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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adolescent pregnancy or sexually transmitted disease (STD) reduction has not occurred, despite sexuality education and abstinence programs, and intensive publicity and community initiatives. An obstacle to adolescent pregnancy, STD, and childbearing prevention is the assumption that adolescent sexuality is a closed system of activity among peers. When a nation is consumed with the preoccupation of condoms versus chastity debates, and is ignoring high poverty levels and abuse of the young, adolescent girls will seek escape from harsh childhoods in early family formation with young adult men. There is a high correlation between poverty rates and teenage birth, AIDS, and STD rates. Schools are not able to produce magical solutions to teenage pregnancy when adult lawmakers abnegate their responsibility to provide for youth well-being. Adolescent pregnancy will occur regardless of the expansion of curative programs such as school-based clinics; fundamental changes in assumptions, attitudes, and policies are needed. Beneficial aspects of programming appear to be fact-based sexuality and contraceptive education, counseling and referrals for youths with histories of child abuse, and child care classes and flexible school schedules for parenting students. A statistical profile in California indicates that 85% of all fathers of babies born to girls between ages of 11 and 18 years were adults. More than 50% of mothers aged 11-15 years were impregnated by adult men. Fathers' average age for births among junior high school mothers was 15-26 years, when the youngest and the oldest 2.5% of fathers are eliminated. There is a greater likelihood that a man older than 23 years will impregnate a junior high girl than will a junior high boy. The partner age gap is greatest among the very young girls. The California profile of father's age is similar to birth patterns in other states and similar to the national average. An examination of STDs shows a higher rate of STDs among females younger than 20. AIDS cases and HIV infections also appear higher among girls ages 13-19 years. The patterns indicate that teenage female STDs are likely to have been acquired by contact with older men by rape or voluntary intercourse. Fathering in abortion cases is not well documented. The predominate neglect of the role of adult-teen intercourse is a major omission. Teenage sex behavior for births, abortion, and STDs is often controlled by the behavior of adult partners.
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PMID:School-age pregnancy: why hasn't prevention worked? 813 47

Although human B19 parvovirus infection has been clearly associated with a number of distinct syndromes (including severe anemia, abortion, and arthritis), detailed knowledge of its pathogenesis has been hindered by the lack of a suitable animal model. We have identified a novel simian parvovirus in cynomolgus monkeys with severe anemia. Sequencing of a 723-bp fragment of cloned viral DNA extracted from serum revealed that the simian parvovirus has 65% homology at the DNA level with the human B19 parvovirus but little homology with other known parvoviruses. Light microscopic examination of bone marrow from infected animals showed intranuclear inclusion bodies, and ultrastructural studies showed viral arrays characteristic of parvoviruses. Another striking feature was the presence of marked dyserythropoiesis in cells of the erythroid lineage, raising the possibility that B19 parvovirus infection may underlie related dyserythropoietic syndromes in human beings. Affected animals had concurrent infection with the immunosuppressive type D simian retrovirus, analogous to HIV patients who develop severe anemia because of infection with B19 parvovirus. The remarkable similarities between the simian and B19 parvoviruses suggest that experimentally infected cynomolgus monkeys may serve as a useful animal model of human B19 infection.
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PMID:Identification of a novel simian parvovirus in cynomolgus monkeys with severe anemia. A paradigm of human B19 parvovirus infection. 816 39

Two complementary surveys were carried out in the 89 hospital units of South-Eastern France which deal with pregnant women. Firstly, in November 1991, medical chiefs of these units were interviewed face-to-face about their current HIV screening policy. Secondly, between Jan 27 and March 22, 1992, all women at the end of their pregnancy attending these units were included in an anonymous unlinked seroprevalence survey, irrespective of pregnancy outcome (n = 11,056). The goal of the research was to compare HIV prenatal screening policies and seroprevalences by pregnancy outcomes in order to contribute to the public debate initiated on that issue by the French health authorities. The seroprevalence survey showed a global prevalence rate of 0.43% (CI 95% = 0.32-0.54) with the prevalence among women who had an elective abortion (0.56%) being more than twice that among women who delivered (0.22%). However, routine HIV screening was more frequent toward women coming for regular prenatal care than for women seeking abortion. A systematic procedure for obtaining women's consent for HIV testing only existed in a minority of units. Only 23 out of the 62 units offering both antenatal and termination services to women had the same screening policy for women attending the different services. The research confirmed that a mandatory requirement would not improve HIV screening policy during prenatal care. However, less emphasis on women who have opted for termination of pregnancy, an absence of appropriate counselling and information procedures, and pressures on HIV-infected women to terminate current pregnancies and discourage future ones strongly suggest that HIV prenatal screening in French hospitals remains mainly focussed on fetal concerns, without sufficient attention towards the needs of women at risk of HIV infection.
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PMID:HIV prenatal screening in south-eastern France: differences in seroprevalence and screening policies by pregnancy outcome. 818 74

