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Latinxs in the U.S. are disproportionately affected by HIV and more likely to have delayed diagnosis than their non-Latinx peers. We developed and implemented Sólo Se Vive Una Vez (You Only Live Once), the first Spanish-language campaign aimed at improving HIV testing and prevention among Latinx immigrants in Baltimore, Maryland. Sólo Se Vive Una Vez featured a website ( www.solovive.org ) and social marketing campaign promoting free HIV testing through the Baltimore City Health Department (BCHD) clinic and Latinx outreach team. The campaign was not associated with a change in the overall number of Latinxs obtaining HIV testing. However, Latinx HIV testers who reported being exposed to the campaign had significantly higher rates of high-risk sexual behaviors, mean number of sexual partners, and substance use. The campaign was also associated with increased PrEP referrals through the BCHD Latinx outreach team.Los latinos en los Estados Unidos están desproporcionadamente afectados por el VIH y es más probable que sean diagnosticados más tarde que pacientes no latinos. Desarrollamos e implementamos Sólo Se Vive Una Vez, la primera campaña en español dirigida a mejorar la detección y prevención del VIH entre los inmigrantes latinos en Baltimore, Maryland. Sólo Se Vive Una Vez consiste en un sitio web (www.solovive.org) y una campaña en las redes sociales que promueve la prueba gratuita de VIH a través de la clínica del Departamento de Salud de la Ciudad de Baltimore así como la unidad móvil operada por nuestro equipo latino de promotores de salud. La campaña no se asoció con un cambio en el número absoluto de latinos que hicieron la prueba del VIH. Sin embargo, los latinos expuestos a la campaña que se hicieron la prueba del VIH tenían tasas más altas de conductas sexuales de alto riesgo, de parejas sexuales, y de uso de sustancias. La campaña también se asoció con un aumento de referidos a PrEP a través del equipo de promotores de salud latinos.

Latinxs in the United States are disproportionately affected by HIV and present with more advanced disease than their non-Latinx peers, due to numerous barriers to care including HIV stigma. We describe the adaptation, implementation, and reach of Sólo Se Vive Una Vez (You Only Live Once), Baltimore's first social marketing campaign promoting HIV screening among Spanish-speaking Latinxs. The 6-month campaign promoted free HIV testing by addressing HIV stigma. The campaign included a website, a social marketing campaign, community outreach events, and advertisements via radio, billboards, local partners, and buses. During the campaign, there were 9,784 unique website users, and ads were served to over 84,592 people on social media platforms. Among Latinx HIV testers at the Baltimore City Health Department, 31.6% reported having seen or heard of Sólo Se Vive Una Vez and 25.3% of Latinx HIV testers reported that the campaign influenced them to get tested.

PURPOSE: To investigate same day, previous day, and next day associations between trust, closeness, commitment, jealousy and provision of instrumental support with dating violence victimization and perpetration. METHOD: A convenience sample of young women, 16–19 years, in a heterosexual dating relationship with at least one act (past month) of physical or psychological victimization or perpetration, were recruited from urban public locations. Participants answered questions daily via text continuously for four months on dating violence and partner-specific emotions. Daily surveys asked about trust, closeness, commitment for their partner, jealousy, perceptions of partner’s jealousy and provision of instrumental support to and from partner, and dating violence victimization and perpetration. Multilevel modeling examined within-relationship associations over time. RESULTS: Mean (sd) age for the full sample was 18.1 (1.1) years. Same-day emotional context (trust, closeness, commitment, jealousy and provision of instrumental support) was more strongly associated with victimization and perpetration compared to previous day emotions. Strongest same-day positive associations were with partner’s perpetration, both partner’s jealousy, and females’ instrumental support. Partner’s jealousy and increased trust were best predictors of next day victimization. Closeness, commitment and trust went down on the day of violence. Perpetration was positively associated with next day commitment. Victimization was positively associated with next day trust. CONCLUSIONS: This event-level analysis demonstrates the role and timing that emotional aspects of adolescent relationships – including positive feelings – have surrounding episodes of dating violence. This granular understanding of the emotional context of dating violence has the potential to facilitate development of effective, developmentally appropriate interventions.

Latinx children in immigrant families have disproportionately high obesity rates; effective obesity treatment for this subset of Latinx children is critically needed.To inform the development of weight management interventions we explored: 1) community facilitators and barriers to achieving childhood healthy weight through photovoice; and 2) participant reflections on the photovoice process.Photovoice was conducted using established methods in a local church. After photovoice, participants completed semi-structured interviews to reflect on their experience. Transcripts were analyzed using a general thematic analysis approach to arrive at preliminary themes, which were presented to participants for validation. Participant input was used to finalize the themes.Six adults and two youth Latinx immigrants identified photograph themes over seven sessions. Four themes emerged regarding community barriers and facilitators to achieving childhood healthy weight: 1) family habits, 2) cultural influences on food, 3) built environment, and 4) food marketing. Participant reflections revealed they were motivated to participate in photovoice to learn more about health, recognized personal growth as a result of group sharing, valued representation as a community, and felt empowered to be role models.Findings from both photovoice and participant reflections reinforced the need for multi-level approaches to treating childhood obesity. Though participant reflections were gathered to inform continued engagement of Latinx families, they ultimately had a significant impact on our conclusions about priority intervention components.

