Characteristics of HIV-1 Discordant Couples Enrolled in a Trial of HSV-2 Suppression to Reduce HIV-1 Transmission: The Partners Study

Background: The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort. Methods: HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count ≥250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed. Results: Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2–9) with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to <350, respectively, p<0.001). Conclusions: The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission. Trial Registration ClinicalTrials.gov NCT0019451

Myocardial Calcinosis in Chronic Renal Failure

The authors are presenting an 18 year old male with history of end stage renal disease and rejected renal transplant. In his workup echocardiogram and non contract CT of chest revealed diffuse endocardial and myocardial calcifications. Extensive cardiac calcification is a rare but important entity in relation to end stage renal disease as it may cause complications such as valvular dysfunction and fatal arrhythmia

Weapon and drug offenses and juvenile disproportionate minority contact: an impact assessment and practical discussion

© 2016 Midwestern Criminal Justice Association. Research on the targeted enforcement of weapons and drug offenses suggests that policies and street-level decisions around those offenses may play a role in disproportionate minority involvement with the justice system. Little research has directly examined the relative influence of these types of offenses on juvenile justice decisions. The analyses were completed using official case records from police agencies (n = 11) and juvenile courts (n = 6) as well as data from focus groups (n = 8) and key informant interviews (n = 56) conducted with personnel in those agencies. The quantitative data used here comprise records from 87,983 cases with measures of youth socio-demographics, case characteristics, offense type, and key juvenile court outcomes. The findings suggest that, although the effects of race as well as weapons and drug-offenses vary across outcome decisions and with the introduction of controls for other relevant factors, race-based disparities often persist in multivariate models. Qualitative data analysis finds that system actors tend to see the weapons and drug offense-based disparities emerging from structural conditions that are often mediated by culture and differential offending. Together, these findings offer important points of departure for further research and discussion of practical responses to disproportionate minority contact for the benefit of youth, communities, and the system itself