Experimental capabilities for liquid jet samples at sub-MHz rates at the FXE Instrument at European XFEL

The Femtosecond X-ray Experiments (FXE) instrument at the European X-ray Free-Electron Laser (EuXFEL) provides an optimized platform for investigations of ultrafast physical, chemical and biological processes. It operates in the energy range 4.7-20 keV accommodating flexible and versatile environments for a wide range of samples using diverse ultrafast X-ray spectroscopic, scattering and diffraction techniques. FXE is particularly suitable for experiments taking advantage of the sub-MHz repetition rates provided by the EuXFEL. In this paper a dedicated setup for studies on ultrafast biological and chemical dynamics in solution phase at sub-MHz rates at FXE is presented. Particular emphasis on the different liquid jet sample delivery options and their performance is given. Our portfolio of high-speed jets compatible with sub-MHz experiments includes cylindrical jets, gas dynamic virtual nozzles and flat jets. The capability to perform multi-color X-ray emission spectroscopy (XES) experiments is illustrated by a set of measurements using the dispersive X-ray spectrometer in von Hamos geometry. Static XES data collected using a multi-crystal scanning Johann-type spectrometer are also presented. A few examples of experimental results on ultrafast time-resolved X-ray emission spectroscopy and wide-angle X-ray scattering at sub-MHz pulse repetition rates are given.

Is the experience of hunger associated with risk of engaging in condomless anal sex among minority young men who have sex with men?

Although emerging evidence suggests that hunger may be a risk factor for engaging in risk behaviors that lead to HIV acquisition, this has rarely been explored for young minority men who have sex with men (YMSM). This study explored a range of sexual risk behaviors for associations with a measure of hunger, assessed among 448 YMSM residing in Los Angeles, CA. Forty-five percent experienced hunger (past 12 months). Hunger was significantly associated with engaging in any condomless anal receptive sex (CARS) (adjusted odds ratio = 1.74; 95% confidence interval = 1.01–3.01; P = .049). Further, hunger was also significantly associated with a greater percentage of CARS (Beta = .12; t = 2.18; P = .03). Parallel effects were not observed relative to condomless anal insertive sex. Findings suggest that the experience of hunger among young minority MSM is generally not associated with a milieu of sexual risk. One important exception is that hunger may lead to having CARS. This suggests a potential ‘trade off’ for receptive partners experiencing hunger and partially supports the idea that at hunger may predispose minority YMSM to partner demands not to use condoms.

Sexual Racism, Psychological Symptoms, and Mindfulness Among Ethnically/Racially Diverse Young Men Who Have Sex with Men: a Moderation Analysis

OBJECTIVES

This study examined the potential moderating role of trait mindfulness on the association between perceived sexual racism and psychological symptoms among a community-based sample of ethnic/racial minority young men who have sex with men (MSM) residing in greater Los Angeles.

METHODS

From a cross-sectional sample of 448 participants, aged 16-24 years, survey data were analyzed to examine rates of perceived sexual racism, mindfulness, psychological symptoms, and moderation by mindfulness through various analyses, including analysis of variance and logistic regression.

RESULTS

Results indicated that Latino young MSM reported the lowest scores of sexual racism, and sexual racism was associated with higher odds of psychological symptoms, suicidal ideation with a plan in the past year, and self-injury in the past 3 months. The protective potential of mindfulness was suggested by its main effects on psychological symptoms; however, it only buffered the effects of sexual racism on suicidal ideation with a plan and self-injury, with marginal buffering effects on depression.

CONCLUSIONS

Findings underscore the potential utility of assessing sexual racism among young MSM of color, as well as the potential benefit of mindfulness approaches to buffer the effects of sexual racism on symptoms of depression. Interpretation of these findings is briefly discussed.

Use of pre-exposure prophylaxis increases the odds of condomless anal sex among young men who have sex with men (MSM) of colour

This study tested the hypothesis that people using pre-exposure prophylaxis (PrEP) would be more likely to report condomless anal sex than those not taking PrEP. Data were from an ongoing study conducted with a cohort of Black and Latino young men who have sex with men (YMSM) recruited in Los Angeles (CA, USA). Of the 399 YMSM in the sample, 14% were currently using PrEP. Using three different measures of condom use, across two different recall periods all except one test result supported an inverse relationship between PrEP and condom use for anal sex. Tests of a risk index provided further significant findings supporting this hypothesis.

