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

HIV infection creates difficulties for patients and staff in drug abuse treatment programs. This article reviews significant problems and coping strategies, drawing on experience in a drug abuse treatment program where a third of the patients are HIV infected. Patient-related problems include denial, anger, depression, and isolation. The coping strategies that patients use can exacerbate their illness. Effective coping strategies may involve the development of mutual-support groups and public education. Staff-related problems include the fear of infection, protecting confidentiality, the need to develop new treatment goals, and recognizing the limitations of drug abuse treatment. To lessen the fears of infection, programs can exercise clear body substance precautions, conduct frequent inservice training, and hold periodic updates for staff. To adequately protect confidentiality, programs can keep up with rapidly changing laws and guidelines. To modify treatment goals, programs can alter admission standards for HIV-infected patients, change treatment methods to minimize the impact of occasional relapses, develop medical referral networks, and give special consideration to counselors who treat HIV-infected patients. To cope with the limitations of drug abuse treatment, programs can support counseling staff in coping with emotionally stressful clinical problems and to avoid burnout.
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PMID:Coping with AIDS: strategies for patients and staff in drug abuse treatment programs. 262 17

The authors administered the Center for Epidemiological Studies Depression (CES-D) Scale to 4,954 homosexual men in the Multicenter AIDS Cohort Study. HIV antibody status at enrollment was a less important predictor of psychological distress than were reported physical symptoms. Multivariate analysis showed an association between a high score on each CES-D Scale component and the number of self-reported possible AIDS- or HIV-related symptoms, perceived lymphadenopathy, and absence of "someone to talk to about serious problems." This relationship between self-reported physical symptoms and psychological distress suggests a possible etiologic relationship between perceived AIDS risk and psychological symptoms in men at risk of AIDS.
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PMID:HIV-related symptoms and psychological functioning in a cohort of homosexual men. 265 26

Since the first case of AIDS in the United Kingdom was described in 1981 (1), there have been up to October 1988, 1794 AIDS cases reported, of whom 965 are dead and 8794 individuals known to be Human Immunodeficiency Virus (HIV) seropositive (2). In fact the actual number of seropositive individuals is likely to be far greater than this figure. A recent study of an HIV seropositive cohort suggests that the majority of individuals infected with HIV will eventually develop AIDS (3). Most of the cases in the U.K. have occurred in homo- or bisexual men, and the pattern of disease in the U.K. closely follows that of the epidemic in the United States. The association between AIDS and infection with HIV was demonstrated in 1983-4 (4,5) and HIV induced damage to the immune system with profound depression of cell mediated immunity is responsible for many of the manifestations of this extraordinary new disease (6). As the lung is the most frequently affected organ in AIDS (7), and as case numbers are likely to increase in the U.K., if the epidemic trend continues, Respiratory Physicians in the U.K. will be increasingly involved in the management of these patients. The purpose of this review is to highlight some of the diagnostic problems encountered in AIDS patients with lung disease.
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PMID:Diagnostic problems in AIDS and the lung. 268 52

Four patients with solid genito-urinary tumors and HIV 1 infection have been treated in our institution over the last 2 years, including 2 with seminoma, 1 with renal adenocarcinoma and 1 with renal angiosarcoma. All had severely impaired immunity with a low CD4 level. Three had or developed a true AIDS syndrome according to the WHO and CDC criteria (1988). The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma, he is the first reported case of renal sarcoma in a patient infected with HIV 1. Two patients were homosexuals and the other 2 were drug addicts. Along with other reported cases, our cases may underline the association between depression of immunity due to HIV and onset of solid genito-urinary tumors.
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PMID:[Urogenital tumors and HIV-1 infection]. 274 46

In 23 out of 227 patients with positive serological tests for the human immunodeficiency virus (10%), seen between June 1987 and May 1988, lingual lesions of hairy leukoplakia (HL) were found. HL was present in 16/188 drug abusers (9%) and in 7/19 homosexuals (32%). In 3 cases HL was the only clinical manifestation of disease, in 11 it was associated with other symptoms of acquired immunodeficiency syndrome related complex (ARC), and in 9 it was found in patients with a previous or concomitant diagnosis of acquired immunodeficiency syndrome. The mean count of CD4 lymphocytes in the 23 patients was 0.22 X 10(9)/l. The diagnosis was made on the basis of the characteristic clinical features. In 3 cases biopsy was carried out, and parakeratosis and vacuolization of the spinous layer cells were found. Remarkably, particles of the herpesvirus group were also found. The lesions oscillated in size or even spontaneously disappeared, at least transiently; however, in the patients treated with zidovudine the improvement appeared to be more significant. The detection of HL discloses a likely infection by the HIV; it is usually associated with other features of ARC and/or severe immune depression, and it requires the institution of antiretroviral treatment.
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PMID:[Hairy leukoplakia: a new disease of the oral mucosa associated with infection by the human immunodeficiency virus]. 274 11

