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

A systematic review was conducted to determine the effectiveness of health education interventions to promote sexual risk reduction behaviours amongst women in order to reduce transmission of human papillomavirus (HPV), a leading agent in the development of cervical cancer. A comprehensive search was conducted to identify relevant studies. Studies were included in the review if they evaluated educational interventions targeting women only and measured the impact on either a behavioural outcome such as condom use for sexual intercourse, partner reduction or abstinence, or a clinical outcome such as incidence of a STD. Thirty studies met the inclusion criteria for the review; all had the primary aim of preventing HIV and other STDs rather than cervical cancer. Ten of the 30 studies were considered to provide the strongest evidence for a causal relationship between the intervention and the change in outcomes measured. Each of these 10 most rigorous studies showed a statistically significant positive effect on sexual risk reduction, typically with increased use of condoms for vaginal intercourse. This positive effect was generally sustained up to 3 months after intervention. It was concluded that educational interventions targeting socially and economically disadvantaged women in which information provision is complemented by sexual negotiation skill development can encourage at least short-term sexual risk reduction behaviour. This effect has the potential to reduce the transmission of HPV and thus possibly reduce the incidence of cervical carcinoma.
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PMID:Cervical cancer and sexual lifestyle: a systematic review of health education interventions targeted at women. 1114 74

The anaerobic protozoa Giardia duodenalis, Trichomonas vaginalis, and Entamoeba histolytica infect up to a billion people each year. G. duodenalis and E. histolytica are primarily pathogens of the intestinal tract, although E. histolytica can form abscesses and invade other organs, where it can be fatal if left untreated. T. vaginalis infection is a sexually transmitted infection causing vaginitis and acute inflammatory disease of the genital mucosa. T. vaginalis has also been reported in the urinary tract, fallopian tubes, and pelvis and can cause pneumonia, bronchitis, and oral lesions. Respiratory infections can be acquired perinatally. T. vaginalis infections have been associated with preterm delivery, low birth weight, and increased mortality as well as predisposing to human immunodeficiency virus infection, AIDS, and cervical cancer. All three organisms lack mitochondria and are susceptible to the nitroimidazole metronidazole because of similar low-redox-potential anaerobic metabolic pathways. Resistance to metronidazole and other drugs has been observed clinically and in the laboratory. Laboratory studies have identified the enzyme that activates metronidazole, pyruvate:ferredoxin oxidoreductase, to its nitroso form and distinct mechanisms of decreasing drug susceptibility that are induced in each organism. Although the nitroimidazoles have been the drug family of choice for treating the anaerobic protozoa, G. duodenalis is less susceptible to other antiparasitic drugs, such as furazolidone, albendazole, and quinacrine. Resistance has been demonstrated for each agent, and the mechanism of resistance has been investigated. Metronidazole resistance in T. vaginalis is well documented, and the principal mechanisms have been defined. Bypass metabolism, such as alternative oxidoreductases, have been discovered in both organisms. Aerobic versus anaerobic resistance in T. vaginalis is discussed. Mechanisms of metronidazole resistance in E. histolytica have recently been investigated using laboratory-induced resistant isolates. Instead of downregulation of the pyruvate:ferredoxin oxidoreductase and ferredoxin pathway as seen in G. duodenalis and T. vaginalis, E. histolytica induces oxidative stress mechanisms, including superoxide dismutase and peroxiredoxin. The review examines the value of investigating both clinical and laboratory-induced syngeneic drug-resistant isolates and dissection of the complementary data obtained. Comparison of resistance mechanisms in anaerobic bacteria and the parasitic protozoa is discussed as well as the value of studies of the epidemiology of resistance.
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PMID:Drug targets and mechanisms of resistance in the anaerobic protozoa. 1114 7