espanolLos hombres latinos que tienen sexo con hombres (HSH) continuan siendo desproporcionadamente afectados por el VIH / SIDA. Identificar el papel de multiples factores sindemicos asociados con las conductas de riesgo sexual es imprescindible para desarrollar estrategias efectivas de prevencion y tratamiento. Los datos transversales para este estudio se derivaron de tres ciclos de la parte de Filadelfia del Sistema Nacional de Vigilancia del Comportamiento del VIH. Este estudio exploro el impacto de los factores sindemicos (consumo excesivo de alcohol, sexo de intercambio y discriminacion homofobica) en los comportamientos sexuales de riesgo de VIH, operacionalizados como el numero de parejas masculinas y las relaciones anales sin condon (IAC) con parejas principales y casuales entre los HSH latinos (n = 464). Los analisis tomaron dos formas: un enfoque sindemico, usando el numero acumulado de condiciones como una variable independiente; y un enfoque no sindemico, que incorpora cada condicion como un factor unico. En analisis sinadicos multivariables, los participantes con dos o mas factores informaron mas parejas masculinas y mas parejas masculinas casuales CAI que aquellos sin ninguno. En los modelos no sindemicos, la discriminacion homofobica y el intercambio sexual se asociaron significativamente positivamente con el numero total de parejas masculinas, mientras que el consumo excesivo de alcohol se asocio con parejas CAI mas casuales. Los resultados cuantitativos indican que los enfoques sindemicos y no sindemicos varian en su capacidad relativa para dar cuenta del riesgo sexual entre los HSH latinos. EnglishLatino men who have sex with men (MSM) continue to be disproportionately impacted by HIV/AIDS. Latino MSM experienced a 13% increase in HIV diagnoses in the U.S., more than any other racial/ethnic group of MSM. Identifying the role of multiple syndemic factors associated with sexual risk behaviors is imperative for developing effective prevention and treatment strategies. Data for this study are derived from three cycles of the Philadelphia portion of the National HIV Behavioral Surveillance System and explored the impact of syndemic factors – heavy drinking, exchange sex, and homophobic discrimination – on sexual HIV risk behaviors, operationalized as number of male partners, and condomless anal intercourse (CAI) with main and casual partners among Latino MSM (n=464). Analyses took two forms: a syndemic approach, using the cumulative number of conditions as an independent variable; and a non-syndemic approach, incorporating each condition as a unique predictor. In multivariable syndemic analyses, participants with two or more factors reported more male partners and more CAI casual male partners than those with none. In non-syndemic models, homophobic discrimination and exchange sex were significantly positively associated with total number of male partners and heavy drinking was associated with more casual CAI partners. Quantitative results indicate that syndemic and non-syndemic approaches vary in their relative capacity to account for sexual risk among Latino MSM.

BACKGROUND Innovative solution-focused research with youth is needed to improve sexually transmitted infection (STI) testing among adolescents and young adults (AYA). We sought to identify moments that matter to AYA during the STI testing experience. METHODS Five social design graduate students and five youth advisory council (YAC) members independently received STI testing and created journey maps documenting their experience. Social design students assisted YAC members in their map creation during group workshops and one-on-one worktime. Participants completed interviews about their experience using their maps to facilitate responses. We used thematic content analysis to synthesize textual interview data. RESULTS Participants experienced stress and discomfort throughout the testing process, with three main sources of stress identified: finding a clinic, completing registration forms, and general lack of clarity during the clinical experience. Friendly interactions with providers and staff improved the experience, however. Finally, the physical environment of the clinic space could positively or negatively impact the overall experience. CONCLUSIONS Journey mapping may be an important tool for identifying solutions to improve STI testing among AYA.

HIV-related stigma exacerbates Latino immigrants’ risk of HIV infection and delayed care. Following the implementation of the social marketing campaign Sólo Se Vive Una Vez (You Only Live Once) to increase HIV testing that addressed stigmatizing beliefs, we conducted a survey among Latinos in Baltimore, Maryland (N = 357). The aims of this paper are to 1) characterize the sociodemographic characteristics, HIV-related stigma beliefs, and testing behaviors of the survey respondents by campaign exposure, and 2) model the effects of Vive exposure on stigma beliefs and testing behaviors. Comparing post-campaign survey respondents exposed and unexposed to the campaign to survey findings previously obtained and reported before the campaign implementation, respondents to the post-Vive survey continued to hold high levels of stigma beliefs, and compared to the pre-Vive survey sample, were more likely to hold four or more stigmatizing beliefs (from the six survey items). Among the post-Vive survey respondents, those for whom religion was important or very important had an increased odds of 1.6 of holding four or more stigmatizing beliefs. Survey respondents who were exposed to the campaign, however, had an increased odds of 2.25 of reporting ever having been tested for HIV. Our findings demonstrate the importance of the changing social context in addressing stigma within emerging immigrant communities and highlight the critical role of religious leaders in efforts to address HIV-related stigma.

