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

During October-November 1988 in Kenya, 344 undergraduate male and female students at Kenyatta University completed a questionnaire designed to determine their knowledge, attitude, and practices towards AIDS. This survey also aimed to shed some light on the success of the media campaign launched in February 1988. 98% were familiar with AIDS. Men and women were equally familiar with AIDS. The leading sources of information on AIDS were newspapers (166) and radio (123). Most students knew that weight loss was a symptom of AIDS. Many also knew that coughing was a symptom. Students had vague knowledge of HIV. Students tended to know that AIDS is transmitted through heterosexual intercourse. Men were more likely to have sexual experience than women (72% vs. 28%). The most common way the students would reduce the risk of contracting AIDS was having 1 sex partner (204 students). Few students (44) would use a condom. Creating awareness (174) was the leading way society should fight AIDS. Only 25 students mentioned condom use as a way to prevent AIDS. Most students (60%) thought that persons with AIDS should be quarantined. Most students had an apathetic attitude if they themselves had AIDS. The leading responses to what the students would do if they learned that they had AIDS included wait to die (193) and commit suicide (120). 20% would not help a family member with AIDS and would let him/her die. These findings suggest that, even though almost everyone knew about AIDS, their misperceptions about and attitudes towards persons with AIDS reflect a need for more information on AIDS prevention and on dealing with HIV infected persons. The Ministry of Health needs to put more effort into counseling AIDS patients and to reduce the hopelessness and stigmatizing of persons with AIDS.
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PMID:Kenyan university students' views on AIDS. 803 74

Female chronic mental patients are likely to have induced abortions, give up children for others to raise, and to engage in unprotected sexual intercourse. There are few studies, however, on the family planning attitudes and needs of male psychiatric patients. 35 male chronic mental patients aged 23-49 years of mean age 36 at the psychiatric outpatient clinic of a publicly-funded general hospital in the Harris County district of Houston, Texas, responded to interview questions about their social situation, medical and sexual histories, previous children, attitudes toward family planning and contraceptive practices, and sources of information about family planning. Findings on their knowledge of AIDS and health locus of control are reported under separate cover. The hospital serves predominantly indigent and uninsured patients. Men 50 years or older were excluded from consideration in the study because it was thought they would be less likely to father future children. The sample was comprised of 30 black males, 4 white males, and one Hispanic male of mean education 11 years. Five men were currently married and nine more had been married at some point in the past. Patients had been attending the clinic for an average of 7 years, in a range of 0.5-27 years, with 17% reporting histories of psychiatric hospitalization within the past year. Diagnoses taken from patients' charts included schizophrenia among 26, schizoaffective disorder among two, organic mental disorder among four, and major affective disorder among two; one patient had an Axis II diagnosis of a severe personality disorder. All patients were being treated with psychotropic medications and all but three were being treated with neuroleptics. The interviews took place over the course of 9 months. 18 patients reported having fathered a total of 41 children. 60% of the children less than 16 years old, however, were not being raised by their biological father. 57% of the men reported having had sexual intercourse within the last year, with 26% reporting three or more sex partners during the period. 41% of the men who had sexual intercourse during the preceding year and had not wanted children reported that they or their sex partner had not used contraception during the most recent episode of intercourse. Many patients in the sample were therefore at significant risk of fathering unwanted children and contracting and/or transmitting sexually transmitted diseases. The authors discuss strategies for preventing unwanted pregnancies within this population.
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PMID:Family planning needs of male chronic mental patients in the general hospital psychiatry clinic. 803 81

