Since 2006, beekeepers have reported increased losses of Apis mellifera colonies, and one factor that has been potentially implicated in these losses is the microsporidian Nosema ceranae. Since N. ceranae is a fairly recently discovered parasite, there is little knowledge of the variation in infection levels among individual workers within a colony. In this study we examined the levels of infection in individual bees from five colonies over three seasons using both spore counting and quantitative real-time PCR. The results show considerable intra-colony variation in infection intensity among individual workers with a higher percentage of low-level infections detected by PCR than by spore counting. Colonies generally had the highest percentage of infected bees in early summer (June) and the lowest levels in the fall (September). Nosema apis was detected in only 16/705 bees (2.3%) and always as a low-level co-infection with N. ceranae. The results also indicate that intra-colony variation in infection levels could influence the accuracy of Nosema diagnosis.

IntroductionHIV care and treatment in cross‐border areas in East Africa face challenges perhaps not seen to the same extent in other geographic areas, particularly for mobile and migrant populations. Here, we estimate the proportion of people with HIV found in these cross‐border areas in each stage of the HIV care and treatment cascade, including the proportion who knows their status, the proportion on treatment and the proportion virally suppressed.MethodsParticipants (n = 11,410) working or socializing in public places in selected East Africa cross border areas were recruited between June 2016 and February 2017 using the Priorities for Local AIDS Control Efforts method and administered a behavioural survey and rapid HIV test. This approach was designed to recruit a stratified random sample of people found in public spaces or venues in each cross border area. For participants testing positive for HIV, viral load was measured from dried blood spots. The proportion in each step of the cascade was estimated using inverse probability weights to account for the sampling design and informative HIV test refusals. Estimates are reported separately for residents of the cross border areas and non‐residents found in those areas.ResultsOverall, 43% of participants with HIV found in cross‐border areas knew their status, 87% of those participants were on antiretroviral therapy (ART), and 80% of participants on ART were virally suppressed. About 20% of people with HIV found in cross border areas were sampled outside their subdistrict or subcounty of residence. While both resident and non‐resident individuals who knew their status were likely to be on ART (85% and 96% respectively), people on ART recruited outside their area of residence were less likely to be suppressed (64% suppressed; 95% CI: 43, 81) compared to residents (84% suppressed; 95% CI: 75, 93).ConclusionsPeople living in or travelling through cross‐border areas may face barriers in learning their HIV status. Moreover, while non‐residents were more likely to be on treatment than residents, they were less likely to be suppressed, suggesting gaps in continuity of care for people in East Africa travelling outside their area of residence despite timely initiation of treatment.

Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )

Background Mortality among adults with HIV remains elevated over mortality in the US general population even in the years after entry into HIV care. We explore whether the elevation in 5-year mortality would have persisted if all adults with HIV had initiated antiretroviral therapy within 3 months of entering care. Methods Among 82,766 adults entering HIV care at North American AIDS Cohort Collaboration clinical sites in the United States, we computed mortality over 5 years since entry into HIV care under observed treatment patterns. We then used inverse probability weights to estimate mortality under universal early treatment. To compare mortality with similar individuals in the general population, we used National Center for Health Statistics data to construct a cohort representing the subset of the US population matched to study participants on key characteristics. Results For the entire study period (1999 – 2017), 5-year mortality among adults with HIV was 7.9 percentage points (95% confidence interval (CI): 7.6, 8.2) higher than the expected mortality based on the US general population. Under universal early treatment, the elevation in mortality for people with HIV would have been 7.2% (95% CI: 5.8, 8.6). In the most recent calendar period examined (2011-2017), the elevation in mortality for people with HIV was 2.6 percentage points (95% CI: 2.0, 3.3) under observed treatment patterns and 2.1 percentage points (95% CI: 0.0, 4.2) under universal early treatment. Conclusions Expanding early treatment may modestly reduce, but not eliminate, the elevation in mortality for people with HIV.

Attention to sexual misconduct has focused on acquaintance rape, leaving a need for research on less highly recognizable forms of harm. We estimated institution of higher education (IHE)-specific prevalence of yellow zone sexual harassment (SH) among students at 27 IHEs. We then examined SH and perceived risk of sexual assault/misconduct, knowledge regarding policies/resources, and perceptions of sexual misconduct response. Between 37.1% and 55.7% of students experienced SH. Harassed students were much more likely than non-harassed students to feel at risk for sexual misconduct and to have negative views of sexual misconduct response. Implications for research, policy, and prevention/response are discussed.