Engaging Young Men in the HIV Prevention and Care Continua: Experiences From Young Men of Color Who Have Sex With Men

Sexual minority individuals experience barriers to receiving equitable health care. Research also indicates that young men who have sex with men (YMSM), particularly young men of color, have limited engagement in the HIV care continuum and there are significant disparities across the continuum. This study aims to uncover how providers can engage YMSM of color in all forms of care, including primary care and HIV prevention through an HIV prevention continuum. This qualitative study reports data from the Healthy Young Men's Cohort Study; a total of 49 YMSM participated in the eight focus groups. This study provides a description of YMSM's overall health concerns, experiences with health care, and under what circumstances YMSM seek care. We then present a model describing the salient characteristics of a HIV prevention continuum for YMSM of color and provide clear areas for education, intervention, and policy change to support better overall health for YMSM of color.

Viewpoints from families for improving transition from NICU-to-home for infants with medical complexity at a safety net hospital: a qualitative study

Background

We have limited information on families’ experiences during transition and after discharge from the neonatal intensive care unit.

Methods

Open-ended semi-structured interviews were conducted with English or Spanish- speaking families enrolled in Medicaid in an urban high-risk infant follow up clinic at a safety-net center, which serves preterm and high-risk term infants. We generated salient themes using inductive-deductive thematic analysis.

Results

Twenty-one participants completed the study. The infant’s median (IQR) birth weight was 1750 (1305, 2641) grams; 71% were Hispanic and 10% were Black non-Hispanic; 62% reported living in a neighborhood with 3-4th quartile economic hardship. All were classified as having chronic disease per the Pediatric Medical Complexity Algorithm and 67% had medical complexity. A conceptual model was constructed and the analysis revealed major themes describing families’ challenges and ideas to support transition centered on the parent-child role and parent self-efficacy. The challenges were: (1) comparison to normal babies, (2) caregiver mental health, (3) need for information. Ideas to support transition included, (1) support systems, (2) interventions using mobile health technology (3) improved communication to the primary care provider and (4) information regarding financial assistance programs. Specific subthemes differed in frequency counts between infants with and without medical complexity.

Conclusions

Families often compare their preterm or high-risk infant to their peers and mothers feel great anxiety and stress. However, families often found hope and resilience in peer support and cited that in addition to information needs, interventions using mobile health technology and transition and financial systems could better support families after discharge.

Electronic supplementary material

The online version of this article (10.1186/s12887-019-1604-6) contains supplementary material, which is available to authorized users.

A Focus on the HIV Care Continuum Through the Healthy Young Men's Cohort Study: Protocol for a Mixed-Methods Study

BACKGROUND

No group is at greater risk for acquiring HIV than young men who have sex with men (YMSM), particularly black or African American (AA) and Hispanic or Latino (L) YMSM living in inner cities, who account for the largest number of new HIV infections each year. Although pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and treatment as prevention hold enormous promise for changing the course of the epidemic, AA/L-YMSM are the least likely population to be receiving primary health care and HIV prevention/care and are the least likely to be using PrEP and PEP.

OBJECTIVE

The overarching aim of the Healthy Young Men's (HYM) cohort study is to conduct longitudinal research with a cohort of AA/L-YMSM to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. Findings from this research will be used to inform the development of new interventions designed to engage AA/L-YMSM in the HIV prevention and care continua.

METHODS

Longitudinal research (baseline and follow-up assessments every 6 months for a total of 8 waves of data collection) is ongoing with a new cohort of 450 high-risk AA/L-YMSM in Los Angeles. Participants were recruited using a venue-based and social media sampling design. In addition to self-report surveys, the study protocol includes the collection of urine to assess recent use of illicit drugs and the collection of blood and rectal/throat swabs to test for current sexually transmitted infection (STI)/HIV infection. An additional sample of blood/plasma (10 mL for 4 aliquots and 1 pellet) is also collected and stored in the HYM cohort study biorepository for future research. By design, we recruited 400 HIV-negative participants and 50 HIV-positive (HIV+) participants. This mixed-methods study design includes collection and triangulated analysis of quantitative, qualitative, and biological measures (ie, drug use, STI/HIV testing, and adherence to antiretroviral therapy among HIV+ participants) at baseline and every 6 months. The HYM cohort study will provide a platform from which new and emerging biomedical prevention strategies (eg, PrEP, rectal microbicides, and PEP) and other HIV prevention and care engagement interventions can be developed and evaluated with AA/L-YMSM.

