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“There is no other option; we have to feed our families…who else would do it?”: The Financial Lives of Women Engaging in Sex Work in Ulaanbaatar, Mongolia

Introduction: This article provides an overview of the financial lives of women (n = 204) engaging in sex work in Ulaanbaatar, Mongolia.

Methods: This paper presents findings from a computer-based, interviewer-administered baseline assessment administered with women recruited for participation in a randomized controlled trial testing the feasibility of a combined HIV risk reduction and savings-led microfinance intervention for women engaging in sex work in Mongolia.

Findings: Findings demonstrate that most women are the primary financial providers for their households, using an array of earning strategies to provide for themselves and other dependents, with sex work often constituting the primary household income source. Financial instability in the lives of people engaging in sex work may increase their risk for HIV and STIs due to a compromised ability to negotiate safer sex with partners in times of economic crisis or need. High levels of financial responsibility for household welfare, when combined with low reported savings, the presence of debt, higher premiums offered for sex without a condom, and high levels of harmful alcohol use, may heighten women’s risk for HIV and other STIs.

Conclusion: Further research that documents the financial lives of people working in sex work is needed in order to understand the complex relationship between financial stability and engagement in sex work, and to inform the development and testing of structural HIV prevention interventions which target the economic determinants of risk. These findings highlight the importance of economic support programming for women engaged in sex work in Mongolia at a time of rapid economic change in Mongolia.

Topic: 
UNI: 
Publication type: 
Author: 
Laura Cordisco Tsai
Susan S. Witte
Toivgoo Aira
Marion Riedel
Hyesung Grace Hwang
Fred M. Ssewamala
Subjects: 
Prostitutes
Women--Finance
Personal
Prostitution--Economic aspects
Title string: 
“There is no other option; we have to feed our families…who else would do it?”: The Financial Lives of Women Engaging in Sex Work in Ulaanbaatar, Mongolia
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:wh70rxwdfm

Systematizing Planning and Formative Phases of HIV Prevention Research: Case Studies from Brazil, Mongolia, and Kazakhstan

Objectives
International Community-Based Participatory Research (CBPR) is vulnerable to contextual, political, and interpersonal issues that may hamper researchers’ abilities to develop and sustain partnerships with local communities. This paper responds to a call for systematizing CBPR practices and to the urgent need for frameworks with potential to facilitate partnership building between researchers and communities in both “developed” and “developing” countries.

Methods
Using three brief case examples, each from a different context, with different partners and varied research questions, we demonstrate how to apply the International Participatory Research Framework (IPRF).

Results
IPRF consists of triangulated procedures (steps and actions) that can facilitate known participatory outcomes: (1) community-defined research goals, (2) capacity for further research, and (3) policies and programs grounded in research.

Conclusions
We show how the application of this model is particularly helpful in the planning and formative phases of CBPR. Other partnerships can use this framework in its entirety or aspects thereof, in different contexts. Further evaluation of how this framework can help other international partnerships, studying myriad diseases and conditions, should be a focus of future international CBPR.

Publication type: 
Author: 
Rog Pintoério M.
Anya Y. Spector
Susan S. Witte
Louisa Gilbert
Subjects: 
HIV infections—Prevention
Participant observation
International cooperation
Title string: 
Systematizing Planning and Formative Phases of HIV Prevention Research: Case Studies from Brazil, Mongolia, and Kazakhstan
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:rr4xgxd27p

Physical and sexual violence, childhood sexual abuse and HIV/STI risk behaviour among alcohol-using women engaged in sex work in Mongolia

Although the prevalence of human immunodeficiency virus (HIV) in Mongolia is low, it could increase without strategic prevention strategies. Female sex workers (FSWs) often experience barriers to prevention, including interpersonal violence. This study investigated if childhood sexual abuse (CSA) or recent physical or sexual violence was associated with HIV sexual risk behaviours and if CSA modified associations between recent violence and HIV sexual risk behaviours. Two-hundred twenty-two women who (1) were at least 18 years old and clients at the National AIDS Foundation; (2) reported vaginal or anal sex in the past 90 days in exchange for money or goods and (3) met criteria for harmful alcohol use in the past year were enrolled. In-person interviews assessed sexual risk behaviours and violence in childhood and adulthood. Negative binomial regression, ordinary least squares regression and modified Poisson regression were performed. Sexual risk with paying partners was associated with penetrative CSA and sexual violence by paying partners. CSA and recent violence were not associated with sexual risk behaviours with intimate partners. CSA modified the association between recent sexual violence and unprotected sex with intimate partners. Findings highlight the need for integrated violence and sexual risk reduction services to ensure safe and effective prevention for FSWs.

