Cuihong Huang

Objective: Limited studies have sought to qualify the extent and trends of racial disparities in viral suppression (VS) among people with HIV(PWH) across the Southern US. This study aims to examine the spatiotemporal trend and structural social determinants of racial disparities of VS. Methods: A population-based retrospective cohort study across all counties in South Carolina (SC) from 2013 to 2020. Linear trend test was employed to explore the temporal trend of the disparity indices (Black to White Ratio [BWR], Index of Disparity [ID], Weighted Index of Disparity [Weighted ID], and Gini coefficient). Linear mixed-effect models were further used to assess the association between different contextual factors and these indices. Results: A decrease in racial disparity in VS ( p < 0.01) was observed from 2013 to 2020 across all disparity indices. When measured using Weighted ID and Gini coefficient, lower risk of racial disparities in VS was associated with more Ryan White HIV centers ( β = -0.92 and β = -0.0046, respectively) and higher disability rates ( β = -1.10 and β = -0.0055, respectively). When measured using ID, Weighted ID, and Gini coefficient, counties in PEE DEE region showed less racial disparities in VS ( β = -3.89, -1.73, and -0.0086, respectively, p < 0.05) compared with those in Lowcountry region. Conclusions: Although a notable decrease in racial disparities in VS was observed among PWH in SC, attention to addressing related social and structural factors (e.g., fewer Ryan White HIV centers within geographic accessibility) that contribute to poorer HIV outcomes is still needed.

People with HIV (PWH) and their family members (FM) function as an interdependent system, where the experience and resources of one member may shape the psychological outcomes of the other. While existing studies have shown caregiving burden of FM might negatively affect mental health of PWH, few research examined the underlying mechanism of this association at a dyadic perspective. This study aimed to examine the association between FM's caregiving burden and PWH's perceived stress, and the potential mediating role of FM's resilience and moderating effect of FM's HIV status. Study data were extracted from the baseline survey of an ongoing clinical trial in Guangxi, China. A total of 800 PWH-FM dyads were included in this study. FM's caregiving burden, resilience, HIV status and PWH's perceived stress were measured by self-reported instruments. A moderated mediation model was conducted to explore whether FM's resilience mediated the effect of FM's caregiving burden on PWH's perceived stress and whether such mediation effect varied by FM's HIV status, adjusting for demographic characteristics. The results showed that when FM experienced more caregiving burden, PWH reported higher levels of perceived stress. This relationship was partially explained by FM's resilience; that is, greater caregiving burden reduced FM's resilience, which in turn increased the perceived stress of PWH. This pathway differed by FM's HIV status. Specifically, the indirect effect of FM's resilience existed only in FM with HIV-positive status, while no significant indirect effect was found among FM without HIV. These findings underscore that FM's caregiving burden and PWH's mental health are not isolated variables; interventions should consider PWH and their families as interdependent systems. Effective family-based interventions targeting improving PWH's mental health might consider placing greater emphasis on reducing the caregiving burden and improving family resilience, especially for HIV-seroconcordant families.

Objectives: To explore the association between family relationships and quality of life (QoL), and the mediating role of resilience among people living with HIV (PLWH) and their family members (FMs). Methods: Baseline data were drawn from an ongoing study in Guangxi, China, including 783 PLWH-FM dyads. The actor-partner interdependence mediation model examined how individuals’ family relationships/cohesion affect their own (actor effects) and their partners’ QoL (partner effects), and the mediating role of resilience. Results: A significant actor-direct effect was observed for FMs’ family relationships on their own mental QoL ( β = 0.136, P < 0.001), while no such effect was found for PLWH. Resilience functioned as a mediator between PLWH's family cohesion and PLWH's QoL (physical: β = 0.109, mental: β = 0.089, P < 0.001) and between FMs’ family relationships and FMs’ QoL (physical: β = 0.062, mental: β = 0.075, P < 0.001). Regarding partner effects, FMs’ resilience mediated the association between PLWH's family cohesion and FMs’ QoL (physical: β = 0.036, mental: β = 0.044, P < 0.01). Conclusion: Findings underscore that future interventions should target the family as a unit to strengthen family ties and improve the cross-dyadic role of resilience, particularly that of FMs.

