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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 an epidemiological study in jail community of Bari, in order to evaluate the incidence of drug abuse on the presence of HIV infection among prison inmates. During the period 1988-89, 1609 adults have been examined 40% of whom were intravenous drug abusers, and 221 adolescents, the 9.5% included in the mentioned risk groups. The average of HIV infection in adult population resulted of 15.4%. The 85% of drug abusers were aged 18 to 30. In this population the seroprevalence resulted of 33.4%, in front of the 3.5% of non drug abusers prisoners while only two cases of seropositivity were found in adolescents among the 21 drug abusers (9.5%). Prevalence in drug abusers was not different from that observed in a population of drug abusers who lived in the general population. These results further confirm that prisons represent a reservoir for HIV infection in relation to the drug abuse problem.
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PMID:[Drug dependence and HIV infection: epidemiologic study in a jail population]. 208 Mar 9

This chapter identified three methods by which crack cocaine is distributed at the retail level: the street-corner or walk-up sales system, the runners and beepermen system, and the crack house. The chapter devoted primary attention to the crack house, because it appears as the most popular method for distribution. In examining the crack house, it is noted that there are identifiable styles of crack-house operations. If the quality and quantity of social interaction, as well as the situation in which sellers posture themselves, are taken as indices, then a typology can be created characterizing crack-house operations. One end of the scale is an austere method in which social interaction between buyer and seller is severely restricted; on the other, crack houses operate as tavern-style exchange locations, which include socialization above and beyond that required for the exchange of money for crack. The nature of these exchanges are themselves important, since they involve social behaviors that are of concern. One concern is the degree and nature of violence as it is associated with drug abuse. The data in this chapter describe some ways in which violence appears within the crack subculture. This violence comes from multiple sources, but some prominent ones appear to be the businesslike operations of crack distribution, the personal disorganization that surrounds and characterizes the crack-consuming environment, and the distortions of character that crack users describe as often accompanying significant binges of crack consumption. Distributors use violence to control situations. Violence is most prominently used for security at the point of retail sale, to periodically resolve conflicts with rivals, and to discipline employees when necessary. Insofar as it is described by this group of informants, crack as a social phenomenon is tied to violent and abusive behavior. This chapter reports on behaviors that, although not traditionally violent, are of concern and bear upon public health and safety. Tavern-style crack houses may encourage and make possible hypersexuality among participants and thus increase STD and HIV risks. The use of barter as a supplement to a cash economy in the crack trade represents further complications in creating social policies in reaction to this behavior. A range of other illegal and problematic behaviors was also described, illustrating the complexity of interactions that constitute the life of street-level crack users. The social policies that may be called for in response to these social events are not simple and are most certainly not defined by these particular data.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The operational styles of crack houses in Detroit. 209 93

Considerable voluntary risk reduction has occurred among IVDUs in New York City. The purpose of the AIDS Outreach Project was to improve upon the existing level of risk reduction by providing information and anonymous HIV testing to street-recruited IVDUs. Intake and follow-up interviews were conducted with 121 subjects (44% of 276 at intake), with a mean of 4.5 months between interviews. Significant risk reduction occurred in many drug and sexual risk behaviors, although not in bleach use, and more than half of the subjects continued to engage in high-risk sexual behavior. An analysis of differences in risk reduction between early and later intake groups indicated that external trends were not sufficient to account for observed risk reduction. Among subjects engaged in high-risk behavior at intake, those who injected less or were enrolled in drug abuse treatment were more likely to stop high-risk drug injecting. Subjects who (at intake) engaged in less frequent unprotected sex, or who had had sex with someone with AIDS, were more likely to stop high-risk sexual behavior. The majority of subjects at low risk at intake maintained low-risk behavior. Informational interventions appear to be most successful among those IVDUs already engaging in lower levels of risk behavior. More effective methods are needed for those whose level of risk behavior is greater. These might include peer pressure and distributing bleach (as opposed to only providing information about bleach).
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PMID:Effects of outreach intervention on risk reduction among intravenous drug users. 209 57

