Reducing HIV Risk among Transgender Women in Thailand: A Quasi-Experimental Evaluation of the Sisters Program

Transgender women are particularly at risk of HIV infection, but little evidence exists on effective HIV prevention strategies with this population. We evaluated whether Sisters, a peer-led program for transgender women, could reduce HIV risks in Pattaya, Thailand. The study used time-location sampling to recruit 308 transgender women in Pattaya into a behavioral survey in 2011. Coarsened exact matching was used to create statistically equivalent groups of program participants and non-participants, based on factors influencing likelihood of program participation. Using multivariable logistic regression, we estimated effects of any program participation and participation by delivery channel on: condom use at last sex; consistent condom and condom/water-based lubricant use in the past 3 months with commercial, casual, and regular partners; and receipt of HIV testing in the past 6 months. Program coverage reached 75% of the population. In a matched sub-sample (n = 238), participation in outreach was associated with consistent condom/water-based lubricant use with commercial partners (AOR 3.22, 95% CI 1.64–6.31). Attendance at the Sisters drop-in center was associated with receiving an HIV test (AOR 2.58, 95% CI 1.47–4.52). Dedicated transgender-friendly programs are effective at reducing HIV risks and require expansion to better serve this key population and improve HIV prevention strategies.     

Root dynamics in a semi-natural grassland in relation to atmospheric carbon dioxide enrichment,soil water and shoot biomass

Plant responses to increasing atmospheric CO₂ concentrations have been studied intensively. However, the effects of elevated CO₂ on root dynamics, which is important for global carbon budgets as well as for nutrient cycling in ecosystems, has received much less attention. We used minirhizotrons inside open-top chambers to study the effects of elevated atmospheric carbon dioxide concentration on root dynamics in a nutrient-poor semi-natural grassland in central Sweden. We conducted our investigation over three consecutive growing seasons during which three treatments were applied at the site: Elevated (≈ 700 μmol mol^-1) and ambient (≈ 360 μmol mol^-1) chamber levels of CO₂ and a control, without a chamber. During 1997, a summer with two dry periods, the elevated treatment compared with ambient had 25% greater mean root counts, 65% greater above-ground biomass and 15% greater soil moisture. The chambers seemed responsible for changes in root dynamics, whereas the elevated CO₂ treatment in general increased the absolute sum of root counts compared with the ambient chamber. In 1998, a wet growing season, there were no significant differences in shoot biomass or root dynamics and both chamber treatments had lower soil moisture than the control. We found that as seasonal dryness increased, the ratio of elevated – ambient shoot biomass production increased while the root to shoot ratio decreased. We conclude that this grasslands response to elevated CO₂ is dependent on seasonal weather conditions and that CO₂ enrichment will most significantly increase production in such a grassland when under water stress. This revised version was published online in June 2006 with corrections to the Cover Date.