Background: Few studies have simultaneously considered the impacts of parental labour migration and childhood maltreatment on psychosocial health.Objective: To estimate the complex associations of parental labour migration and childhood maltreatment with psychosocial health among adolescents and young adults in China.Method: This cross-sectional study was conducted among undergraduates aged 17 to 24 years from sixty colleges and universities across 10 provinces of China. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire-Short Form, and psychosocial health was measured using the Strengths and Difficulties Questionnaire (SDQ). Weighted linear mixed regression models, multiplicative interactions, and joint and mediation analyses were performed.Results: Of the 28,810 participants included (mean [SD] age, 19.87 [1.62] years), 12035 (41.8%) were male. In the fully adjusted model, participants who experienced parental migration were more likely to report higher levels of SDQ total difficulties (e.g. β = 0.16 [95% CI, 0.05 to 0.28]) compared with those with non-migrant parents. A positive association was found between the cumulative number of childhood maltreatment and SDQ total difficulties (β = 0.54 [95% CI, 0.49 to 0.60]), with a dose-response relationship observed for the levels of childhood maltreatment and SDQ total difficulties. Compared with individuals without exposure to both parental migration and childhood maltreatment, those exposed to both parental migration and at least 2 numbers of childhood maltreatment had the highest magnitude of psychosocial health difficulties (β = 1.12 [95% CI, 0.91 to 1.33]). Moreover, childhood maltreatment may partially mediate the association between parental migration and psychosocial health, with the mediation proportion being 58.8%.Conclusion: Exposure to parental labour migration or childhood maltreatment was positively associated with psychosocial health among adolescents and young adults. Parental migration and childhood maltreatment may jointly aggravate psychosocial health problems. These findings indicate the necessity of comprehensive interventions targeting adversity stressors to improve psychosocial health, especially for left-behind children experiencing maltreatment.

Background and aims: Gender nonconformity (GNC), which refers to an individual's expression of gender that does not align with the socially prescribed norms for their biological sex, may be associated with adverse behavioral problems, such as problematic smartphone use (PSU) and problematic internet use (PIU). This study examined the associations between GNC and PSU and GNC and PIU among Chinese adolescents.Methods: This cross-sectional study utilized data from the 2021 School-based Chinese Adolescents Health Survey, recruiting 23,054 eligible adolescents aged 11 to 21, with an average age of 14.9 (SD: 1.7) years from 504 classes in 84 public high schools across 7 cities in China. Gender nonconformity, PSU/PIU, and demographics were measured. Mixed-effect linear regression models were performed.Results: Among the participants (51.0% male), 5.3% reported high GNC and 26.9% reported moderate GNC. After adjusting for covariates, high GNC was significantly and positively associated with PSU (Β = 1.11, 95% CI = 0.49–1.72) and PIU severity (Β = 2.16, 95% CI = 1.40–2.93). Stratified analyses indicated that the associations between GNC and PSU differed between males and females, with a significant association observed only among male students (Β = 1.91, 95% CI = 0.97–2.86).Discussion and conclusions: GNC is positively associated with the severity of PSU and PIU among Chinese adolescents, with male gender-nonconforming adolescents being more vulnerable to PSU. These results highlight the importance of implementing education on gender expression diversity in schools to create an inclusive school environment, which may potentially help prevent PSU and PIU among gender-nonconforming adolescents.

Hypoxia is one of the most important environmental factors which affect fish growth, development and survival, but regulation mechanisms of hypoxia in fish remain unclear. Therefore, to further understand molecular functions of factor inhibiting HIF-1 (Fih-1), an essential hypoxia sensor, the full-length cDNA of fih-1 was cloned from Megalobrama amblycephala, a hypoxia-sensitive cyprinid fish. The deduced amino acid sequence showed high homology with that of other vertebrates, and all structural and functional domains were highly conserved. The mRNA level in different tissues and developmental stages indicated that M. amblycephala fih-1 expression was higher in liver and muscle, followed by gill, intestine and spleen. During embryogenesis, the fih-1 mRNA was highly expressed in the early embryonic development, then decreased to a very low level, and maintained a relative high level of expression after hatching. In most tissues, the fih-1 mRNA was down-regulated at 2 h but up-regulated at 4 h after hypoxia treatment. In addition, the promoter sequence of M. amblycephala fih-1 was obtained using thermal asymmetric interlaced PCR. Three single nucleotide polymorphism (SNP) sites were found in the cDNA and promoter sequences, and identified significant association with hypoxia trait by correlation analysis in hypoxia-sensitive group and hypoxia-tolerant group. These results demonstrated that M. amblycephala fih-1 plays important roles in embryo development and hypoxia response, which will contribute to systematic understanding of the molecular mechanisms of fish in response to hypoxia, and provide help for fish genetic breeding with hypoxia-tolerant strains or breeds.