Background Sexually transmitted infections (STIs) disproportionately affect young people in the United States. Although social determinants have been identified as important in shaping STI prevalence and STI disparities, the voice of young people and key stakeholders representing young people is lacking to prioritize interventions aiming to improve these. Objective The objective of this study was to use a community-based participatory research (CBPR) framework to explore how young people and community key stakeholders representing young people understand the context of STI risk experienced in their community, and gather information about their prioritization of social determinants of STIs and STI inequities in Baltimore City, Maryland. Methods We conducted key informant interviews (n = 27) with young people ages 15 to 24 years and key stake-holders in neighborhoods with high rates of STIs. Interview transcripts were analyzed through a constant comparison approach. Results Participants overwhelmingly identified trauma as the key challenge among young people in their communities and largely focused on the role of community violence as a source of chronic trauma. Participants described two pathways through which this trauma contributes to young people's risk of STI acquisition and transmission: (1) competing short-term priorities in a struggle for daily survival, and (2) sex as an available resource for stress relief, self-medication, and escapism. Conclusions These findings demonstrate a need to understand social determinants through youth voice and engage young people and key stakeholders in prioritizing and addressing STI disparities. Findings also support the urgent need for structural interventions for STI prevention.

BACKGROUND: Female sex workers (FSW) constitute a highly vulnerable population challenged by numerous co-existing, or syndemic, risk factors. FSW also display resilience to these, and some evidence suggests that resilience may be associated with protective factors that improve health outcomes. METHODS: We conducted in-depth interviews with indirect sex workers (n = 11) and their clients (n = 18). Interviews were coded utilizing an iterative, modified constant comparison method to identify emergent themes. RESULTS: We identified five syndemic risk factors (difficulty finding work due to undocumented status, shame and mental health hardship, lack of social support, alcohol use, and violence) and five resilient factors (rationalizing sex work, identifying as a “decent” woman, fulfilling immigrant goals, reducing alcohol consumption, and creating rules to reduce risk of violence and HIV/STIs). DISCUSSION: Understanding the syndemic risk factors and resiliency developed by FSW is important to develop tailored, strength-based interventions for HIV/STIs and other risks.

