Publications by authors named "Michael T LeVasseur"

17 Publications

  • Page 1 of 1

No Evidence of Food or Alcohol Substitution in Response to a Sweetened Beverage Tax.

Am J Prev Med 2021 02;60(2):e49-e57

Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Introduction: Evidence suggests real-world beverage taxes reduce sweetened beverage purchases, but it is unknown if consumers consequently increase food or alcohol purchases. This study examines whether Philadelphia's 1.5 cents/ounce beverage tax was associated with substitution to 3 kinds of hypothesized substitutes: snacks, nontaxed beverage concentrates, and alcohol.

Methods: Using commercial retail sales data and a difference-in-differences approach, analyses compared logged volume and dollar sales of snacks and beverage concentrates between 2016 (pretax) and 2017 (post-tax) at chain food retail stores in Philadelphia (n=180) and Baltimore (nontaxed control city; n=60), and logged volume and dollar sales of wine and spirits at liquor stores in Philadelphia (n=44) and nearby Pennsylvania counties (alternate control; n=66). Additional food analyses examined change in logged volume sales of hypothesized products compared to control products (other foods). Analyses were conducted in 2020.

Results: Across store types, analyses showed no statistically significant increases in logged volume or dollar sales of snacks or spirits in Philadelphia stores compared to control sites (decreased, ranging from -10% to 0%). Supermarket analyses showed substitution to nontaxed beverage concentrates (27% increase in volume, 36% increase relative to other food) but remained a relatively small percentage of overall beverage dollar sales (12% at baseline, 15% at post).

Conclusions: At the population level, there is no evidence that Philadelphia's decline in taxed beverage purchases is offset by increases in snacks or spirits purchasing, but there is evidence of substitution to beverage concentrates in supermarkets. Future studies should explore individual-level purchasing changes.
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http://dx.doi.org/10.1016/j.amepre.2020.08.021DOI Listing
February 2021

The Association Of A Sweetened Beverage Tax With Changes In Beverage Prices And Purchases At Independent Stores.

Health Aff (Millwood) 2020 07;39(7):1130-1139

Christina A. Roberto is an assistant professor in the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania.

In January 2017 Philadelphia, Pennsylvania, implemented an excise tax of 1.5 cents per ounce on beverages sweetened with sugar or artificial sweeteners. Small independent stores are an important yet understudied setting. They are visited frequently in urban and low-income areas, and sugary beverages are among the most commonly purchased items in them. We compared changes in beverage prices and purchases before and twelve months after tax implementation at small independent stores in Philadelphia and an untaxed control city, Baltimore, Maryland. Our sample included 134 stores with price data and 4,584 customer purchases. Compared with Baltimore, Philadelphia experienced significantly greater increases in the price of taxed beverages (1.81 cents per ounce, or 120.4 percent of the tax) and significantly larger declines in the volume of taxed beverages sold (5.76 ounces, or 38.9 percent) after tax implementation. Beverage excise taxes may be an effective policy tool for decreasing the purchase of sweetened drinks in small independent stores, particularly among populations at higher risk for sugar-sweetened beverage consumption.
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http://dx.doi.org/10.1377/hlthaff.2019.01058DOI Listing
July 2020

One-year changes in sugar-sweetened beverage consumers' purchases following implementation of a beverage tax: a longitudinal quasi-experiment.

Am J Clin Nutr 2020 09;112(3):644-651

Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

Background: Few longitudinal studies examine the response to beverage taxes, especially among regular sugar-sweetened beverage (SSB) consumers.

Objective: This study aimed to examine changes in objectively measured beverage purchases associated with the Philadelphia beverage tax on sugar-sweetened and artificially sweetened beverages.

Methods: A longitudinal quasi-experiment was conducted with adult sugar-sweetened beverage (SSB) consumers in Philadelphia (n = 306) and Baltimore (n = 297; a nontaxed comparison city). From 2016 to 2017 participants submitted all food and beverage receipts during a 2-wk period at: baseline (pretax) and 3, 6, and 12 mo posttax (91.0% retention; data analyzed in 2019). Linear mixed effects models were used to assess the difference-in-differences in total purchased ounces (fl oz) of taxed beverages in a 2-wk period in Philadelphia compared with Baltimore. Secondary analyses: 1) excluded weeks that contained major holidays at baseline and 12 mo (42% of measured weeks at baseline and 12 mo) because policy implementation timing necessitated data collection during holidays when SSB demand may be more inelastic, and 2) aggregated posttax time points to address serial correlation and low power.

