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

120 AIDS patients (mean age 33 +/- 9 years, 108 males) were evaluated regarding rheumatic manifestations. According to CDC's classification, 18.3% belonged to group II, 28.3% to group III, and 53.4% to group IV. Arthralgia was present in 33 patients (27.5%), and in only 8 could be associated with infections other than HIV (5 cases of tuberculosis, 3 P. carinii, and 1 gonococcal infection). Incidence of arthralgia was equal in either sex. Arthritis was present in 8 patients, 2 of them with Reiter's syndrome. In 6 patients arthralgia was the first symptom (3 with arthritis) before AIDS diagnosis. There was a higher incidence of dry mouth, dry eyes, and muscular complaints in patients with arthralgia than in patients without arthralgia. Antinuclear antibodies and rheumatoid factor were absent in the serum of the patients studied. Arthritic manifestations possibly occur in AIDS, even in patients without other clinical manifestations, as a reactive state to HIV infection.
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PMID:[Rheumatic manifestations of acquired immunodeficiency syndrome (AIDS)]. 130 73

Sexually active travelers are at risk for a variety of STDs, including traditional venereal infections such as gonorrhea, chlamydial urethritis, syphilis, chancroid, and herpes simplex infection. More recently, hepatitis B, hepatitis C, and HIV-1 have also been described. Risk varies depending on the geographic area of travel and the type of sexual contact. Physicians should be aware of the prevalence of antimicrobial resistance of N. gonorrhoeae and H. ducreyi because this will affect empiric antibiotic therapy. Prevention should focus on proper and consistent usage of barrier contraceptives.
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PMID:Sexually transmitted diseases and travelers. 140 28

The origin of the word condom is the subject of some debate, but the use of a linen sheath as a preventive measure for venereal disease was noted in the writings of Fallopius in 1564. In recent years condom sales have increased, and in a sample of San Francisco male homosexuals consistent condom use was reported to have increased from 26% to 79% between 1984 and 1987. Condom sales in drugstores increased by over 20% from 1986 to 1987, with women being responsible for an estimated 40-50% of US purchases. Studies suggest a failure rate of 2-15/100 couples using condoms. Failure rates for 1st-year users average about 12%, but consistent and correct condom use theoretically results in approximately a 2% failure rate. Mean breakage rates ranging from 0% to 13% have been reported. Both epidemiological and laboratory studies have demonstrated that latex condoms are effective mechanical barriers to important viral transmissions including HIV, herpes simplex virus (HSV), hepatitis B virus (HBV), and cytomegalovirus (CMV), as well as bacteria such as Chlamydia trachomatis and Neisseria gonorrhea. Condoms are safe to use, particularly in view of the fact that AIDS is now 1 of the 5 leading causes of death for women ages 15-44. An important contraindication, however, is the presence of latex allergy, potentially leading to contact urticaria or manifestations of anaphylaxis. The female condom shows promise for placing personal protection increasingly under the control of women. Condom promotion in the US with education at both public and individual levels could emulate developed and developing countries that have promoted condom use with marketing and mass-media techniques, as well conspicuous and aggressive distribution methods. Nursing is involved in program efforts aimed at enhancing condom use and nurses can be effective in encouraging clients to use condoms to protect themselves.
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PMID:Condoms as primary prevention in sexually active women. 140 10

The US Department of Health and Human Service reported that 25% of sexuality active teenagers have had a sexually transmitted disease (STD). In school, youth are reported to have a lower STD prevalence of 4% based on Centers for Disease Control high school surveys. The seriousness of the problem is approached through discussion of the prevalence and health impact, the determinants (behavioral, social, biological, institutional), control strategies, and educational strategies. STD educational strategies can be effective only when part of a larger health education program (human sexuality and family life education) rather than including HIV infection instruction in a biology class. Populations particularly affected are young women and low income, urban minority youth. The adolescent risk of STDs is higher than in other age groups. Unfortunately severe consequences may involve reproductive health, i.e., tubal infertility from pelvic inflammatory disease and ectopic pregnancies from, for instance, chlamydia and gonorrhea. Females suffer more damage than males, although more males die of AIDS. Behavioral factors are sexual behavior, drug use, and health care behavior. Psychological factors such as self-esteem and locus of control are associated with STD risk behavior. Sexual activity is possible earlier due to a decrease in the average age of menarche. Access to services is a critical factor in prevention. Effective intervention programs should take into account risk factors and adolescent development. Adolescent clinical services need to be improved through better diagnosis, treatment, and counseling; research and education are needed also. The goal of STD education is to provide adolescents with an increased self-sufficiency in practicing STD prevention and risk reduction. Programs must be sensitive to youth subcultures and include messages about HIV and AIDS. School and community programs are essential to reach all teenagers. The optimum conditions for controlling STDs are an improved social and economic environment, accessible and effective health clinics, and quality education.
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PMID:Adolescents and sexually transmitted diseases. 143 62