Topic: 
Publication type: 
Author: 
Angela M. Parcesepe
Toivgoo Aira
Mingway P. Chang
Marion Riedel
Catherine E. Carlson
Rebecca DiBennardo
Susan S. Witte
Subjects: 
Sexual abuse victims
Public health
Prostitutes--Violence against
HIV infections--Risk factors
Women--Alcohol use
Title string: 
Physical and sexual violence, childhood sexual abuse and HIV/STI risk behaviour among alcohol-using women engaged in sex work in Mongolia
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:fxpnvx0k8m

The Eventfulness of Translation: Temporality, Difference, and Competing Universals

The article seeks to develop a new angle for translation studies by rethinking its relationship to the political. It begins with the question “Can the eventfulness of translation itself be thought?” Since neither the familiar model of communication (translatable and untranslatable) nor the biblical model of the Tower of Babel (the promise or withdrawal of meaning) can help us work out a suitable answer to that question, the author proposes an alternative method that incorporates the notions of temporality, difference, and competing universals in the reframing of translation. This method requires close attention to the multiple temporalities of translation in concrete analyses of translingual practices, or what the author calls “differentially distributed discursive practices across languages.” The author’s textual analysis focuses on a few pivotal moments of translation in global history—chosen for their world transforming influences or actual and potential global impact—to demonstrate what is meant by the “eventfulness of translation.” These include, for example, the nineteenth-century Chinese translation of Henry Wheaton’s "Elements of International Law" or "Wanguo gongfa", the post-World War II multilingual fashioning of the Universal Declaration of Human Rights with a focus on P. C. Chang’s unique contribution, and the Afro-Asian writers’ translation project during the Cold War.

UNI: 
Publication type: 
Author: 
Lydia H. Liu
Subjects: 
Translations
Title string: 
The Eventfulness of Translation: Temporality, Difference, and Competing Universals
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:69p8cz8wbt

A transcriptomic atlas of aged human microglia

With a rapidly aging global human population, finding a cure for late onset neurodegenerative diseases has become an urgent enterprise. However, these efforts are hindered by the lack of understanding of what constitutes the phenotype of aged human microglia—the cell type that has been strongly implicated by genetic studies in the pathogenesis of age-related neurodegenerative disease. Here, we establish the set of genes that is preferentially expressed by microglia in the aged human brain. This HuMi_Aged gene set captures a unique phenotype, which we confirm at the protein level. Furthermore, we find this gene set to be enriched in susceptibility genes for Alzheimer’s disease and multiple sclerosis, to be increased with advancing age, and to be reduced by the protective APOEε2 haplotype. APOEε4 has no effect. These findings confirm the existence of an aging-related microglial phenotype in the aged human brain and its involvement in the pathological processes associated with brain aging.

Topic: 
Publication type: 
Author: 
Marta Olah
Ellis Patrick
Alexandra Villani-Chloe
Jishu Xu
Charles C. White
Katie J. Ryan
Paul Piehowski
Alifiya Kapasi
Parham Nejad
Maria Cimpean
Sarah Connor
Christina J. Yung
Michael Frangieh
Allison McHenry
Wassim Elyaman
Vlad Petyuk
Julie A. Schneider
David A. Bennett
De Philip Lawrence Jager
Elizabeth Bradshaw
Subjects: 
Microglia
Neuroimmunology
Nervous system--Degeneration
Brain--Aging
Title string: 
A transcriptomic atlas of aged human microglia
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:jsxksn02xm

The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis

Background
Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in “real-life” settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia.

Methods and findings
Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5–5.2) years for the total cohort and 6.4 (3.6–8.0) years in Europe, 3.7 (2.0–5.4) years in North America, 2.5 (1.2–4.4) years in South and Southeast Asia, 5.0 (2.7–7.5) years in South America and the Caribbean, and 2.1 (0.9–3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3–2.1) years in North America to 7.1 (5.3–8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4–2.6) years in North America to 7.9 (6.0–9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%–2.8%), 15.6% (15.1%–16.0%), and 11.3% (10.9%–11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%–1.1%]) and highest in South America and the Caribbean (4.4% [3.1%–6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%–6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%–13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria.

Conclusion
To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.