RESULTS

To date, all participants in the HYM cohort study have been recruited and baseline assessment has been conducted.

CONCLUSIONS

The findings from this research will be used to inform the development of new and/or adaptation of existing evidence-based HIV prevention interventions and interventions designed to engage this population in the HIV prevention and care continua.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/10738.

Perceptions of Family Among Low-Income Patients With Diabetes in a Text-Based Mobile Health Intervention

BACKGROUND

Diabetes disproportionately affects the US Latino population, due to socioeconomic pressures, genetics, reduced access to care and cultural practices. While efforts to improve self-care through interventions incorporating family are highly rated by Latinos, family can be both supportive and obstructive. To develop effective interventions, this role needs clarification.

METHODS

We conducted group interviews in Spanish and English with 24 participants with diabetes from a mobile health diabetes self-care intervention. We imported transcripts into Dedoose, a qualitative computer analysis program and analyzed them with a modified grounded theory technique. Utilizing an iterative process, we reexamined transcripts with new codes derived in each round of analysis until saturation was reached. We employed techniques to improve trustworthiness (co-coding, member checking). Broad categorical themes arose from the initial codes and were developed into a conceptual model of barriers to and strategies for diabetes management.

RESULTS

Family and family responsibilities emerged as both a supportive and obstructive force for diabetes self-care. While the desire to care for family motivated patients, food at family gatherings and pressure from managing multiple family responsibilities contributed to poor diet choices. Yet, some patients believed their diabetes caused their immediate family to make healthier choices.

CONCLUSIONS

Among these predominantly Latino patients, family and family responsibilities were key motivators as well as obstacles to self-care, particularly regarding nutrition. Finding the ideal design for social support mHealth-based interventions will require careful study and creation of culturally based programs to match the needs of specific populations, and may require educating family members to provide effective social support.

Setting an Agenda to Address Intimate Partner Violence Among Young Men Who Have Sex With Men: A Conceptual Model and Review

Research investigating intimate partner violence (IPV) among sexual minorities is limited. The research that does exist has found that rates of IPV are similar to or higher than the rates found for heterosexual women, the most commonly studied population in this area. This limited research has resulted in a dearth of prevention/intervention programs targeted for these populations. While some may argue that existing IPV programs can be used for these populations, this review presents an argument for more targeted work with sexual minority populations, using young men who have sex with men (YMSM) as an example. Drawing on the framework of intersectionality, this article argues that the intersectionality of age, sexual identity, and gender combines to create a spectrum of unique factors that require specific attention. This framework allows for the identification of known correlates for IPV as well as factors that may be unique to YMSM or other sexual minority populations. The article presents a conceptual model that suggests new areas of research as well as a foundation for the topics and issues that should be addressed in an intervention.

The Community Mentorship Program: Providing Community-Engagement Opportunities for Early-Stage Clinical and Translational Scientists to Facilitate Research Translation

PROBLEM

A goal of the Southern California Clinical and Translational Science Institute (SC-CTSI) at the University of Southern California and Children's Hospital Los Angeles is to train early-stage clinical and translational scientists (CTSs) to conduct research that improves the health of diverse communities. This goal aligns well with the Institute of Medicine's recommendations emphasizing community engagement in biomedical research that facilitates research translation. The Community Mentorship Program (CMP), created to complement community-engaged research didactics, matches CTSs with community mentors who help them identify and complete community-engaged experiences that inform their research.

APPROACH

The CMP was piloted in 2013-2015 by the SC-CTSI Workforce Development and Community Engagement cores. The CMP team matched three CTSs (assistant professors pursuing mentored career development awards) with mentors at community-based organizations (CBOs) aligned with their research interests. Each mentor-mentee pair signed a memorandum of understanding. The CMP team checked in regularly, monitoring progress and addressing challenges in CTSs' completion of their community-engaged experience.