Men attending four Seattle gay bars were asked to complete a self-administered questionnaire including measures of sexual behavior, perceptions of peer norms in the area of sexual safety, personal human immunodeficiency virus (HIV) risk estimate, and knowledge and use of a variety of acquired immunodeficiency syndrome (AIDS) prevention services. Twenty-nine percent of the sample reported engaging in unprotected anal intercourse at least once during the 2 months before the survey. Differences in peer norm perceptions, age, HIV risk estimate, and intent to be sexually safe in the future were found between those engaging in unprotected anal intercourse and those not reporting unprotected anal intercourse. No significant differences were found in level of education, use of AIDS prevention services, and whether or not a person had been tested for HIV. Implications for prevention programs are discussed.
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PMID:Risk behavior for HIV transmission among gay men surveyed in Seattle bars. 804 57

Violence against women--in the form of rape, sexual abuse, and battering--impairs women's ability to protect themselves from unwanted pregnancy and sexually transmitted diseases and, thus, constitutes a major obstacle to reproductive freedom. Men's superior strength and control over economic resources make acquired immunodeficiency syndrome (AIDS) prevention strategies based on encouraging women to insist on condom use unrealistic; moreover, they may place some women at risk of further abuse. A growing number of studies suggest that childhood sexual abuse is associated with psychological issues in adulthood that increase vulnerability to drug addiction, prostitution, and other risk factors for AIDS. Other links between male violence and women's health include battering during pregnancy and female circumcision. Even the health care system has been implicated in practices that forcibly undermine women's self-determination, e.g., forced sterilizations, unnecessary cesarean sections, and inhumane treatment of women who are deemed to be promiscuous. Health activists are urged to be more responsive to the needs of many women to make sexual and reproductive decisions that enable them to avoid domestic violence. For example, Depo-Provera, despite controversies over its safety, may be an ideal choice for women whose partners object to contraception. Reproductive health care providers are further well placed to identify victims of child sexual abuse, rape, and battering and provide counseling. Finally, women's health advocates and AIDS activists are urged to unite to demand the development of a safe, effective female-controlled virucide that could give women protection against sexually transmitted diseases, including AIDS.
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PMID:Reproductive freedom and violence against women: where are the intersections? 804 74

Psychology professors from the University of California conducted 3 studies to develop a multidimensional, multiple-indicator condom attitudes scale that would include items drawing upon several independent determinants of condom use. These studies would help them correlate 5 factors of the UCLA Multidimensional Condom Attitudes Scale (MCAS) with other criterion variables to establish the construct validity for each factor in the scale. The first study involved 239 male and female 15-35 year old undergraduate students who completed a 15-page, 187-item questionnaire. The professors used these data to develop 5 domains in the MCAS and to correlate the MCAS with relevant criterion variables. The 5 domains of the MCAS were reliability and effectiveness of condoms, sexual pleasure associated with condom use, stigma attached to persons who use condoms, embarrassment about negotiation and use of condoms, and embarrassment about purchase of condoms. 181 undergraduate students, 18-30 years old, completed a modified questionnaire an item added to improve the identity stigma factor) so the researchers could cross-validate MCAS' domains by means of factor analysis (study 2). Study 3 involved 426 undergraduate students whose data the researchers analyzed to test the 5-factor structure against a 1-factor model, to replicate the factor structure using methods of confirmatory factor analysis in structural equations modeling, and to confirm that the reliability and effectiveness domain included reliability and effectiveness as protection against AIDS, other STDs, and pregnancy. Men were not as embarrassed about buying condoms as women, while women had a more positive attitude towards identity stigma-related issues. Overall, men's and women's attitudes towards condoms were different. The studies' results show that condom attitudes are indeed multidimensional, and that the MCAS goes beyond individual decision making to include the social, interpersonal determinants of sexual behavior.
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PMID:The UCLA Multidimensional Condom Attitudes Scale: documenting the complex determinants of condom use in college students. 805 58

