Background Male clients of female sex workers (FSWs) serve as a potential bridge of HIV to the general population. Little is known about the characteristics and risk factors for HIV infection among male clients patronizing FSWs in Hekou County, Yunnan Province in southern China bordering with Vietnam. Methods Male clients were recruited through outreach of study staff, referrals by Vietnamese FSWs, their bosses, and snowball sampling. Each participant completed a questionnaire survey and donated a blood specimen to test for HIV, herpes simplex virus type 2 (HSV-2), and syphilis. Logistic regression models were fitted to identify factors associated with HIV infection. Results Among 306 participants, 28 (9.2%) were HIV positive, 81 (26.5%) were HSV-2 positive, and none were infected with syphilis. Approximately half (n=149, 49.2%) reported always using condoms with sex workers in the past year; 36 (11.8%) reported a history of injection drug use (IDU). Compared to HIV negative men, HIV positive men were more likely to have a history of IDU (64.3% vs. 6.5%) and be co-infected with HSV-2 (50.0% vs. 24.1%). Conclusions IDU was the most salient risk factor for HIV infection in this study, which suggests that male clients may acquire HIV from routes other than commercial sex, but the significance of HSV-2 infection indicates that sexual transmission is also of concern. HIV prevention intervention programs for this often ignored and hard-to-reach risk group should be two-pronged, addressing both drug use and commercial sex.

Triple-negative breast cancer (TNBC) is characterized by its high invasiveness, high metastasis and poor prognosis. More than one-third of patients with TNBC will present with recurrence or distant metastasis. Chemotherapy based on anthracyclines and taxanes is the standard treatment strategy for metastatic TNBC (mTNBC). Due to the lack of expression of progesterone receptor, estrogen receptor, and human epidermal growth factor receptor 2, therapies targeting these receptors are ineffective for mTNBC, thus special treatment strategies are required. In recent years, the development of new chemotherapy drugs, targeted drugs and immunotherapy drugs offers good prospects for the treatment of mTNBC. However, as these drugs are still in their infancy, several problems regarding the optimization and management of the clinical application of these new options should be considered. Pharmacists can play an important role in drug selection, drug therapy management, the management of adverse drug reactions and pharmacoeconomic evaluation. In this review, we summarized traditional treatment strategies, and discussed the efficacy and safety of novel agents approved in the last ten years and combination regimens for mTNBC, with the aim of providing management strategies for the clinical management of mTNBC from pharmacists’ perspective.

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