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Http Dx Doi Org 10 1080 17441692 2012 729220, Jan 31, 2013

$Research paper thumbnail of Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors$

Military Medicine, Mar 1, 2002

Research evaluating human immunodeficiency virus (HIV) behavioral interventions among U.S. milita... more Research evaluating human immunodeficiency virus (HIV) behavioral interventions among U.S. military personnel has been lacking. In this study, a behavioral intervention to prevent HIV and sexually transmitted diseases (STDs) was implemented in a sample of Marine security guards. Participants were assessed before and after a three-session intervention on a measure of STDs/HIV knowledge and a number of psychosocial scales. The results indicated that STDs/HIV knowledge was significantly greater after the intervention. Significant pre-test vs. post-test differences were also found on the Social Norms, Behavioral Intentions, Attitudes toward Condoms, and Self-Efficacy/Impulse Control scales. On Social Norms and Behavioral Intentions, the differences were as expected: subjects perceived greater social norms supporting condom use and had stronger intentions to practice safe sex after the intervention than they had before. On Attitudes toward Condoms and Self-Efficacy/Impulse Control, the differences were not in the expected direction. Psychosocial factors associated with self-reported condom use were also identified.

ABSTRACT Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become a major public... more ABSTRACT Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become a major public health threat, and HIV-infected persons are at heightened risk for developing MRSA infections. Since colonization increases the risk of infection, we evaluated factors associated with colonization among HIV patients. Methods: A cross-sectional study of HIV-infected adults was performed to evaluate factors, including sexual behaviors, associated with MRSA colonization. Subjects were enrolled from four HIV clinics in various geographic areas of the U.S. Swabs were collected at five body sites from each participant. Associations between MRSA carriage and variables of interest were performed using logistic regression. Results: 550 HIV-infected persons were enrolled with a median age of 42 years; 93% were male; 46% Caucasian and 35% African American. The median CD4 count was 529 (IQR 404-704) cells/mm3, and 70% were receiving HAART. Twenty-one percent had a documented sexually transmitted infection (STI) in the year before enrollment (including 8% with syphilis), 20% reported having >2 sexual partners in the last 6 months, 50% reported always using a condom, and 8% reported public bath use. Four percent of HIV patients were colonized with MRSA at one or more body sites. In the multivariate model, STI in the last year (OR 4.2, p<0.01), history of a MRSA infection (OR 9.4, p<0.01), and African American versus Caucasian race (OR 3.5, p=0.01) were associated with MRSA colonization. In separate multivariate models, syphilis in the last year (OR 9.3, p<0.01) and public bath use (OR 8.9, p<0.01) were also associated with MRSA carriage. Conclusion: MRSA colonization is associated with recent STIs, suggesting that MRSA may be transferred in the setting of sexual contact. High-risk behaviors that place HIV-infected persons at risk for STIs may also increase the risk of MRSA transmission, signifying the potential dual benefit of safe sex practices.

Annals of Internal Medicine, Sep 1, 1992

▪ Patients: One hundred forty-eight of 206 consecutive adult active duty Navy and Marine Corps pe... more ▪ Patients: One hundred forty-eight of 206 consecutive adult active duty Navy and Marine Corps personnel who were hospitalized for isolation and inpatient therapy of varicella and who could be treated within 72 hours of rash onset completed the study. The diagnosis of varicella ...

Journal of Community Health, 2016

Anemia is a public health problem in Mexico. This study sought to determine the prevalence and co... more Anemia is a public health problem in Mexico. This study sought to determine the prevalence and correlates of anemia among women and children residing in a rural farming region of Baja California, Mexico. An existing partnership between universities, non-governmental organizations, and an underserved Mexican community was utilized to perform cross-sectional data collection in 2004-2005 (Wave 1) and in 2011-2012 (Wave 2) among women (15-49 years) and their children (6-59 months). All participants completed a survey and underwent anemia testing. Blood smears were obtained to identify etiology. Nutrition education interventions and clinical health evaluations were offered between waves. Participants included 201 women and 99 children in Wave 1, and 146 women and 77 children in Wave 2. Prevalence of anemia significantly decreased from 42.3 to 23.3 % between Waves 1 and 2 in women (p &amp;amp;amp;amp;amp;lt; 0.001), from 46.5 to 30.2 % in children 24-59 months (p = 0.066), and from 71.4 to 45.8 % in children 6-23 months (p = 0.061). Among women in Wave 1, consumption of iron absorption enhancing foods (green vegetables and fruits high in vitamin C) was protective against anemia (p = 0.043). Women in Wave 2 who ate ≥4 servings of green, leafy vegetables per week were less likely to be anemic (p = 0.034). Microscopic examination of blood smears revealed microcytic, hypochromic red blood cells in 90 % of anemic children and 68.8 % of anemic women, consistent with iron deficiency anemia.

Military Medicine, Apr 1, 2004

Journal of Acquired Immune Deficiency Syndromes, Dec 1, 1993

The Navy population is centered around 19 U.S. home ports and several inland duty stations. This ... more The Navy population is centered around 19 U.S. home ports and several inland duty stations. This is a study of variation in human immunodeficiency virus (HIV) seroconversions in Navy enlisted men by location in the United States, based on 949,570 enzyme-linked immunosorbent assays and 812 seroconversions during 1987-90. Seroconversion rates were higher in personnel in San Francisco (p = 0.0004), Washington, D.C. (p = 0.001), and Orlando, FL (p = 0.04) than in other areas. They were lower in Charleston, SC, New London, CT, Seattle; and Brunswick, ME (p < 0.05). Black men had triple the seroconversion rate of all other men (p < 0.0001). After adjustment for race, age, marital status, and occupation, risk of seroconversion remained high in San Francisco (p = 0.02) and Orlando (p = 0.03). The risk of seroconversion in San Francisco was twice that of other areas in a cohort that did not change location (p = 0.01). In contrast to declining trends overall in the Navy, rates did not decrease in Washington, D.C., a result consistent with previous calculations indicating a delayed second wave of HIV infection in the region.

Http Dx Doi Org 10 1089 Aid 2005 21 424, Jun 1, 2005

Infections with non-B HIV-1 subtypes are rare in the United States, but comprise a significant pe... more Infections with non-B HIV-1 subtypes are rare in the United States, but comprise a significant percentage of infections among U.S. military personnel. Risk behavior while on overseas deployment correlates with non-B infection in this population. Extensive genetic characterization will be required to define HIV-1 diversity, and to effectively evaluate requirements for HIV-1 vaccines and other prevention strategies in this group. From 1997 to 2000, 520 recent seroconverters, identified through routine HIV-1 testing in the U.S. active military force, volunteered for a prospective study. V3 loop serology or partial genome sequencing identified 28 non- B subtype infections; 14 were studied by full genome sequencing and phylogenetic analysis. Five strains were CRF01_AE. Four of these clustered with CM240 from Thailand, and one clustered with African CRF01_AE. Four strains were CRF02_AG, prevalent in West and West Central Africa. Two strains were subtype C. One strain was a unique recombinant between CRF01_AE and subtype B, and another was a complex unique recombinant between subtype A and D. The final strain was a member of a complex circulating recombinant first identified in Senegal, CRF09_cpx, incorporating subtypes A, F, G, and an unclassified genome. This diversity of non-B subtype HIV-1 strains, encompassing three globally prevalent non-B strains and including rare or even possibly unique strains, illustrates the breadth of U.S. military exposure while deployed and sets the bar higher for breadth of cross-subtype protection to be afforded by an HIV-1 vaccine.