In April and May 1991 in Papua New Guinea, interviews were conducted with 896 randomly selected men and women living in or near Lae, Goroka, and Mt. Hagen and in 12 villages 25 km from Madang to obtain baseline data on AIDS knowledge and condom-related attitudes and behaviors. 93% were familiar with the word AIDS. Only 3% demonstrated a high level of knowledge concerning HIV transmission and prevention. Virtually no one mentioned vertical transmission of HIV from mother to infant as a mode of HIV transmission. Only 14% mentioned blood contact. Knowledge of sexual transmission was relatively high. Only around 18% knew that AIDS prevention requires consistent condom use during sexual intercourse. Urban residents were just as informed as rural people about AIDS prevention. Men with university education were 2 times more likely to use condoms than those with no education. Less than 50% of all respondents believed condoms can prevent HIV transmission. Messages stating that one is protected if there is only 1 sexual partner and avoidance of sexual intercourse with prostitutes did not address the reality of sexual culture in Papua New Guinea. Even though many men said that they would use condoms, explicit and culturally appropriate education needs to be promoted to effect a significant change in condom usage patterns.
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PMID:Knowledge of AIDS in Papua New Guinea. 805 44

Though HIV prevention campaigns in Zimbabwe have increased public awareness of HIV, they have not meaningfully changed sexual behaviour. Possibly these campaigns are based on wrong assumptions about sexual behaviour. By means of 111 structured interviews with hospital patients, secondary school students and teachers, and 11 focus group discussions with traditional healers, midwives, village community workers, secondary school students and teachers, and commercial sex workers in a rural district of Matabeleland in Zimbabwe, this low-budget study explores attitudes towards sex and sexual behaviour in order to define more appropriate health education messages. Results indicate that traditional sex education no longer takes place and that communication between sexual partners is limited. The almost ubiquitous expectation of women to get rewards for sex outside marriage motivates mostly single women out of economic necessity to meet the male demand for sexual partners, which is created by large scale migrant labour and men's professed 'biological' need for multiple partners. Types of sexual behaviour other than penetrative vaginal sex are uncommon and considered deviant. Safe sex messages from the West therefore are inappropriate in the Zimbabwean context. Recommendations are given to restore traditional communication about sexual matters across generations and to urge sexual partners to discuss sex. Women who, for economic reasons, engage in casual sex should at least learn to negotiate the use of condoms. Men seriously need to reconsider their attitudes to sex and sexual practices in view of the high HIV sero-prevalence. Faithfulness, rather than multiple sexual contacts, should become a reason to boast.
AIDS Care 1994
PMID:Attitudes to sex and sexual behaviour in rural Matabeleland, Zimbabwe. 806 Oct 79

Clinical trials have shown that the prophylactic use of zidovudine and aerosolized pentamidine (or other antibiotics used as prophylaxis against Pneumocystis carinii pneumonia) in acquired immunodeficiency syndrome (AIDS)-free human immunodeficiency virus (HIV)-infected persons delays the development of AIDS, but the effectiveness of such therapy in general use in the population still remains largely undocumented. To help answer this question, the authors estimate the effectiveness of this therapy in a population-based cohort of HIV-infected homosexual and bisexual men in San Francisco. The authors use a continuous-time Markov process to model the decline of CD4+ T-lymphocytes (T4-cells) measured in cells/microliter in HIV-infected persons. The model partitions the HIV (type 1) infection period into six progressive T4-cell count intervals (stages), followed by a seventh stage: AIDS diagnosis. The authors use maximum likelihood methods to fit the model to the observed transitions for 428 HIV-infected men during June 1984 to March 1991, from the San Francisco Men's Health Study. Since zidovudine was not widely used before 1988, the model has a component that controls for calendar time-related biases. The fitted model provides statistical estimates and confidence intervals for measuring therapy effectiveness. The authors estimate that prophylactic therapy reduces the progression rate from stage 4 (T4-cell count, 350-499) to stage 5 (T4-cell count, 200-349) by a factor of 0.26 (95% confidence interval (CI) -0.22 to 0.55); from stage 5 to stage 6 (T4-cell count < 200) by a factor of 0.33 (95% CI 0.04-0.54); and from stage 6 to 7 (AIDS) by a factor of 0.62 (95% CI 0.47-0.73). In addition, therapy started by an HIV-infected person in stage 4 is estimated to reduce the risk of developing AIDS by a factor of 0.83 (95% CI 0.46-0.94) at 6 months and 0.68 (95% CI 0.35-0.89) at 24 months after entering stage 4. Therapy started by HIV-infected persons in more advanced stages is estimated to reduce the risk of developing AIDS by factors ranging from 0.70 (95% CI 0.39-0.90), early in stage 5, to 0.28 (95% CI 0.14-0.45), late in stage 6. Thus, the prophylactic use of zidovudine and pentamidine in routine medical care has a strong, consistent, and significant effect in slowing the clinical course of HIV infection in a population-based cohort.
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PMID:Effect of routine use of therapy in slowing the clinical course of human immunodeficiency virus (HIV) infection in a population-based cohort. 810 Jun 82

