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

Surveillance systems have been developed in Victoria to determine trends in sexually transmissible diseases (STDs). Notifications to the Health Department (including laboratory notification since May 1990) have been supplemented by data about strains of Neisseria gonorrhoeae and cultures for Chlamydia trachomatis processed by the Microbiological Diagnostic Unit, enhanced laboratory surveillance of syphilis, and data on genital herpes and genital warts from the Melbourne Sexual Health Centre. During the period under review the incidence of gonorrhoea declined, rapidly at first, and then more slowly. For women, this trend has continued, while gonorrhoea acquired abroad by men has become relatively more important. Since 1988, gonorrhoea in homosexual men has increased, and rectal isolates have increased concurrently, raising concerns about HIV risk behaviour. Cases of syphilis are likely to be ascertained through STD, antenatal and refugee screening, rather than because of symptoms or contact tracing. Chlamydia is a the most common notifiable STD, despite underreporting and underdiagnosis. In 1991, 832 cases were notified, increasing to 1377 in 1992. In 1992, of the 73 cases (65 per cent of notifications) where the doctor identified a risk, 15 per cent was attributed to homosexual contact, and 27.4 per cent to heterosexual exposure. Limitations in the data include inadequate standard case definitions for many STDs, changes in the statutory requirement for notifications in 1990, underreporting, changes in diagnostic and screening patterns, and lack of detailed demographic data. Education of general practitioners is needed to improve diagnosis and notification of chlamydia.
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PMID:Surveillance for sexually transmissible diseases in Victoria, 1983 to 1992. 764 73

This paper describes the establishment of Genito-Urinary Medicine outreach clinics based in 2 drop-in centres for female prostitutes in Edinburgh; 242 women have received medical care at these outreach clinics. STD screening has been carried out on 160 (63%), detecting one case of gonorrhoea, 11 cases of chlamydia, 11 cases of genital warts, and 2 cases of recurrent genital herpes. With regards to HIV serostatus, 8 women were already known to be HIV seropositive and 18 were known to be seronegative. One hundred and fifteen women have been tested at the outreach clinics, yielding one positive result. The serostatus of 91 women is unknown. There have been 42 pregnancies, some of which were conceived through client contact. The prevalence of STDs including HIV is low and would suggest that condom usage is high. However, this level of usage is associated with significant numbers of unwanted pregnancies. Prostitutes in Edinburgh do not appear to act as a significant focus for dissemination of HIV infection.
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PMID:Outreach STD clinics for prostitutes in Edinburgh. 764 23

In northern Thailand, baseline interviews with and blood testing for syphilis and HIV-1 antibodies of military conscripts were conducted during May-November 1993. Researchers also examined conscripts discharged in April 1993. They interviewed and tested a total of 2047 men. 134 men (6.5%) had had at least one male sex partner. (These men are referred to as MSM.) Only 4 (2.9%) had had sex with only men. The remaining 130 (97.1%) had also had female sex partners. The 134 MSM men were more likely than heterosexual men to be married (odds ratio [OR] = 2.67) and to have a girlfriend with whom they had sex (OR = 1.6). They were also more likely than heterosexual men to have ever had any sexually transmitted disease (STD) (OR = 2.71), gonorrhea (2.05), syphilis (OR = 3.17), nongonococcal urethritis (OR = 4.54), penile discharge with pus (OR = 2.47), watery penile discharge (OR = 6.24), and dysuria (OR = 2.43). The overall HIV prevalence was 12.1% (247 men). MSM men were only somewhat more likely to be HIV infected (PR = 1.51). MSM men with more than one male lifetime partner were significantly more likely to be infected with HIV than those with only one male partner (OR = 2.89). Same-sex behavior was more common among discharged men who had returned to civilian life than those were still in the military (9.3% vs. 6.5%). Discharged bi/homosexual men was the only group of Royal Thai Army current or former conscripts in which sex with men was independently associated with HIV infection (27.3% vs. 12.4% for HIV-infected heterosexual former conscripts; OR = 2.54). Among all subjects, HIV infection was associated with ever visited a female commercial sex worker (OR = 4.16) and ever had any STD (OR = 5.47), gonorrhea (OR = 3.08), syphilis (OR = 3.81), genital herpes (OR = 3.54), genital warts (OR = 3.56), and genital ulcer disease (OR = 5.59). These findings show that MSM in Northern Thailand are at high risk of STDs and HIV. HIV/STD prevention efforts should target all young Thai men and try to change high risk sexual practices.
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PMID:Same-sex behavior, sexually transmitted diseases and HIV risks among young northern Thai men. 771 88

