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

We carried out the investigation on 225 drug abusers in L village, Ruili county in March 1990, and tested blood specimens of intravenous users (IVDUs) for HIV infection. Of 225 drug abusers, 153 (68.0%) were by inhaling and 72 (32.0%) were by intravenous. In the recent two years, the proportion of IVDUs in drug abusers sharply increased from 13.5% in 1988 to 30.5% in 1989, and 32.0% in spring 1990. Blood specimen were collected from 64 out of 72 IVDUs, among them 51 (79.7%) were HIV-positive. The findings of relation between HIV infection and drug abuse suggested that the sharing common syringes with others and failure of their sterilization were independent risk factors.
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PMID:[A preliminary study on the behavior of 225 drug abusers and the risk factors of HIV infection in Ruili county Yunnan Province]. 187 54

Although most women infected with HIV are intravenous drug users, some contact the virus through sexual contact with IV drug users. To reach at-risk women, public health officials must develop a range of prevention strategies. One approach, skills training, holds promise as a means of altering risk-related sexual behavior. In this study, 91 women methadone patients were pretested and randomly assigned to an information-only control control group or a skills-building intervention group. Skills-building intervention consisted of five sessions of small groups in which participants identified their own high risk sexual behaviors, discussed their negative associations with condoms, and practiced skills which involved asking partners to use condoms. Compared with members of the control group, respondents in the intervention group reported that they initiated discussion of sexual issues with their partners more frequently, felt more comfortable talking with them about safer sex, and reported using and carrying condoms more frequently. The high rates of attendance and program retention by skills-building participants suggest that such groups may be supportive and useful in the design of risk reduction and drug abuse treatment programs. The modest outcomes of this study underscore the difficulty of altering risk behavior but also serve as a basis for future AIDS prevention studies.
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PMID:Building skills of recovering women drug users to reduce heterosexual AIDS transmission. 190 51

In the United States, the decades preceding the 1980s were characterized by a decline in the incidence of tuberculosis. More recently, the trend has undergone a significant reversal: Case rates have been increasing by 3% to 6% annually. In 1990, more than 25,700 cases were reported to the Centers for Disease Control. In a sense, tuberculosis is adapting to the '90s. The recent increase in its incidence tends to affect populations with identifiable characteristics. Among the most important of these groups are the populations at high risk for infection by the human immunodeficiency virus. The increase is also fueled by cases in populations that are medically underserved, including foreign-born persons from high-prevalence countries, persons with low incomes, and persons living in long-term-care facilities--especially persons with previous tuberculosis infection. Thus, factors such as homelessness, chronic alcohol or drug abuse, malnutrition, and crowded living conditions continue to favor development and transmission of disease. The increase in the incidence of tuberculosis appears to be greatest when subpopulations in such circumstances are also at high risk for HIV infection. Complex issues in the diagnosis and treatment of tuberculosis arise from these epidemiologic patterns. HIV infection is associated with unusual presentations of tuberculosis. Thus, the clinician must maintain a high index of suspicion for the disease in the setting of HIV infection or risk of the infection. The populations at greatest risk are likely to be mistrustful of the medical system, making the long-term administration of potentially toxic chemotherapy more difficult than it already is. Chronic substance abuse may complicate compliance and add further difficulties to the monitoring of chemotherapy. At the same time, the monitoring becomes even more important in the physician's effort to minimize adverse effects of the medications. Outbreaks of drug-resistant disease have recently occurred, complicating the selection of drugs and affecting the duration of treatment. Despite all of these problems, it is essential to establish a diagnosis and initiate treatment rapidly, both to arrest the disease process and to limit its transmission. Since Mycobacterium tuberculosis is spread to uninfected persons in aerosols generated by coughing or sneezing, the infectiousness of a patient with active disease can be related, at least in part, to the number of organisms seen on sputum smears. Initiation of therapy is followed by a rapid decline in infectivity.
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PMID:Tuberculosis: a disease of the 1990s. 191 97

It is projected that the proportion of black Americans, American Indians, Asian Americans, and Hispanic Americans entering the ESRD program will continue to increase. Despite the increase in the average age of the ESRD population, the minorities entering the ESRD program are much younger. The major risk factors of ESRD--hypertension, diabetes, and glomerulonephritis--are affecting these minorities at a higher rate and in varying combinations. High prevalence and severity of hypertension followed by diabetes mellitus are the major risk factors in blacks, especially black women. Heroin and HIV nephropathies, tied to the epidemic of illicit drug abuse, have a major impact on young black men. The high prevalence of diabetes and the epidemic of glomerulonephritis in certain tribes are the major risk factors in American Indians. Hypertension and diabetes are the risk factors for the rapidly increasing Asian American population, especially for the elderly segment of this population. Diabetes predominates as the risk factor for the rapidly growing Hispanic American population, a group that needs to be identified separately within the ESRD program. Diabetes and hypertension are treatable, and adequate control can prevent progression of renal failure. However, with minority groups, it is difficult to fully implement the measures necessary to achieve this control. Outreach programs are necessary not only to provide medical treatment but to include instruction in socioeconomic and educational strategies. Programs that will seek out these patients and treat them should also educate them about their diet, about the detrimental effects of alcohol and smoking, and about the danger of substance abuse. Ultimately, these programs may be much cheaper than supporting a rapidly increasing ESRD program.
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PMID:End stage renal disease in minorities. 192 May 1