The acquired immunodeficiency syndrome (AIDS) results from infection with the human immunodeficiency virus (HIV). The time of infection is generally unknown since transmission usually occurs during the course of repeated sexual contacts or needle sharing. Brookmeyer and Gail describe the biases that may arise in survival analyses using the recruitment time rather than the unknown infection time as the origin in prevalent cohorts of HIV-infected individuals. We apply a non-parametric hazard estimator, introduced by Nielsen, that assumes the hazard of an AIDS diagnosis depends upon the unknown time of infection solely through the value of possibly multidimensional markers of HIV-disease progression such as CD4+ T lymphocyte cell counts. Essentially, we estimate the hazard for a specific marker value y by dividing the number of occurrences among subjects with marker measurements in a neighbourhood of y by the total risk time in that neighbourhood. We present this estimator, which relies upon kernel estimator techniques to produce a smooth estimate, within a counting process framework. We apply this method to marker data from the San Francisco Men's Health Study.
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PMID:Marker-dependent hazard estimation: an application to AIDS. 810 Oct 12

More than 1 in 40 young adults in South Africa were estimated to be infected with HIV through the end of 1992. The rate of infection has slowed so that the current doubling time is 16 months; 400 people are nonetheless newly infected daily. HIV and AIDS were first noted among gay White Men in the Cape of South Africa. Education and support from within the gay community, however, prompted the rapid and substantial decrease in the incidence of infection. The 1st evidence of infection among Black heterosexuals was then noted in 1987. It is mainly young adults who are infected, with women affected earlier than and at least as often as men. The arrival of HIV to South Africa and its expected pattern of transmission should have been no surprise to country health policymakers and administrators. Sexually transmitted diseases (STD) facilitate the spread of HIV infection and tuberculosis (TB) fosters the development of AIDS once people are infected with HIV. An estimated 3 million cases of STD present annually in South Africa and almost half of the adult population is infected with quiescent TB. The failure to learn from experiences with HIV in some central and eastern Africa countries simply highlights the extent of poor public health in South Africa. South Africa has the infrastructure and health funding needed to check AIDS, but failed to take action. The central health ministry did not respond to the epidemic until 1990 with the establishment of an AIDS unit, secondary school AIDS prevention programs and packages in 8 languages, a neutral national information campaign, workshops to increase awareness, and funding to organizations targeting hard-to-reach groups. The AIDS unit was soon merged into a health promotion section and the unit's head fired, with all the prevention initiatives terminated except the continued availability of pamphlets in only English and Afrikaans. An official complaint has been made to no avail against the health department official who closed the AIDS campaign. Meanwhile, the government contends that it holds no responsibility for educating its population in the prevention of AIDS. These recent actions suggest that the government is committing genocide by allowing excess mortality from AIDS to decimate Black heterosexuals during the impending period of interim rule and political transition. These observations and conclusions are based in part on the author's experience as medical advisor to South Africa's AIDS unit in 1991/92.
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PMID:HIV in South Africa. 810 97


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