OUTCOMES

Each pair completed at least one community-engaged activity informing the CTS's research. In exit interviews, the CTSs and CBO mentors expressed satisfaction with the program and stated that they would continue to work together. The CTSs reported that the program provided opportunities to develop networks outside academia, build trust within the community, and receive feedback and learn from individuals in communities affected by their research.

NEXT STEPS

The CMP will be expanded to include all eligible early-career CTSs and promoted for use in similar settings outside the SC-CTSI.

Making Informed Decisions: How Attitudes and Perceptions Affect the Use of Crystal, Cocaine, and Ecstasy among Young Men Who Have Sex with Men

Although the use of illicit substances, particularly those commonly categorized as “club drugs”, among men who have sex with men (MSM), is well established in the literature, little is known about the decision making process that is used in deciding whether or not to use a particular substance. In this study, we examine the positive and negative attitudes and perceptions among young men who have sex with men (YMSM) in regards to three specific drugs: crystal methamphetamine, cocaine, and ecstasy. The findings reported here emerged from the baseline quantitative interviews and an accompanying qualitative phase of the Healthy Young Men's study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can design new and innovative interventions to prevent young men from initiating substance use.

Enhancing Dissemination, Implementation, and Improvement Science in CTSAs through Regional Partnerships

BACKGROUND AND IMPORTANCE

Challenges in healthcare policy and practice have stimulated interest in dissemination and implementation science. The Institute of Medicine Committee on the Clinical Translational Science Award (CTSA) program recommended expanding the CTSA program's investment and activity in this domain. Guidance is needed to facilitate successful growth of DII science infrastructure, activity and impacts.

OBJECTIVES

Several CTSAs in Southern California collaborated to identify and respond to local challenges and opportunities to expand dissemination, implementation and improvement research by strengthening capacity and relationships between DII researchers and community, health system, and population health partners.

MAIN OUTCOMES

Planning and outreach by the Southern California CTSAs increased awareness and interest in DII research and generated recommendations for growth. Recommendations include: increasing strong partnerships with healthcare and population health systems to guide policy research agendas and collaborative DII science; promoting multi-sector partnerships that involve researchers and delivery systems throughout DII processes; bringing together multiple disciplines; and addressing national and international barriers as well as opportunities in DII science.

IMPLICATIONS

CTSAs through regional collaboration can increase their contributions to improved community health via skill-building, partnership development and enhanced outreach to local healthcare and public health agencies and delivery systems.

Young Men Who Have Sex With Men’s Experiences With Intimate Partner Violence

Research estimating the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) and other sexual minority populations is limited. However, existing research indicates rates similar to heterosexual women. This mixed-methods study was designed to inform intervention development and provides a description of the types of IPV experienced by young MSM (YMSM) within their dating and intimate relationships. Data collected include 101 surveys with YMSM aged 18 to 25 and 26 semi-structured qualitative interviews. YMSM experienced high levels of psychological aggression, physical assault, and sexual coercion both as victims and perpetrators. The study also found that there were high rates of mutual perpetration, young men reporting being both victim and perpetrator of partner violence. Qualitative data provide context and descriptions of these incidents to provide more information about the circumstances and perceptions of these incidents. The findings indicate that interventions should be multifaceted and include schools, communities, and families to address anger management, conflict resolution, and communication skills within young men’s relationships.

Attitudes and perceptions of biomedical HIV prevention methods: voices from young men who have sex with men

In the third decade of the HIV/AIDS epidemic in the United States, the prevalence rates of new HIV infections among young men who have sex with men (YMSM) continue to increase. As new and emerging HIV prevention methods are developed, it is important to understand the perceptions of this vulnerable population-as they may be an ideal target for these intervention methods. This pilot study provides an overview of YMSM of color's awareness and perceptions of pre-exposure prophylaxis (PrEP) and rectal microbicides (RM). A total of 6 focus groups were convened with 53 YMSM (23 Latino/Hispanic and 30 Black/African American). Findings indicate a lack of knowledge of biomedical interventions and high perceived acceptability. Concerns regarding PrEP included potential side effects, potential for misinterpretation of its use and cost. RMs were perceived to be more acceptable than PrEP, but the limited knowledge about their potential was emphasized by YMSM. Results are discussed in relation to the need for providers to continue to provide general health education about safe sexual practices. As PrEP and other biomedical interventions are introduced into community settings, caution should be taken with regards to determining the appropriate target user and sufficient education.