This study was concerned with the emotional reaction of men who are HIV antibody positive, and with whether their expression of enjoyment is better viewed as the result of rigid defending or flexible coping. A sample of these men was matched with samples of patients with other major illnesses and well controls. Enjoyment was found to be more frequently expressed in the two ill samples, as were anxiety, depression and helplessness. The HIV antibody positive patients expressed more anger, and yet more competence, than the other patients. These patterns of emotional reaction proved to be modified by different levels of enjoyment in a manner more indicative of coping than defending, because depressive emotions appeared to be reduced when some enjoyment of life was apparent. The implications of these findings for health professionals working with people who are HIV antibody positive are discussed.
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PMID:The emotional reactions of HIV antibody positive men. 275 44

To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample.
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PMID:Motor slowing in asymptomatic HIV infection. 276 96

Using structured interviews and the SCL-90R, study was made of the behaviors of 29 applicants to a residential treatment program for cocaine abuse who had been placed on the program's waiting list for periods ranging from 1 to 6 months. It was hypothesized that applicants waiting treatment for 3 months or less (N = 16) would be more likely to view themselves as treatment candidates and would show behaviors different from those waiting 4-6 months (N = 13). Being on the waiting list a longer period was associated with greater evidence of criminal justice involvement, but with few other differences. Nearly half the total sample (48.3%) reported having significantly reduced drug use in association with their applying for treatment, but most applicants (58.6%) were pessimistic about their long-term capacity to remain free of drug-related difficulty. The pattern of SCL-90R scores for all subjects suggested significant psychiatric symptoms, including depression. Nonetheless, a majority of all applicants (51.7%) reported themselves as having become less interested in entering treatment. Nearly all applicants reported high levels of encouragement for their decision to enter treatment from persons with whom they were living and about half reported encouragement from friends. Of the 23 applicants who were IV drug users, 10 (41.7%) reported knowing someone who had contracted AIDS, 87.0% reported having changed behaviors--chiefly needle sharing--to reduce the risk of infection, and 69.6% reported having obtained HIV testing. The difficulty encountered in locating a random sample of applicants suggests the problem of maintaining a useful waiting list for treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The functioning of individuals on a drug abuse treatment waiting list. 276 83

This paper describes a method of psychosocial counseling that was used with HIV-infected patients in Lusaka, Zambia between February to August 1987 which aims to enable HIV patients to avoid behaviors that would damage their own health, minimize further HIV transmission, and prolong period of asymptomatic infection and life expectancy. The study population was composed of 130 patients (either asymptomatic, with AIDS-related complex or AIDS). The protocol included providing patients with factual information about HIV infection, understanding the concept of their illness, teaching the need to change sexual behavior, reduce alcohol intake, prevent stress, and adjust to family changes. Although all the patients stated that they had heard about AIDS, more than 90% and 60%, respectively, do not have any knowledge regarding the symptoms and mode of transmission. Moreover, promiscuity was found to be associated with excessive alcohol consumption, which was reduced because of illness. Reactions to HIV diagnosis during the second counseling session include denial, anger or fear, bargaining and depression, and acceptance and resignation. In conclusion, counseling helps HIV patients to behave in ways that could delay progression of the disease and reduce transmission. It could also help them cope better with their situation.
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PMID:Psychosocial counselling of patients infected with human immunodeficiency virus (HIV) in Lusaka, Zambia. 221 27

We have recently shown that phosphorothioate (PS) oligodeoxynucleotide (ODN) analogs, unlike their normal congeners, exhibit significant anti-HIV activity (Matsukura et al., (1987) Proc. Natl. Acad. Sci. USA 84, 7706-7710). We now report the syntheses, melting temperatures (Tm), and nuclease susceptibilities of a series of phosphorothioate ODN analogs. These include all-PS duplexes, duplexes with one normal chain and the other chain either all-PS, or end-capped with several PS groups at both 3' and 5' ends. The DNase susceptibilities of the S-ODNs are much less than the normal phosphodiesters, but by contrast duplexes of poly-rA with S-dT40 are much more susceptible to RNase H digestion. The Tm's for AT base pairs of S-ODNs are significantly depressed relative to normals, while GC base pairs show much less Tm depression. The Tm's of S-dT oligomers with poly-rA are reduced relative to the duplexes with normal dA oligomers. These results have significance for the biological properties of these analogs as anti-message inhibitors of gene expression, and provide a rational basis for the S-dC/G sequences as potential effective anti-AIDS agents.
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PMID:Physicochemical properties of phosphorothioate oligodeoxynucleotides. 283 90


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