We compared retention in treatment and psychological reactions during drug abuse treatment by 22 HIV-antibody positive, physically asymptomatic cocaine addicts to 22 matched HIV-seronegative cocaine addicts. All subjects participated in an outpatient clinical research project. There were no significant differences between groups in sociodemographics and psychiatric symptom scores on entrance or cocaine use except for route of administration (chi 2 = 11.59, df = 2, p less than .005). There were no significant differences among groups regarding being informed of serostatus and beginning treatment. There was a trend (p = .079) for more seropositives to complete treatment. Using end-point analysis to compare 11 seropositive subjects who completed a minimum of 2 weeks of treatment to a matched seronegative comparison groups, there were no significant differences in mood states except for "anger/hostility" (interaction of group x time; F = 2.24, df = 13/260, p less than .05). Informing drug abusers in treatment regarding positive HIV-serostatus was not associated with a lower treatment-retention rate or adverse psychological reactions when counseling regarding HIV issues was integrated with drug abuse treatment.
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PMID:Psychological reactions and retention by cocaine addicts during treatment according to HIV-serostatus: a matched-control study. 192 28

Development has been undertaken for microcomputer software intended to assess individual risk for HIV infection by analyzing personal case histories pertinent to drug abuse, receptive blood transfusion, and sexual behavior. The software performs interactive confidential interviews of individuals desiring expert assistance when deciding whether to commit to an antibody test. In the first phase of a validation study, 87 subjects responded to the computer interview. For each subject, human immunodeficiency virus (HIV) antibody status was on clinical record. This sample included 70 subjects, 29 of whom were HIV seropositive, recruited from the clientele of an AIDS antibody testing and counseling facility. In this phase, the software accurately assessed 28 of 29 seropositives (96.6%) to be at risk for HIV. The second phase was based upon participation of an additional 74 subjects who were undergraduates at the University of Oklahoma. In this presumed low-risk sample, 55 members reported never having previously tested for HIV antibodies. Seven members (12.7%) of the untested group were declared at risk in the course of receiving confidential computer screen advice. Of these 7, there were 3 members (42.9%) who were motivated by the computer to voluntarily seek HIV antibody testing. Of the 7 declared at risk, 2 members (3.9%) were among the 51 seronegative subjects classified as heterosexuals without specific and identified risks. All Phase II subjects seeking follow-up antibody tests were found seronegative.
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PMID:Risk assessment for HIV infection: validation study of a computer-assisted preliminary screen. 193 25

The endocrine and metabolic consequences of illicit drug use and HIV disease are extensive and profound. Both narcotic drug use and AIDS have the capacity to cause clinically significant multiglandular derangements. Admittedly, we were not able to focus as much attention on the less frequently occurring disturbances of calcium, phosphorus, or folate metabolism in HIV disease. Similarly, we reported very little information about the endocrinologic significance of the use of classes of narcotics other than opiates and to a far lesser extent cocaine. Even with these limitations, the spectrum of drug abuse and HIV-related endocrine manifestations discussed previously is quite diverse. Given the pervasive effects of drug abuse on other organ systems, it is not surprising to find expanding interest in the endocrine consequences of narcotic drug use. In fact, the use of these drugs is responsible, in part, for the past and continuing interest in identifying receptors for these agents and similarly structured endogenous ligands. As these investigations proceed, we must appreciate the limitations in translating basic and clinical scientific findings to the clinical setting. Much of the current research does not study street-relevant narcotic doses, does not use research designs involving polydrug use, and does not involve the processes or routes of drug administration used by active narcotic addicts. There is a critical need for more research methods with animal models and clinical study settings that more adequately mimic drug use outside of the laboratory. Our ability to develop appropriate psychopharmaceutical agents to respond to the different faces of drug abuse in the United States will depend on continued progress in the area of neuroendocrinology. With respect to the consequences of HIV disease, the clinical findings of elevated hormonal levels in some endocrine systems are amazing given what one would expect if one postulated direct or indirect destruction by HIV or the opportunistic complications that accompany AIDS. In unraveling this puzzle, careful attention must be given to evaluating the degree to which the clinical or biochemical consequences are due to a direct HIV effect, to an effect of a complicating infection or neoplasm, or to an AIDS-related therapeutic intervention. More work is needed also in obtaining histopathologic information to correlate with the biochemical and clinical derangement. In summary, there is a wealth of information demonstrating a wide spectrum of endocrine/metabolic consequences of drug abuse and AIDS. Still, just as many questions remain unanswered. While the exact biologic mechanisms are unclear, many of the biochemical aberrations have clinical relevance.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Endocrine complications of AIDS and drug addiction. 193 23