Compared with HIV-negative individuals, HIV-positive individuals have a higher prevalence of anogenital human papillomavirus (HPV) infection, as well as a higher incidence of HPV-associated anal cancer. Little is currently known of chromosomal changes occurring in anal intraepithelial neoplasia (AIN), the probable precursor to anal cancer. Genetic changes in AIN were characterized by comparative genomic hybridization (CGH) in a study of samples obtained from 19 HIV-positive and 11 HIV-negative men. The proportion with genetic changes significantly increased with the severity of the histopathologic grade with none diagnosed as (0%) AIN 1; 5 of 17 (29%) as AIN 2; and 5 of 9 (56%) AIN 3 showing genetic changes (p = .02). This correlation was also found in study subjects who had multiple biopsies with different grades of pathology concurrently or serially over time. The most common regional DNA copy number change was gain mapped to chromosome arm 3q (12% of AIN 2 and 33% of AIN 3). This alteration was previously reported to be commonest alteration in cervical cancer, which suggests a common molecular pathway for these two HPV-associated anogenital neoplasias.
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PMID:Detection of genetic changes in anal intraepithelial neoplasia (AIN) of HIV-positive and HIV-negative men. 1124 98

Between September 1991 and September 1993, husbands of women with and without cervical neoplasia and commercial sex workers in one brothel and one massage parlor in Bangkok, Thailand, were interviewed; serologic tests for sexually transmitted infections were performed; and cervical and penile scrapings were tested for human papillomavirus (HPV) DNA. The risks of cervical carcinoma in monogamous women and of oncogenic HPV in their husbands were associated with the men's having unprotected intercourse with prostitutes. The prevalence of oncogenic HPV was higher in commercial sex workers than in women attending gynecologic and family planning clinics. Oncogenic HPV prevalence declined with age in human immunodeficiency virus (HIV)-negative, but not in healthy HIV-positive, commercial sex workers and was weakly associated with hepatitis B antigenemia, suggesting that persistence of HPV infection is due to subtle changes in immunity. Associations of HPV with recent pregnancy and oral contraceptive use suggest that hormonal factors may increase the risk of cervical neoplasia by enhancing persistence of HPV infection. The prevalence of high-grade squamous intraepithelial lesions was strongly related to oncogenic HPV types and weakly to HIV infection only in their presence. Commercial sex workers in Bangkok are reservoirs of oncogenic HPV, and cervical cancer in monogamous Thai women develops in part as a result of transmission of these viruses to them by their husbands from prostitutes.
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PMID:Human papillomaviruses and cervical cancer in Bangkok. III. The role of husbands and commercial sex workers. 1129 45

Discussions from a recent cancer conference held in May of 1995 are summarized in the following areas: 1) the effect of mitoguazone in relapsed non-Hodgkin's lymphoma; 2) the addition of ddI or ddC to chemo for advanced Kaposi's sarcoma (KS); 3) progress in use of three new anti-KS agents; 4) the effectiveness of phototherapy as palliation for KS; and 5) reasons why HIV prevalence is probably underestimated in women. Additionally, the paper reviews the Lymphoma Project Report which analyzed the epidemiology, pathogenesis, diagnosis, clinical manifestations, molecular characteristics, prognostic factors, and treatment of AIDS lymphoma. The following were among the findings: a regimen of doxorubicin, bleomycin, and vincristine with either ddI or ddC was well tolerated and evoked antitumor responses in patients with KS; 9-cis-retinoic acid and beta-human chorionic gonadotropin can induce remission of KS lesions; photodynamic therapy is an effective palliative therapy for some people with KS, but doses above 300 joules/cm2 result in scarring; and most American women who die of cervical cancer probably also have HIV infection according to a clinician from State University of New York in Brooklyn. The article concludes with a discussion of the differences between the focus of HIV research and HIV meetings for the ASCO assembly and the AIDS community.
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PMID:Oncologists scout new directions for KS and lymphoma therapies. 1136

