The primary end point was newly acquired infection with HIV type 1 or 2. The secondary end point was newly

acquired gonococcal or chlamydial infection. The primary analysis was based on a log-rank test of no difference in the distribution of time to HIV infection, stratified according to site.

Results: A total of AZD2014 1398 women were enrolled and randomly assigned to receive cellulose sulfate gel (706 participants) or placebo (692 participants) and had follow-up HIV test data. There were 41 newly acquired HIV infections, 25 in the cellulose sulfate group and 16 in the placebo group, with an estimated hazard ratio of infection for the cellulose sulfate group of 1.61 (P=0.13). This result, which is not significant, is in contrast to the interim finding that led to the trial being stopped prematurely (hazard ratio, 2.23; P=0.02) and the suggestive result of a preplanned secondary (adherence-based) analysis (hazard ratio, 2.18; P=0.03). No significant effect of cellulose sulfate as compared with placebo was found on the risk of gonorrheal infection (hazard ratio, 1.10; 95% confidence interval [CI], 0.74

to 1.62) or chlamydial infection (hazard ratio, 0.71; 95% CI, 0.47 to 1.08).

Conclusions: Cellulose sulfate did not prevent HIV infection and may have increased the risk of HIV acquisition. (ClinicalTrials.gov number, NCT00153777; and Current Controlled Trials number, ISRCTN95638385.).”
“Objectives. Although evidence suggests that physical disability and depression may be reciprocally related, questions of, causalily Versus spuriousness and MX69 in vivo the direction of causality remain to be confidently answered. This study considered the hypotheis of reciprocal influence the possibility of spuriousness in relation to pain, stress, and lifetime major depression; and the

possible mediating effects of pain and social stress.

Methods. We analyzed data from a two-wave panel Study of Miami-Dade County residents (n = 1,455) that included a substantial oversampling of individuals reporting a physical disability. Results. Results CYTH4 indicated that, although prior levels of physical limitations predicted changes in depressive symptoms, there was no evidence of the reversc association.

Results also indicated that pail of the association between prior physical limitations and changes in depressive symptoms was explained by intervening level of pain and, to a lesser extent, by the day-to-day experience of discrimination.

Discussion. Much of whatever causation may be involved in the linkage between physical limitations and depressive symptomatology flows from limitations to depression rather than in the reverse direction. Results also make clear that this linkage is not in artifact of shared associations with pain, social stress, or litetime major depression.