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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To obtain better understanding of the nature and cost of health care related to human immunodeficiency virus (HIV) infection, medical payment records were analyzed for 204 men, women, and children older than 60 months who had indications of HIV infection. The records were those of Michigan Medicaid, the General Assistance Medical Program, and the Resident County Hospitalization Program, with service dates on or after January 1, 1984, and which were processed by November 30, 1987. Patient payment records were coded according to whether the patient's condition was considered to be pre-HIV, HIV unrelated, possibly HIV related, or HIV related. Average monthly payments were found to be $150 for pre-HIV patient payment records, $114 for those HIV unrelated, $57 for those possibly related, and $1,213 for those related to HIV infection. HIV-related monthly payments rose from about $1,500 per month in the period 3 months prior to the patient's death to more than $8,000 in the last month of life. Men were found to have twice as many claims as women, and men's claims cost about three times as much. A higher percentage of women than men (91 percent versus 37 percent) received pre-HIV paid services, indicating a higher percentage of women were at least initially receiving Medicaid for reasons other than an HIV-related disability. Diagnostic categories that accounted for the bulk of the HIV-related health care utilization included infectious and parasitic diseases, acquired immunodeficiency syndrome, diseases of the respiratory system, and non-HIV-specific immunity disorders. Inpatient hospitalization accounted for more than 75 percent of the payments, followed by physician costs (11 percent), pharmacy costs (5 percent), and outpatient costs (3 percent). A total of 45, or about 22 percent of the recipients, received zidovudine (AZT) prescriptions at an average monthly cost of $404.
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PMID:Analysis of Michigan Medicaid costs to treat HIV infection. 250 70

Between 1978 and 1980, 359 hepatitis B seronegative homosexual and bisexual men were recruited from the San Francisco municipal sexually transmitted disease clinic for hepatitis B vaccine trials. Of the 359 participants, 320 (89%) consented to have their stored blood samples tested for human immunodeficiency virus antibodies. The prevalence of human immunodeficiency virus infection in these 320 vaccine trial participants rose from 0.3% in 1978 to 50.9% in 1988. The annual incidence of human immunodeficiency virus infection showed that seroconversion peaked in 1980-1982, dropped significantly in 1983, and has remained low. Men less than 30 years old on entry into the study seroconverted earlier in the epidemic and had higher incidence rates than men 30 years or older (p = 0.07). No statistical difference in seroconversion rates was found for other demographic variables. Using a Kaplan-Meier survival curve of the cumulative proportion of men without acquired immunodeficiency syndrome by duration of human immunodeficiency virus infection, an estimated 39% (95% confidence interval 27%-51%) will develop acquired immunodeficiency syndrome within 9.2 years of infection. Cox proportional hazard stepwise analysis showed no correlation between age at seroconversion, race, or year of seroconversion and progression to acquired immunodeficiency syndrome.
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PMID:Prevalence, incidence, and progression of human immunodeficiency virus infection in homosexual and bisexual men in hepatitis B vaccine trials, 1978-1988. 253 43

We studied 388 homosexual or bisexual men from the Baltimore-Washington area to define the spectrum of enteric pathogen carriage in a population at high risk for "gay bowel syndrome" in association with human immunodeficiency virus infection. Seventy-seven patients with acquired immunodeficiency syndrome, 68 gay men with symptoms of acute diarrhea or proctitis, and 243 gay men without gastrointestinal symptoms and participating in a natural history study of human immunodeficiency virus infection were selected for study. Approximately 12% of the asymptomatic men harbored at least one enteric pathogen; the most frequently recovered were Chlamydia trachomatis, herpes simplex virus, and Giardia lamblia. Men carrying a pathogen were more likely to be human immunodeficiency virus seropositive (48%) than men without a pathogen (25%) (p = 0.018), more likely to have fewer T helper cells (p = 0.015), and more likely to have a mucopurulent exudate (p = 0.014). We recovered an agent of enteric disease from 68% of gay men presenting with diarrhea or proctitis. Campylobacter species, herpes simplex virus, Neisseria gonorrhoeae, C. trachomatis, G. lamblia, and Shigella species were identified most frequently. The most common pathogen associated with diarrhea in acquired immunodeficiency syndrome was Cryptosporidium (16% of 49 cases). Other agents identified were Clostridium difficile, Vibrio parahemolyticus, Campylobacter species, G. lamblia, Isospora, and cytomegalovirus. Approximately half of the identifiable etiologic agents of diarrhea in acquired immunodeficiency syndrome patients were treatable with antibiotics, but these agents required special culture procedures for detection.
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PMID:Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome. 283 Nov 7