HIV-antibody testing has been carried out as a routine among pregnant women in Norway since September 1987. Up to September 1991 (later information is incomplete) 339,823 women have been tested. 25 of these were positive. In this survey we interviewed by questionnaire 55 physicians and nurses who had been asked for a second blood sample from their patients. None of the physicians who had tested the 25 HIV-positive women were included. Among these 55, nine stated that the women had suffered psychological distress after the second testing, and one reported that the woman in question had chosen to have an abortion. The study demonstrates possible opportunities for improving the handling of information, both between laboratories and physicians/nurses and between physicians/nurses and the women who are asked to give a second blood sample. We also interviewed 290 physicians who had asked for a HIV-test for pregnant women but had received no false positive results (the number of respondents was 258). Among a total of 379 physicians and nurses, one third stated that they seldom or never asked explicitly if the woman wanted to be tested. 88% were in favour of routine testing and 97% reported a positive or very positive attitude among the pregnant women towards screening. Nearly one third stated that they had insufficient knowledge about the significance of a false positive test result.
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PMID:[Information routines in HIV screening of pregnant women]. 819 34

Childbearing, now and in the future, brings with it many challenges due to the complexity of living in a highly technological world with diminishing natural resources. A dialogue about these challenges should be initiated and should involve everyone in the community: patients, families, policy-makers, health professionals, and business leaders. Key problems in 1989 were unintended pregnancy, pregnancy among unmarried mothers, lack of prenatal care, children in poverty, teenage births, lack of health insurance, low birth weight babies, birth defects among infants, pregnancy among alcoholic mothers, and infant mortality. Controversial issues will continue to be abortion, lesbian health care, AIDS and pregnancy, and lifestyle issues. The women's health research agenda for the future aims to improve the health of all women and to eliminate competing agendas. Working mothers are viewed as representing the prevalent lifestyle. More study should, therefore, be devoted to the impact of the work situation on the health of mothers and children and to such issues as quality day care and sharing of household responsibilities among families. Global demographic trends referenced from Kennedy's "Preparing for the 21st Century" indicate that costs of health care for the aged, teenagers, and HIV-infected infants and mothers will be high. Women are viewed as vulnerable in sexual relationships. Assisted reproductive technology has advanced women's ability to bear children, but little has been studied about who infertility affects. Poverty among women is increasing, and it is estimated that by the year 2000, three billion people will lack adequate fuel, food, or energy. Economic cooperation and integration will be needed to accommodate increases in technology, communications, and trade.
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PMID:Women and the family of the future. 820 53

In England between November 1989 and February 1991, 917 new female patients at a department of genitourinary medicine (GUM), a family planning clinic (FPC), and an abortion clinic, all in inner London, completed a questionnaire so researchers could examine sexual behavior and HIV risk behavior between these women and to determine the effect of ethnic origin and socioeconomic status on these behaviors. 25.3% of GUM women and 25% of women at the abortion clinic did not use any contraception. The median numbers of sexual partners in the last 1-2 years and 4-6 years were essentially the same in all 3 groups (1.5-2.0 and 6.8-11.1, respectively). 54.8-68.9% of the women had had sexual intercourse with a nonregular sexual partner in the last 12 months. Few (10.4-17.1%) always used a condom with their regular partners. The percentage who always used a condom with nonregular partners was also low (31.3-39.7%). 18.6-23.9% of the women had at least 1 major HIV risk behavior. Age at first intercourse was younger in women of lower socioeconomic class than those of higher class (17.39 years vs. 18.04 years; p 0.0001). Whites had more lifetime sexual partners (10.34 vs. 5.18; p = 0.02) and were more likely to have practiced fellatio and anal sex (p 0.0001 and p 0.05) than did Afro-Caribbean women. Whites were more likely to have had a history of genital herpes (4.6% vs. 1%; p 0.02) and to have had sex with an IV drug user (6.9% vs. 1.5%; p = 0.005) than Afro-Caribbean women. Yet, Afro-Caribbean women were more likely to have at least 1 HIV risk behavior than Whites (29.5% vs. 21.4%; p = 0.01), almost entirely because they had had intercourse with a man from Sub-Saharan Africa. These findings suggest that staff at FPCs and abortion centers should provide women advice on sexually transmitted diseases and HIV infection and that staff at GUM clinics need to offer contraception advice. The 3 clinical disciplines must be integrated so women can receive more comprehensive sexual health services.
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PMID:A comparison of sexual behaviour and risk behaviour for HIV infection between women in three clinical settings. 828 97

Adolescent sexual activity is increasing. Premature sexual intercourse results in high figures of adolescent pregnancy and abortion, as well as in increased risk of sexually transmitted diseases (STDs). Lack of information on the prevention of STDs and poor hygiene in both boys and girls are also main reasons for increased morbidity because of STDs during adolescence. Contraceptive behaviour during adolescence varies between countries and communities. It seems, however, that the condom and oral contraceptives (OC) are popular contraceptive methods. Ineffective methods such as periodic abstinence, coitus interruptus, and withdrawal before ejaculation are in use. On the other hand, compliance of adolescents on contraception is poor. The above are additional causes for increasing rates of adolescent pregnancies. Countries providing sexual education programs in schools present lower rates of pregnancy and abortion. Adolescent pregnancy is safe if a careful follow up is accepted by the teenager. A significant number of homeless youth are homosexuals or lesbian adolescents. Most of them are at high risk for HIV infection, AIDS, and STDs. It is concluded that sexual education programs are absolutely necessary to offer adolescents the knowledge on the complications of premature sexual activity, as well as prevention of the undesired pregnancy and STDs.
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PMID:Sexuality: sexual activity and contraception during adolescence. 828 89