Results: There were no statistically significant changes in purchased ounces of taxed beverages in Philadelphia compared with Baltimore in the primary analysis. After excluding holiday purchasing, the tax was associated with statistically significant reductions of taxed beverage purchases at 3 and 6 mo (-157.1 ounces, 95% CI: -310.1, -4.1 and -175.1 ounces, 95% CI: -328.0, -22.3, respectively) but not 12 mo. Analyses aggregating all 6 wk of posttax time points showed statistically significant reductions (-203.7 ounces, 95% CI: -399.6, -7.8).

Conclusions: A sweetened beverage tax was not associated with reduced taxed beverage purchases among SSB consumers 12 mo posttax in the full sample. Both secondary analyses excluding holiday purchasing or aggregating posttax time periods found reductions in taxed beverage purchases ranging from -4.9 to -12.5 ounces per day. Larger longitudinal studies are needed to further understand tax effects.
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http://dx.doi.org/10.1093/ajcn/nqaa158DOI Listing
September 2020

Modeling HPV vaccination scale-up among urban young men who have sex with men in the context of HIV.

Vaccine 2019 06 30;37(29):3883-3891. Epub 2019 May 30.

Department of Pediatrics, Christiana Care Health System, 4745 Ogletown-Stanton Road, MAP 1, Suite 116, Newark, DE 19713, United States.

Introduction: Young men who have sex with men (YMSM) are at high risk to contract human papillomavirus (HPV). While an effective vaccination exists, its use among YMSM is markedly lower compared to non-MSM and women. This study compares scaling up HPV vaccination in conjunction with other prevention strategies.

Methods: An agent-based model of urban YMSM (≤26 years of age) reflective of the demography of Philadelphia, PA, simulated for up to ten years of follow-up to examine anal and oral transmission of the HPV genotypes covered in the nonavalent (9v) vaccine: 6, 11, 16, 18, 31, 33, 45, 52, 58. Starting HPV prevalences ranged from a high of 18% (type 6) to a low of 6% (type 31); overall 65% of individuals carried any HPV genotype. Simulated levels of vaccination were ranged from 0% to 13% (present-day level), 25%, 50%, 80% (Healthy People 2020 target), and 100% in conjunction with condom use and HIV seroadaptive practices. The primary outcome was the relative reduction in HPV infection.

Results: Compared to present-day vaccination levels (13%), scaling-up vaccination led to expected declines in 10-year post-simulation HPV prevalence. Anal HPV (any 9v types) declined by 9%, 27%, 46%, and 58% at vaccination levels of 25%, 50%, 80%, and 100%, respectively. Similarly, oral HPV (any 9v types) declined by 11%, 33%, 57%, and 71% across the same levels of vaccine uptake. Comparing the prevention strategies, condoms blocked the greatest number of anal transmissions when vaccination was at or below present-day levels. For oral transmission, vaccination was superior to condom use at all levels of coverage.

Conclusions: Public health HPV preventions strategies should continue to emphasize the complementary roles of condoms and vaccination, especially for preventing oral infection. Improving vaccination coverage will ultimately have the greatest impact on reducing HPV infection among YMSM.
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http://dx.doi.org/10.1016/j.vaccine.2019.05.047DOI Listing
June 2019

Association of a Beverage Tax on Sugar-Sweetened and Artificially Sweetened Beverages With Changes in Beverage Prices and Sales at Chain Retailers in a Large Urban Setting.

JAMA 2019 05;321(18):1799-1810

Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Importance: Policy makers have implemented beverage taxes to generate revenue and reduce consumption of sweetened drinks. In January 2017, Philadelphia, Pennsylvania, became the second US city to implement a beverage excise tax (1.5 cents per ounce).

Objectives: To compare changes in beverage prices and sales following the implementation of the tax in Philadelphia compared with Baltimore, Maryland (a control city without a tax) and to assess potential cross-border shopping to avoid the tax in neighboring zip codes.

Design, Setting, And Participants: This study used a difference-in-differences approach and analyzed sales data to compare changes between January 1, 2016, before the tax, and December 31, 2017, after the tax. Differences by store type, beverage sweetener status, and beverage size were examined. The commercial retailer sales data included large chain store sales in Philadelphia, Baltimore, and the Pennsylvania zip codes bordering Philadelphia. These data reflect approximately 25% of the ounces of taxed beverages sold in Philadelphia.

