Although religion and spirituality can promote healthy behaviours and mental well-being, negative religious experiences may harm sexual minority men's health. Despite increasing vulnerability to HIV infection among young gay and bisexual men, few studies examine how religion and spirituality might affect them. To this end, we interviewed young gay and bisexual men who were diagnosed with HIV infection during January 2006-June 2009. Questionnaires assessed religious service attendance, disclosure of sexuality within religious communities, and beliefs about homosexuality being sinful. A subset described religious and spiritual experiences in qualitative interviews. We calculated the prevalence of religion- and spirituality-related factors and identified themes within qualitative interviews. Among men completing questionnaires, 66% currently attended religious services, 16% believed they could disclose their sexuality at church, and 37% believed homosexuality was sinful. Participants who completed qualitative interviews commonly discussed religious attendance and negative experiences within religious settings. They often expressed their spirituality through prayer, and some used it to cope with adverse experiences. These data suggest that religion and spirituality are notable factors that shape young, HIV-infected gay and bisexual men's social contexts. Programmes and interventions that constructively engage with religious institutions and are sensitive to spiritual beliefs may promote these men's health.

SUMMARY Objective To examine genetic testing preferences in families containing multiple individuals with epilepsy. Methods One hundred forty-three individuals with epilepsy and 165 biological relatives without epilepsy from families containing multiple affected individuals were surveyed using a self-administered questionnaire. Four genetic testing scenarios were presented, defined by penetrance (100% vs. 50%) and presence or absence of clinical utility. Potential predictors of genetic testing preferences were evaluated using generalized estimating equations with robust Poisson regression models. The influence of 21 potential testing motivations was also assessed. Results For the scenario with 100% penetrance and clinical utility, 85% of individuals with epilepsy and 74% of unaffected relatives responded that they would definitely or probably want genetic testing. For the scenario with 100% penetrance but without clinical utility, the proportions who responded they would want testing were significantly lower in both affected individuals (69%) and unaffected relatives (57%). Penetrance (100% vs. 50%) was not a significant predictor of genetic testing interest. The highest-ranking motivations for genetic testing were: the possibility that the results could improve health or healthcare, the potential to know if epilepsy in the family is caused by a gene, and the possibility of changing behavior or lifestyle to prevent seizures. Significance Interest in epilepsy genetic testing may be high in affected and unaffected individuals in families containing multiple individuals with epilepsy, especially when testing has implications for improving clinical care.

Several community level measures of healthy food access exist, but evaluation efforts have been limited leaving uncertainty about how to prioritize communities for intervention. This study aimed to assess several existing measures to inform statewide public health planning efforts in New Jersey, USA. We assessed agreement between community measures of healthy food access and then evaluated the predictive validity of each measure by describing its association with complete fruit and vegetable cash-value voucher redemption (proportion redeemed ≥70, ≥80, ≥90%) among 30,078 low-income households participating in the New Jersey Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during 2013-2014. The United States Department of Agriculture's (USDA) food desert measure agreed with the Centers for Disease Control and Prevention's (CDC) no healthier food retailers (NHFR) measure for 76.5% of New Jersey census tracts, but the Kappa statistic was only 0.10. For urban households, the NHFR measure was negatively associated with complete redemption after adjusting for demographic factors and Supplemental Nutrition Assistance Program participation (≥70% odds ratio (OR) 0.68, 95% confidence interval (CI) 0.61-0.75; ≥80% OR 0.67, 95% CI 0.62-0.73; ≥90% OR 0.72, 95% CI 0.66-0.77). For rural households, a negative association was observed for the USDA's low-income/low-vehicle access measure (≥70% OR 0.48, 95% CI 0.26-0.90). The CDC's NHFR measure is more appropriate for prioritizing urban areas while the USDA's low-income/low-vehicle access measure may be better for rural areas.