The cause of the abnormal T lymphocyte subsets reported in healthy homosexual men is not known. Frequent sexually transmitted infections including human T cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) are possible causes. To determine if the T lymphocyte subsets were abnormal in this population in an area without endemic acquired immune deficiency syndrome (AIDS), T lymphocyte subsets of 52 homosexual men in Rochester, New York, were enumerated, and evidence of infections known to cause these abnormalities was sought. Unlike the findings in previous reports, relative numbers of T helper and T suppressor cells and helper/suppressor T cell ratios were normal. Prevalence of cytomegalovirus infection (86 percent) was similar to that found in analogous populations, but only 9 percent had seropositive results for HTLV-III/LAV. Men with serologic evidence of nonprimary cytomegalovirus disease had lower helper/suppressor T cell ratios (1.5 +/- 0.2 versus 2.2 +/- 0.2; p less than 0.01). Hence, despite frequent infections with cytomegalovirus and other sexually transmitted pathogens, T cell subsets are normal in homosexual men in an area without endemic AIDS. Therefore, HTLV-III/LAV is primarily responsible for the T cell abnormalities observed elsewhere.
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PMID:Normal T cell subsets in homosexual men living in a community without endemic AIDS. 294 32

Using blood samples collected since 1978, we investigated the epidemiology of human T-cell lymphotropic virus type III (HTLV-III), the etiologic agent of the acquired immunodeficiency syndrome, in a group of 378 homosexually active men who have resided in New York City since the acquired immunodeficiency syndrome epidemic began. The anti-HTLV-III prevalence was 6.6% in sera from 1978 or 1979, and the subsequent annual incidence of seroconversion among susceptible men ranged between 5.5% and 10.6%. The highest incidences were in recent years, even though these men reported a decrease in their sexual activity during this time. These data demonstrate the continuing risk of HTLV-III infections in the homosexual population studied and emphasize the need for more effective prevention of transmission. The year during which antibody was first present was the only factor identified that was associated with altered cell-mediated immunity in antibody-positive men. Men who became antibody positive in 1981 or earlier currently had significantly lower OKT4/OKT8 ratios than did those who seroconverted more recently. Further follow-up will be necessary to establish the reasons for this association.
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PMID:Human T-cell lymphotropic virus type III infection in a cohort of homosexual men in New York City. 300 89

The ombudsman position was created at the Gay Men's Health Crisis (GMHC) in New York to link AIDS patients with the health care system. The department, which has served 3,400 clients since 1982, handles complaints and problems relating to such areas as ambulatory care, home attendant care, and advocacy for improved patient care. Social work, discharge planning, and mental health issues are discussed. The efforts of the ombudsman office has led to many supportive relationships with providers and increased awareness of the needs by political organizations.
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PMID:Health care advocacy for AIDS patients. 309 54