"Same-sex relationship in a straight world": individual and societal influences on power and control in young men's relationships

Young men who have sex with men (YMSM) continue to experience higher rates of HIV infection than other populations. Recently, there have been recommendations to consider HIV prevention at the dyadic or couple level. Using a dyadic approach to HIV prevention would also address an unaddressed concern related to intimate partner violence (IPV) among YMSM. Although research on IPV among YMSM is still in its infancy, great strides have been made in the past 10 years to describe the prevalence and related correlates of IPV within older adult same-sex relationships. These studies have found rates of IPV among MSM to be similar to rates among heterosexual women, and to be on the rise. The present study is designed to provide insight into how power is conceptualized within YMSM relationships and the role it may play in relationship challenges. This study draws from qualitative data collected from 11 focus groups with 86 YMSM and 26 individual semi-structured interviews to understand relationship challenges and the experiences of YMSM involved in partner violence. YMSM described relationship power as stemming from numerous sources including sexual positioning, gender roles, education, income, prior relationship experiences, and internalized homophobia. The findings have a number of implications for service providers and program design. Interventionists and other researchers need to consider power dynamics and other contextual elements of IPV before effective interventions can be developed for YMSM and other sexual minority populations.

Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates

Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of "coding consensus, co-occurrence, and comparison" and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities.

High-risk sexual activity in the House and Ball community: influence of social networks

OBJECTIVES

We investigated the roles of House membership and the influence of social and sexual network members on the sexual risk behavior of men in the Los Angeles House and Ball community.

METHODS

From February 2009 to January 2010, male participants (n = 233) completed interviewer-assisted surveys during a House meeting or Ball event. We used logistic regression to model the effects of sexual network size, influence of sexual network members, House membership status, and their interactions on high-risk sex.

RESULTS

Significant predictors of high-risk sex included number of sexual partners in the nominated social network, multiethnicity, and previous diagnosis of sexually transmitted infection. House membership was protective against high-risk sex. Additionally, a 3-way interaction emerged between number of sexual partners in the network, influence, and network members' House membership.

CONCLUSIONS

Future research should assess network members' attitudes and behavior in detail to provide a greater understanding of the dynamics of social influence and to identify additional avenues for intervention.

Perceptions of successful cues to action and opportunities to augment behavioral triggers in diabetes self-management: qualitative analysis of a mobile intervention for low-income Latinos with diabetes

BACKGROUND

The increasing prevalence of diabetes and the associated cost of managing this complicated disease have a significant impact on public health outcomes and health expenditures, especially among resource-poor Latino patients. Mobile health (mHealth) may be the solution to reaching this group and improving their health.

OBJECTIVE

In this qualitative study, we examined nuances of motivation, intention, and triggers to action effected by TExT-MED (Trial to Examine Text Messaging for Emergency Department patient with Diabetes), an mHealth intervention tailored to low-income, urban Latinos with diabetes. TExT-MED is a fully-automated, text message-based program designed to increase knowledge, self-efficacy, and subsequent disease management and glycemic control.

METHODS

We conducted 5 focus group interviews with 24 people who participated in TExT-MED. We employed a modified grounded theory analytic approach-an iterative process of coding and immersion in the data used to recognize the patterns and links between concepts voiced by the participants. We coded data to identify themes of participant experiences, motivations, and responses to the program. We organized themes into a theory of TExT-MED's action.

RESULTS

Participants enjoyed their experience with TExT-MED and believed it improved their diabetes management. Through analysis of the transcripts, we identified that the strengths of the program were messages that cued specific behaviors such as medication reminders and challenge messages. Our analysis also revealed that increasing personalization of message delivery and content could augment these cues.