Exposures: Philadelphia's tax on sugar-sweetened and artificially sweetened beverages.

Main Outcomes And Measures: Change in taxed beverage prices and volume sales.

Results: A total of 291 stores (54 supermarkets, 20 mass merchandise stores, 217 pharmacies) were analyzed. The mean price per ounce of taxed beverages in Philadelphia increased from 5.43 cents in 2016 to 6.24 cents in 2017 at supermarkets; from 5.28 cents to 6.24 cents at mass merchandise stores, and from 6.60 cents to 8.28 cents at pharmacies. The mean price per ounce in Baltimore increased from 5.33 cents in 2016 to 5.50 cents in 2017 at supermarkets, from 6.34 cents to 6.52 cents at mass merchandise stores, and from 6.76 cents to 6.93 cents at pharmacies. The mean per-ounce difference in price between the 2 cities was 0.65 cents (95% CI, 0.60 cents-0.69 cents; P<.001) at supermarkets; 0.87 cents (95 % CI, 0.72 cents-1.02 cents; P<.001) at mass merchandise stores, and 1.56 cents (95% CI, 1.50 cents-1.62 cents; P<.001) at pharmacies. Total volume sales of taxed beverages in Philadelphia decreased by 1.3 billion ounces (from 2.475 billion to 1.214 billion) or by 51.0% after tax implementation. Volume sales in the Pennsylvania border zip codes, however, increased by 308.2 million ounces (from 713.1 million to 1.021 billion), offsetting the decrease in Philadelphia's volume sales by 24.4%. In Philadelphia, beverage volume sales in ounces per 4-week period between before and after tax periods decreased from 4.85 million to 1.99 million at supermarkets, from 2.98 million to 1.72 million at mass merchandise stores, and from 0.16 million to 0.13 million at pharmacies. In Baltimore, the beverage volume sales in ounces decreased from 2.83 million to 2.81 million at supermarkets, from 1.05 million to 1.00 million at mass merchandise stores, and from 0.14 million to 0.13 million at pharmacies. This was a 58.7% reduction at supermarkets (difference-in-differences, -2.85 million ounces; 95% CI, -4.10 million to -1.60 million ounces; P < .001), 40.4% reduction at mass merchandise stores (difference-in-differences, -1.20 million ounces; 95% CI, -2.04 million to -0.36 million ounces; P = .001), and 12.6% reduction in pharmacies (difference-in-differences, -0.02 million ounces; 95% CI, -0.03 million to -0.01 million ounces; P < .001).

Conclusions And Relevance: In Philadelphia in 2017, the implementation of a beverage excise tax on sugar-sweetened and artificially sweetened beverages was associated with significantly higher beverage prices and a significant and substantial decline in volume of taxed beverages sold. This decrease in taxed beverage sales volume was partially offset by increases in volume of sales in bordering areas.
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http://dx.doi.org/10.1001/jama.2019.4249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518342PMC
May 2019

Association of a Beverage Tax on Sugar-Sweetened and Artificially Sweetened Beverages With Changes in Beverage Prices and Sales at Chain Retailers in a Large Urban Setting.

JAMA 2019 05;321(18):1799-1810

Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Importance: Policy makers have implemented beverage taxes to generate revenue and reduce consumption of sweetened drinks. In January 2017, Philadelphia, Pennsylvania, became the second US city to implement a beverage excise tax (1.5 cents per ounce).

Objectives: To compare changes in beverage prices and sales following the implementation of the tax in Philadelphia compared with Baltimore, Maryland (a control city without a tax) and to assess potential cross-border shopping to avoid the tax in neighboring zip codes.

Design, Setting, And Participants: This study used a difference-in-differences approach and analyzed sales data to compare changes between January 1, 2016, before the tax, and December 31, 2017, after the tax. Differences by store type, beverage sweetener status, and beverage size were examined. The commercial retailer sales data included large chain store sales in Philadelphia, Baltimore, and the Pennsylvania zip codes bordering Philadelphia. These data reflect approximately 25% of the ounces of taxed beverages sold in Philadelphia.

Exposures: Philadelphia's tax on sugar-sweetened and artificially sweetened beverages.

