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

Travel to tropical countries is an important factor in the spread of sexually transmitted diseases. In spite of intensive anti-AIDS campaigns, some 30% of Swiss tourists have casual sexual contacts abroad. The prevalence of sexually transmitted diseases is higher in tropical countries than in western industrialized countries. More than 25% of cases of gonorrhea treated in Switzerland from 1989-1991 were imported from abroad. The penicillin producing Neisseria gonorrhoeae strains (PPNG) isolated in Switzerland from 1989-1991 are mainly imported from abroad (60%). The typical "imported sexually transmitted diseases" in Switzerland are chancroid, lymphogranuloma venereum and donovanosis. The clinical manifestations, laboratory and special examinations, and treatment of these diseases are described. The most frequent sexually transmitted disease from the so-called "imported tropical STD's" is chancroid. Chancroid is also a major risk factor for HIV infection.
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PMID:[Sexually transmissible diseases following travel in tropical countries]. 832 73

Haemophilus ducreyi, the causal organism of chancroid, has increased in significance recently due to its association with HIV transmission. Most previous typing systems have exploited phenotypic characteristics. Detection of ribosomal RNA cistrons, ribotyping, was successfully developed to examine H. ducreyi, but required the use of 32P. We have used digoxigenin to define ribotypes from 30 strains of H. ducreyi from diverse geographical locations. This was achieved by agarose gel electrophoresis of restriction enzyme (RE) digested DNA extracts. These extracts were vacublotted onto nylon membrane and probed using digoxigenin labelled complementary DNA probe, prepared from Escherichia coli 16S and 23S ribosomal RNA. From 19 REs tested, Ava II, Hinc II, Bgl II and BstE II gave clear ribotypes. The ribotypes of BstE II and Bgl II used together gave the highest index of discrimination (D = 0.95), 16 types, and showed good reproducibility. This non-radioactive method demonstrates the three important features of a typing system; discrimination, typability and reproducibility.
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PMID:Non-radioactive ribotyping of Haemophilus ducreyi using a digoxigenin labelled cDNA probe. 838 96

Modern international travel contributed greatly to the global AIDS pandemic. About 500,000 Australians have sexual intercourse in the Philippines and Thailand annually. Many do not practice safer sex. A significant potential means of HIV entering the Australian heterosexual population is unprotected intercourse with prostitutes in Southeast Asia. The median HIV prevalence rate in female prostitutes in Thailand is 15%. Other sexually transmitted diseases (STDs) also pose a risk to Australian travelers. In 1991, in Victoria, 44% of gonorrhea cases were heterosexual males who had acquired gonorrhea abroad. Sex workers transmitted gonorrhea to 68% of these cases. A history of gonorrhea or chancroid increases the risk of HIV transmission. Other cofactors of HIV transmission are genital warts and genital herpes, both of which are common in Australia. Various types of men have taken great risks overseas, which places their partners at risk when they return. Since it is not easy to identify the type of persons who places himself at risk when abroad, physicians should discuss sexual risks with any patient who plans to travel overseas or who has returned. Women experience more severe consequences of STDs (e.g., pelvic inflammatory disease) than men because they are more likely to be asymptomatic in the early stages. Women should know that the risk of HIV transmission is high in Africa, Southeast Asia, and some areas in the US. Physicians should know behavioral risk factors (e.g., heavy drinking or drug use). They should remind homosexual men to practice safer sexual practices abroad, even though they may be better informed than heterosexual men. Physicians need to tell travelers that a prostitute is having a health certificate does not guarantee that she does not have STDs or HIV. Further, a healthy appearance does not equate STD-free status. Travelers should carry condoms with them. Physicians should refrain from prescribing prophylactic antibiotics to minimize antibiotic resistance.
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PMID:STDs and the overseas traveller. 844 79

Fleroxacin was prescribed to treat both HIV-negative and HIV-positive men with proven chancroid in an open study. HIV-negative men were treated with a single 400-mg dose of fleroxacin, and HIV-positive men were treated with 400 mg daily for 5 days. Three of the 58 evaluable HIV-negative men were clinical and microbiologic failures, and two of the 22 evaluable HIV-positive men had persisting infection with Haemophilus ducreyi. Both regimens were well tolerated. Fleroxacin is an acceptable alternative to existing treatment regimens for chancroid in men.
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PMID:Fleroxacin in the treatment of chancroid: an open study in men seropositive or seronegative for the human immunodeficiency virus type 1. 845 88