Background:Since the 2015 GRAPPA treatment recommendations were published, therapeutic options and management strategies for psoriatic arthritis (PsA) have advanced considerably.Objectives:The goal of the GRAPPA recommendations update is to develop high quality, evidence-based recommendations for the treatment of PsA, including related conditions and comorbidities.Methods:GRAPPA rheumatologists, dermatologists and patient research partners (PRPs) updated overarching principles for the management of adults with PsA by consensus. Principles considering use of biosimilars and tapering/discontinuing of therapy were added to this update. Systematic literature searches based on data publicly available from three databases (MEDLINE, EMBASE, and Cochrane CENTRAL) were conducted from the end of the previous recommendations’ searches through August 2020. Additional abstract searches were performed for conference presentations in 2017-2020. Searches covered PsA treatments (peripheral arthritis, axial arthritis, enthesitis, dactylitis, skin, and nail disease). Additional searches were performed for related conditions (uveitis and IBD) and comorbidities evaluating their impact on safety and treatment outcomes. Individual groups assessed the risk of bias and applied the GRADE system to generate strong or conditional recommendations for therapies within the domain groups and for the management of comorbidities and related conditions. These recommendations were then incorporated into an overall treatment schema.Results:Updated, evidence-based treatment recommendations are shown (Table 1). Since 2015, many new medications have been incorporated. Additional results for older medications, such as methotrexate, have been published across PsA domains. Based on the evidence, the treatment recommendations developed by individual groups were incorporated into the overall schema including principles for management of arthritis, spondylitis, enthesitis, dactylitis, skin, and nail disease in PsA, and associated conditions (Figure 1). Choice of therapy for an individual should ideally address all of the domains that impact on that patient, supporting shared decision making with the patient involved. Additional consideration in the recommendations was given to key associated conditions and comorbidities as these often impact on therapy choice.Conclusion:These GRAPPA treatment recommendations provide up to date, evidence-based guidance to providers who manage and treat adult patients with PsA. These recommendations are based on domain-based strategy for PsA and supplemented by overarching principles developed by consensus of GRAPPA members.IndicationStrongForConditional ForConditionalAgainstStrongAgainstInsufficient evidencePeripheral Arthritis DMARD NaïvecsDMARDs, TNFi, PDE4i, IL-12/23i, IL-17i, IL-23i, JAKiNSAIDs, oral CS, IA CS,IL-6i,Peripheral Arthritis DMARD IRTNFi, IL-12/23i, IL-17i, IL-23i, JAKiPDE4i, other csDMARD, NSAIDs, oral CS, IA CS,IL-6i,Peripheral ArthritisbDMARD IRTNFi, IL-17i, IL-23i, JAKi,NSAIDs, oral CS, IA CS, IL-12/23i, PDE4i, CTLA-4-IgIL-6i,Axial arthritis, Biologic NaïveNSAIDs, Physiotherapy, simple analgesia, TNFi, IL-17i, JAKiCS SIJ injections, bisphosphonatescsDMARDs, IL-6i,IL-12/23i, IL-23iAxial PsA, Biologic IRNSAIDs, Physiotherapy, simple analgesia, TNFi, IL-17i, JAKi csDMARDs, IL-6i,IL-12/23i, IL-23iEnthesitisTNFi, IL-12/23i, IL-17i, PDE4i, IL-23i, JAKiNSAIDs, physiotherapy, CS injections, MTXIL-6i,Other csDMARDsDactylitisTNFi IL-12/23i, IL-17i, IL-23i, JAKi, PDE4iNSAIDs, CS injections, MTXOther csDMARDsPsoriasisTopicals, phototherapy, csDMARDs, TNFi, IL-12/23i, IL-17i, IL-23i, PDE4i, JAKi AcitretinNail psoriasisTNFi, IL12/23i, IL17i, IL23i, PDE4iTopical CS, tacrolimus and calcipotriol combination or individual therapies, Pulsed dye laser, csDMARDs, acitretin, JAKiTopical Cyclosporine / Tazarotene, Fumarate, Fumaric Acid Esters, UVA and UVB Phototherapy, AlitretinoinIBDTNFi (not ETN), IL-12/23i, JAKiIL-17iUveitisTNFi (not ETN)Disclosure of Interests:Laura C Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Gilead, Eli Lilly, Janssen, Medac, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Pfizer, and Novartis, Enrique Soriano Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb,GSK, Genzyme, Janssen, Lilly, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb,GSK, Genzyme, Janssen, Lilly, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Grant/research support from: AbbVie, Janssen, Novartis Pharma, Pfizer, Roche, and UCB, Nadia Corp: None declared, Heidi Bertheussen Consultant of: Pfizer, Kristina Callis-Duffin Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Lilly, Janssen, Novartis, Pfizer, Sienna Biopharmaceuticals, Stiefel Laboratories, UCB, Ortho Dermatologics, Inc, Regeneron Pharmaceuticals, Inc., Anaptys Bio, Boehringer Ingelheim., Cristiano Barbosa Campanholo Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Jeffrey Chau: None declared, Lihi Eder Consultant of: Abbvie, UCB, Janssen, Eli Lily, Pfizer, Novartis, Grant/research support from: Abbvie, UCB, Janssen, Eli Lily, Pfizer, Novartis, Daniel Fernandez Consultant of: Abbvie, UCB, Roche, Janssen, Pfizer, Amgen and Brystol, Grant/research support from: Abbvie, UCB, Roche, Janssen, Pfizer, Amgen and Brystol, Oliver FitzGerald Speakers bureau: AbbVie, Janssen and Pfizer Inc, Consultant of: BMS, Celgene, Eli Lilly, Janssen and Pfizer Inc, Grant/research support from: AbbVie, BMS, Eli Lilly, Novartis and Pfizer Inc, Amit Garg Consultant of: Abbvie, Amgen, Asana Biosciences, Bristol Myers Squibb, Boehringer Ingelheim, Incyte, InflaRx, Janssen, Pfizer, UCB, Viela Biosciences, Grant/research support from: Abbvie, Dafna D Gladman Consultant of: Abbvie, Amgen, BMS, Eli Lilly, Galapagos, Gilead, Jansen, Novartis, Pfizer and UCB, Grant/research support from: Abbvie, Amgen, Eli Lilly, Jansen, Novartis, Pfizer and UCB, Niti Goel: None declared, Suzanne Grieb: None declared, Philip Helliwell Speakers bureau: Janssen, Novartis, Pfizer, Consultant of: Eli Lilly, M Elaine Husni Consultant of: Abbvie, Amgen, Janssen, Novartis, Lilly, UCB, Regeneron, and Pfizer, Deepak Jadon Speakers bureau: AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Healthcare Celltrion, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Healthcare Celltrion, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Healthcare Celltrion, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Arnon Katz: None declared, Dhruvkumar Laheru: None declared, John Latella: None declared, Ying Ying Leung Speakers bureau: Novartis, AbbVie, Eli Lilly, Janssen, Consultant of: Pfizer and Boehringer Ingelheim, Grant/research support from: Pfizer and conference support from AbbVie, Christine Lindsay Shareholder of: Amgen, Employee of: Aurinia pharmaceuticals, Ennio Lubrano Speakers bureau: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Consultant of: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Luis Mazzuoccolo Speakers bureau: Abbvie, Amgen, Novartis, Elli Lilly, Jansen, Consultant of: Abbvie, Amgen, Novartis, Elli Lilly, Jansen, Roland McDonald: None declared, Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galapagos, Gilead Sciences, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead Sciences, Janssen, Novartis, Pfizer, SUN and UCB, Denis O’Sullivan: None declared, Alexis Ogdie Consultant of: AbbVie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, and Pfizer, Grant/research support from: Novartis and Pfizer and Amgen, Wendy Olsder: None declared, Lori Schick: None declared, Ingrid Steinkoenig: None declared, Maarten de Wit Consultant of: AbbVie, BMS, Celgene, Janssen, Lilly, Novartis, Pfizer, Roche, Danielle van der Windt: None declared, Arthur Kavanaugh Speakers bureau: AbbVie, Amgen, BMS, Eli Lilly, Gilead Janssen, Novartis, Pfizer, UCB, Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Gilead Janssen, Novartis, Pfizer, UCB

Sexual and gender minority Hispanics/Latinxs (henceforth: Latinxs) continue to be disproportionately impacted by HIV/AIDS in the U.S. Pre-exposure prophylaxis (PrEP) is a biomedical prevention approach which holds significant promise for at risk and vulnerable populations. We discuss barriers and facilitators to uptake of PrEP among sexual and gender minority Latinxs living in the U.S. through an ecosocial lens that takes into account structural, community, and individual contexts. The impact of immigration status on PrEP uptake emerges as a major and recurrent theme that must be understood and addressed by HIV prevention programs aiming to promote an inclusive strategy for sexual and gender minority Latinxs living in the U.S.