Main Outcomes And Measures: Change in taxed beverage prices and volume sales.

Results: A total of 291 stores (54 supermarkets, 20 mass merchandise stores, 217 pharmacies) were analyzed. The mean price per ounce of taxed beverages in Philadelphia increased from 5.43 cents in 2016 to 6.24 cents in 2017 at supermarkets; from 5.28 cents to 6.24 cents at mass merchandise stores, and from 6.60 cents to 8.28 cents at pharmacies. The mean price per ounce in Baltimore increased from 5.33 cents in 2016 to 5.50 cents in 2017 at supermarkets, from 6.34 cents to 6.52 cents at mass merchandise stores, and from 6.76 cents to 6.93 cents at pharmacies. The mean per-ounce difference in price between the 2 cities was 0.65 cents (95% CI, 0.60 cents-0.69 cents; P<.001) at supermarkets; 0.87 cents (95 % CI, 0.72 cents-1.02 cents; P<.001) at mass merchandise stores, and 1.56 cents (95% CI, 1.50 cents-1.62 cents; P<.001) at pharmacies. Total volume sales of taxed beverages in Philadelphia decreased by 1.3 billion ounces (from 2.475 billion to 1.214 billion) or by 51.0% after tax implementation. Volume sales in the Pennsylvania border zip codes, however, increased by 308.2 million ounces (from 713.1 million to 1.021 billion), offsetting the decrease in Philadelphia's volume sales by 24.4%. In Philadelphia, beverage volume sales in ounces per 4-week period between before and after tax periods decreased from 4.85 million to 1.99 million at supermarkets, from 2.98 million to 1.72 million at mass merchandise stores, and from 0.16 million to 0.13 million at pharmacies. In Baltimore, the beverage volume sales in ounces decreased from 2.83 million to 2.81 million at supermarkets, from 1.05 million to 1.00 million at mass merchandise stores, and from 0.14 million to 0.13 million at pharmacies. This was a 58.7% reduction at supermarkets (difference-in-differences, -2.85 million ounces; 95% CI, -4.10 million to -1.60 million ounces; P < .001), 40.4% reduction at mass merchandise stores (difference-in-differences, -1.20 million ounces; 95% CI, -2.04 million to -0.36 million ounces; P = .001), and 12.6% reduction in pharmacies (difference-in-differences, -0.02 million ounces; 95% CI, -0.03 million to -0.01 million ounces; P < .001).

Conclusions And Relevance: In Philadelphia in 2017, the implementation of a beverage excise tax on sugar-sweetened and artificially sweetened beverages was associated with significantly higher beverage prices and a significant and substantial decline in volume of taxed beverages sold. This decrease in taxed beverage sales volume was partially offset by increases in volume of sales in bordering areas.
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http://dx.doi.org/10.1001/jama.2019.4249DOI Listing
May 2019

Unemployment claims in Philadelphia one year after implementation of the sweetened beverage tax.

PLoS One 2019 27;14(3):e0213218. Epub 2019 Mar 27.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.

Objectives: Possible adverse economic impacts of sweetened drink taxes are a key concern for numerous stakeholders. This study examined changes in unemployment benefit claims filings in Philadelphia compared to its neighboring counties two years prior to and 14 months post implementation of a 1.5 cents per ounce excise tax on sugar- and artificially-sweetened beverages.

Methods: Data were obtained from the Pennsylvania Department of Labor. Interrupted time series analysis was used to determine if there was a change in new monthly unemployment claims filings post-tax implementation in Philadelphia compared to surrounding counties in supermarkets, select potentially affected industries, and in total claims filings across all industries combined.

Results: Results showed there were no statistically significant changes to unemployment claims in Philadelphia compared to neighboring counties for supermarkets (ß = -9.45, 95% CI = -98.11, 79.22), soft drink manufacturers (ß = -0.13, 95% CI = -9.13, 8.88), across other potentially affected industries (ß = 9.16, 95% CI = -488.29, 506.60), or across all industries (ß = -445.85, 95% CI = -4272.39, 3380.68) following implementation of the beverage tax. Unemployment declined similarly in Philadelphia compared to surrounding counties.

Conclusions: Public reports of increased unemployment within the first year following the implementation of the Philadelphia beverage tax are not supported by this analysis. Future work should examine employment outcomes and include longer follow-up periods.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0213218PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436769PMC
December 2019

The Effect of PrEP on HIV Incidence Among Men Who Have Sex With Men in the Context of Condom Use, Treatment as Prevention, and Seroadaptive Practices.

