Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy

Importance A key factor in assessing the effectiveness and cost-effectiveness of antiretroviral therapy (ART) as a prevention strategy is the absolute risk of HIV transmission through condomless sex with suppressed HIV-1 RNA viral load for both anal and vaginal sex. Objective To evaluate the rate of within-couple HIV transmission (heterosexual and men who have sex with men [MSM]) during periods of sex without condoms and when the HIV-positive partner had HIV-1 RNA load less than 200 copies/mL. Design, Setting, and Participants The prospective, observational PARTNER (Partners of People on ART-A New Evaluation of the Risks) study was conducted at 75 clinical sites in 14 European countries and enrolled 1166 HIV serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex (September 2010 to May 2014). Eligibility criteria for inclusion of couple-years of follow-up were condomless sex and HIV-1 RNA load less than 200 copies/mL. Anonymized phylogenetic analysis compared couples' HIV-1 polymerase and envelope sequences if an HIV-negative partner became infected to determine phylogenetically linked transmissions. Exposures Condomless sexual activity with an HIV-positive partner taking virally suppressive ART. Main Outcomes and Measures Risk of within-couple HIV transmission to the HIV-negative partner. Results Among 1166 enrolled couples, 888 (mean age, 42 years [IQR, 35-48]; 548 heterosexual [61.7%] and 340 MSM [38.3%]) provided 1238 eligible couple-years of follow-up (median follow-up, 1.3 years [IQR, 0.8-2.0]). At baseline, couples reported condomless sex for a median of 2 years (IQR, 0.5-6.3). Condomless sex with other partners was reported by 108 HIV-negative MSM (33%) and 21 heterosexuals (4%). During follow-up, couples reported condomless sex a median of 37 times per year (IQR, 15-71), with MSM couples reporting approximately 22 000 condomless sex acts and heterosexuals approximately 36 000. Although 11 HIV-negative partners became HIV-positive (10 MSM; 1 heterosexual; 8 reported condomless sex with other partners), no phylogenetically linked transmissions occurred over eligible couple-years of follow-up, giving a rate of within-couple HIV transmission of zero, with an upper 95% confidence limit of 0.30/100 couple-years of follow-up. The upper 95% confidence limit for condomless anal sex was 0.71 per 100 couple-years of follow-up. Conclusions and Relevance Among serodifferent heterosexual and MSM couples in which the HIV-positive partner was using suppressive ART and who reported condomless sex, during median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission (upper 95% confidence limit, 0.30/100 couple-years of follow-up). Additional longer-term follow-up is necessary to provide more precise estimates of risk.

The genius of Christianity; or, The spirit and beauty of the Christian religion.

Preface dated 1856.

Alchemy and Symbolism in the Work of Carlos Estevez

The purpose of this thesis was to explore how alchemy has influenced Carlos Estevez’s work through a study of the symbolic repertoire and the philosophical concepts associated with it in his art, particularly how these are expressed in his artworks and how alchemy has evolved thematically in his oeuvre. The study of alchemy influenced this artist so deeply that even pieces that were not primarily inspired by this philosophical system show traces of it, essentially by representing the concept of transformation, crucial to understanding the alchemical process. This thesis is based on Carl Gustav Jung’s idea of metaphysical transformation as one of the main aspects of alchemy, and on his theory of active imagination as a tool to represent thoughts through artworks. Alchemy transformed Estevez’s art, and by extension the way he approaches life, making him conscious of the importance of transmutation and alchemical concepts.

Caffeine Intake and its Association with Disease Progression, Sleep Quality and Anxiety Symptoms and Nutritional Alterations in People Living with HIV in the Miami Adult Studies on HIV Cohort

Miami-Dade County has approximately 27,000 people living with HIV (PLWH), and the highest HIV incidence in the nation. PLWH have reported several types of sleep disturbances. Caffeine is an anorexic and lipolytic stimulant that may adversely affect sleep patterns, dietary intakes and body composition. High caffeine consumption (>250 mg. per day or the equivalent of >4 cups of brewed coffee) may also affect general functionality, adherence to antiretroviral treatment (ART) and HIV care. This study assess the relationship of high caffeine intake with markers of disease progression, sleep quality, insomnia, anxiety, nutritional intakes and body composition. A convenience sample of 130 PLWH on stable ART were recruited from the Miami Adult Studies on HIV (MASH) cohort, and followed for three months. After consenting, questionnaires on Modified Caffeine Consumption (MCCQ), Pittsburg Insomnia Rating Scale (PIRS), Pittsburg Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), socio-demographics, drug and medication use were completed. CD4 count, HIV viral load, anthropometries, and body composition measures were obtained. Mean age was 47.89±6.37 years, 60.8% were male and 75.4% were African-Americans. Mean caffeine intake at baseline was 337.63 ± 304.97 mg/day (Range: 0-1498 mg/day) and did not change significantly at 3 months. In linear regression, high caffeine consumption was associated with higher CD4 cell count (β=1.532, P=0.049), lower HIV viral load (β=-1.067, P=0.048), higher global PIRS (β=1.776, P=0.046), global PSQI (β=2.587, P=0.038), and GAD-7 scores (β=1.674, P=0.027), and with lower fat mass (β=-0.994, P=0.042), energy intakes (β=-1.643, P=0.042) and fat consumption (β=-1.902, P=0.044), adjusting for relevant socioeconomic and disease progression variables. Over three months, these associations remained significant. The association of high caffeine with lower BMI weakened when excluding users of other anorexic and stimulant drugs such as cocaine and methamphetamine, suggesting that caffeine in combination, but not alone, may worsen their action. In summary, high caffeine consumption was associated with better measures of disease progression; but was also detrimental on sleep quality, nutritional intakes, BMI and body composition and associated with insomnia and anxiety. Large scale studies for longer time are needed to elucidate the contribution of caffeine to the well-being of PLWH.