Many different peoples are considered Hispanic within the US. Specifically, Hispanics constitute 9% of the US population and include 10.32 million Mexicans, 2.6 million Puerto Ricans, 1 million Cubans, 1.7 million Central or South Americans, and 1.4 million individuals of other Spanish origin. 2/3 reside in California, Texas, and New York. Together they make up the fastest growing ethnic minority population in the US. Accordingly, efforts are being made to understand the behavioral characteristics, sociocultural norms, and social needs of these peoples within the broad context of american society. As may be expected, however, differences among subgroups of Hispanics in poverty, education, employment, family structure, and age distribution are often greater than overall differences between Hispanics and non-Hispanics. Such differences make broad-based generalizing about Hispanics difficult and suspect at best. Nonetheless, some general observations may be made. Hispanics are overall younger than non-hispanics; Hispanics are of median age 25 years, while non-Hispanics are of median age 32. Of high fertility, the US population of Hispanic youth will grow by almost 80% to 10 million by the year 2030. This growth contrasts with an expected 14% increase in the black population and a proportional drop of 10% in the population of white youth. Further, Hispanics tend to highly value family and children and suffer considerable prevalences of poverty, 1-parent families, and low educational status. 1/3 Hispanic youths are sexually active. A relatively high prevalence of gonorrhea and syphilis exist within this population, yet they are underrepresented in the number of reported cases of HIV infection. Less likely than Whites to use contraceptives, Hispanics are more likely to become pregnant and keep their children. Unprotected sexual intercourse exposes these youths to the risk of HIV infection. Relatively early childbearing is common among young Hispanic women. A 1982 National Survey of Family Growth revealed that more than 4/10 Hispanic teens gave birth by age 20. A multi-strategy approach involving organizations, homes, schools, churches, and mass media is needed to help increase educational, vocational, political, and health care opportunities for Hispanic youths. Intervention strategies and recommendations are provided.
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PMID:Adolescent pregnancy prevention for Hispanic youth: the role of schools, families, and communities. 143 64

Trends in mortality related to infection by human immunodeficiency virus type 1 (HIV-1) and to other causes were examined from 1978 to 1988 in a cohort of 8,906 homosexual men who participated in studies of hepatitis B virus infection in the late 1970s in New York City. HIV-related mortality rates increased from 1 per 10,000 person-years in 1980 to 181 per 10,000 person-years in 1986, followed by a plateau from 1986 to 1988. The standardized mortality ratio among white men in the cohort was 3.7 (95% confidence interval (Cl) 3.4-3.9) as compared with white men from across the United States. Higher HIV-related mortality rates were associated with a higher number of sexual partners, a history of gonorrhea and/or syphilis, and serologic markers of infection with hepatitis B virus. After adjustment for demographics and sexual behaviors, the relative risk of mortality for Hispanic men as compared with white men was 1.5 (95% Cl 1.1-1.9). This study illustrates the large excess in mortality among homosexual men over the last decade, with the excess accounted for by deaths from HIV-related diseases. The recent plateau in mortality may be due to the effect of new treatments and/or the decline in new HIV-1 infections among homosexual men. The excess in HIV-related mortality among Hispanic homosexual men was not explained by differences in demographics and factors associated with the sexual transmission of HIV-1.
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PMID:Mortality trends in a cohort of homosexual men in New York City, 1978-1988. 144 31

The study subjects were recruited among heterosexual men attending the male sexually transmitted disease (STDs) clinic operated by the Dermatology Unit, Siriraj Hospital, Mahidol University, Bangkok, Thailand. The subjects had no history of intravenous drug use, homosexuality, or bisexuality, had not received blood transfusion in the preceding 5 years, and claimed that they had contracted the disease from prostitutes. Between December 1989 and February 1991, 352 men enrolled in the study who had a median age of 28 years (range 15-63 years). The participants completed a questionnaire about occupation and clinical symptoms of STDs. Sera were assayed for VDRL and TPHA. HIV antibody screening was performed by gel particle agglutination or ELISA technique, and the specimens were confirmed as positive by HIV antibody Immunoblot technique. Of the 328 HIV seronegative men, 44% had nonspecific urethritis, 13.3% had gonorrhea, 13.1% had genital ulcers (including syphilis and chancroid), and 7.6% had syphilis (including positive VDRL or TPHA 1:160). 334 of 352 men (94.9%) reported prostitutes as the source of their STDs. HIV antibody was detected in 19 (5.4%) of 352 men. Only 100 of the 333 men whose first HIV antibody was negative returned to the clinic for a second HIV antibody test within 12 weeks, and HIV antibody was detected in 5 (5.0%) of these 100 men. Thus, the HIV antibody was found in a total of 24 (6.8%) of 352 men. This rate was 15 times the rate found in blood samples from healthy donors at Siriraj Hospital during the period between 1989 and 1990. The HIV seropositivity was significantly associated with syphilis (including positive VDRL or TPHA 1:160), but was not associated with genital ulcers (including syphilitic ulcer and chancroid). None of the 24 seropositive men had clinical evidence of AIDS-related complex or full-blown AIDS. The lack of association between HIV seropositivity and genital ulcer remains to be further investigated.
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PMID:HIV infection in male patients attending a sexually transmitted disease clinic. 146 Apr 10