J Acquir Immune Defic Syndr 2018 01;77(1):31-40

Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.

Background: HIV preexposure prophylaxis (PrEP) is an effective tool in preventing HIV infection among high-risk men who have sex with men (MSM). It is unknown how effective PrEP is in the context of other implemented HIV prevention strategies, including condom use, seroadaption, and treatment as prevention (TasP). We evaluate the impact of increasing uptake of PrEP in conjunction with established prevention strategies on HIV incidence in a high-risk population of MSM through simulation.

Methods: Agent-based simulation models representing the sexual behavior of high-risk, urban MSM in the United States over the period of 1 year were used to evaluate the effect of PrEP on HIV infection rates. Simulations included data for 10,000 MSM and compared increasing rates of PrEP uptake under 8 prevention paradigms: no additional strategies, TasP, condom use, seroadaptive behavior, and combinations thereof.

Results: We observed a mean of 103.2 infections per 10,000 MSM in the absence of any prevention method. PrEP uptake at 25% without any additional prevention strategies prevented 30.7% of infections. In the absence of PrEP, TasP, condom use, and seroadaptive behavior independently prevented 27.1%, 48.8%, and 37.7% of infections, respectively, and together prevented 72.2%. The addition of PrEP to the 3 aforementioned prevention methods, at 25% uptake, prevented an additional 5.0% of infections.

Conclusions: To achieve a 25% reduction in HIV infections by 2020, HIV prevention efforts should focus on significantly scaling up access to PrEP in addition to HIV testing, access to antiretroviral therapy, and promoting condom use.
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http://dx.doi.org/10.1097/QAI.0000000000001555DOI Listing
January 2018

The benefits of data linkage for firefighter injury surveillance.

Inj Prev 2018 02 14;24(1):19-28. Epub 2017 Feb 14.

Department of Environmental and Occupational Health, Dornsife School of Public Health at Drexel University, Philadelphia, Pennsylvania, USA.

Background: While survey data are available for national estimates of fire events and firefighter fatalities, data on firefighter injury at the national and local levels remain incomplete and unreliable. Data linkage provides a vehicle to maximise case detection and deepen injury description for the US fire service.

Methods: By linking departmental Human Resources records, despatch data, workers' compensation and first reports of injury, researchers were able to describe reported non-fatal injuries to 3063 uniformed members of the Philadelphia Fire Department (PFD), for the period of 2005 through 2013.

Results: Among all four databases, the overall linkage rate was 56%. Among three of the four databases, the linkage rate was 88%. Because there was duplication of some variables among the datasets, we were able to deeply describe all the linked injuries in the master database. 45.5% of uniformed PFD members reported at least one injury during the study period. Strains, falls, burns and struck-by injuries were the most common causes. Burns resulted in the highest lost time claim payout, and strains accounted for the highest medical claim cost. More than 70% of injuries occurred in the first 15 years of experience.

Discussion: Data linkage provided three new benefits: (1) creation of a new variable-years of experience, (2) reduction of misclassification bias when determining cause of injury, leading to more accurate estimates of cost and (3) visualisation of injury rates when controlling for the number of fire department responses, allowing for the generation of hypotheses to investigate injury hot spots.
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http://dx.doi.org/10.1136/injuryprev-2016-042213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800341PMC
February 2018

Drug use among men by sexual behaviour, race and ethnicity: Prevalence estimates from a nationally representative US sample.

Int J Drug Policy 2016 10 18;36:148-50. Epub 2016 Jan 18.

Department of Epidemiology and Biostatistics, Drexel University School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States.

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http://dx.doi.org/10.1016/j.drugpo.2016.01.008DOI Listing
October 2016

Is this thing on? Getting the public to listen to the pro-vaccine message.

Vaccine 2017 03 13;35(9):1208. Epub 2016 Jan 13.

Department of Health Management & Policy, Drexel University School of Public Health, Philadelphia, PA 19104, United States.

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http://dx.doi.org/10.1016/j.vaccine.2015.12.070DOI Listing
March 2017

What role does transactional sex play in the HIV/STI and reproductive health risk behaviour among high-tier entertainment centre workers in China?