CONCLUSIONS

This in-depth qualitative analysis of TExT-MED shows that low-income Latino patients will accept text messages as a behavioral intervention. This mHealth intervention acts as a behavioral trigger rather than an education platform. Personalization is an opportunity to enhance these cues to action and further research should be conducted on the ideal forms of personalization.

"It's like our own little world": resilience as a factor in participating in the Ballroom community subculture

We are well into the third decade of the HIV epidemic. While strides have been made in HIV prevention, rates for African American men who have sex with men (AAMSM) and young AAMSM continue to increase-perhaps indicating that traditional deficit-approaches of HIV prevention are not effective for all populations. Following a recent call to investigate the resiliency of young gay men, this study identifies sources of resilience and strength within the House and Ball communities, a subculture comprised primarily of AAMSM. The mixed-methods design included survey data (N = 263) collected at community events, interviews with Ball attendees and focus group data with House members. Survey data indicate a relationship between participating in the House and Ball communities and seeking support, acceptance and entertainment. Qualitative data validate these findings and provide detail on motivations for AAMSM to participate and the perceived benefits of participation. Findings are discussed in relation to building strengths-based interventions, using concepts of resiliency including shamelessness, social creativity, social support and volunteerism.

Laying the groundwork for an HIV prevention intervention: a descriptive profile of the Los Angeles House and Ball communities

African American young men who have sex with men (AAYMSM) represent the largest proportion of new HIV infections among MSM. While evidence-based interventions are lacking, all too often HIV interventions are implemented in a community without thoroughly understanding its needs, risks and assets. AAYMSM are not homogenous; subgroups exist that may require different approaches to be effective. The House and Ball communities represent one such subgroup. A community-engaged, mixed-methods approach was used. Participant observations, qualitative interviews (N = 26), and a survey at House/Ball events (N = 252) were completed. Survey data broadly describe the community. For example: 69 % of survey respondents identify as gay; 25 % as bisexual; 13 % reported recent use of ecstasy and 11 % recently participated in sex exchange. The depth of qualitative data is key for intervention development. For example, while the survey provides broad descriptions of respondents' involvement in the House and Ball communities, leaders provided in-depth descriptions of the structure of the House and Ball scene-something vital to the development of HIV prevention programs within these communities. This kind of rigorous study is recommended prior to implementing an intervention. Findings are discussed in relation to leveraging the communities' supportive aspects to design culturally relevant HIV prevention programs.

Community-engaged research to identify house parent perspectives on support and risk within the House and Ball scene

This article describes a community-engaged study with the Los Angeles House and Ball scene in which the perspectives of the leaders of these communities are captured to better understand how the House and Ball communities may protect or increase its members' risks for HIV infection. Data were collected through in-depth interviews with House parents (N = 26). This study identified key features of both support (e.g., family and support, acceptance, and validation and recognition) and risk (e.g., members' struggles to maintain status in the Ballroom scene, sex work, substance use, danger of becoming too involved in the Ball community, and perception and stigma of the Ballroom scene within the larger gay community) within these communities. Findings are discussed in relation to framing how to leverage the supportive aspects of the House and Ball communities to design relevant HIV-prevention interventions.

HIV prevention service utilization in the Los Angeles House and Ball communities: past experiences and recommendations for the future

African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however, little research exists on effective approaches to HIV prevention within these communities. Using a mixed-methods approach, the present study sought to document participation in HIV prevention activities of a sample from the Los Angeles House and Ball communities (n = 263) in order to inform future service development. While 80% of participants were tested for HIV within the past 6 months, only 26% report HIV prevention program attendance. House leaders recommend a holistic approach to HIV prevention, one that incorporates attention to social problems beyond HIV, including poverty, housing difficulties, and lack of job training.

Photovoice as a tool to adapt an HIV prevention intervention for African American young men who have sex with men

Objective. HIV rates for African American young men who have sex with men (AAYMSM) have reached as much as 14.7%, compared with 2.5% and 3.5% among Caucasian and Latino YMSM. However, there remains a lack of HIV prevention interventions for this population. This study describes the use of Photovoice in the adaptation process of an evidence-based intervention (Adult Identity Mentoring) to make it developmentally and culturally appropriate for AAYMSM. Method. A total of 36 AAYMSM (aged 18-24 years) participated in weekly working group sessions to conduct a community-, youth-, and data-driven adaptation process. Photovoice was used as a technique to facilitate guided discussions on topics that were identified for the new curriculum. Results. Through Photovoice discussions, we identified a new focus for the adapted intervention, Young Men's Adult Identity Mentoring (YM-AIM): development and maintenance of healthy intimate relationships. This new focus and the resulting curriculum are rooted in the voices and perceptions of the target population. Conclusions. Including youth was integral to the adaptation process and the use of techniques such as Photovoice helped ensure that the resulting adaptation was relevant to the target population.

