objectives To quantify the HIV care cascade in a Cape Town sub-district to understand rates of linkage to and engagement in HIV care.methods We used routinely collected data to reconstruct the treatment cascade for 8382 infected individuals who tested HIV + in 2012/2013. We obtained data on patient gender, year of initial HIVpositive test, age at testing and initial CD4 cell count and defined five stages of the HIV care cascade. We quantified attrition across cascade stages.results Two-thirds of the sample (5646) were women. Men were older at time of first testing (36.5 vs. 31.3 years) and had more advanced HIV disease at diagnosis (298 vs. 404 CD4 cells/µL for women). The median duration of follow-up was 818 days. Among women, 90.5% attended an initial HIV care visit, 54.6% became eligible for antiretroviral therapy under local guidelines during followup, 49.3% initiated ART and 45.6% achieved a therapeutic response. Among men, 88.0% attended an initial HIV care visit, 67.4% became ART eligible during follow-up, 48.0% initiated ART and 42.4% achieved a therapeutic response. Approximately 3% of women and 5% of men died during follow-up.conclusions We were able to reconstruct the HIV treatment cascade using routinely collected data. In this setting, rates of engagement in care differ by gender in key stages of the cascade, with men faring worse than women at each cascade point. This highlights the need for interventions aimed at encouraging earlier testing, linkage, ART initiation and retention among men.keywords HIV treatment cascade, linkage to care, gender differences, South Africa Sustainable Development Goals (SDGs): SDG 3 (good health and well-being), SDG 5 (gender equity), SDG 10 (reduced inequalities), SDG 17 (partnerships for the goals)

The rise in social media use among emerging adults in the United States has been well-documented, but researchers are still working on identifying how the type—not just the frequency—of use impacts psychological well-being. We identified “profiles” of social media use among young adults based on the frequency and purposes of use, and examined their associations with benefits and harms to psychosocial well-being, using data from 2828 incoming undergraduate students (Mage = 18.29 years; age range: 17 to 25 years). Using Latent Profile Analysis, we identified three unique profiles of individuals who used social media with varying levels of intensity across different purposes: Active Users (32.4%), Passive Users (25.3%), and Average Users (42.4%). Each profile was associated with varying levels of beneficial and harmful psychosocial outcomes. Compared to Average Users, (a) Active Users reported significantly better psychosocial well-being, but also more harmful outcomes; and (b) Passive Users experienced significantly lower levels of perceived social media benefits and social connectedness, while also reporting less problematic social media use and social media stress. Implications of these findings for research and practice are discussed.

Larger numbers of people are living to retirement and old age, posing a threat to the financing of the welfare state. In Denmark, statutory retirement age is increasing gradually to account for changes in life expectancy. However, the chances of reaching retirement age are not equal across the population, and raising the retirement age could disproportionally affect those from lower socioeconomic backgrounds. In this paper, we investigate socioeconomic inequalities in mortality before retirement age or shortly thereafter in Denmark. We use Danish registry data over a 30-year period, focusing on individuals aged 50 to 70. We perform sex-specific survival analyses across socioeconomic groups using three measures of socioeconomic status: education, income, and occupation. We observe an increase in survival inequalities over time between the lowest and highest socioeconomic groups for each measure. The reason for the widening gap lies in minimal mortality improvements in the lowest socioeconomic group. These results are complemented by lifespan inequality measures, which have the same mortality trends. We show that individual level variability in socioeconomic characteristics play a crucial role in defining the survival chances just before and shortly after retirement and thus should be accounted for in designing retirement policies.

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