A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia.

Background: Co-occurrence of social conditions and infections may affect HIV/HCV disease risk and progression. We examined the changes in relationship of these social conditions and infections on HIV and hepatitis C virus (HCV) infections over time in British Columbia during 1990-2013.

Methods: The BC Hepatitis Testers Cohort (BC-HTC) includes ~1.

Estimating the Size of the MSM Population in Metro Vancouver, Canada, Using Multiple Methods and Diverse Data Sources.

Men who have sex with men (MSM) are disproportionately affected by HIV globally, regionally in Canada, and locally in Vancouver. Lack of reliable population size estimates of MSM impedes effective implementation of health care services and limits our understanding of the HIV epidemic. We estimated the population size of MSM residing in Metro Vancouver drawing on four data sources: the Canadian Community Health Survey (CCHS), a cross-sectional bio-behavioural MSM survey, HIV testing services data from sexually transmitted infection (STI) clinics serving MSM, and online social networking site Facebook.

Disclosure of Sexual Orientation by Gay and Bisexual Men in Government-Administered Probability Surveys.

Purpose: Researchers are increasingly using national population surveys (NPS) to understand the health of gay and bisexual men (GBM). However, valid inference from these surveys depends on accurate identification of GBM.

Methods: We asked 8126 GBM in an anonymous, online, community-recruited survey about their willingness to reveal their sexual orientation in NPS.

Get Checked… Where? The Development of a Comprehensive, Integrated Internet-Based Testing Program for Sexually Transmitted and Blood-Borne Infections in British Columbia, Canada.

Background: Testing for sexually transmitted and blood-borne infections (STBBI) is an effective public health strategy that can promote personal control of one's health and prevent the spread of these infections. Multiple barriers deter access to testing including fear of stigmatization, inaccurate health care provider perceptions of risk, and reduced availability of clinic services and infrastructure. Concurrent increases in sexually transmitted infection (STI) rates and demands on existing clinical services make this an even more pressing concern.

Contribution of influenza viruses to medically attended acute respiratory illnesses in children in high-income countries: a meta-analysis.

Aim: The burden of disease in children attributable to influenza viruses is difficult to quantify given the similarity of symptoms caused by infection due to influenza and other viruses. This uncertainty impacts clinical decision-making and estimates of burden. We aimed to systematically review the literature to determine the proportion of healthy children presenting for health care with an acute respiratory illness (ARI) who have laboratory-confirmed seasonal influenza (PROSPERO ID#CRD42014013896).

Predictors identifying those at increased risk for STDs: a theory-guided review of empirical literature and clinical guidelines.

SummarySexually transmitted diseases (STDs) are leading causes of substantial morbidity worldwide. Identification of risk factors for estimating STD risk provides opportunities for optimising service delivery in clinical settings, including improving case finding accuracy and increasing cost-efficiency by limiting the testing of low-risk individuals. The current study was undertaken to synthesise the evidence supporting commonly cited chlamydia and gonorrhoea risk factors.

Time since last negative HIV test among men who have sex with men and people who use injection drugs in British Columbia, 2006-2011.

Objectives: Canadian surveys of men who have sex with men (MSM) and people using injection drugs (IDU) demonstrate that most have tested for HIV at least once, but that half or fewer have done so in the previous year. To better inform targeted HIV testing guidelines for these populations, we derived estimates of inter-test interval (ITI) for persons newly diagnosed with HIV in British Columbia (BC) between 2006 and 2011, and assessed variables associated with longer ITI among MSM and IDU.

Methods: Provincial HIV case report and testing data were linked by deterministic and probabilistic matching (based on unique personal health number, name, and date of birth).

A critical appraisal of risk models for predicting sexually transmitted infections.

Background: Prediction rules have been proposed as alternatives to screening recommendations and have potential applications in sexual health decision making. To our knowledge, there has been no review undertaken providing a critical appraisal of existing prediction rules in sexual health contexts. This review aims to identify and characterize prediction rules developed and validated for sexually transmitted infection (STI) screening, describe the methodological issues essential to the suitability of derived models for clinical or public health application, and synthesize the literature on the performance of these models.

Factors associated with intention to use internet-based testing for sexually transmitted infections among men who have sex with men.

Background: Internet-based testing programs are being increasingly used to reduce testing barriers for individuals at higher risk of infection, yet the population impact and potential for exacerbation of existing health inequities of these programs are not well understood.

Objective: We used a large online sample of men who have sex with men (MSM) in Canada to measure acceptability of Internet-based testing and perceived advantages and disadvantages of this testing approach.