Chlamydia trachomatis is currently the major sexually transmitted disease (STD) in Sweden. In the early 1980s 20% of young clinic attenders were infected. Treatment policies, including partner tracing, instituted in 1988 reduced the prevalence to less than 5%. Pelvic inflammatory disease (PID) has also declined with the decrease of gonorrhea and chlamydia. The improvements can be associated with policy: the introduction of compulsory sex education at school in 1956 and the establishment of youth clinics in the 1970s with contraceptive counselling, screening, and treatment for STDs. a 1992 study of more than 9000 sexually active Swedish teenagers revealed that 99% considered the condom the most effective means against STDs, and 84% recognized chlamydia, HIV/AIDS, gonorrhea, and genital warts as STDs. 75% of the subjects had engaged in coitus at first intercourse and 82% at the most recent encounter. 17% had had an STD, and 9% had been or had made somebody pregnant, mostly ending in abortion. In 1975, when the new abortion law was adopted, the teenage abortion rate was high at 30/1000 teenagers aged 15-19. Counseling and free contraceptives reduced the rate by 30% in the next 10 years. However, news about the possible risks of oral contraceptives in the 1980s again boosted the rate from 18 to 25/1000. Recent concerted efforts cut the rate anew. Preventive policies need to convey a positive attitude about sexuality and deal with the basic teenage problems of multiple partners and stress the importance of condom use. Condoms are effective only in stable relationships, and those with less education or those unemployed take more risks, using condoms and contraceptives less frequently. Girls from emotionally poor environments often engage in sex for emotional satisfaction. Openness and further knowledge is needed to ensure the safe sexual behavior of young people.
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PMID:The sexual behaviour of young people. 829 38

Novel methods of human fertility regulation in the post-HIV era are discussed, based on the control of regulatory peptides and their respective genes. 3 mechanisms are examined: selective control of the genes encoding the gonadotropins and/or the interception of circulating gonadotropins by receptor antagonists or binding proteins; the selective neutralization of hCG and other signals involved in the maternal recognition of pregnancy by receptor antagonists and antibodies; and the interception of the putative disintegrin-integrin recognition events involved in sperm-oocyte recognition and fusion. By 2020, contraception, abortion, and unplanned pregnancy could be replaced by reversible sterilization based on the molecular interception of events involved in sperm-oocyte recognition and fusion. Contraceptive-like steroids will be targeted to positive health care, with regard to breast cancer and osteoporosis. The permanent ablation of the gonadotrophs could provide a reversible form of sterilization for both men and women beyond the age of 30 years requiring longterm use of steroid replacement therapy which could support libido and provide protection against cancer and osteoporosis. A first-generation prototype vaccine has been developed in which beta-hCG-carboxy terminal peptide (beta-hCG-CTP) has been linked to a carrier conjugate (diphtheria toxoid), mixed with a synthetic immuno-stimulant, and formulated into a viscous water emulsion. The disintegrin-integrin motives expressed by sperm and oocytes could be used as targets for female contraception. Strategies of vaccination and gene therapy could circumvent the problems of dose, time, and location for the longterm regulation of fertility. In the vaccination strategy, the immune system provides both great specificity and a long duration of action. Gene therapy is currently the subject of a massive research endeavor designed to develop treatments for some of the 2500 inherited diseases afflicting humans.
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PMID:Contraception for the year 2020. 832 11

The Authors describe a case of dessicant pseudomembranous vaginitis caused by HPV types 6, 11, 16 and 18 in a 44-year-old HIV seropositive woman. A material mixed with blood, simulating a spontaneous abortion because of its quantity and consistency, was ejected vaginally. A spontaneous abortion was excluded on the basis of a pelvic echographic exam and on the beta-HCG plasma level. Histologic examination of the ejected material demonstrated an epithelium of the vaginal mucosa in which was found a marked and extensive koilocytosis of intermedial and parabasal layers. The vaginal mucosa in this patient differed from the commonly observed koilocytosis and condylomatous proliferation histological aspects seen in vaginal HPV lesions. In the context of the epithelium, by means of confluence of voluminous koilocytotic elements, pseudocystic lacunar spaces of varying dimensions definable as "koilocytotic pseudocysts" were observed. Within the vaginal epithelium, along a line of reduced resistance, a massive and extensive dessication resulted in a laminar detachment of the overlying epithelial stratum. Regarding the association between HIV and HPV infection, it is known that seropositive patients with immunodeficiencies are at high risk of infection by a variety of pathogens and, among these, different types of HPV. The viral association in this case undoubtedly promoted the extension and seriousness of the lesion and its exceptional complication.
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PMID:[Dissecting pseudomembranous celiocytic vaginitis caused by HPV in a HIV positive patient]. 839 24


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