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

Evidence that behavioral factors affect the spread of HIV infection, both direct and by implication from high-risk behavior in general, and a model for further research and intervention are reviewed. Measurement of prevalence of high-risk behaviors over time is essential to see whether risk is increasing or decreasing in populations. There is good evidence that AIDS education programs have controlled HIV spread among homosexual and bisexual men in San Francisco, judging by both HIV seroprevalence and that of gonococcal proctitis. These educational interventions virtually saturated the area. Other populations have failed to respond to AIDS education, particularly teens, young adults, poor, non-white, less educated, and people from other areas. 39% of AIDS cases in the U.S. are from minority groups; 50% are Black and 24% are Hispanic. Currently homosexual men living outside a gay community, those without social ties and bisexual men are still showing increasing HIV infections, while homosexual men in open, active communities have decreasing rates. Other risk-behaviors associated with HIV infection include use of drugs, alcohol, tobacco, and having sex outside of "relationships." Conditions correlated with safe behaviors included knowing of one's positive HIV status, possessing skills of safe sex, perceiving one's risk accurately, and having peer support. Peer support is extremely influential, and includes general social support, peer expectations and support for behavior change, and capability to seek help when needed. A detailed AIDS risk reduction model is proposed and described.
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PMID:Behavioral factors in the spread of HIV infection. 314 77

Recent developments concerning heterosexual transmission of HIV (review of 1988 literature only) suggest improved understanding of the pattern of spread and role of risk behaviors and biological cofactors in its transmission. 3 distinct patterns if HIV infection are known: heterosexual spread in sub-Saharan Africa and the Caribbean, spread primarily among homosexuals and injecting drug users in Europe, North American and much of Latin America and Australia, and both homosexual and heterosexual transmission in Asia, the Pacific, the Middle East and Eastern Europe, where prevalence is low. In Africa an estimated 80% of cases are acquired heterosexually. Important risk factors are number of sex partners, sex with prostitutes, being a prostitute, being a sex partner of an infected person, and having a history of other sexually transmitted diseases. Prevalence rates have risen rapidly in Zaire and Kenya. In Africa, acquisition of HIV is related to sexual activity only. In contrast, in the U.S., heterosexual cases make up only 4% of all cases, and in Europe only 6%. Data on types of sexual transmission of HIV are mounting, in aggregate suggestive of a marked heterogeneity in infectivity and possibly susceptibility between individuals. Among couples where the man is positive, in some places individuals appear to be highly infective, notably those from Kinshasa, Zaire and Haiti, while other series of discordant couples the receptive partner remained seronegative for several years. Transmission from women to men appears to be less efficient than from men to women, as has been observed with other STDs such as gonorrhea. Biological cofactors implicated in enhanced HIV transmission appear to be advanced CDC Stage IV AIDS disease, with low T-helper lymphocyte counts and high antigenemia; concomitant STDS, especially those with genital ulceration; lack of circumcision; oral contraceptive use; practice of anal intercourse; inconsistent or no use of condoms. Theoretical models for future heterosexual spread emphasize number of partners, use of condoms, and treatment of STDs.
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PMID:Heterosexual transmission of HIV. 314 80

235 homosexual men participated in a prospective study conducted in Helsinki, Finland, in 1983-86 aimed at identifying associations between sexually transmitted diseases (STDs), condom use, and human immunodeficiency virus (HIV) infection. The mean observation time was 22.7 months and the average age of study participants was 35.3 years. Of the 235 men, 27 (12%) gave no history of previous STD at the 1st examination. The remainder reported at least 1 STD, the most common being pubic lice (65%), gonorrhea (43%), and nongonococcal urethritis (26%). The 31 men (13%) who were seropositive for HIV infection at the end of the study had experienced significantly more STD episodes than seronegative subjects. All 9 of the seroconversions considered to have taken place during the study period involved men whose sexual behavior included unprotected receptive or insertive intercourse into the mouth or rectum. No HIV infection emerged among the men who practiced safe sex practices--monogamous sex with an HIV seronegative partner, no mucosal contact during sex, or the consistent use of condoms during anal sex. There was a weak association between HIV and hepatitis B infection, but a strong link between HIV and the prevalence of hepatitis B c antibodies. The statistically significant association observed in this sample between HIV seropositivity and heavy exposure to STDs may either reflect an enhanced probability of encountering HIV along with other pathogens or the role of other STDs as cofactors in HIV infection. The decreasing incidence of STDs observed during the follow-up period reflects counseling about risk reduction that was provided as part of the study. By the end of the study period, almost half the men had stopped practicing anal sex and almost 1/3 were using condoms. However, further spread of HIV can be expected in Finland given the fact that 57% of study subjects were still practicing anal sex at the end of the follow-up, the majority of them without condoms.
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PMID:Sexually transmitted diseases and the use of condoms in a cohort of homosexual men followed since 1983 in Finland. 339 35