High-precision laser-assisted absolute determination of x-ray diffraction angles

A novel technique for absolute wavelength determination in high-precision crystal x-ray spectroscopy recently introduced has been upgraded reaching unprecedented accuracies. The method combines visible laser beams with the Bond method, where Bragg angles (θ and -θ) are determined without any x-ray reference lines. Using flat crystals this technique makes absolute x-ray wavelength measurements feasible even at low x-ray fluxes. The upgraded spectrometer has been used in combination with first experiments on the 1s2p(1)P(1) → 1s(2)(1)S(0) w-line in He-like argon. By resolving a minute curvature of the x-ray lines the accuracy reaches there the best ever reported value of 1.5 ppm. The result is sensitive to predicted second-order QED contributions at the level of two-electron screening and two-photon radiative diagrams and will allow for the first time to benchmark predicted binding energies for He-like ions at this level of precision.

Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men

The Internet has opened many doors with its accessibility to information, entertainment and web-based communities. For young men who have sex with men (YMSM), the Internet can provide access to information on relevant sexual behavior and health information, stories from other men about relationship issues, and a venue for locating potential sexual and dating partners. Understanding YMSM's motivations for going online for information, advice or sexual relationships, is important as the Internet becomes increasingly used not only as a space to find sexual partners, but also as a venue for HIV and STI interventions. Having an understanding of the risks associated with searching for partners online, and how and why YMSM use the Internet for a variety of purposes, can inform the development of more effective Internet-based risk reduction programs. This article presents qualitative and quantitative data from the Healthy Young Men's Study, a longitudinal study of an ethnically diverse cohort of 526 YMSM. Qualitative interviews (N = 24) described not only the prevalence of using the Internet for finding sexual partners and the possible benefits and risks associated with that practice, but also the processes and perceptions of using this mechanism. Our data indicate that YMSM used the Internet to find information related to sex and sexuality, seek friendships, sexual partners as well as "hook-ups" or casual sex. Findings were presented in relation to how YMSM researchers and interventionists can identify how to most effectively reach YMSM through online methods.

In the dark: young men's stories of sexual initiation in the absence of relevant sexual health information

A growing body of research has investigated the effectiveness of abstinence-only sexual education. There remains a dearth of research on the relevant sexual health information available to young men who have sex with men (YMSM). Drawing on a mixed-methods study with 526 YMSM, this study explores how and where YMSM receive relevant information on sexual health/behavior. Findings indicate that information related to gay men's sexuality is not readily available from family, friends, or schools. At initiation of anal intercourse, respondents generally had limited information about HIV and sexually transmitted infections (STIs). In some cases, this resulted in the perception that activities such as unprotected sex were "low risk." Many mentioned they first learned about anal sex during their sexual debut, describing painful and/or unpleasant experiences. Some relied on older/more experienced partners, the Internet, and pornography for information. Findings are discussed in relation to how providers can help YMSM build solid foundations of sexual education to protect them from STI and HIV infection.

Deconstructing the complexity of substance use among young men who have sex with men (YMSM) by optimizing the role of qualitative strategies in a mixed methods study

Qualitative data can be a powerful tool in developing interventions for substance use and other HIV-risk behaviors. Mixed methods design offers researchers the ability to obtain data that provides both breadth and depth to their research questions. However, the integration of qualitative data in mixed methods research has been limited. This paper describes the qualitative study design of the Healthy Young Men's Study, a longitudinal mixed method study with an ethnically diverse cohort of young men who have sex with men (YMSM) (N = 526) in Los Angeles. Integral to this discussion is how a mixed methods study can address common challenges such as sampling, representation and integration of both datasets.