The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

Loop openness: a video reflection on the open work of art

The objective of this article is to reflect on the video art work in its loop production to perceive the possibility of it being received as an open work. In order to contextualize this reflection the text is anchored in the concept of image-crystal from Gilles Deleuze. For the purpose of empirically explore theoretical concepts such as video art, open work and image-crystal it was produced a practical project of video art that intends to reflect on the notion of time in a context of a loop exhibition. Therefore this project aims to motivate the reflection on the loop as a mechanism to contour the ephemeral character of video art and, at the same time, it seeks to emphasize questions about the element of multiplicity and plurality in art. It is a scientific and artistic project in which the practical component supports the dialectic between theory and practice, action and reflection. In this sense, based on the video entitled "The Walk" this article demonstrates how the theoretical concepts were used to support the artistic creation. Finally the conclusions sustain that the work of video art, when presented in loop, is a creative and expository strategy which encourages multiple interpretations that vary according to the narrative, the context in which it takes place and the attitude and the background of the spectator.

Crop

Solo exhibition of sculptural works that use the portrait bust as a vehicle for problematising notions of subjectivity, authority and representation. The exhibition comprised three life-sized figurative busts, each portraits of the artist, sparsely positioned throughout the gallery space to convey a sense of isolation and abandonment. By emphasising the fragmented nature of the bust format by removal of all supports (ie. Socle, plinth or alcove) the works sought to address the vulnerability that frmes this apparently authoritative Enlightenment portrait format. In so doing the exhibition aimed to offer, by example, a new way of seeing and interpreting the portrait bust in history. The exhibition was exhibited at the Institute of Modern Art (Brisbane) and the Perth Institute of Contemporary Arts. Works fro the exhibition were included in group shows at Linden Centre for Contemporary Arts, Ballarat Fine Art Gallery. Work from the exhibition was purchased for the collection of MONA, Hobart.The exhibition received favourable reviews in Eyeline, Art and Australia and Machine magazines.

The same river twice

This article reviews an exhibition of art works at the Institute for Modern Art that dealt with the idea of history. The review suggests that history is an unstable product of our collective imaginations and is constantly open to revisions and individual perspectives. Each of the artists deal with these issues by reinterpreting past events. The artists were Pierre Huyghe, Thomas Demand, Mike Kelley, paul McCarthy, Jeremy Deller, Danius Kesminas, Gerard Byrne, Emma Kay, and Omer Fast.

Gardens le grande

The gardens of Versailles are a prime example of the beauty that can be attained where art and horticulture meld on a truly grand scale. Carrying on that tradition in the former veggie garden of the French palace is one of the world's most prestigious landscape architecture schools. Julian Raxworthy, a senior lecturer in landscape architecture at Queensland University of Technology recently taught a workshop at the Versailles school. As he explains, the concepts that underlie the school's teaching and the formal grandeur of the gardens of Versailles continue to be as innovative and relevant today as they were in the 17th century.

The moment of exchange : risk, vulnerability, responsibility

Any cycle of production and exchange – be it economic, cultural or aesthetic – involves an element of risk. It involves uncertainty, unpredictability, and a potential for new insight and innovation (the boom) as well as blockages, crises and breakdown (the bust). In performance, the risks are plentiful – economic, political, social, physical and psychological. The risks people are willing to take depend on their position in the exchange (performer, producer, venue manager or spectator), and their aesthetic preferences. This paper considers the often uncertain, confronting or ‘risky’ moment of exchange between performer, spectator and culture in Live Art practices. Encompassing body art, autobiographical art, site-specific art and other sorts of performative intervention in the public sphere, Live Art eschews the artifice of theatre, breaking down barriers between art and life, artist and spectator, to speak back to the public sphere, and challenge assumptions about bodies, identities, memories, relationships and histories. In the process, Live Art frequently privileges an uncertain, confrontational or ‘risky’ mode of exchange between performer, spectator and culture, as a way of challenging power structures. This paper examines the moment of exchange in terms of risk, vulnerability, responsibility and ethics. Why the romance with ‘risky’ behaviours and exchanges? Who is really taking a risk? What risk? With whose permission (or lack thereof)? What potential does a ‘risky’ exchange hold to destabilise aesthetic, social or political norms? Where lies the fine line between subversive intervention in the public sphere and sheer self-indulgence? What are the social and ethical implications of a moment of exchange that puts bodies, beliefs or social boundaries at ‘risk’? In this paper, these questions are addressed with reference to historical and contemporary practices under the broadly defined banner of Live Art, from the early work of Abrovamic and Burden, through to contemporary Australian practitioners like Fiona McGregor.