Forty-two Tanzanian patients with genital warts were treated with 0.5% podophyllotoxin solution (Wartec) for 3 days. Thirteen patients (30.9%) were cured and a further 7 patients (16.7%) had more than 50% of lesions cleared at 6 weeks, while 19 patients were resistant to treatment. Three patients had a recurrence of lesions after an initial response. Thirty-three patients were tested for serological evidence of infection with human immunodeficiency virus (HIV) and 15 (45.5%) patients were shown to be HIV-1 antibody positive. The response to treatment was analysed in relation to HIV antibody status. The cure rate was significantly higher in HIV seronegative patients (8/18 = 44.4%) compared to HIV seropositive patients (1/15 = 6.7%) (P = 0.018). We conclude that podophyllotoxin treatment provides a useful non-hospital based treatment for genital warts, but HIV infection appears to contribute to the failure of treatment for genital warts.
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PMID:Response to podophyllotoxin treatment of genital warts in relation to HIV-1 infection among patients in Dar es Salaam, Tanzania. 777 23

During mid-1987 to mid-1988 and mid-1990 to mid-1991, researchers conducted cross sectional serological surveys at the STD clinic in Port of Spain in Trinidad to examine trends in HIV-1 prevalence among 2019 and 1606 STD patients, respectively. They also conducted a case control study of risk factors for HIV-1 infection among heterosexual STD patients (131 cases and 173 age- and sex-matched controls) in 1992-1993. Between 1987-1988 and 1990-1991, HIV-1 seroprevalence increased markedly (3% to 13.6%). It increased more in women than in men (9- vs. 4-fold). During 1987-1988, men were more likely to be infected with HIV-1 (odds ratio [OR] = 3.1), but by 1990-1991, gender was no longer a significant risk factor (OR = 1.3). In 1990-1991, significant risk factors for HIV-1 infection were urban residence (OR = 2.2), HTLV-1 infection (OR = 3.1), and being at least 40 years old (OR = 1.8). None of these risk factors were significant in 1987-1988. HIV-1/HTLV-1 coinfection increased between the two surveys (0.05% to 1.5%). Significant independent HIV-1 risk factors in men identified in the case control study were: used crack cocaine in the past 6 months (adjusted OR [AOR] = 6.2; p = 0.0001); ever had anal sex (AOR = 7.2; p = 0.003); ever had syphilis (AOR = 3.2; p = 0.02); current genital ulcer disease (AOR = 5.2; p = 0.0001); and current genital warts (AOR = 3.9; p = 0.02). Significant independent HIV-1 risk factors in women were: less than 14 years old at first sex (OR = 4.8; p = 0.01); ever been a commercial sex worker (AOR = 5.7; p = 0.02); and ever had nongonococcal cervicitis (AOR = 4.1; p = 0.005). These findings suggest that sexual exposure to HIV-1 through ulcers for men and inflammatory STD and/or prostitution for women, all fueled by the crack cocaine epidemic, account for much of HIV-1 exploding in Trinidad. Public health interventions to prevent, detect, and treat STDs and crack cocaine addition may greatly reduce HIV-1 transmission.
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PMID:HIV-1 prevalence and risk factors among sexually transmitted disease clinic attenders in Trinidad. 779 44

A cohort of human immunodeficiency virus (HIV)-infected (n = 253) and uninfected (n = 658) women was prospectively studied to assess the relationship between venereal warts and HIV status, adjusting for self-reported and biologic measures of sexual risk behavior. Participants were assessed every 6 months for venereal warts and other sexually transmitted diseases, self-reported sexual behavior, and CD4 cell counts. The incidence of venereal warts was significantly increased in HIV-infected women (8.2 vs. 0.8/100 person-years of follow-up). This difference remained after adjusting for measures of high-risk sexual behavior and was observed in women at all levels of immune function, including those with > or = 500/mm3 CD4 cells. The increased risk of venereal warts in HIV infection can occur relatively early in HIV disease and appears chiefly attributable to a higher risk of progression from subclinical to clinical human papillomavirus (HPV) disease rather than to a higher risk of HPV acquisition.
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PMID:Incidence of venereal warts in human immunodeficiency virus-infected and uninfected women. 779 19

