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

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

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

We report a case of HIV infection with herpes simplex, syphilis, and condyloma acuminatum in a 66-year-old heterosexual man. The patient was an asymptomatic carrier (group II) of HIV infection. Herpes simplex on his penis was controlled by aciclovir. Secondary syphilis was treated with penicillin G, after which skin lesions disappeared. These four diseases were all sexually transmitted diseases (STD). One should consider the possible existence of other STD in similar cases.
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PMID:Sexually transmitted diseases in a HIV infected patient. 847 96

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

Molluscum contagiosum is common in HIV disease and available therapies have a poor success rate and require frequent clinic visits. Interferon alpha has been used to treat recalcitrant condylomata acuminata and this study was undertaken to assess the use of this treatment in unresponsive molluscum contagiosum. A total of 30 molluscum contagiosum were injected with one megaunit of interferon alpha weekly for 4 weeks; 11 molluscum contagiosum completely cleared and 18 reduced in size by over 50%. Molluscum less than 0.5 cm in diameter, and those in patients without AIDS were more likely to respond. No surrounding lesions changed in size.
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PMID:Intralesional interferon for the treatment of recalcitrant molluscum contagiosum in HIV antibody positive individuals--a preliminary report. 854 17

The aim of the study was to investigate the association between infection with HIV-1 infection and a history of other sexually transmitted diseases (STD). We were able to match 1295 HIV-1 infected patients who attended St Mary's Hospital between 1985 and 1991 with 1273 seronegative controls on gender, sexual orientation, injecting drug use and age at time of test. The cases were 3 times more likely to have a history of ever having had another STD than the controls: multivariate conditional logistic regression showed that, after controlling for sexual behaviour, for known sexual contact with an HIV infected individual or AIDS patient or with a resident from a high HIV prevalence area, area of residence and for year of test, a history of gonorrhoea, syphilis, hepatitis B, genital herpes or genital warts were all significantly associated with HIV-1 seropositive status. These findings reinforce the need for HIV containment strategies to be promoted in conjunction with containment programmes for others STDs.
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PMID:Case-control study of sexually transmitted diseases as cofactors for HIV-1 transmission. 865 8

This study analyzes data on all female sex workers who attended the Sydney Sexual Health Center for a first visit for a sexually transmitted disease (STD) screening during June 1, 1991, and May 31, 1993. International sex workers were identified as women who do not speak English at home and were born outside Australia. Diseases were confirmed clinically, by specimen or culture or by antibody or serological tests. Results apply to 91 local and 123 international prostitutes. 47% of international prostitutes and 34% of local prostitutes were aged 21-25 years. Most international sex workers spoke Thai or a Chinese dialect. 10% of local prostitutes were born in Asia. 90% of international prostitutes were born in Thailand, Malaysia, or China. Local prostitutes were better educated. 7% of the local prostitutes and none of the international sex workers had a history of injectable drug use. Local prostitutes tended to use condoms for birth control, and international prostitutes tended to use oral contraceptives. One international prostitute tested HIV positive. 1 in 7 international prostitutes had gonorrhea and the same proportion had chlamydia. Viral STDs (chronic hepatitis B, HIV infection, and genital warts) were more prevalent, but uncommon among international prostitutes. More international prostitutes had multiple STDs. 79 international sex workers and only 9 local sex workers had an STD. 47% of international sex workers and only 10% of local sex workers had worked overseas as a prostitute in the preceding 12 months. Over half of local sex workers and only 8% of international sex workers consistently used condoms. Failure to use condoms was associated with being an international sex worker. Inconsistent use of condoms among local prostitutes was related to increased age.
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PMID:Sexual health and use of condoms among local and international sex workers in Sydney. 865 67