Distracted : poetic interpretations of climate change

This paper introduces the creative work Distracted and discusses conceptual, aesthetic and technical aspects of the work. The work was conceived as a luminous, interactive, computational media installation informed by our interest in the Antarctica. Through the paper we focus on: how the work addresses the themes of climate change and sustainability; how we attempted to work with selected sets of scientific data to evoke the delicate yet extreme nature of the environment and the ways in which ice is a record of the earth’s geological history and recent human impacts; and how the process of making this artwork caused us to reconsider our practices and formulate strategies for redirecting our practice in a manner that addresses the challenges of sustainability.

Creative Industries : A New Direction?

This paper looks at the work of the ARC Centre for Creative Industries and Innovation at Queensland University of Technology. They have attempted to deal with some of the definitional and policy ambiguities surrounding the DCMS’s re-branding of ‘cultural industries’ as ‘creative industries’. The paper focuses on three central claims. First, that Art falls outside the creative industries; second, that the creative industries moves beyond a cultural policy paradigm towards that of innovation systems; third, that the notion of ‘social network markets’ represents the central defining characteristic of the creative industries. The paper suggests that the attempt to separate out art and culture from the creative industries is misplaced and represents a significant shift away from a longer trajectory of ‘cultural industries’ policies with some damaging consequences for cultural policy and creative businesses.

The Remnant

An Interactive Installation with holographic 3D projections, satellite imagery, surround sound and intuitive body driven interactivity. Remnant (v.1) was commissioned by the 2010 TreeLine ecoArt event - an initiative of the Sunshine Coast Council and presented at a remnant block of subtropical rainforest called ‘Mary Cairncross Scenic Reserve’ - located 100kms north of Brisbane near the township of Maleny. V2 was later commissioned for KickArts Gallery, Cairns, re-presenting the work in a new open format which allowed audiences to both experience the original power of the work and to also understand the construction of the work's powerful illusory, visual spaces. This art-science project focused upon the idea of remnant landscapes - isolated blocks of forest (or other vegetation types) typically set within a patchwork quilt of surrounding farmed land. Participants peer into a mysterious, long tunnel of imagery whilst navigating entirely through gentle head movements - allowing them to both 'steer' in three dimensions and also 'alight', as a butterfly might, upon a sector of landscape - which in turn reveals an underlying 'landscape of mind'. The work challenges audiences to re-imagine our conceptions of country in ways that will lead us to better reconnect and sustain today’s heavily divided landscapes. The research field involved developing new digital image projection methods, alternate embodied interaction and engagement strategies for eco-political media arts practice. The context was the creation of improved embodied and improvisational experiences for participants, further informed by ‘eco-philosophical’ and sustainment theories. By engaging with deep conceptions of connectivity between apparently disparate elements, the work considered novel strategies for fostering new desires, for understanding and re-thinking the requisite physical and ecological links between ‘things’ that have been historically shattered. The methodology was primarily practice-led and in concert with underlying theories. The work’s knowledge contribution was to question how new media interactive experience and embodied interaction might prompt participants to reflect upon appropriate resources and knowledges required to generate this substantive desire for new approaches to sustainment. This accentuated through the power of learning implied by the works' strongly visual and kinaesthetic interface (i.e. the tunnel of imagery and the head and torso operated navigation). The work was commissioned by the 2010 TreeLine ecoArt event - an initiative of the Sunshine Coast Council and the second version was commissioned by Kickarts Gallery, Cairns, specifically funded by a national optometrist chain. It was also funded in development by Arts Queensland and reviewed in Realtime.

Full circle : the future of sustainable fashion manufacturing in New Zealand

Many fashion businesses in New Zealand have followed a global trend towards inexpensive off shore manufacturing. The transfer of the production of garments to overseas workers has had consequences for the wellbeing of local businesses, fashion designers and garment makers. The gradual decline of fashion manufacturing also appears to have resulted in a local fashion scene where many garments look the same in style, colour, fabric, cut and fit. The excitement of the past, where the majority of fashion designers established their own individuality through the cut and shape of the garments that they produced, may have been inadvertently lost in an effort to take advantage of cost savings achieved through mass production and manufacturing methods which are now largely unavailable in New Zealand. Consequently, a sustainable local fashion and manufacturing industry, with design integrity, seems further out of reach. This paper is focussed upon the thesis that the design and manufacture of a fashion garment, bearing in mind certain economic and practical restrictions at its inception, can contribute to a more sustainable fashion manufacturing industry in New Zealand.