Patients with sexually transmitted diseases (STD) are especially vulnerable to HIV infection. 355 heterosexuals with multiple partners, 6 homosexuals, and 238 female sex workers with STDs in Bombay were surveyed serologically to determine the extent to which HIV-1 may be disseminated within their subpopulation. ELISA and Western blot test results found that the seroprevalence of antibody to HIV-1 increased from 1.3% in 1987 to 5.3% in 1988 and 7% in 1989. The increase in seropositivity occurred among both sexes and was maximally associated with condylomata acuminata, genital herpes, and chancroid. These findings clearly indicate the HIV-1 is established in this population and urgently needs to be controlled.
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PMID:Human immunodeficiency virus-1 infection among patients with sexually transmitted diseases in Bombay. 845 53

WHO estimates 250 million new cases worldwide of sexually transmitted diseases (STDs) each year. STDs of growing concern are chlamydial infections responsible for pelvic inflammatory disease (PID) in women and pneumonia and ophthalmia in newborns, and incurable viral infections, including Herpes simplex virus, human papilloma virus (HPV), hepatitis B virus, and HIV infection. HPV types 16 and 18 are associated with cervical intraepithelial neoplasia, one of the most serious complication of STDs. PID is another serious STD complication because it tends to recur and causes chronic abdominal pain, eventually resulting in hysterectomy, infertility, ectopic pregnancy, or chronic backache. STDs adversely affect pregnancy, often leading to ectopic pregnancy, stillbirth, prematurity, congenital and perinatal infections, and puerperal maternal infections. Genital ulcer diseases, e.g., chancroid, facilitate HIV transmission. HIV infection boosts the virulence of STD pathogens, e.g., Herpes simplex virus. Many people with STDs are asymptomatic and the clinical profile of STDs is always in flux, thus resulting in less than optimal case detection. Obstacles of STD treatment include antibiotic resistance of betalactamase-producing Neisseria gonorrhoea strains and the immunocompromising effect of HIV infections. Tourists are responsible for introducing HIV infection into many countries. Some countries (e.g., Saudi Arabia) require a negative HIV test before foreigners can work in those countries. Health resources are not keeping up with the spread of STDs and HIV. Governments should embark on health education campaigns to stem the spread of HIV. They should also integrate AIDS prevention with the control of other STDs.
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PMID:Sexually transmitted diseases in the age of AIDS. 847 83

Data derived from laboratory and activity statistics of the Venereal Disease" department of the Public Health Office in Bremen were analysed between 1961 and 1991. The traditional concept to fight venereal diseases" aimed at controlling persons "at risk" for syphilis, gonorrhoea, chancroid or lymphogranuloma. This "high-risk" approach of STD prevention stressed the compulsory, at least twice monthly screening of female prostitutes and neglected other population groups like clients of prostitutes and young people, who might have an elevated risk in acquiring STD. The spread of STD like chlamydia, HPV, herpes and even HIV in considerable parts of the general population underlines the need for developing a more effective STD prevention, based on scientific diagnosis and treatment. Intervention programmes in STD control must be performed in full partnership with the targeted population; this can require great effort and time. But STD control certainly cannot be achieved under the threat of punishment or proscription.
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PMID:[Prevention of sexually transmitted diseases or control of prostitutes and patients with venereal diseases? An exemplary, epicritical study in Bremen]. 850 94