The medical care of HIV-positive women needs to be considered. After initial evaluation, HIV-positive women need to have a genealogical evaluation to determine if any conditions are present which may be difficult to treat or may have a more accelerated course. Pap smears should be done again after 6 months and then yearly. If CD4 counts fall below 250, pap smears should be done biannually. An abnormal pap smear could be a sign of a genital tract infection, which can cause cervical inflammation. Vaginal candidiasis, a yeast infection in the genital tract, occurs more frequently in women with lower CD4 counts. Some women may need chronic suppressive pill therapy for candidiasis. Human papillomavirus (HPV) also occurs more frequently in HIV-positive women. HPV infection can cause cervical dysplasia, which can only be diagnosed with a pap smear. Left untreated, certain kinds of HPV infections can lead to cervical cancer. Radical surgery and radiation therapy are the two treatments for cervical cancer. HIV-associated wasting may be related to the menstrual problems connected to HIV (i.e., irregular cycles and no menstruation), but this has not been proven. The treatment for female-specific conditions is not differentiated between HIV-positive and HIV-negative women. There are two large-scale national studies following the course of sexually transmitted diseases in HIV-positive and HIV-negative women.
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PMID:HIV-positive women and their care. 1136 16

Dysplasia, an abnormal development of the cervix, can be caused by the sexually transmitted human papillomavirus. Dysplasia occurs more often in women who smoke or who have nutritional deficiencies. HIV-positive women have a higher risk of developing dysplasia and cervical cancer than those who are HIV-negative. A pap smear can detect abnormal cells in the cervix. HIV-positive women are encouraged to get a pap smear each month. Those with dysplasia can prevent cancerous growths through regular medical attention. Cervical dysplasia can disappear, remain unchanged, or become malignant. Cervical cancer can be removed by biopsy or by hysterectomy.
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PMID:[Prevention and treatment of dysplasia and cervical cancer]. 1136 11

Women make up twelve percent of the AIDS cases in the United States. AIDS research has not been as aggressive for women as it has been for men. Women have different social, psychological, and physiological aspects. An HIV-positive woman must inform her lover of her status for their protection and safer sex methods need to be used. An HIV-positive woman should seek out support groups to find others in similar situations. Stress management is essential. Physically, little is known about the correlation between HIV, menstruation and hormone production. HIV-positive women report increased menstrual irregularities. Researchers are unsure if these irregularities are due to HIV-related hormone changes or drug side effects. Non-prescription medications are available to relieve some discomforts. Regular routine gynecological exams, including Pap smears, are extremely important in detecting early signs of cervical cancer. Pelvic inflammatory disease and its treatment are discussed. During pregnancy, the fetus can contract HIV, as can a nursing baby. Prenatal care is vital. AZT and other studies are discussed. References and a hotline number are provided.
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PMID:[A guide for women with HIV/AIDS]. 1136 39

Early diagnosis and treatment of cervical cancers are essential for all women, particularly HIV-positive women who have a higher incidence of cervical cancer than the general population. The development of screening tools such as PAP smears and colposcopy are described, and treatment options are discussed in detail. Stages of the disease are defined in a table.
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PMID:Cervical cancer screening issues for HIV positive women: a physician's perspective. 1136 48

A study of 268 women in Malawi (116 HIV-positive women, 152 HIV-negative women) found that the HIV-infected women were 3 times more likely to have persistent human papillomavirus infections (HPV), and twice as likely to have cervical abnormalities. Also, the most immunosuppressed women--those with fewer than 300 CD4+ T cells/mm3--were most likely to have persistent HPV infections. Two types of HPV associated with cervical cancer, HPV-16 and HPV-18, accounted for half of the HPV types identified in the study. Other studies have shown that HIV-infected women in the United States and Europe have elevated rates of HPV infection, cervical abnormalities and cervical cancer. This study emphasizes the need to detect and monitor HPV-related cervical lesions.
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PMID:Increased risk of cervical abnormalities among HIV-infected African women. 1136 11


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