There were approximately 3 million HIV-positive women in the world, most of them in reproductive age according to the WHO's 1991 estimates. One third of the world's HIV-positive individuals are women; by the year 2000, women will account for half of the HIV-positive population. There are at least 200,000 HIV-positive women in Asia, mainly in Thailand, India, and China. The community-based Botswana project approach to AIDS prevention for women was based on a community-based model project at the University of Illinois to promote health in 2 low-income communities in Chicago by teams of trained residents and a nurse. Program elements included: women as health promoters; acceptance of primary health care; and emphasis on self-care in basic health. In Botswana the fertility rate is 5%, and approximately 40% of the women use contraceptives. The overall mortality rate is 37 per 1000. The 1st case of AIDS in Botswana was identified in 1985. As of January 1991, there were 180 cases and 59 AIDS-related deaths. There are 20,000 to 47,000 HIV-positive individuals in Botswana. There have been more women than men among reported AIDS cases in Botswana. Most women in their childbearing years are at moderate risk of HIV infection because of weak partner ties and occasional multiple partners. A 2-stage study of the effectiveness of nurse-managed peer education and support groups for AIDS prevention for women has been in operation for the 2nd year. In the 1st phase, interviews with more than 50 urban women explored their current risk of HIV infection and the risk-reduction strategies. The strategy for change used peer education and support groups led by trained community women to achieve lasting behavioral changes that promote health. The target group approach will include all women in the community. Heterosexual transmission of HIV is the predominant route of infection for women, hence promotion of safer sex is central in the Botswana intervention. The same AIDS preventive practices also protect against other sexually transmitted diseases including gonorrhea, syphilis, and chlamydiosis, which have high prevalence rates in Botswana.
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PMID:AIDS prevention for women: a community-based approach. 146 55

Between January 1989 and December 1991, health workers took blood samples from 4883 pregnant women attending the Nairobi City Commission's Langata Clinic in Nairobi, Kenya to determine demographic factors and indicators of sexual behavior to explain the increase in HIV-1 infection and syphilis among these women of low socioeconomic status. HIV-1 seroprevalence stood at 8.8%. Syphilis seroreactivity was 3.6%. HIV-1 seropositive mothers were 2.5 times more likely to also test positive for syphilis than were HIV-1 seronegative mothers (7.7% vs. 3.2%; p.001). There was no significant association between HIV-1 seropositivity and gonococcal infection rate (7.3% vs. 8.9%), however. Women who tested HIV-1 positive tended to be from western Kenya (60.1% vs. 39.1%; p.0001). Between 1989 and 1991, annual HIV-1 seroprevalence rates increased from 6.5% to 13% (p.001) as did annual syphilis seroreactivity rates (2.9-5.3%; p=.02). The HIV-1 seroprevalence rates remained high, but did not rise significantly among syphilis seroreactive women between 1989 and 1991 (17.9-20.7%). They did rise among syphilis seronegative women (6.9-12.5%; p.0001), however. The HIV-1 infection rate increase was greater among 25-year old women (5.6-13.2%; p.001) than it was among 25-year old women (6.8-12.7%; p=.09). Indeed the annual incidence rate for 25-year old women was 3-4%. Between 1989-1991, there was a decrease in the percentage of both HIV-1 seropositive and seronegative women who had had 1 sex partner during the last 2 years (39.1% vs. 20%; p=.0001). Demographic factors remained the same throughout the study period. These results verified the link between HIV-1 infection and syphilis and their rapid rise among women in low risk groups. Thus there was a pressing need to improve HIV-1 and sexually transmitted disease prevention programs.
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PMID:Rapid increase of both HIV-1 infection and syphilis among pregnant women in Nairobi, Kenya. 146 50

Chancroid is a mucocutaneous infection caused by Haemophilus ducreyi that produces ulcerative lesions and enhances the efficiency of transmission of human immunodeficiency virus (HIV). Confirmation of infection by culture of H. ducreyi is essential in therapeutic trials. Minimal inhibitory concentrations of antibiotics for the isolate should be determined by agar dilution. Patients should be evaluated by appropriate laboratory tests for syphilis, infection with herpes simplex virus, gonorrhea, and (in North America) infection with Chlamydia trachomatis. The clinical history of the disease should be recorded and ulcers, buboes, and lymphadenitis mass described. Whenever possible, study participants also should be tested for HIV infection. Randomized, prospective, double-blind, active-control comparative clinical trials are preferred for evaluation of the safety and efficacy of new anti-infective drugs. Otherwise-healthy men and women should be enrolled in these studies. Patients with active syphilis or genital herpes should be excluded. Microbiological and clinical outcomes are paramount.
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PMID:Evaluation of new anti-infective drugs for the treatment of chancroid. Infectious Diseases Society of America and the Food and Drug Administration. 147 17


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