Beginning in the latter part of 1985, 2,047 gay and bisexual men who were enrolled in the Pitt Men's Study, the Pittsburgh cohort of the Multicenter AIDS Cohort Study (MACS), were invited by mail to learn the results of their antibody test for HIV infection--human immunodeficiency virus infection. Participants were asked to complete and return a questionnaire designed to assess the factors influencing their (a) decision about learning the results, (b) recent sexual behavior, (c) knowledge about acquired immunodeficiency syndrome (AIDS), and (d) attitudes toward AIDS risk reduction. Of those men, 1,251 (61 percent) accepted the invitation, 188 (9 percent) declined, and 608 (30 percent) failed to respond. Fifty-four percent of the cohort subsequently learned their results. There were no significant differences in demographic, behavioral, and attitudinal characteristics or HIV seroprevalence between the men who accepted and those who declined. However, significant demographic differences were noted between the men who responded to the invitation versus those who did not; the latter group was composed of a greater proportion of men who were younger, nonwhite, and less educated. The most frequently cited reason (90 percent) why men wanted their test results was to determine if they had been infected with HIV. Of those who declined, 30 percent cited concerns about the psychological impact of learning about a positive result as being the most important factor for their decision. The two most frequently selected reasons for declining were the belief that the test is not predictive of the development of AIDS (48 percent) and concern about the worry that a positive result would produce (48 percent). These findings are discussed in the context of a nationwide, voluntary HIV screening program for gay and bisexual men.
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PMID:The HIV antibody test: why gay and bisexual men want or do not want to know their results. 311 76

A random, stratified sample of 2601 adult Australians from all states and territories was interviewed about knowledge of the acquired immunodeficiency syndrome (AIDS). After the interview, an anonymous questionnaire on the prevalence of practices that are associated with risk of human immunodeficiency virus (HIV) infection was left with the respondents; 60.2% of these questionnaires were returned. Data from this survey suggest that the prevalences of male homosexual behaviour, prostitute contact and lesbian contact are substantially lower than were estimated previously. Men with homosexual experience were significantly more prevalent in the more populous states, but the majority of other risk factors--intravenous drug abuse, male respondents' contact with prostitutes, transfusion of blood or blood products during 1980-1985 and heterosexual contact--showed few significant associations with geographical, occupational or marital status. Intravenous drug abusers were significantly younger, and heterosexual contact was associated with age for both male and female respondents. No significant differences were found in the prevalence of homosexual contact among single, married and previously-married men, although the prevalence of homosexual contact was lower in married men. The results of the study are discussed in terms of targeting preventive campaigns and assessing the future potential for the spread of HIV infection.
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PMID:Prevalence of risk factors for human immunodeficiency virus infection in the Australian population. 317 93

Two hundred and seventy seven homosexual men participating in an AIDS study in Amsterdam, The Netherlands, were interviewed in July to December 1986 regarding their experiences with the use of condoms during anogenital intercourse. It appeared that in many cases the condoms used could not be described as reliable, or were not used safely. In 8% (117/1468) of cases the condom tore or slipped off. When different condoms were compared, it was seen that "qualified" anal condoms functioned best. Other anal condoms functioned worse, and in many cases even worse than classic vaginal condoms. Whether these differences exclusively depended on differences in quality cannot be assessed. Men who buy a qualified anal condom are possibly more motivated and thus also less likely to have failures. Regarding the apparent unreliability of the condoms used, homosexual men are advised to refrain from anogenital intercourse. When this is not feasible, a qualified anal condom should be used.
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PMID:Failure rate of condoms during anogenital intercourse in homosexual men. 320 34

This report is a brief summary of important points concerning AIDS and homosexual men. We present the current overall figures of the cumulative AIDS incidence for Switzerland, the United States and the world and similar figures for homosexual men in Switzerland, the United States and Europe. A brief history of the epidemic is included with focus on the role of homosexual men. The main risk factors for acquiring HIV infection among homosexual men, including large numbers of sexual partners, receptive and intercourse and rectal douching, are mentioned with emphasis on results from "The San Francisco Men's Health Study". The development of education and prevention programs is outlined along with the role in these areas of The Swiss AIDS Foundation and Swiss Federal Office of Public Health. Decreases in high risk sexual practices and decrease in seroconversion rates are also discussed.
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PMID:Selected aspects of AIDS among homosexual men. 322 99


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