Malawi is one of the countries that has been most affected by the HIV epidemic with an estimated national HIV seroprevalence rate of 10% in the age group over 15 years and 32% among pregnant women who attended prenatal clinics in Blantyre in 1993. Queen Elizabeth Central Hospital (QECH) is the district hospital in Blantyre, Malawi, and the tertiary referral hospital for Malawi's southern region. About 11,000 patients were admitted there in 1993. The aim of this cross-sectional study was to determine the prevalence of sexually transmitted diseases (STDs) in inpatients under general medical care in view of the limited examination facilities in the wards. All patients who were in the general medical wards on June 23, 1994, were enrolled for the study. After obtaining informed consent, external genital lesions were identified visually noting the presence of ulcers, warts, and urethral discharge in men. The patients' case notes were reviewed to identify those with known current STDs. A total of 123 patients were examined: 62 males (age range 20-90 years) and 61 females (age range 16-65 years). There were 6 (9.7%) males vs. 8 (13.1%) females with discrete ulcers; no males vs. 2 (3.3%) females had nondiscrete ulcers; 3 (4.8%) males and 6 (9.8%) females had genital warts; 6 (9.7%) males had urethral discharge; and 13 (21%) males vs. 14 (23%) females had one or more lesions. One man had Kaposi's sarcoma of the glans penis. The survey showed that STDS are common in general medical patients in Blantyre with an overall prevalence of 22%. This percentage is an underestimate given the fact that the limited facilities precluded the diagnosis of trichomoniasis, gonorrhea, and chlamydia in women. Of the 123 patients, 14 (11.4%) who had discrete genital ulcers received treatment with erythromycin and penicillin to cover the main possible causes (chancroid, syphilis, and lymphogranuloma venereum). In view of the known link between STDs and the risk of HIV transmission, treatment of STDs may be more effective in preventing sexual transmission of HIV.
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PMID:Prevalence of genital infections in medical inpatients in Blantyre, Malawi. 852 42

To explore a possible association between bacterial vaginosis and human immunodeficiency virus (HIV) infection, 144 consecutively enrolled commercial sex workers from a sexually transmitted disease clinic (STD) in Chiang Mai, Thailand, were interviewed and underwent serologic testing and genital examination. 62 (43%) of sex workers were HIV-positive. A self-reported history of syphilis, chancroid, herpes, gonorrhea, or Chlamydia was significantly associated with HIV infection. Bacterial vaginosis, detected in 49 (34%), was also associated with HIV infection. Sex workers reporting 10-19 and 20 or more sexual encounters per week were 2.2 and 3.5 times, respectively, more likely to be infected with HIV than those reporting under 10 encounters. A clinically established diagnosis of bacterial vaginosis was independently associated with HIV seropositivity even when age, number of sexual encounters per week, current condom use, and past and current STD infection were controlled (odds ratio, 4.0; 95% confidence interval, 1.7-9.4). When the bacterial vaginosis diagnosis was based on Gram stain (score 7-10), however, the association with HIV seropositivity disappeared, but having abnormal vaginal flora (gram stain score 4-10) was related to HIV status. Further epidemiologic studies are recommended to investigate the possibility that bacterial vaginosis--the most prevalent genital infection in Thailand--acts as a cofactor for the heterosexual transmission of HIV.
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PMID:Bacterial vaginosis and HIV seroprevalence among female commercial sex workers in Chiang Mai, Thailand. 852 84

During November-December 1992, in Madras, India, interviews were conducted with 84 public and private physicians who treated at least five sexually transmitted disease (STD) patients each week in Royapuram, Washerman, Evr High Road, T. Nagar, and Adyar regions of the city. Field workers also observed 108 medical consultations of 48 of the physicians interviewed. Researchers aimed to use the findings of this baseline survey to optimize STD services in order to reduce the population at risk of HIV/AIDS. 61% of the physicians interviewed made specific clinical diagnoses. 17% made only syndrome-based diagnoses. 22% used both types of diagnoses. 48% used a treatment effective against the two main pathogens for male urethritis, Neisseria gonorrhoeae and Chlamydia trachomatis. 20% used a treatment that was not effective against either of these pathogens. Only 12% used a treatment effective against chancroid and syphilis for men with genital ulcers. 29% did not use a treatment effective against chancroid or syphilis. For female genital ulcers, only 10.7% of physicians used an effective treatment against chancroid or syphilis. 21.4% provided treatment effective against neither chancroid nor syphilis in female STD patients with genital ulcers. 79% claimed to counsel their STD patients to use condoms, but only 30% were observed actually promoting condoms for STD or HIV/AIDS prevention. Physicians instructed only 6% of STD patients how to use condoms. Condoms were given to only one STD patient. These findings highlight the need for physicians and other health care providers to adopt the syndromic approach to STD treatment and for developing and evaluating innovative and effective programs of patient education in order to reduce the risk of HIV infection.
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PMID:Sexually transmitted disease services in Madras: could their role in AIDS prevention be strengthened? 869 Apr 98


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