Background:Flares in PsA, presenting as periods of acute disease activity, are thought to negatively impact patients’ lives. This has not been extensively studied in a real-world setting.Objectives:Describe flares, assess impact on quality of life and work productivity, and explore predictors.Methods:A cross-sectional survey among patients with PsA recruited by rheumatologists and dermatologists was conducted in France, Germany, Italy, Spain, UK and US. Data were collected Jun-Aug 2018 via patient record forms and patient self-complete forms. Physicians recorded flare status (in flare currently/flared in last 12 mo/longer than 12 mo or never), demographics, physician perceived severity and clinical outcomes. Patients reported quality of life [QoL] (EQ5D-5L), work productivity (WPAI), disability (HAQ-DI), pain (PsAID12 pain scale). Patients were compared by flare status using parametric or non-parametric tests. Logistic regression explored predictors of flare. Multivariate regression explored the impact of flare status on patient reported outcomes (PRO). The model was adjusted for gender, age, BMI, physician speciality.Results:Data were collected for 2,238 patients (586 US, 1,652 EU). Mean age was 48.7 years (13.2 SD), 53.8% were male. Physicians reported 7.5% were currently in flare and 22.0% had flared in the last 12 mo. Patients had experienced 2.2 mean flares in the last 12 mo (4.9 SD), lasting a mean 16.4 days (16.2 SD). Patients in flare were comparable demographically with those not; however, those in flare were less likely to work full time (43.6 vs. 59.3%, pTable 1.Clinical characteristics of patients by flare statusCurrently in flare (n=168)Flared in last 12 mo(n=492)Not flared in last 12 mo/never flared(n=1578)p-valueIn remission, n (%)4 (2.4)157 (33.2)799 (53.5)*Current BSA affected, mean (SD)10.3 (12.0)6.5 (7.6)5.0 (7.7)*66 SJC, mean (SD)5.4 (4.6)4.5 (7.3)2.4 (6.9)*68 TJC, mean (SD)7.8 (5.8)5.5 (8.3)3.1 (5.6)Physician-perceived severity, n (%)Mild35 (20.8)346 (70.3)1297 (82.2)Moderate101 (60.1)139 (28.3)261 (16.5)Severe32 (19.0)7 (1.4)20 (1.3)*Calculated on available data: Total base sizes: BSA=1665; SJC=514; TJC=493; Satisfaction=931Results showed that flare status significantly impacted QoL, work productivity, disability, and pain (Table 2). Exploring predictors of flare in the last 12 mo in un-adjusted analyses showed that demographic characteristics were not predictive of flare status, however patients presenting as moderate or severe at diagnosis were at greater risk of flare. Patients who were prescribed a bDMARD at diagnosis were at lower risk (Figure 1).Table 2.Impact of flare status on PROsCurrent flare statusChange in predicted PRO valuesP valueEQ5D utility (n=933)Not in flare (ref)In flare0.83-0.23EQ5D VAS (n=946)Not in flareIn flare76.1-21.3WPAI % overall work impairment (n=496)Not in flareIn flare20.1+28.5HAQ-DI (n=901)Not in flareIn flare0.4+0.6PsAID12 pain score (n=922)Not in flareIn flare2.5+3.0PRO key for worse outcome (range): EQ5D utility (0-1.0) = lower; EQ5D VAS (1-100) = lower; WPAI (0-100) = higher; HAQ-DI (0-3) = higher; PsAID12 pain (0-10) = higherFigure 1.Predictors of flaring in last 12 monthsConclusion:One third of patients surveyed were either currently in flare or had flared in the last 12 mo. Being in flare adversely impacted QoL, disability and work productivity. Flare may be predicted by overall physician-reported PsA disease severity at diagnosis.Disclosure of Interests:Ana-Maria Orbai Grant/research support from: Abbvie, Eli Lilly and Company, Celgene, Novartis, Janssen, Horizon, Consultant of: Eli Lilly; Janssen; Novartis; Pfizer; UCB. Ana-Maria Orbai was a private consultant or advisor for Sun Pharmaceutical Industries, Inc, not in her capacity as a Johns Hopkins faculty member and was not compensated for this service., William Tillett Grant/research support from: AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, Consultant of: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, MSD, Pfizer Inc, UCB, Speakers bureau: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer Inc, UCB, Suzanne Grieb Grant/research support from: Janssen, Steve Peterson Employee of: Janssen Research & Development, LLC, Elizabeth Holdsworth Employee of: Adelphi Real World, Sophie Meakin Employee of: Adelphi Real World, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB, Soumya D Chakravarty Shareholder of: Johnson & Johnson, Employee of: Janssen Scientific Affairs, LLC, Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB

BACKGROUND Although Latinos living in the United States are disproportionately affected by HIV, the development, implementation, and evaluation of HIV prevention, testing, and linkage to care interventions lag behind efforts occurring in other communities. To address sociocultural barriers to testing, we developed a multilevel intervention. This study is a pilot evaluation of the individual-level component of the intervention-animated video modules that address specific barriers to HIV testing common among foreign-born Latino men. METHODS We conducted a survey assessing HIV risk and barriers to testing with a convenience sample of 104 foreign-born Latino men in Baltimore, MD, who had not tested for HIV within the past year. Intention to test in the next 3 months was measured before and after viewing an intervention module selected based on survey responses. RESULTS Fifty-two (50.0%) participants had never tested for HIV. Of the participants who had previously tested for HIV, the mean time since their last test was 3.48 years (SD = 3.55). Participants' intention to test for HIV significantly increased after watching the module (t = -8.28, P < 0.001). Increased intention to test was not associated with any socio-demographic characteristics (ie, age, country of origin) or reported sexual behaviors (ie, number of sex partners in the past year). DISCUSSION These results suggest that our culturally sensitive, individually tailored intervention can be an additional tool to encourage HIV testing among previously untested foreign-born Latino men, one of the demographic groups at highest risk for delayed HIV diagnosis in the United States.