Sharing of equipment used to inject illicit drugs intravenously is a risk factor for human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). Systematic surveillance of HIV infection among intravenous drug users (IVDUs) in the United States is essential to monitor the HIV epidemic and to target and evaluate prevention programs for IVDUs and their partners. The most accessible segment of the largely covert population of IVDUs are those in drug treatment programs. In collaboration with State and local health departments and drug abuse treatment agencies, the Centers for Disease Control is conducting blinded (serologic test results not linked to identifiable persons) and nonblinded (in which clients voluntarily agree to participate) surveys of IVDUs entering drug treatment in 39 U.S. metropolitan areas. The same protocol is used in all participating drug treatment centers. Blinded surveys will be carried out annually to determine HIV seroprevalence rates in eligible IVDUs entering drug treatment and to monitor trends over time. Each year, nonblinded surveys of IVDUs entering drug treatment will assess self-reported drug use and sexual behaviors to help design educational interventions and to detect changes in behavior over time. This sentinel surveillance system, using a standardized methodology, will provide the best national and regional data available on the seroprevalence of HIV among IVDUs and the relationships of drug use, sexual behaviors, and HIV serologic status of IVDUs.
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PMID:HIV seroprevalence surveys in drug treatment centers. 210 56

Surveillance systems indicate that the most documented human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) cases among children and women of childbearing age in the United States occur among black and Hispanic populations. Intravenous-drug use (IVDU) is the presumptive origin of HIV infection for most of these cases, through direct IVDU, sexual contact with an intravenous (IV)-drug user, or birth to women with either mode of exposure. These data confirm the need for HIV-prevention programs directed to the racial, ethnic, age, and reproductive concerns of black and Hispanic women of childbearing age and their children. Services should be available for those who are HIV infected, as well as for those who are not infected with HIV, to prevent the further spread of HIV. Services for prevention and treatment of drug abuse are an integral part of HIV prevention and treatment for these groups.
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PMID:Surveillance for AIDS and HIV infection among black and Hispanic children and women of childbearing age, 1981-1989. 211 8

Serum specimens from 111 human immunodeficiency virus type 1 (HIV-1) infected and 183 HIV-1 seronegative patients were analysed for antibodies to hepatitis C virus (HCV), hepatitis B virus (HBV) and hepatitis A virus (HAV) by enzyme linked immunoassay (ELISA) and radioimmunoassay. Anti-HCV and anti-HBV antibodies were found in the vast majority (89 and 83%, respectively) of intravenous drug addicts (IVDA), independent of the type of drug abuse or whether the patients were HIV-1 infected or not. Anti-HAV antibodies were found in 60% of the IVDA. Anti-HCV antibodies were found in anti-HIV-1 positive homosexual men (14%) and anti-HIV-1 negative heterosexual persons (8%), but not in HIV-1 seronegative homosexual men. Also anti-HAV antibodies were found to a small extent in these groups. In contrast, anti-HBV antibodies were common in the homosexual men. The absorbance values of the positive reactions in the anti-HCV ELISA were lower for HIV-1 seropositive patients than those for HIV-1 seronegative subjects, particularly in the late stages of HIV-1 infection. These data suggest that HCV infection is transmitted as readily as HBV infection by intravenous drug abuse and that all three types of hepatitis virus infection are common in IVDA. Although transmission of HCV is primarily mediated by blood, sexual transmission may also occur. HIV-1 infection seems to be associated with unusually low levels of anti-HCV antibodies, especially in the late stages of HIV-1 infection.
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PMID:Hepatitis C virus infection in individuals with or without human immunodeficiency virus type 1 infection. 212 86