In 1985, 132 female prostitutes and 55 female nonprostitutes at a sexually transmitted disease (STD) clinic in Sydney, Australia requested to be tested for HIV antibodies and completed a questionnaire covering a wide range of social and medical issues. The 2 groups were matched for age and were similar in other respects, excluding the number of sexual partners. Laboratory personnel tested the serum using the ELISA test and confirmed by the H9 exclusionary ELISA and by immunofluorescence using a T cell line infected with HIV. All the women tested seronegative for HIV antibodies. 19% of the prostitutes and 24% of the nonprostitutes had used IV drugs. A substantial number of women from both groups reported using 1 or more other drugs. 37% of the prostitutes and 45% of nonprostitutes claimed to not have used any of the illegal drugs listed in the questionnaire, during the preceding 6 months. 29% of the prostitutes and 33% of the nonprostitutes recorded partners at risk from IV drug use. The number of sexual partners reported by the 2 groups in the month prior to the survey ranged from 1-250 (median 24.5) for prostitutes and 0-4 (median 1.50) for nonprostitutes. For a 1 year period the corresponding figures included 1-3000 (median 175) for prostitutes and 1-13 (median 3.5) for nonprostitutes. More than 1/3 reported having bisexual partners during the previous 5 years. Prostitutes had significantly more episodes of gonorrhea, chlamydial infection, and pelvic inflammatory disease than the nonprostitute group (p.05). 1/2 of the 8 prostitutes who had hepatitis B were IV drug users. 76% of nonprostitute partners and 49% of prostitute partners did not use condoms. Despite the fact that HIV antibodies were not detected in these women, the researchers concluded that HIV could spread rapidly within the prostitution population and back into the wider community through sexual contacts and IV drug use. Current control measures need to be enhanced and the medical community needs to continue to monitor prostitutes' health.
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PMID:Human immunodeficiency virus and female prostitutes, Sydney 1985. 341 Apr 67

The term masturbation entered the English language in 1776 in the translation of Tissot's Treatise on the Diseases Produced by Onanism. Tissot linked semen conservation theory from antiquity with degeneracy theory and attributed degeneration and death from the social disease (syphilis and gonorrhea) to semen wastage not only in the social vice of promiscuity and prostitution, but also in the secret vice of masturbation. Nocturnal semen loss became designated as spermatorrhea, a new disease requiring treatment. In the nineteenth century the campaign against masturbation became a medical mania. It reached its apogee under John Harvey Kellogg, M.D., who invented Corn Flakes and other cereal and nut foods as meat substitutes to reduce all carnal desire and, hence, masturbation. The stigma on masturbation remains. It prohibits rational discourse on masturbation, and nourishes the perpetuation of fallacies regarding its effects. The imagery of a masturbation fantasy is also the imagery of the personal lovemap, which may be unorthodox, warped and distorted paraphilically. Masturbation might become societally endorsed as a public health policy to help contain the HIV epidemic of AIDS. Nonetheless, the President of the United States in 1995 dismissed his Surgeon General, Dr. Jocelyn Elders, for advocating so sane a policy.
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PMID:Safe sex in the era of AIDS. 749 73

Annual cross-sectional prevalence, incidence of new infection, and risks for human immunodeficiency virus type 1 (HIV-1) infection were studied in 607 women convicted of prostitution between October 1987 and December 1990 and tested for HIV under court order. Cross-sectional prevalence was stable for 4 years (23-24% positivity in 1987-1991, p = 0.6). However, the incidence of new infections (rate of seroconversion) in 264 women tested more than once increased significantly each year from 12 per 100 person-years in 1987-1988 to 19 per 100 person-years in 1991 (p < 0.03). Seroconverters were more likely to be young black women with a prior history of syphilis or gonorrhea. A new episode of syphilis or rectal gonorrhea during the follow-up period predicted HIV seroconversion in a survival analysis model. Female sex workers are at great risk of acquiring HIV infection. Although HIV prevalence in cross-sectional samples was stable, incidence was increasing. Interpretation of prevalence trends from convenience samples, such as screening programs, may be difficult because changes in incidence may not be detected.
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PMID:Prevalence, incidence, and risks for HIV-1 infection in female sex workers in Miami, Florida. 760 Jan 7