Methods: We asked participants of the 2011/2012 Sex Now Survey (a serial online survey of gay and bisexual men in Canada) whether they intended to use Internet-based testing and their perceived benefits and disadvantages of use.

Evidence of a syndemic among young Canadian gay and bisexual men: uncovering the associations between anti-gay experiences, psychosocial issues, and HIV risk.

Syndemic has become an important theoretical model toward understanding how psychosocial issues may interact to increase HIV acquisition among gay and bisexual men. We measured the extent to which anti-gay experiences are associated with psychosocial issues, which in turn were hypothesized to have an additive effect on HIV risk, in a sample of Canadian young gay and bisexual men. Sixty-eight percent of men reported at least one form of anti-gay experience.

Cephalosporin and azithromycin susceptibility in Neisseria gonorrhoeae isolates by site of infection, British Columbia, 2006 to 2011.

Background: Widespread resistance of Neisseria gonorrhoeae to penicillin, tetracycline, and fluoroquinolones has challenged effective treatment and control; recent international case reports of cefixime, ceftriaxone, and azithromycin resistance suggest that the remaining treatment options are now additionally threatened. To explore trends in antimicrobial susceptibility of N. gonorrhoeae, we reviewed provincial laboratory data from British Columbia, 2006 to 2011.

Estimates of influenza vaccine effectiveness for 2007-2008 from Canada's sentinel surveillance system: cross-protection against major and minor variants.

Objectives: To estimate influenza vaccine effectiveness (VE) for the 2007-2008 season and assess the sentinel surveillance system in Canada for monitoring virus evolution and impact on VE.

Methods: Nasal/nasopharyngeal swabs and epidemiologic details were collected from patients presenting to a sentinel physician within 7 days of influenza-like illness onset. Cases tested positive for influenza A/B virus by real-time polymerase chain reaction; controls tested negative.

Internet-based HIV and sexually transmitted infection testing in British Columbia, Canada: opinions and expectations of prospective clients.

Background: The feasibility and acceptability of Internet-based sexually transmitted infection (STI) testing have been demonstrated; however, few programs have included testing for human immunodeficiency virus (HIV). In British Columbia, Canada, a new initiative will offer online access to chlamydia, gonorrhea, syphilis, and HIV testing, integrated with existing clinic-based services. We presented the model to gay men and other men who have sex with men (MSM) and existing clinic clients through a series of focus groups.

Transmission dynamics and risk factors for pandemic H1N1-related illness: outbreak investigation in a rural community of British Columbia, Canada.

Objective: To characterize the first-wave epidemiologic features of influenza-like illness (ILI) associated with the novel pandemic A/H1N1 [A(H1N1)pdm09] virus.

Methods: We used generalized linear mixed models (GLMM) to assess risk factors and non-parametric and/or parametric distributions to estimate attack rates, secondary attack rates (SAR), duration of illness, and serial interval during a laboratory-confirmed community outbreak of A(H1N1)pdm09 clustered around on-reserve residents and households of an elementary school in rural British Columbia, Canada, in late April/early May 2009. ILI details were collected as part of outbreak investigation by community telephone survey in early June 2009.

Influenza Β/Victoria antigen induces strong recall of Β/Yamagata but lower Β/Victoria response in children primed with two doses of Β/Yamagata.

Objectives: Trivalent inactivated influenza vaccine (TIV) contains 1 of 2 influenza B/lineages (B/Yamagata or B/Victoria) annually. We assessed prime-boost responses in young children following a change in the B/lineage included in TIV.

Methods: Participants were primed during a clinical trial as infants or toddlers with two 0.

Influenza vaccine effectiveness in the elderly based on administrative databases: change in immunization habit as a marker for bias.

Background: Administrative databases provide efficient methods to estimate influenza vaccine effectiveness (IVE) against severe outcomes in the elderly but are prone to intractable bias. This study returns to one of the linked population databases by which IVE against hospitalization and death in the elderly was first assessed. We explore IVE across six more recent influenza seasons, including periods before, during, and after peak activity to identify potential markers for bias.

Randomized controlled trial of dose response to influenza vaccine in children aged 6 to 23 months.

Objectives: We assessed whether 2 full versus 2 half-doses of trivalent inactivated influenza vaccine (TIV) could improve immunogenicity without increasing reactogenicity in infants (aged 6-11 months) and toddlers (aged 12-23 months).

Methods: Previously unimmunized infants and toddlers were separately randomly assigned to receive 2 full (0.5-mL) or 2 half (0.