Women attending the Queen Elizabeth Central Hospital in Blantyre, Malawi, between November 1989 and October 1993 were studied as part of a longitudinal cohort study of mother-to-infant HIV transmission. 694 HIV-seropositive and 687 HIV-seronegative women were enrolled at delivery. In the follow-up phase, women attended the clinic every 3 months for the first 24 months and every 6 months thereafter, where they were administered a questionnaire and underwent pelvic exam for the diagnosis of sexually transmitted diseases. HIV testing was performed by ELISA and Western Blotting. A nested case-control study was performed to identify risk factors for HIV seroconversion, and for each seroconverter, 2 seronegative women were selected. A total of 43 women seroconverted in the follow-up period. The rate of new HIV infection increased in the first 24 months postpartum. Postpartum rates were 1.42, 1.70, 2.43, and 4.33 per 100 person-semesters, respectively, in each of the first 4 semesters, which corresponded to annual seroconversion rates of 2.84 per 100 person-years in the 1st year and 6.66 in the 2nd year postpartum. Only 2.2% of the women reported sexual contact in the first 6 weeks postpartum, increasing to 57.6% in the period of 6 weeks to 6 months and to 86.5% in the period 7-12 months postpartum. Univariate analysis indicated the largest risk factor for HIV seroconversion as reported condom use (odds ratio [OR] = 5.67). Other factors included young age and low parity (OR = 2.90 and 2.77, respectively), a short interval between the birth of the study infant and a subsequent conception (OR = 4.20), and vaginal infection with Trichomonas vaginalis (OR = 3.4). Other factors with nonsignificant association with HIV seroconversion included: 1) genital ulcerations with a fourfold higher risk, 2) visible genital warts with a threefold increase, 3) hormone-containing contraceptives and cervical ectopy (OR = 1.13 and 1.07, respectively), and 4) vaginal irritants. Syphilis, cervical human papilloma virus, and cervical gonococcal infection were not associated with HIV seroconversion.
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PMID:Preparations for AIDS vaccine evaluations. Rate of new HIV infection in a cohort of women of childbearing age in Malawi. 786 10

We report on three HIV-infected homosexual male patients with atypical manifestations of mollusca contagiosa (MC). Their clinical presentation mimicked sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata. HIV-infected patients feature MC with atypical morphology in about two thirds of the cases. The atypical aspects of MC concern the localization, morphology, growth pattern and size of the lesions. MC is a late manifestation of HIV infection and mirrors marked cellular immune deficiency. We conclude that in HIV-infected patients all tumorous lesions should be biopsied because the clinical characteristics are often not specific enough for a definite diagnosis.
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PMID:Molluscum contagiosum mimicking sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata in HIV-infected patients. 787 28

In Nigeria, the sexually transmitted disease clinic staff at the hospital of the University of Ibadan collected 153 urethral, vaginal, and endocervical samples from 116 patients between November, 1991, and November, 1992, so researchers could isolate, identify, and type the herpes simplex virus (HSV). They used the complete fixation test and the indirect immunofluorescent antibody technique to confirm HSV. The patients also had genital herpes (31.6%), Neisseria gonorrhoeae urethritis (15.8%), nonspecific urethritis (15.8%), candidiasis (21%), genital warts (10.5%), and trichomoniasis (1%). No one had syphilis. The laboratory staff isolated HSV from only 7 samples (4.6% of all samples). All 7 isolates were from males (genital ulcer and urethral samples). Five of the isolates were HSV-2 and 2 were HSV-1. This study was the first documented isolation of HSV in Nigeria. These findings provide baseline data on genital herpes for projected studies. Further research should examine the significance of these findings for other areas, particularly HIV transmission and immunocompromised patients.
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PMID:Isolation of herpes simplex virus from sexually transmitted disease patients in Ibadan, Nigeria. 797 67

In India, staff at the National Institute of Virology used the anti-HIV-1 antibody ELISA to conduct primary screening of blood samples from 63 men, 19-46 years old, who engaged in oral and anal intercourse with men (56 homosexuals and 7 bisexuals), who were attending 2 sexually transmitted disease (STD) clinics in Bombay over a 6-month period. Researchers wanted to determine the prevalence of HIV-1, HIV-2, or dual HIV-1 and HIV-2 infections among sexually active men who had sex with men. The Western blot test confirmed ELISA results. Staff used line immunoassay to distinguish between HIV-1 and HIV-2 infection. Ten samples reacted to ELISA for HIV-1 infection and were confirmed to be HIV-1 positive by Western blot. The 3 samples that were borderline reactive by ELISA were reactive to HIV-2 by line immunoassay. Both HIV-1 and HIV-2 infection were identified in 2 samples. Clinically-diagnosed STDs among the 63 men were: condylomata acuminata (22), herpes (20), gonorrhea (15 confirmed by gram stains of urethral smear), candidiasis (3), and syphilis (3). HIV infection was particularly common in men with condylomata infection (12 or 92.3% of all HIV-positive cases). These findings show that, even though heterosexual transmission of HIV is the most common transmission mode in India, homosexual transmission is rather frequent in a large city.
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PMID:Detection of human immunodeficiency virus antibody among homosexual men from Bombay. 797 77


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