SummaryBackground-Metformin might reduce insulin requirement and improve glycaemia in patients with type 1 diabetes, but whether it has cardiovascular benefits is unknown. We aimed to investigate whether metformin treatment (added to titrated insulin therapy) reduced atherosclerosis, as measured by progression of common carotid artery intima-media thickness (cIMT), in adults with type 1 diabetes at increased risk for cardiovascular disease.

HIV-positive women were more likely to have sexual re-exposure than were HIV-negative women, although the rate of treatment failure was similar in both groups. High rates of treatment failure among both HIV-positive and HIV-negative women indicate that a 2-g dose of metronidazole may not be adequate for treatment of some women and that rescreening should be considered.

No abstract

Unintended pregnancy is defined as a pregnancy that is mistimed or unwanted, and this classification has been widely used in survey research. This chapter explores the utility of these constructs for women in New Orleans, LA. It examines sexual debut and history, contraceptive knowledge and use, abortion, pregnancy history, partner relations, and service use among seventy-seven women (seventy-three of whom were African-American) using a qualitative methodology. It provides insight into the cultural and social context in which these events and decisions take place, and explores the multiple dimensions that shape women's sexual behaviors and their desires for pregnancy. Many structural and individual factors affect women's preferences and ability to postpone a pregnancy or to use contraception.

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.

Background: Trichomonias is the most common non-viral STI among women worldwide and is associated with serious reproductive morbidity, poor birth outcomes and amplified HIV transmission. Single-dose metronidazole therapy has been the treatment of choice for over three decades. There is mounting evidence, however, of high rates of repeat positives following single-dose metronidazole, and among HIVinfected women, bacterial vaginosis (BV) was found to alter treatment efficacy. The purpose of this study was to examine the effectiveness of single-dose metronidazole compared to 7 day-dose metronidazole for the treatment of trichomoniasis among HIV-uninfected, non-pregnant women and to determine if this effect was modified by BV. Methods: This was a randomized, parallel, multi-site, open-label trial of single-dose (2 g one-time) versus 7 day-dose (500 mg twice daily) for the treatment of trichomoniasis. The primary outcome was T. vaginalis infection by arm, per nucleic acid amplification test or culture, four weeks post-completion of treatment, in intentto-treat analyses. This analysis was also stratified by BV status. Findings: Of 623 women randomized, those in the 7 day-dose arm were less likely to be T. vaginalis positive at test-of-cure compared to those in the single-dose arm [34/312 (10.9%) vs. 58/311 (18.6%), p=0·001] [R.R. 0.55 (95% C.I. 0.34–0.70)]. Risk was similar by BV status (p=0·17). Self-reported adherence in both arms was > 95%. Side effects were similar by arm. Interpretation: In this sample of HIV-uninfected, non-pregnant women with trichomoniasis, compared to single-dose, 7 day-dose metronidazole treatment resulted in 45% fewer treatment failures. The 7 day-dose metronidazole should be the preferred treatment for trichomoniasis among women.

Among women with TV, PDPT did not result in more partners taking the medicine or lower follow-up rates than PR but was less costly.

Objective To determine if the metronidazole (MTZ) 2 gm single dose (recommended) is as effective as the 7 day 500 mg BID dose (alternative) for treatment of Trichomonas vaginalis (TV) among HIV+ women. Methods Phase IV randomized clinical trial; HIV+ women with culture confirmed TV were randomized to treatment arm: MTZ 2 gm single dose or MTZ 500 mg BID 7 day dose. All women were given 2 gm MTZ doses to deliver to their sex partners. Women were re-cultured for TV at a test-of-cure (TOC) visit occurring 6-12 days after treatment completion. TV-negative women at TOC were again re-cultured at a 3 month visit. Repeat TV infection rates were compared between arms. Results 270 HIV+/TV+ women were enrolled (mean age = 40 years, ± 9.4; 92.2% African-American). Treatment arms were similar with respect to age, race, CD4 count, viral load, ART status, site, and loss-to-follow up. Women in the 7 day arm had: lower repeat TV infection rates at TOC [8.5% (11/130) versus 16.8% (21/125) (R.R. 0.50, 95% CI=0.25, 1.00; P<0.05)], and at 3 months [11.0% (8/73) versus 24.1% (19/79) (R.R. 0.46, 95% CI=0.21, 0.98; P=0.03)] compared to the single dose arm. Conclusions The 7 day MTZ dose was more effective than the single dose for the treatment of TV among HIV+ women.