms among Multicenter AIDS Cohort Study (MACS) participants.

Pain in human immunodeficiency virus (HIV) frequently co-occurs with substance use and depression. The complex associations among patient characteristics, pain, depression, and drug use in HIV suggests a role for testing models that can account for relationships simultaneously, control for HIV status, and also test for mediation. Using structural equation modeling, the current study examined associations among pain, sociodemographics, illicit drug use, and depressive symptoms in 921 HIV-seropositive and 1019 HIV-seronegative men from the Multicenter AIDS Cohort Study, an ongoing prospective study of the natural history of HIV infection among gay/bisexual men.

Transition from intravenous epoprostenol to oral or subcutaneous therapy in pulmonary arterial hypertension: a retrospective case series and systematic review.

Background: Intravenous epoprostenol, a prostaglandin analogue, has been a mainstay of therapy for patients with advanced pulmonary arterial hypertension (PAH) since the early 1990s. This medication has multiple side effects, and sudden discontinuation is potentially associated with severe sequelae. Several recent case series have described the transition from intravenous to newer oral or subcutaneous therapies.

Changes in stimulant drug use over time in the MACS: evidence for resilience against stimulant drug use among men who have sex with men.

Stimulant drug use is associated with numerous health problems among men who have sex with men (MSM). This paper describes how stimulant drug use changes over a four and one-half year period from 2003 until 2008. Participants were 2,389 men (17,222 person-visits) from The Multicenter AIDS Cohort Study (MACS)-an ongoing, prospective study of HIV infection among MSM.

A prospective study of alcohol consumption and HIV acquisition among injection drug users.

Objective: to estimate the effect of alcohol consumption on HIV acquisition while appropriately accounting for confounding by time-varying risk factors.

Design: african-American injection drug users in the AIDS Link to Intravenous Experience cohort study. Participants were recruited and followed with semiannual visits in Baltimore, Maryland between 1988 and 2008.

Determinants of alcohol consumption in HIV-uninfected injection drug users.

We assess the association between time fixed and time varying participant characteristics and subsequent alcohol consumption in 1968 injection drug users (median age 37 years, 28% female, 90% African-American) followed semi-annually from 1988 to 2008. Median alcohol consumption was seven drinks per week at study entry (first and third quartile: 1, 26) with 36% reporting binge drinking. Alcohol consumption and binge drinking decreased over follow-up.

Specific sex drug combinations contribute to the majority of recent HIV seroconversions among MSM in the MACS.

Background: New HIV infections are being observed among men who have sex with men (MSM). Understanding the fusion of risky sexual behaviors, stimulant and erectile dysfunction drug use with HIV seroconversion may provide direction for focused intervention.

Methods: During the follow-up period (1998-2008), we identified 57 HIV seroconverters among 1667 initially HIV-seronegative men.

Anal cancer screening behaviors and intentions in men who have sex with men.

Background: The incidence of anal cancer has increased in the past decade, especially among men who have sex with men (MSM) and HIV-infected individuals. There is controversy about whether to routinely screen for anal cancer in MSM.

Objectives: To determine whether current anal cancer screening behaviors, intention, and concern differ by HIV serostatus and to identify characteristics of men who intend to seek anal cancer screening.

Patterns and predictors of changes in adherence to highly active antiretroviral therapy: longitudinal study of men and women.

Background: Adherence to therapy is a dynamic behavior. However, few studies have identified factors associated with changes in adherence to highly active antiretroviral therapy (HAART) among men and women.

Methods: From 1999 through 2004, self-reported adherence to HAART was recorded twice yearly as part of 2 prospective cohort studies.

Acquisition of new sexual partners among women with HIV infection: patterns of disclosure and sexual behavior within new partnerships.

Unlabelled: This study describes the sexual behavior of HIV-positive women within new versus more established relationships and determines whether beliefs about HIV antiretroviral therapy (ART) impact these behaviors. The Women's Interagency HIV Study is a longitudinal cohort study of HIV among women in the United States. Sexually active HIV-positive women (N = 1,090) completed interviews on beliefs and behaviors at 6-month intervals.