ObjectiveTo identify a core set of domains (outcomes) to be measured in psoriatic arthritis (PsA) clinical trials that represent both patients' and physicians' priorities.MethodsWe conducted (1) a systematic literature review (SLR) of domains assessed in PsA; (2) international focus groups to identify domains important to people with PsA; (3) two international surveys with patients and physicians to prioritise domains; (4) an international face-to-face meeting with patients and physicians using the nominal group technique method to agree on the most important domains; and (5) presentation and votes at the Outcome Measures in Rheumatology (OMERACT) conference in May 2016. All phases were performed in collaboration with patient research partners.ResultsWe identified 39 unique domains through the SLR (24 domains) and international focus groups (34 domains). 50 patients and 75 physicians rated domain importance. During the March 2016 consensus meeting, 12 patients and 12 physicians agreed on 10 candidate domains. Then, 49 patients and 71 physicians rated these domains' importance. Five were important to >70% of both groups: musculoskeletal disease activity, skin disease activity, structural damage, pain and physical function. Fatigue and participation were important to >70% of patients. Patient global and systemic inflammation were important to >70% of physicians. The updated PsA core domain set endorsed by 90% of OMERACT 2016 participants includes musculoskeletal disease activity, skin disease activity, pain, patient global, physical function, health-related quality of life, fatigue and systemic inflammation.ConclusionsThe updated PsA core domain set incorporates patients' and physicians' priorities and evolving PsA research. Next steps include identifying outcome measures that adequately assess these domains.

Summary In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in anti-immigrant rhetoric and arrests by US Immigration and Customs Enforcement, patients have voiced concerns about the availability of HIV treatment in their home countries much more frequently. Although antiretroviral therapy is available throughout Latin America, access depends on economic, social, and political circumstances. Maintaining uninterrupted continuity of care among immigrants held in detention or deported to their home countries is challenging. In this Viewpoint, we identify periods of particular vulnerability for immigrants during deportation proceedings, from initial detention to deposition in their country of origin. We discuss the effect of enhanced immigration enforcement on the health and wellbeing of HIV-infected immigrants, and on public health. Finally, we also discuss recommendations for clinicians, immigration authorities, and public health institutions in the USA and in receiving countries.

Background: In 2007 the journal Progress in Community Health Partnerships was launched to advance the field of community-engaged research and the journal's editors engaged in a Delphi process to identify priorities for the journal and field. Ten years later, the increased adoption of community-engaged research continues to improve public health. Objectives: The purpose of this manuscrip t is to i dentify community-engaged research priorities for the next 10 years. Methods: The study engaged leaders in community-engaged research using a two-round Delphi process, whereby leaders in the field were asked to identify and then rank order topics in community-engaged research that needed to be prioritized for the next decade. Results: In stage 1, 41 respondents generated 441 priorities across 8 categories (e.g., theory, epidemiology, intervention science) that were collapsed into 90 priority topics, ranging from 8 to 15 per category. In stage 2, 73 respondents ranked five prioritized items for each category. The prioritized items are provided, with the following themes present across all categories: 1) improvements to equity among partners, 2) partnership sustainability, and 3) increased efforts to translate community-engaged research into policy change. Conclusions: We compare the findings from this Delphi process with the priorities identified in 2007 to reflect on how the field has progressed. It is our hope that community and academic stakeholders will be able to use these priorities as a guide to their community-engaged research in the coming years.

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has reached the third of 5 stages of organizational maturity regarding incorporating patient research partners (PRP) into psoriatic arthritis (PsA) and psoriasis research and educational efforts. Herein, we report the involvement of PRP at the GRAPPA 2017 annual meeting and plans for future PRP engagement.

The association between housing and HIV has been widely demonstrated, although inquiry into HIV testing has been largely limited to the homeless. This study examines correlates of HIV testing within the past 6 months with housing stability and residential transience (moving two or more times in the past 6 months) among 620 low-income urban African Americans. Unstably housed and transient participants were more likely to participate in high-risk sex behaviors than stably housed participants and non-transient participants, respectively. In multivariate analyses, residential transience was positively associated with recent HIV testing; however, persons unstably housed were not more likely to have recently been tested for HIV despite their increased vulnerability and risk. While structural interventions are necessary to address the HIV disparities related to housing, increased community-based and mobile testing centers may be able to improve access to HIV testing among unstably housed.

In this study we used photovoice to better understand transitional housing residents' perceptions of housing and health at the individual and community levels. Discussion sessions were recorded, transcribed, and analyzed through a modified constant comparison approach. The results demonstrate that participants had a rich understanding of the complex connections between housing, neighborhood, and health that were intimately tied to the spatial concentration of incarceration in their community. The men identified social and physical sources of stress that manifest in a community-wide sense of hopelessness; however, utilization of community social networks and social capital provide opportunities for addressing these issues locally.

