Criminalization of HIV Exposure: A Review of Empirical Studies in the United States

This review of literature identifies and describes US empirical studies on the criminalization of HIV exposure, examines findings on key questions about these laws, highlights knowledge gaps, and sets a course for future research. Studies published between 1990 and 2014 were identified through key word searches of relevant electronic databases and discussions with experts. Twenty-five empirical studies were identified. Sixteen of these studies used quantitative methods with more than half of these being cross-sectional survey studies. Study samples included male and female HIV-positive persons, HIV-positive and -negative men who have sex with men, public health personnel, and medical providers. Research questions addressed awareness of and attitudes toward HIV exposure laws, potential influences of these laws on seropositive status disclosure for persons living with HIV, HIV testing for HIV-negative persons, safer sex practices for both groups, and associations between HIV exposure laws and HIV-related stigma. Surveys of the laws and studies of enforcement practices were also conducted. Attention should be shifted from examining attitudes about these laws to exploring their potential influence on public health practices and behaviors related to the HIV continuum of care. Studies examining enforcement and prosecution practices are also needed. Adapting a theoretical framework in future research may be useful in better understanding the influence of HIV exposure laws on HIV risk behaviors.     

"It's like . . . a confronting issue": life-changing narratives of young people

In this article, the authors report on the narrative accounts given in interviews by 27 first-year university students in New South Wales, Australia, regarding their experiences of loss. The students were drawn from four campuses: a large city campus, a smaller urban campus, one outer metropolitan campus, and one rural campus. From participants' accounts, the researchers found that it was important for these students to organize their experience and make sense of it. In making sense, these students imposed meaning on their experiences and thereby constructed and reconstructed stories of loss to make better sense of their experience. The researchers recognized that within the interviews, they were positioned as an audience and that they were part of a reexperiencing of the narrative. In this sense, they were collaborators in the retelling of the narrative of a lived experience.     

Effect of hemodialysis on the deformability and lipid peroxidation of erythrocytes in chronic renal failure

Deformability and lipid peroxidation (LP) have been compared in erythrocytes of 45 chronic hemodialysis patients and 30 healthy subjects. The relative cell transit time (RCTT), correlating negatively to deformability, was measured using a St. George filtrometer. Thiobarbituric acid reactive material was measured and expressed as nanomoles of malondialdehyde (MDA) per gram of hemoglobin as a marker of LP. RCTT and MDA were found to be significantly higher not only before but also after HD compared with controls. Weak negative correlations were found between RCTT and the dosage of EPO as well as between RCTT and the daily amount of urine. These observations indicate the importance of residual renal function and the beneficial effect of EPO on erythrocyte deformability. The mean values of results suggest that HD does not affect the erythrocyte injury. The individual modifications of RCTT and MDA are also discussed.     

Charges for Criminal Exposure to HIV and Aggravated Prostitution Filed in the Nashville, Tennessee Prosecutorial Region 2000–2010

This paper examines comprehensive data on arrests for HIV-specific crimes within a single jurisdiction, the Nashville Tennessee prosecutorial region, over 11 years. There were 25 arrests for HIV exposure and 27 for aggravated prostitution. Eleven of the arrests for HIV exposure involved nonsexual behaviors; none alleged transmission. Sixteen of the arrests for HIV exposure involved sexual behavior; three alleged transmission. Aggravated prostitution cases (i.e. prostitution while knowing one has HIV) often involved solicitation of oral sex; none alleged transmission. Maximum sentences for HIV-specific crimes ranged from 5 to 8 years. We conclude that enforcement of US HIV-specific laws is underestimated. Fifty-two arrests over 11 years were recorded in one jurisdiction. Over half of the arrests involved behaviors posing minimal or no HIV transmission risk. Despite concerns about malicious, intentional HIV transmission, no cases alleged malice or intention.     

Nicotine, lung and cancer

The respiratory epithelium expresses the cholinergic system including nicotinic receptors (nAChRs). It was reported that normal human bronchial epithelial cells (BEC), which are the precursor for squamous cell carcinomas, and small airway epithelial cells (SAEC), which are the precursor for adenocarcinomas, have slightly different repertoires of nAChRs. Studies shown that nAChRs expressed on lung carcinoma or mesothelioma form a part of an autocrine-proliferative network facilitating the growth of neoplastic cells; others demonstrated that nicotine can promote the growth of colon, gastric, and lung cancers. Nicotine and structurally related carcinogens like NNK [4-(methylnitrosoamino)- 1-(3-pyridyl)-1-butanone] and NNN (N'-nitrosonornicotine) could induce the proliferation of a variety of small cell lung carcinoma cell lines and endothelial cells and nicotine in non-neuronal tissues -including lung- induces the secretion of growth factors (bFGF, TGF-alpha, VEGF and PDGF), up regulation of the calpain family proteins, COX-2 and VEGFR-2, causing the eventual activation of Raf/MAPK kinase/ERK (Raf/MEK/ERK) pathway contributing to the growth and progression of tumors exposed to nicotine through tobacco smoke or cigarette substitutes. It has been demonstrated that nicotine promotes the growth of solid tumors in vivo, suggesting that might induce the progression of tumors already initiated. While tobacco carcinogens can initiate and promote tumorigenesis, the exposure to nicotine could confer a proliferative advantage to early tumors but there is no evidence that nicotine itself provokes cancer. This is supported by the findings that nicotine can prevent apoptosis induced by various agents - such as chemotherapeutic in NSCLC, conferring a survival advantage as well.     

Cor Triatriatum

Cor triatriatum is defined as a membrane within the left atrium, which might lead to restricted pulmonary venous return. Diagnosis is usually achieved by echocardiography, therapy of choice is excision of the membrane. Upon ten new cases, the association with other congenital heart diseases (CHDs), clinical symptoms and the surgical approach are discussed. Eight of ten patients were children, six of them aged<1 year. Additional CHDs included atrial and ventricular septal defects, partial anomalous pulmonary venous return and complex CHD. Surgery was performed in all cases. Prognosis is related to associated CHD.     

Projections of primary afferent fibers to last-order premotor interneurons in the lumbar spinal cord of rats

It is well established that last-order premotor interneurons in the spinal cord have crucial importance in the integration of activities generated by the spinal motor apparatus, sensory information and volleys arising from higher motor centers, indicating that they play a substantial role in spinal motor functions. Despite extensive studies, synaptic input systems of these neurons have not been investigated in detail up to now with morphological approaches. On this basis, the present experiments were aimed at the visualization of possible contacts between primary afferents and last-order premotor interneurons in the lumbar spinal cord of rats using double label neural tracing methods in light microscopy. The findings show that terminal puncta of primary afferents do establish indeed appositions on last-order premotor interneurons. From the quantitative point of view, these appositions occur, however, in limited numbers. The study also shows that last-order premotor interneurons contacted by primary afferents tend to be concentrated at the segmental level of the innervated motoneurons, and are evenly distributed along the mediolateral extent of laminae V-VI and in the dorsal portion of lamina VII.