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IntroductionFamily physicians (FPs) play a critical role in the early detection of skin cancers. Dermoscopy can improve diagnostic accuracy but its use by FPs in the United States (US) remains understudied.ObjectivesTo examine dermoscopy use, factors associated with ever having used (Model 1) and currently using the dermascope (Model 2), and barriers.MethodsWe recruited 705 practicing FPs in-person at conferences and on-line to complete an anonymous, 46 item survey measuring: demographic factors, physician and practice characteristics; confidence in differentiating skin lesions; knowledge and use of dermoscopy; intentions to use; and barriers to use. We conducted bivariate analysis for each outcome and entered the significant predictors into two logistic regressions.ResultsAlmost 20% had ever used a dermascope and 8.3% were currently using it. Ever having used a dermascope was associated with being 39 years of age or younger, practicing in academia or community centers, and having higher confidence differentiating skin lesions. Current use was associated with seeing more than 400 patients per month and being 60 years-of-age or older.ConclusionUse of dermoscopy by FPs is low. This study is an initial step in understanding its use among US FPs.

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals' likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.

POWER is a theory-based, on-line HIV prevention intervention developed specifically for Black men who have sex with men and women (BMSMW), an understudied group significantly impacted by HIV. To test its efficacy, we recruited 224 BMSMW using chain referral methods and randomly assigned 108 to POWER and 103 to a health information comparison condition. Three months after the intervention, participants assigned to POWER had lower odds of reporting any condomless vaginal or condomless anal intercourse (CVAI) compared to those in the comparison group (aOR = 0.49; 95 % CI 0.25-0.98; p = 0.044). The intervention was associated with significantly lower odds of condomless anal intercourse with male partners (aOR = 0.55; 95 % CI 0.34-0.91; p = 0.020) but not with female partners and serodiscordant sex with male partners but not with female partners. Future studies are needed to replicate these findings in larger and more diverse samples of BMSMW and to understand the underlying mechanisms through which intervention efficacy was achieved.

Responding to the demands of the HIV/AIDS epidemic necessitates a diverse scientific and clinical workforce trained in applying interdisciplinary research approaches to address the epidemic domestically and internationally. Ensuring diversity in our workforce requires concerted efforts. Yet, the majority of graduate and post-graduate programs are ill-equipped to provide this type of training. Research networks, the HPTN, HVTN, CFAR and ATN, are uniquely positioned to implement interdisciplinary mentoring programs and all four have done so. We describe these programs, the nuts and bolts of program implementation and efforts to recruit and retain diversity scholars. We outline some inherent challenges such as competing demands for network resources or tension in aligning scholars' research agenda with that of the networks. We argue that the benefits to be gained from continuing these programs far outweigh their costs and that these programs are an essential component of a comprehensive strategy for developing the future HIV research workforce.