HIV-related stigma has been associated with a reluctance to test for HIV among Latinos. This study assessed community HIV-related stigma within an emerging Latino immigrant receiving city. We conducted a brief survey among a convenience sample of 312 Spanish-speaking Latinos in Baltimore, Maryland. HIV-related stigma was assessed through six items. Associations between stigma items, socio-demographic characteristics, and HIV testing history were considered. Gender, education, and religiosity were significantly associated with stigmatizing HIV-related beliefs. For example, men were 3.4 times more likely to hold more than three stigmatizing beliefs than women, and were also twice as likely as women to report feeling hesitant to test for HIV for fear of people's reaction if the test is positive. These findings can help inform future stigma interventions in this community. In particular, we were able to distinguish between drivers of stigma such as fear and moralistic attitudes, highlighting specific actionable items.

Social networks, including sexual networks, have increasingly been considered in research addressing HIV disparities in the United States. The goal of this study is to examine correlates of concurrent involvement in multiple sexual partnerships with social (i.e. non-sexual) and sexual network characteristics among a sample of 337 low-income urban African American women reporting main sexual partnerships longer than six months in duration. In the multivariate analyses, women who had larger non-sexual social networks, more family members in that network, and reported high levels of trust in their partner(s) were less likely to be in concurrent partnerships. Women who had one or more sexual partner who used drugs in the past six months were more likely to be in concurrent partnerships. Our results provide further evidence of the important association of drug use and concurrent sexual partnerships, but suggest that family members, immediate and extended, may be an important area of focus in addition to structural interventions that address the root causes of poverty and drug abuse.

To determine correlates of concurrent sexual partnerships among high-risk low-income urban African American women, survey responses of 337 women who had main sexual partners for over six months and reported high-risk behaviors were analyzed; 142 of these women also reported other sexual partnerships within the past 90 days. Unadjusted analyses showed that concurrency was significantly associated with relationship status, sexual debut, forced sex, incarceration of self and partners, depression, drug use, known or suspected partner nonmonogamy, and partner drug use. Age of sexual debut, relationship status, and indicators of problem drug use remained significantly associated with concurrency when controlling for individual factors, and only indicators of problem drug use and known or suspected partner nonmonogamy remained significantly associated with concurrency when also controlling for partner characteristics. Our results suggest the presence of extensive sexual networks within this population and document the need for interventions that address drug abuse and partnership instability. Moreover, the strong association between concurrency and perceptions of partners’ nonmonogamy suggest the need for intervention to target men and women in this core group.

Background: Latinos, particularly immigrant men, are more likely to present late to care for human immunodeficiency virus (HIV) infection. Objectives: This manuscript describes the development of iSolo Se Vive Una Vez! (iVive!) (You Only Live Once), a multilevel (individual and community) intervention aimed at increasing HIV testing. Methods: A partnership was established between the Baltimore Latino outreach team, a community coalition, designers, and academics. Intervention priorities were identified through a nominal group technique process. Design students then developed intervention material through an iterative process including feedback from the partners and 75 Latino immigrant men who participated in focus group discussions. Results: iVive! is composed of nine motion graphic modules that can be individually tailored and delivered through a tablet or cell phone, and a complementary social marketing campaign to address HIV stigma in the community. Conclusions: An iterative process with ongoing feedback resulted in intervention components that were engaging and appealing, and reflected the community’s experience.

Background : Qualitative research is appearing with increasing frequency in the public health and medical literature. Qualitative research in combination with a community-based participatory research (CBPR) approach can be powerful. However little guidance is available on how to present qualitative research within a CBPR framework for peer-review publications. Objectives : This article provides a brief overview of how qualitative research can advance CBPR partnerships and outlines practical guidelines for writing for publication about qualitative research within a CBPR framework to (1) guide partners with little experience publishing in peer-reviewed journals and/or (2) facilitate effective preparation of manuscripts grounded in qualitative research for peer-reviewed journals. We provide information regarding the specific benefits of qualitative inquiry in CBPR, tips for organizing the manuscript, questions to consider in preparing the manuscript, common mistakes in the presentation of qualitative research, and examples of peer-reviewed manuscripts presenting qualitative research conducted within a CBPR framework. Conclusions : Qualitative research approaches have tremendous potential to integrate community and researcher perspectives to inform community health research findings. Effective dissemination of CBPR informed qualitative research findings is crucial to advancing health disparities research.

The role of incarceration and community reentry after incarceration has been studied extensively for individual and community health; however, little attention has been given to the experiences of individuals who provide support to those in reentry. Through a community-academic partnership, seven focus groups were conducted with 39 individuals supporting a family member in reentry in the summer of 2012. The primary objectives of the focus groups were to explore community experiences and perspectives regarding providing support during a family member's reentry from a period of incarceration and any desired support for themselves during this time. Five themes emerged under a metatheme of stress, indicating that family members experience acute stress as a result of family reentry that adds to the chronic stress they already endure. Programs that acknowledge the difficult role of family members as supporters during an individual's reentry and provide support to them are desperately needed.