Although a recent Cavalieri d'Oro et al. article correctly concludes that while barrier methods reduce the risk of gonorrhea and HIV, they may be less consistent for other diseases, the review does not include the female condom, the newest method of barrier contraception. Laboratory tests have shown polyurethane, the material of which the new condom is manufactured, to be impermeable to HIV and cytomegalovirus. Similar permeability studies using bacteriophages smaller than hepatitis and HIV show the membrane to be a complete barrier. As such, one may expect polyurethane to be the raw material from which male condoms will be made in the future. One clinical study assessed the prevention of reinfection with Trichomonas vaginalis among 104 women who had sexual intercourse with infected male partners. No woman who used the female condom during every act of sexual intercourse became infected. 14% of nonusers and 14% of inconsistent users were, however, reinfected. A study by Soper et al. found use of the female condom to not be associated with genital trauma. Leeper and Conrardy subjected the female condom and the male condom to the standard ASTM water leak test to find a 0.6% incidence of leakage from pinholes and tears for the female condom compared to 3.5% with the male condom. The risk of semen leakage during actual use as identified by acid phosphatase was 2.7% with the female condom and 8.1% with the male condom. Perfect users of the female condom may expect a 2.6% probability of failure over six months' use. Perfect use, however, reduces the annual risk of acquiring HIV by more than 90% among women who have sexual intercourse twice weekly with an infected male.
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PMID:Barrier methods of contraception. 770 60

Five hundred and fifty-one patients attending the Special Treatment Clinic (STC) of the University College Hospital, Ibadan, between January 1989 and July 1990 were investigated for the common sexually transmitted diseases to determine the current relative prevalence rates of these infections. The patients were also investigated for human immunodeficiency virus (HIV) infection. Of the 551 patients, 384 (69.9%) were diagnosed as having sexually transmitted diseases. The most frequent STDs were gonococcal infections, non-specific urethritis and cervicitis and the genital ulcer diseases (GUDs) with prevalence rates 25.6%, 17.8% and 12% respectively. In addition to the common STDs, HIV infection was detected in 28 (5.1%) patients. Both HIV-1 and HIV-2 were detected as follows: HIV-1 in 16 (2.9%) patients and HIV-2 in 12 (2.2%) patients. All but one of the HIV-seropositive patients also had concurrent sexually transmitted diseases.
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PMID:Sexually transmitted diseases in Ibadan in the 1990's: HIV infection--an additional dimension. 765 4

Although vaccines for the prevention of syphilis, gonorrhea, and infection with human papillomavirus, Chlamydia, herpes simplex virus, and HIV are progressing, medical caregivers cannot wait for these vaccines to become available to prevent HIV infection and classic sexually transmitted diseases (STDs). Furthermore, it has been argued that a 90% effective HIV vaccine would not equal regular appropriate condom use in preventing the disease. Healthcare workers should include counseling on prevention of STDs and HIV infection in their routine practice. Sexual history can help to determine the degree of counseling needed. Algorithms to help identify patients at greatest risk for asymptomatic STDs (which will lead to screening) are in development. Counseling that focuses on abstinence and monogamy, recognition and eradication of classic STDs, and proper use of condoms can be expected to reduce the risk of HIV.
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PMID:HIV and sexually transmitted diseases. The physician's role in prevention. 767 45

The impact of heterosexual transmission of the human immunodeficiency virus (HIV) on the United States blood supply was assessed, and deferral criteria that may exclude potential donors who are at high risk for heterosexually acquired HIV infection were evaluated. Interviews were conducted with 508 HIV-seropositive blood donors from May 1, 1988, to August 31, 1989 (Phase 1), and with 472 donors from January 1, 1990, to May 31, 1991 (Phase 2), at 20 blood centers. From Phase 1 to Phase 2, the overall HIV prevalence decreased from 0.021 to 0.018 percent (p < 0.001). HIV risk factors among HIV-1-seropositive donors were similar during both study phases. Eleven percent of the men and 56 percent of the women reported as their only risk that they had a heterosexual partner who was at increased risk for HIV or was known to have HIV. These percentages were similar during both study periods. During Phase 2, 13 percent of the men and 17 percent of the women with heterosexual transmission risk had a positive serologic test for syphilis, hepatitis B core antibody, or hepatitis C antibody. Among HIV-1-seropositive donors reporting heterosexual risk, the median numbers of previous-year and lifetime sex partners for men were 2 and 30, respectively; for women, those numbers were 1 and 7, respectively. Thirty-one percent of the men and 6 percent of the women reporting heterosexual transmission risk also reported having had syphilis or gonorrhea within 3 years of donation. It is concluded that the impact of heterosexual transmission of HIV infection on transfusion safety is not worsening at this time.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heterosexually acquired human immunodeficiency virus infection and the United States blood supply: considerations for screening of potential blood donors. HIV Blood Donor Study Group. 768 91


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