Glob Public Health 2015 ;10(8):947-67

a HIV Center for Clinical and Behavioral Studies , New York State Psychiatric Institute and Columbia University , New York , NY , USA.

China's rapid economic growth over the last three decades has led to increased population wealth and the proliferation of entertainment centres where people can conduct business, relax and meet new people. Little is known about the sexual risk behaviours of employees at high-tier entertainment centres. This paper addresses this gap in knowledge by comparing HIV risk perception and sexual and reproductive health behaviours among female and male employees at three high-tier entertainment centres in two cities in China, comparing those who report a history of transactional sex to those who do not. In both cities, participants who reported a history of transactional sex were more likely than those without a history of transactional sex to report multiple sexual partnerships, more lifetime sexual partners, a history of sexually transmitted infections (STIs), having anal sex and/or recent abortions, and were more likely to perceive themselves to be at risk for STIs/HIV. However, risk behaviour was also high among those with no history of transactional sex. These findings highlight the need for targeted sexual and reproductive health initiatives for employees in these work settings.
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http://dx.doi.org/10.1080/17441692.2015.1045918DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575811PMC
June 2016

Identification of a nuclear export sequence in the MHC CIITA.

J Immunol 2015 Jun 6;194(12):6102-11. Epub 2015 May 6.

Department of Biology, Sarah Lawrence College, Bronxville, NY 10708

Initiation of an immune response through expression of MHC class II and related genes is under the control of the CIITA. Normally found in both the cytoplasm and nucleus, CIITA is tightly controlled by a variety of posttranslational modifications as well as interactions with other nuclear and cytoplasmic factors, whereas disruption of this dual subcellular localization impairs CIITA functioning and expression of target genes. Although CIITA has well-defined domains necessary for its nuclear import, the region responsible for the translocation of CIITA from the nucleus has not been characterized. In this study, we identify a leucine-rich motif at residues 717-724 that bears strong homology to known nuclear export sequence (NES) domains. Mutation of this region renders CIITA insensitive to treatment with leptomycin B, an inhibitor of nuclear export, whereas fusion of this domain to a heterologous GFP is sufficient to induce its export to the cytoplasm or cause its retention in the nucleus following leptomycin B treatment. Point mutations of specific leucine residues within the NES disrupt the normal subcellular distribution of the full-length CIITA, impair its ability to interact with the nuclear export factor CRM1, and enhance CIITA-induced gene expression from an MHC class II gene promoter. IFN-γ stimulation of class II genes is further enhanced by inhibiting the nuclear export of endogenous CIITA. Collectively, these data demonstrate the first identification of a specific NES within CIITA and place it among the other protein domains that contribute to the posttranslational regulation of CIITA activity.
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http://dx.doi.org/10.4049/jimmunol.1402026DOI Listing
June 2015

Identification of a nuclear export sequence in the MHC CIITA.

J Immunol 2015 Jun 6;194(12):6102-11. Epub 2015 May 6.

Department of Biology, Sarah Lawrence College, Bronxville, NY 10708

Initiation of an immune response through expression of MHC class II and related genes is under the control of the CIITA. Normally found in both the cytoplasm and nucleus, CIITA is tightly controlled by a variety of posttranslational modifications as well as interactions with other nuclear and cytoplasmic factors, whereas disruption of this dual subcellular localization impairs CIITA functioning and expression of target genes. Although CIITA has well-defined domains necessary for its nuclear import, the region responsible for the translocation of CIITA from the nucleus has not been characterized. In this study, we identify a leucine-rich motif at residues 717-724 that bears strong homology to known nuclear export sequence (NES) domains. Mutation of this region renders CIITA insensitive to treatment with leptomycin B, an inhibitor of nuclear export, whereas fusion of this domain to a heterologous GFP is sufficient to induce its export to the cytoplasm or cause its retention in the nucleus following leptomycin B treatment. Point mutations of specific leucine residues within the NES disrupt the normal subcellular distribution of the full-length CIITA, impair its ability to interact with the nuclear export factor CRM1, and enhance CIITA-induced gene expression from an MHC class II gene promoter. IFN-γ stimulation of class II genes is further enhanced by inhibiting the nuclear export of endogenous CIITA. Collectively, these data demonstrate the first identification of a specific NES within CIITA and place it among the other protein domains that contribute to the posttranslational regulation of CIITA activity.
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http://dx.doi.org/10.4049/jimmunol.1402026DOI Listing
June 2015

A public health perspective on HIV/AIDS in Africa: Victories and unmet challenges.