Topic: 
UNI: 
Publication type: 
Author: 
Amy L. Slogrove
Michael Schomaker
Mary Davies-Ann
Paige Williams
Suna Balkan
Jihane Ben-Farhat
Nancy Calles
Kulkanya Chokephaibulkit
Charlotte Duff
Tanoh Francois Eboua
Adeodata Kekitiinwa-Rukyalekere
Nicola Maxwell
Jorge Pinto
Seage George R. III
Chloe A. Teasdale
Sebastian Wanless
Josiane Warszawski
Kara Wools-Kaloustian
Marcel Yotebieng
Venessa Timmerman
Intira J. Collins
Ruth Goodall
Colette Smith
Kunjal Patel
Mary E. Paul
Diana Gibb
Rachel Vreeman
Elaine J. Abrams
Rohan Hazra
Van Russell Dyke
Linda Bekker-Gail
Lynne Mofenson
Marissa Vicari
Shaffiq Essajee
Martina Penazzato
Gabriel Anabwani
Edith Q. Mohapi
Peter N. Kazembe
Makhosazana Hlatshwayo
Mwita Lumumba
Tessa Goetghebuer
Claire Thorne
Luisa Galli
van Annemarie Rossum
Carlo Giaquinto
Magdalena Marczynska
Laura Marques
Filipa Prata
Luminita Ene
Liubov Okhonskaia
Pablo Rojo
Claudia Fortuny
Lars Naver
Christoph Rudin
Le Sophie Coeur
Alla Volokha
Vanessa Rouzier
Regina Succi
Annette Sohn
Azar Kariminia
Andrew Edmonds
Patricia Lelo
Samuel Ayaya
Patricia Ongwen
Laura F. Jefferys
Sam Phiri
Mwangelwa Mubiana-Mbewe
Shobna Sawry
Lorna Renner
Mariam Sylla
Mark J. Abzug
Myron Levin
James Oleske
Miriam Chernoff
Shirley Traite
Murli Purswani
Ellen G. Chadwick
Ali Judd
Valeriane Leroy
The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
Subjects: 
Epidemiology
Teenagers
Cohort analysis
Title string: 
The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:qjq2bvq869

Oxidative stress and protein damage responses mediate artemisinin resistance in malaria parasites

Due to their remarkable parasitocidal activity, artemisinins represent the key components of first-line therapies against Plasmodium falciparum malaria. However, the decline in efficacy of artemisinin-based drugs jeopardizes global efforts to control and ultimately eradicate the disease. To better understand the resistance phenotype, artemisinin-resistant parasite lines were derived from two clones of the 3D7 strain of P. falciparum using a selection regimen that mimics how parasites interact with the drug within patients. This long term in vitro selection induced profound stage-specific resistance to artemisinin and its relative compounds. Chemosensitivity and transcriptional profiling of artemisinin-resistant parasites indicate that enhanced adaptive responses against oxidative stress and protein damage are associated with decreased artemisinin susceptibility. This corroborates our previous findings implicating these cellular functions in artemisinin resistance in natural infections. Genomic characterization of the two derived parasite lines revealed a spectrum of sequence and copy number polymorphisms that could play a role in regulating artemisinin response, but did not include mutations in pfk13, the main marker of artemisinin resistance in Southeast Asia. Taken together, here we present a functional in vitro model of artemisinin resistance that is underlined by a new set of genetic polymorphisms as potential genetic markers.

Publication type: 
Author: 
Frances Rocamora
Lei Zhu
Kek Yee Liong
Arjen Dondorp
Olivo Miotto
Sachel Shu Li Mok
Zbynek Bozdech
Subjects: 
Artemisinin
Malaria--Treatment
Drug resistance
Parasitic diseases
Oxidative stress
Biology
Title string: 
Oxidative stress and protein damage responses mediate artemisinin resistance in malaria parasites
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:cvdncjsxnt

Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial

Background
As the number of HIV-infected women initiating lifelong antiretroviral therapy (ART) during pregnancy increases globally, concerns have emerged regarding low levels of retention in HIV services and suboptimal adherence to ART during the postpartum period. We examined the impact of integrating postpartum ART for HIV+ mothers alongside infant follow-up within maternal and child health (MCH) services in Cape Town, South Africa.

Methods and findings
We conducted a randomised trial among HIV+ postpartum women aged ≥18 years who initiated ART during pregnancy in the local antenatal care clinic and were breastfeeding when screened before 6 weeks postpartum. We compared an integrated postnatal service among mothers and their infants (the MCH-ART intervention) to the local standard of care (control)—immediate postnatal referral of HIV+ women on ART to general adult ART services and their infants to separate routine infant follow-up. Evaluation data were collected through medical records and trial measurement visits scheduled and located separately from healthcare services involved in either arm. The primary trial outcome was a composite endpoint of women’s retention in ART care and viral suppression (VS) (viral load < 50 copies/ml) at 12 months postpartum; secondary outcomes included duration of any and exclusive breastfeeding, mother-to-child HIV transmission, and infant mortality. Between 5 June 2013 and 10 December 2014, a total of 471 mother–infant pairs were enrolled and randomised (mean age, 28.6 years; 18% nulliparous; 57% newly diagnosed with HIV in pregnancy; median duration of ART use at randomisation, 18 weeks). Among 411 women (87%) with primary endpoint data available, 77% of women (n = 155) randomised to the MCH-ART intervention achieved the primary composite outcome of retention in ART services with VS at 12 months postpartum, compared to 56% of women (n = 117) randomised to the control arm (absolute risk difference, 0.21; 95% CI: 0.12–0.30; p < 0.001). The findings for improved retention in care and VS among women in the MCH-ART intervention arm were consistent across subgroups of participants according to demographic and clinical characteristics. The median durations of any breastfeeding and exclusive breastfeeding were longer in women randomised to the intervention versus control arm (6.9 versus 3.0 months, p = 0.006, and 3.0 versus 1.4 months, p < 0.001, respectively). For the infants, overall HIV-free survival through 12 months of age was 97%: mother-to-child HIV transmission was 1.2% overall (n = 4 and n = 1 transmissions in the intervention and control arms, respectively), and infant mortality was 1.9% (n = 6 and n = 3 deaths in the intervention and control arms, respectively), and these outcomes were similar by trial arm. Interpretation of these findings should be qualified by the location of this study in a single urban area as well as the self-reported nature of breastfeeding outcomes.