Incarceration has been extensively linked with HIV and sexually transmitted infections (STIs). While a great deal of attention has been given to the risk behaviors of people who have been incarcerated, examination of the behaviors of partners of incarcerated individuals is also needed to understand the direct and indirect links between incarceration and HIV and to identify prevention avenues. In the present study, we hypothesize that incarceration is associated with risk behavior through attitudes and norms. The purpose of this paper is: (1) to describe the attitudes and norms about sexual behaviors that women have when a sexual partner is incarcerated; and (2) to examine the association between attitudes and norms with the behavior of having other sex partners while a main partner is incarcerated. In our sample (n = 175), 50 % of women reported having other sex partners while their partner was incarcerated. Our findings show that attitudes, descriptive norms (i.e., norms about what other people do), and injunctive norms (i.e., norms about what others think is appropriate) were associated with having other partners. Interventions designed for couples at pre- and post-release from prison are needed to develop risk reduction plans and encourage HIV/STI testing prior to their reunion.

In New York City, HIV is increasingly concentrated in the foreign-born population, necessitating a greater exploration of the mechanisms through which changes in behavior and risk for HIV occur within migrant populations. Interviews were conducted with 22 Honduran-born Garifuna women to explore partnerships, sexual behaviors, and HIV risk in the context of migration, and transcripts were coded by thematic analysis procedures. Five themes emerged: (1) migration ends relationships, (2) new relationships in the U.S. form because of material and psychological needs, (3) secondary sexual partnerships are a man’s issue, (4) female secondary sexual partnership participation as a marker of equality, and (5) monogamy due to a lack of time. These findings suggest that greater attention be paid to women’s participation in secondary sexual partnerships for purposes other than economic need, and demonstrate a need for HIV interventions that are based in an understanding of how the social context of migration affects sexual behaviors.

Background Kidney and renal pelvis cancers account for 4% of all new cancer cases in the United States, among which 85% are renal cell carcinomas (RCC). While cigarette smoking is an established risk factor for RCC, little is known about the contribution of environmental tobacco smoke (ETS) to RCC incidence. This study assesses the role of smoking and ETS on RCC incidence using a population-based case-control design in Florida and Georgia. Methods Incident cases (n = 335) were identified from hospital records and the Florida cancer registry, and population controls (n = 337) frequency-matched by age (+/- 5 years), gender, and race were identified through random-digit dialing. In-person interviews assessed smoking history and lifetime exposure to ETS at home, work, and public spaces. Home ETS was measured in both years and hours of exposure. Odds ratios and 95% confidence intervals were calculated using logistic regression, controlled for age, gender, race, and BMI. Results Cases were more likely to have smoked 20 or more pack-years, compared with never-smokers (OR: 1.35, 95% CI: 0.93 – 1.95). A protective effect was found for smoking cessation, beginning with 11–20 years of cessation (OR: 0.39, 95% CI: 0.18–0.85) and ending with 51 or more years of cessation (OR: 0.11, 95% CI: 0.03–0.39) in comparison with those having quit for 1–10 years. Among never-smokers, cases were more likely to report home ETS exposure of greater than 20 years, compared with those never exposed to home ETS (OR: 2.18; 95% CI: 1.14–4.18). Home ETS associations were comparable when measured in lifetime hours of exposure, with cases more likely to report 30,000 or more hours of home ETS exposure (OR: 2.37; 95% CI: 1.20–4.69). Highest quartiles of combined home/work ETS exposure among never-smokers, especially with public ETS exposure, increased RCC risk by 2 to 4 times. Conclusion These findings confirm known associations between smoking and RCC and establish a potential etiologic role for ETS, particularly in the home. Differences in methods of retrospective measurement of lifetime smoking and ETS exposure may contribute to discrepancies in measures of associations across studies, and should be addressed in future research.

Background The role of diet in renal cell carcinoma risk has been inconclusive. This study uses an integrative approach to assess the role of food groups and food items in renal cell carcinoma risk. Design A case-control study was conducted from 2003-2006. Subjects/setting Incident cases (n=335) were identified from hospital records and the Florida cancer registry, and population controls (n=337) frequency matched by age (±5 years), sex, and race were identified through random-digit dialing. Eating habits were assessed through the use of the 70-item Block food frequency questionnaire. Statistical analyses Odds ratios (ORs), 95% confidence intervals (CIs), and tests for trends were calculated using logistic regression, controlled for age, sex, race, income, body mass index, and pack-years of smoking. Results Decreased renal cell carcinoma risk was observed among the total sample and for men for vegetable consumption (all subjects: OR 0.56, 95% CI 0.35, 0.88; men: OR 0.49, 95% CI 0.25, 0.96) but not for fruit consumption. Tomato consumption decreased renal cell carcinoma risk for the total population and for men (all subjects: OR 0.50, 95% CI 0.31, 0.81; men: OR 0.47, 95% CI 0.24, 0.95). Increased risk of renal cell carcinoma was observed among all subjects and among women with increased consumption of red meat (all subjects: OR 4.43, 95% CI 2.02, 9.75; women: OR 3.04, 95% CI 1.60, 5.79). White bread consumption increased renal cell carcinoma risk among women only (OR 3.05, 95% CI 1.50, 6.20), as did total dairy consumption (OR 2.36, 95% CI 1.21, 4.60). Conclusions The protective role of vegetables and the increased risk of renal cell carcinoma with meat consumption are supported. The protective role of fruits is not. Novel findings include the increased risk of renal cell carcinoma with white bread and white potato consumption and the decreased risk of renal cell carcinoma with tomato consumption.