Pathophysiology 2014 Sep 22;21(3):237-56. Epub 2014 Jul 22.

Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, United States. Electronic address:

More than three decades after the first cases of HIV were recognized in the United States and worldwide, Africa remains a remarkable example of both public health successes and remaining challenges. Although many African countries initially lacked the resources and sociopolitical will to advance HIV treatment and prevention strategies, world governments, a committed scientific community, and activists have made tremendous advances. We present a public health perspective on the history of the HIV epidemic in Africa, combining summaries of the epidemiology of HIV infection rates and risk factors for horizontal and vertical HIV transmission, along with a historic perspective on programmatic and funding initiatives that have strongly reduced levels of HIV infection across the continent. In our preparation of this review two clear themes emerged: that (1) the HIV epidemic in Africa remains geographically and culturally heterogeneous, so that treatment and prevention strategies need to be thoughtfully tailored for maximal effectiveness; and (2) a lack of openness to recognize and discuss infection disparities in high risk groups, disseminate prevention information, and enact policies to partner with these highly stigmatized risk groups. This is especially true of female sex workers, people who inject drugs, and men who have sex with men, communities that are often not recognized or typically undercounted when HIV testing and prevention policies are developed by many African governments. Without changes to recognize and de-stigmatize these high-risk groups, a lack of sociopolitical will to alter public health perspectives will likely hinder advances to further curb the HIV epidemic.
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http://dx.doi.org/10.1016/j.pathophys.2014.07.001DOI Listing
September 2014

Use of the Internet and mobile-based "apps" for sex-seeking among men who have sex with men in New York City.

Am J Mens Health 2014 Nov 20;8(6):510-20. Epub 2014 Mar 20.

York College of The City University of New York, Jamaica, NY, USA.

The Internet continues to be a popular venue for men who have sex with men (MSM) to seek sexual partners. Increased sexual risk behavior has been linked to MSM who use the Internet to seek partners. However, there has been little research on how new mobile-based social networking applications ("apps") may affect sex-seeking and sexual risk behaviors of MSM. One hundred twenty-six MSM in New York City were recruited to complete an online survey on the use of the Internet and other technology for sex-seeking. The authors collected data on variables of interest including sexual sensation seeking, gay identity affirmation, internalized homophobia, Internet/app use, and sexual behavior with men met via the Internet and mobile apps. Results indicated that men who use both the Internet and mobile apps to seek partners were younger and reported higher incomes (p<.05) than men who used the Internet only. There were no significant differences between the groups with regard to race, sexual sensation seeking, gay identity affirmation, or internalized homophobia, indicating that the use of mobile-based apps for sex-seeking may be simply an example of evolving technologies. These findings may provide insight for the feasibility and planning of effective mobile app-based HIV/STI programs for MSM.
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http://dx.doi.org/10.1177/1557988314527311DOI Listing
November 2014

Use of the Internet and mobile-based "apps" for sex-seeking among men who have sex with men in New York City.

Am J Mens Health 2014 Nov 20;8(6):510-20. Epub 2014 Mar 20.

York College of The City University of New York, Jamaica, NY, USA.

The Internet continues to be a popular venue for men who have sex with men (MSM) to seek sexual partners. Increased sexual risk behavior has been linked to MSM who use the Internet to seek partners. However, there has been little research on how new mobile-based social networking applications ("apps") may affect sex-seeking and sexual risk behaviors of MSM. One hundred twenty-six MSM in New York City were recruited to complete an online survey on the use of the Internet and other technology for sex-seeking. The authors collected data on variables of interest including sexual sensation seeking, gay identity affirmation, internalized homophobia, Internet/app use, and sexual behavior with men met via the Internet and mobile apps. Results indicated that men who use both the Internet and mobile apps to seek partners were younger and reported higher incomes (p<.05) than men who used the Internet only. There were no significant differences between the groups with regard to race, sexual sensation seeking, gay identity affirmation, or internalized homophobia, indicating that the use of mobile-based apps for sex-seeking may be simply an example of evolving technologies. These findings may provide insight for the feasibility and planning of effective mobile app-based HIV/STI programs for MSM.
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http://dx.doi.org/10.1177/1557988314527311DOI Listing
November 2014
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