"God Made me Gay for a Reason": Young Men who have Sex with Men's Resiliency in Resolving Internalized Homophobia from Religious Sources

Research investigating the role of religion in the lives of young men who have sex with men (YMSM) is limited. Given the unique developmental stage of emerging adults and the fact that most religions have restrictions on homosexual behavior, it is important to understand how YMSM integrate their sexual and religious/spiritual identities. Drawing upon a longitudinal, mixed methods study, we explore the role of religion and spirituality in the lives of a sample of YMSM. Presented are descriptions of messages about homosexuality from religious contexts and how these messages are internalized. The process used to resolve the conflict between these messages and their sexual identity is then described. Findings discuss how to help YMSM retain the more supportive and nurturing aspects of religion to integrate their sexual and religious identities for a functional support system.

Accountability and assessment of emergency drill performance at schools

Many schools throughout the United States are mandated to hold drills, or operational exercises, to prepare for fires, earthquakes, violence, and other emergencies. However, drills have not been assessed for their effectiveness in improving preparedness at schools. This mixed-methods study measures the quantity and the quality of drills in an urban school district in Los Angeles. Compliance with California mandates was fair; most schools barely met requirements. Drills were not used as opportunities to improve procedures. Sites neither conducted any self-assessments nor made changes to procedures on the basis of performance. Suggestions include developing realistic simulated exercises, debriefing, and better school accountability for drills.

Strategies Used by Gay and Bisexual Young Men to Cope with Heterosexism

Although the pervasiveness of heterosexism in the lives of gay and bisexual youth is well established, little is known about the strategies these youth use to cope with stigma and discrimination based on their sexual minority status. In this qualitative study, the authors present findings and implications for clinical practice based on interviews with 43 gay and bisexual young men. Respondents' coping strategies are discussed in relation to current theory and research on coping with stigma, as well as the emerging field of emotion regulation. The narratives from the current study suggest that the emotion regulation paradigm is well suited to understanding the functions of strategies for coping with heterosexism and similar types of stigma.

Young men's perspectives on family support and disclosure of same-sex attraction

Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM's (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support.

Integrating professional and folk models of HIV risk: YMSM's perceptions of high-risk sex

Risks associated with HIV are well documented in research literature. Although a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the "professional" and "folk" models of HIV risk based on YMSM's understanding of high-risk sex and where and how they gathered their understanding of HIV risk behaviors. The findings reported here emerged from the quantitative and qualitative interviews from the Healthy Young Men's Study, a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can increase YMSM's knowledge of sexual behavior and help them build solid foundations of sexual health education to protect them from sexually transmitted infections and HIV.

Testing QED screening and two-loop contributions with He-Like ions

We report wavelength measurements of H-like and He-like ions obtained with a novel x-ray spectrometer at the Heidelberg Electron Beam Ion Trap. The experimental uncertainty for the Lyman-alpha1 wavelength in Cl16+ is reduced by a factor of 3 and, as expected, excellent agreement with theory is maintained. For the resonance line in He-like Ar16+, an uncertainty of only deltalambda/lambda=2x10(-6) was achieved. This is the most precise x-ray wavelength reported for highly charged ions to date, and allows to test recent predictions on QED two-electron and two-photon radiative corrections for He-like ions. The results also point to the advantages of establishing absolute x-ray wavelength standards using Lyman-alpha transitions (in the present case Ar17+ Lyman-alpha1) to supersede the current ones.

The health and health behaviors of young men who have sex with men

PURPOSE

To describe the range of health and mental health problems for which young men who have sex with men (YMSM) may be at risk.

METHODS

An audio-computer-assisted survey was administered to a large, ethnically diverse sample of 526 YMSM (aged 18-24 years) recruited from bars, clubs, and other social venues using a venue-based probability sampling method.

RESULTS

Subjects reported a range of health and mental health problems, and involvement in health-compromising behaviors, such as overweight/obesity, depression, and suicidal thoughts/attempts, and many were found to have high rates of sexually transmitted infections. Moreover, many reported not having insurance coverage and/or limited access to care.

CONCLUSIONS

Many of the health concerns and risks reported by these young men are preventable and can be addressed by any number of sectors, including health care and social service providers, religious organizations, schools, and employers.