Infection with human immunodeficiency virus Type-1 (HIV-1), the causative agent of AIDS, can be associated with central nervous system as well as immune system disease. Advanced AIDS can be complicated by a dementia. Short of frank dementia, many AIDS patients manifest neuropsychological (NP) impairment including disturbance in speeded information processing, abstraction, learning, and recall. Data conflict on whether medically asymptomatic HIV-1 carriers have subtle NP deficits. Variations in tests chosen, criterion specification, and sample selection may all be contributing to disparate results. Longitudinal research is needed, and this should examine representative samples of HIV-1 seropositive individuals for whom approximate date of seroconversion is known and in whom sources of comorbidity (e.g., drug abuse, concurrent infections, CNS injuries) can be specified.
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PMID:Human immunodeficiency virus-type 1 (HIV-1) and the brain. 218 Oct 1

Substance abuse and psychiatric disorders commonly occur together. This form of dual diagnosis is notable because it complicates assessment and makes treatment more difficult for both psychiatric and drug abuse problems. Drugs can cause psychiatric disorders and can also be used as an attempt to "cure" them by self-medication. The spread of the human immunodeficiency virus (HIV) among drug users has added a third potential clinical problem, that of the acquired immunodeficiency syndrome, to the difficulties already presented by drug abuse and psychiatric disorders. Patients with this triple diagnosis pose challenges to primary care physicians as well as addiction medicine specialists or psychiatrists. Assessment should include a drug abuse history, preferably corroborated by others, evaluation of the mental state, and examination focusing on signs of drug abuse and HIV infection. Treatment should include the management of HIV disease, abstinence from drug abuse, and access to psychiatric care. New systems of health care service, including interdisciplinary case management, may be needed to manage patients with a triple diagnosis.
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PMID:Drug abuse, psychiatric disorders, and AIDS. Dual and triple diagnosis. 219 Apr 23

In parenteral drug abuse, cutaneous manifestations are very common. A variety of skin lesions are indicators of a possible drug addiction: obliteration of peripheral veins and hyperpigmentation of the overlying skin, punched-out scars due to subcutaneous injection, persistent edema following thrombophlebitis, and excoriations due to heroin pruritus. Infectious and non-infectious complications may be accompanied by typical skin alterations, such as ecthyma in sepsis caused by Pseudomonas aeruginosa, multiple ulcers due to embolic infarct, or hypersensitivity reactions mediated by an immunological process. A variety of serious complications may develop at the injection sites: abscesses, gangrene, necrosis, or necrotizing fasciitis. These examples show that the dermatologist is in many ways involved in the care for addicted patients. In addition, these patients frequently suffer from sexually transmitted diseases or blood-borne infections; HIV-infection is rapidly spreading in this group. We now face new problems of differential diagnosis, especially since constitutional symptoms of HIV-infection may mimic symptoms of drug abuse and vice versa. Moreover, immunological alterations similar to those in HIV patients may even occur in drug addicts who are not infected with the virus.
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PMID:[Skin changes in drug-dependent patients]. 219 89

Pulmonary function studies are often limited to the alone measurement of transfer lung factor for CO (TLCO) in screening for pneumonia in patients with Human Immunodeficiency Virus (HIV) infection. We prospectively measured pulmonary function tests (PFT) in 112 HIV seropositive patients. The population consisted of two groups: on one hand, a group free of clinical and radiological abnormalities, on the other hand, one with respiratory symptoms and/or abnormal chest X-Ray, with or without overt pneumonitis. For this latter group, a fiberoptic bronchoscopy with bronchoalveolar lavage was routinely performed in addition to PFT. In case of pneumonitis, PFT showed a restrictive disease and a reduced TLCO. The specificity of this functional pattern was however weaker in the subgroup of drug abusers than in the non-drug addicts. This difference was above all linked to a low TLCO value in the subgroup of drug addicts without pulmonary complications. Multivariate statistical analysis, including discriminant analysis, maintained the same sensibility and improved specificity of PFT in diagnosis of pneumonia, especially if the analysis takes the existence of drug abuse into account. Moreover, initial PFT, performed before any lung disease, improved the sensibility of the screening. The results are discussed in relation to new tests proposed for the screening of pneumonitis in HIV positive patients. At the present time, PFT seems to be useful and enables one to understand natural functional evolution.
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PMID:[Respiratory function abnormalities and pneumonia in HIV-positive patients. A prospective study of 112 patients]. 220 71


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