We report here on brain associated autoimmune features in opiate-dependent subjects. This study includes 107 (37 HIV + and 70 HIV -) hospitalized heroin-addicted subjects on a methadone maintenance program, and 45 healthy individuals. Human brain S100 protein, neuron specific enolase (NSE), myelin basic protein (MBF), and old tuberculin (OT) were used as antigens in the study. Serum autoantibodies to brain antigens S100, NSE and MBP were detected by ELISA, whereas delayed hypersensitivity skin reactions were evaluated after intradermal injection of S100, NSE, MBP and OT (control brain-irrelevant antigen). In drug-dependent subjects, 68.2% produced anti-S100, 56.1% anti-NSE and 20.5% anti-MBP autoantibodies, while the incidence of autoantibodies in control healthy individuals was 4.4%, 2.2% and 0%, respectively. Occurrence and amount of anti-S100 and anti-NSE autoantibodies were much higher in HIV + than in HIV - heroin-abusing adults. In drug abusers, the incidence of positive delayed hypersensitivity skin reactions were as follows: 67.2% to S100, 51.4% to NSE, 14.9% to MBP, and 94.3% to OT. In control subjects, the occurrence of hypersensitivity reactions to brain antigens was insignificant. Cutaneous reactions were more frequent in HIV - addicts. The incidence of both autoantibodies and delayed skin responses was positively related to the duration of drug abuse, worsening of HIV infection, and dementia. The high incidence of autoantibodies and delayed hypersensitivity skin reactions to S100 and NSE human brain antigens in heroin-abusers indicates that heroin dependence, as well as HIV infection, are associated with a hyperergy towards brain-related autoimmune phenomena. It has been suggested that the brain-associated autoimmune phenomena in HIV + heroin-addicts represent a hyperimmune phase which precedes immunodeficiency that occurs in the further development of HIV infection.
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PMID:Brain-associated autoimmune features in heroin addicts: correlation to HIV infection and dementia. 193 73

Researchers conducted a retrospective blind study of 743 women attending the family planning clinic at Hahnemann University Hospital in Philadelphia, Pennsylvania to determine HIV-1 prevalence in a family planning population. HIV-1 seroprevalence stood at 1.1% (8 patients). The researchers were confident that the population size was large enough to accurately reflect HIV-1 prevalence in a family planning population. Since around 90,000 women used family planning services in Philadelphia, they estimated that 1600 women were actually HIV-1 seropositive in Philadelphia. HIV-1 seropositive patients were older than seronegative patients, but the difference was not significant (26.9% vs. 23.6%). 57.1% of seropositive patients and 48.7% of seronegative patients used oral contraceptives. HIV-1 seropositive clients used them. None of the HIV-1 seropositive patients had a sexually transmitted disease (STD) which alters the epithelium (condyloma, herpes, and syphilis) while 4.9% for the seronegative patients had such an STD. IN fact, 66.7% of the HIV-1 seropositive patients had no STD at all compared to 50% of seronegative patients. No association existed between HIV-1 seropositivity and illicit drug abuse. In conclusion, no association was found between HIV-1 seropositivity and ethnicity, marital status, education, history of STDs, drug and/or alcohol use, and contraceptive method. The researchers suggested that the inability to establish relationships may be due to a function of methods, sample size, or a reflection of a different population. Nevertheless they believed that the family planning clinic should offer HIV testing to women.
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PMID:Seroprevalence of human immunodeficiency virus type I (HIV-1) antibodies in a family-planning population. 194 10

The Tuskegee study of untreated syphilis in the Negro male is the longest nontherapeutic experiment on human beings in medical history. The strategies used to recruit and retain participants were quite similar to those being advocated for HIV/AIDS prevention programs today. Almost 60 years after the study began, there remains a trail of distrust and suspicion that hampers HIV education efforts in Black communities. The AIDS epidemic has exposed the Tuskegee study as a historical marker for the legitimate discontent of Blacks with the public health system. The belief that AIDS is a form of genocide is rooted in a social context in which Black Americans, faced with persistent inequality, believe in conspiracy theories about Whites against Blacks. These theories range from the belief that the government promotes drug abuse in Black communities to the belief that HIV is a manmade weapon of racial warfare. An open and honest discussion of the Tuskegee Syphilis Study can facilitate the process of rebuilding trust between the Black community and public health authorities. This dialogue can contribute to the development of HIV education programs that are scientifically sound, culturally sensitive, and ethnically acceptable.
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PMID:The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community. 195 92


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