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

Recent trends in sexually transmitted diseases (STDs) in the U.S., and their bearing on pelvic inflammatory disease (PID) and infertility are evaluated. STDs have increased 12-fold in the last decade, in comparison with a 200-fold rise in AIDS. While the total gonorrhea rate fell 10% last year, the incidence of gonorrhea resistant to penicillin or to all drugs is mounting. Syphilis increased 25% last year, probably because resources for contact-tracing were devoted to HIV infection, because of increasing incidence in crack users, and because new drugs, such as spectinomycin, used for resistant gonorrhea, are not effective against early syphilis. Chancroid, an easily diagnosed, treated, and traced disease, is appearing in the U.S. Genital herpes now infects 40 million, and attacks 400,000 new Americans yearly. Pelvic infections in the form of salpingitis, endometritis, and peritonitis were thought to be caused by gonorrhea in 90% of cases 10 years ago. Now a third are due to gonorrhea, a third are due to chlamydia, and the rest are due to mycoplasma and anaerobes. PID is so difficult to diagno se that 35% of diagnoses are false positives, and perhaps 25% of asymptomatic infertility patients have subclinical chlamydia. Yet the rate of PID seems constant, while STDs multiply. Reported infertile couples are also higher than ever. Whether this increased infertility is a result of tubal infections with STD organisms is not known. Physicians should be aware of the possibility of STD infection in any sexually active patient, and recommend that all women use spermicides. Spermicides are possibly more effective than condoms against STDs, and are under the control of women who suffer the consequences of STDs.
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PMID:Fallout from the STD epidemic: salpingitis, ectopic pregnancy, and infertility. 1228 94

This paper reviews reproductive health-related legislation introduced and acted on in the 50 states of the US to August 31, 1992. California, Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Wisconsin had not, however, closed session as of the end of August, and the legislatures of Arkansas, Montana, Nevada, North Dakota, Oregon, and Texas did not convene in 1992. Subjects addressed include abortion, family planning services, sex education, teenage pregnancy, adoption, infertility, maternal and infant care, and sexually transmitted diseases/AIDS. Specifically under abortion, the paper considers the status of legal abortion, parental consent, informed consent and waiting periods, and clinic licensing and harassment of providers. Subtopics on family planning, NORPLANT, welfare reform, sex education, and teen pregnancy prevention are then presented, followed by a review of current issues in adoption, infertility, and surrogacy contracts. Prenatal and infant care, perinatal drug and alcohol abuse, and family/medical leave are also covered. Closing section address HIV testing, consent, and notification; education and prevention strategies; treatment, insurance coverage, and discrimination.
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PMID:Overview. 1228 4

At least 8 new male contraceptives have emerged and most can be used now, but little promotion of these new methods has occurred. No-scalpel vasectomy developed in China consists of a small puncture instead of an incision through which the health worker either cuts or blocks the vas deferens. This technique is safer and heals faster than the conventional technique. The Association for Voluntary Surgical Contraception has a list of US physicians trained in this technique. Another new male contraceptive is injection of chemicals in the vas deferens thereby blocking sperm movement. It is permanent. Research in China shows the injectable plug in the vas deferens to be an effective, potentially reversible method. Similarly the surgically implanted "shug" performs the same purpose as the injectable plug and has the same potential to be reversible. Another method is injection of a spermicide into the vas deferens which temporarily brings about infertility. Animal trials indicate it is safe and effective. Human trials are now going on in India and will soon be underway in the US. The wet heat method has been known since the 4th century B.C. It involves placing the testes in hot water (116 degrees Fahrenheit) for 45 minutes every night for 3 weeks. This provides protection for 6 months. A similar method is artificial cryptorchidism where men wear special underwear during the day to keep the testes inside the inguinal canal which increases their temperature. Applying ultrasound to the testes for 10 minutes once every 6 months also brings about azoospermia. Ultrasonography requires physician intervention but wet heat and artificial cryptorchidism do not. Funding agencies have not provided monies to male contraception research, claiming men are not committed to contraception, yet vasectomies comprise 12% of global contraceptive use. Another excuse is that new male contraceptives do not prevent HIV transmission but neither does Norplant. Men should familiarize themselves with the new male contraceptives and then pressure authorities to sponsor their research and development.
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PMID:New nonhormonal contraceptive methods for men. 1228 17