Conclusions
In this study, we found that integrating ART services into the MCH platform during the postnatal period was a simple and effective intervention, and this should be considered for improving maternal and child outcomes in the context of HIV.

Topic: 
UNI: 
Publication type: 
Author: 
Landon Myer
Tamsin Phillips
Allison Zerbe
Kirsty Brittain
Maia Lesosky
Nei Hsiao-Yuan
Robert Howard Remien
Claude Mellins
James A. McIntyre
Elaine J. Abrams
Subjects: 
HIV-positive women
Public health
HIV-positive children
Postnatal care
Epidemiology
Title string: 
Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:8pk0p2nggm

BRDT is an essential epigenetic regulator for proper chromatin organization, silencing of sex chromosomes and crossover formation in male meiosis

The double bromodomain and extra-terminal domain (BET) proteins are critical epigenetic readers that bind to acetylated histones in chromatin and regulate transcriptional activity and modulate changes in chromatin structure and organization. The testis-specific BET member, BRDT, is essential for the normal progression of spermatogenesis as mutations in the Brdt gene result in complete male sterility. Although BRDT is expressed in both spermatocytes and spermatids, loss of the first bromodomain of BRDT leads to severe defects in spermiogenesis without overtly compromising meiosis. In contrast, complete loss of BRDT blocks the progression of spermatocytes into the first meiotic division, resulting in a complete absence of post-meiotic cells. Although BRDT has been implicated in chromatin remodeling and mRNA processing during spermiogenesis, little is known about its role in meiotic processes. Here we report that BRDT is an essential regulator of chromatin organization and reprograming during prophase I of meiosis. Loss of BRDT function disrupts the epigenetic state of the meiotic sex chromosome inactivation in spermatocytes, affecting the synapsis and silencing of the X and Y chromosomes. We also found that BRDT controls the global chromatin organization and histone modifications of the chromatin attached to the synaptonemal complex. Furthermore, the homeostasis of crossover formation and localization during pachynema was altered, underlining a possible epigenetic mechanism by which crossovers are regulated and differentially established in mammalian male genomes. Our observations reveal novel findings about the function of BRDT in meiosis and provide insight into how epigenetic regulators modulate the progression of male mammalian meiosis and the formation of haploid gametes.

Topic: 
Publication type: 
Author: 
Marcia Manterola
Taylor Brown
Min Young Oh
Corey Michael Garyn
Bryan Jose Gonzalez
Debra J. Wolgemuth
Subjects: 
Genetics
Epigenetics
Meiosis
Chromatin
Sex chromosomes
Title string: 
BRDT is an essential epigenetic regulator for proper chromatin organization, silencing of sex chromosomes and crossover formation in male meiosis
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:j9kd51c5d7

Unprecedented climate events: Historical changes, aspirational targets, and national commitments

The United Nations Paris Agreement creates a specific need to compare consequences of cumulative emissions for pledged national commitments and aspirational targets of 1.5° to 2°C global warming. We find that humans have already increased the probability of historically unprecedented hot, warm, wet, and dry extremes, including over 50 to 90% of North America, Europe, and East Asia. Emissions consistent with national commitments are likely to cause substantial and widespread additional increases, including more than fivefold for warmest night over ~50% of Europe and >25% of East Asia and more than threefold for wettest days over >35% of North America, Europe, and East Asia. In contrast, meeting aspirational targets to keep global warming below 2°C reduces the area experiencing more than threefold increases to <10% of most regions studied. However, large areas—including >90% of North America, Europe, East Asia, and much of the tropics—still exhibit sizable increases in the probability of record-setting hot, wet, and/or dry events.

Publication type: 
Author: 
Noah S. Diffenbaugh
Deepti Singh
Justin S. Mankin
Subjects: 
Climatology
Environmental sciences
Natural disasters
Climatic changes--International cooperation
Title string: 
Unprecedented climate events: Historical changes, aspirational targets, and national commitments
GUID update: 
https://academiccommons.columbia.edu/catalog/ac:vt4b8gthx3

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