It has long been recognized that sexually transmitted diseases (STDs) may occur concurrently hence necessitating screening in individuals attending Genito-Urinary Medicine (GUM) clinics. However there are few data on individuals with more than one concurrent STD. Individuals attending the GUM Department in the Royal Infirmary of Edinburgh between 1990 and 1994 with the diagnosis of HIV infection, genital warts, genital herpes, non-specific genital infection (NSGI), gonorrhoea and syphilis were included in the study. A multivariate comparison was made between those presenting with multiple concurrent STDs and a control group comprising individuals with a solitary STD with respect to year of attendance, social class, location of acquisition of infection, sex, sexual orientation and age using a logistic regression model. A total of 680 of 9265 patients in the study period had more than one concurrent STD. Individuals in lower socio-economic class were at higher risk and older individuals at lower risk of multiple concurrent STDs. Multiple sexually acquired infections are common in individuals who attend GUM clinics. Age and socio-economic class were the only significant variables. Identification of populations at highest risk for multiple infection can direct interventions against all STDs.
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PMID:Characterizing patients with multiple sexually acquired infections: a multivariate analysis. 889 26

During August-October 1995, in northern Thailand, laboratory personnel examined 7594 condoms from 4734 client visits and 5040 sexual acts to evaluate mechanisms of condom breakage and slippage among 68 female commercial sex workers (CSWs) (mean age, 25 years) in 7 brothels in Lamphun City in Lamphun Province in order to verify condom use self-reports among the CSWs and to identify targets for interventions to reduce condom failure. Sexually transmitted disease (STD) episodes in the last year among the CSWs were gonorrhea (45.6%), pelvic inflammatory disease (29.4%), genital ulcer (29.3%), syphilis (13.2%), nongonococcal cervicitis (13.2%), and genital warts (8.8%). A condom was not used during 0.6% (30) of the sexual acts. 99.4% (5010) of the sexual acts involved use of at least one condom. There were only 5 condom slippage events--a condom slippage rate of 0.1%. This rate did not vary with the number of condoms used per sexual act. On the other hand, the condom breakage rate decreased as the number of condoms used per sexual act increased (1 condom = 1.8%; 2 condoms = 0.2%; 3-4 condoms = 0). Single condom use was more likely to yield breakage than multiple condom use (odds ratio [OR] = 11.4). The condom breakage rate 1 year after initiation of the 100% Condom Campaign (1992) was 5.9% compared to 1% in 1995. Condom breaks occurred just below the reservoir (40.2%), at reservoir tips (31.7%), along the shaft (18.3%), and at the base (9.8%). Multiple condom use increased from 2.8% to 50.4% during 1992-95. Factors independently associated with condom breaks included high-intensity (rough) sex (OR = 8.49; p 0.0001), more than one sexual act with the same client on the night of the breakage (OR = 2.72; p = 0.02), and sexual service after midnight (OR = 2.58; p = 0.03). These findings suggest that multiple condom use significantly contributed to the decline in condom breakage among multiple users. Another strong possible factor was greater skill in condom use by CSWs and by clients in response to the 100% Condom Campaign. Multiple condom use may reduce exposure to HIV-1 and other STDs.
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PMID:Multiple condom use and decreased condom breakage and slippage in Thailand. 905 27

Human papillomaviruses (HPVs) cause benign tumors (i.e., warts) and are occasionally responsible for malignant tumors such as squamous-cell carcinomas. Therapy for most warts is commonly via surgical or cytodestructive methods. Presently, only one antiviral/immunomodulatory drug is available for wart therapy; this agent, interferon alpha (IFN alpha), is approved only for genital warts (condylomata acuminata) and is expensive, relatively difficult to use, associated with systemic side effects, and somewhat slow acting. Two new antiviral/immunomodulatory drugs, imiquimod and cidofovir, have been proved to be effective and able to overcome many of the shortcomings of IFN alpha. While these two agents are pending approval, other treatments are being evaluated, such as antisense oligonucleotides and therapeutic HPV vaccines. In contrast to surgical and cytodestructive therapies, the goal of these new antiviral/immunomodulatory agents is not just to remove the tumor but also to reduce sufficiently the amount of latent and subclinical HIV so as to reduce the rate of recurrence.
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PMID:Therapeutic approaches to papillomavirus infections. 909 42


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