Suggestions are made on how best to integrate sexually transmitted disease (STD) screening and education within family planning (FP) programs in the UK. FP programs are in a good position to advise about HIV infections and STDs because most clients are in a vulnerable age group (women aged 15-50 years) and because health personnel are experienced in discussing sexual issues. When FP clinics do not provide STD services, the options are to collaborate on joint referral and training efforts with STD clinics and to train staff to recognize and talk about STDs. Information about STDs can be clearly displayed in the clinics. Health personnel can talk about STD transmission to clients, explain the role of condoms in infection prevention, and demonstrate how to use condoms properly. Examples are given of integrated HIV and STD and FP programs in the US, Gambia, Zambia, and Mexico. In the US, Planned Parenthood of New York City trains staff in prevention and counseling skills and supervises staff until a level of comfort is reached. HIV and AIDS education and risk assessment are part of the initial and annual follow-up visits. The Gambia FP Association helps staff learn to counsel clients about the problems with sexual satisfaction between men and women and with communication between partners, impotence, painful intercourse from female circumcision, STDs and AIDS, infertility, and contraceptive side effects. In Zambia, a women's organization helps women prepare educational skits on condom use for males and helps women learn to talk with spouses about condom use without suffering rejection or charges of infidelity. The Ghana Planned Parenthood Association has a Daddy's Club where men learn about HIV and safe sex with condoms and meet for private counseling. Mexfam in Mexico educates for female farm laborers on sex education, FP, reproductive health and pregnancy, child health, water and sanitation, and energy-saving methods.
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PMID:Making good connections. 1228 38

HIV is in the semen and epididymal epithelia. A possible malfunction of the physiological barriers in the seminiferous epithelium may be an early response to HIV. Tight bonds between Sertoli cells serving as the blood-testis barrier may be the site of the breakdown that permits circulating HIV to penetrate the seminal compartment. Receptive partners of anogenital intercourse are more susceptible to HIV infection and progression to AIDS because some metabolites of semen extend to the vascular/lymphatic system. As couples move closer to stage IV of HIV infection, infertility is more likely. Condom use during all sexual encounters outside of long term monogamous relationships is advocated, even if other contraceptives are used. The US government requires strict quality controls on the manufacture of condoms to eliminate condom failure during correct use. HIV cannot penetrate an intact latex condom, thus it prevents the spread of HIV. Not everyone accepts condoms. Laboratory tests show that various spermicidal compounds destroy HIV and other sexually transmitted disease organisms. Yet, epidemiologic studies do not show that spermicides alone can protect against HIV transmission. Either intracellular location of HIV protects it from spermicides, or the toxicity of the spermicide causes genital ulcers which facilitate HIV transmission. An increase in condom sales in the US has occurred, particularly in the states with the highest AIDS rates (California and New York). Condoms made of lamb cecum are an option to men who are allergic to latex. Spermicides can also cause allergic reactions. Physicians should not prescribe the pill to prostitutes who reject condom use. Future research should examine HIV receptor on T lymphocyte, sperm, and brain neurons; local immunity against sperm antigen; development of locally enhanced immune response within the genital tract lumen; and purification/identification of immunosuppressive substances in seminal plasma.
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PMID:HIV infections / preventative medicine: condoms / spermicide agents. 1228 46

The topic of human reproduction encompasses events throughout the human and especially female life-cycle as well as ideas and practices surrounding fertility, birth, and child care. Most of the scholarship on the subject, up through the 1960s, was based on cross-cultural surveys focused on the beliefs, norms, and values surrounding reproductive behaviors. Multiple methodologies and subspecialties, and fields like social history, human biology, and demography were utilized for the analysis. The concept of the politics of reproduction synthesizes local and global perspectives. The themes investigated include: the concept of reproduction, population control, and the internationalization of state and market interests (new reproductive technologies); social movements and contested domains; medicalization and its discontents; fertility and its control; adolescence and teen pregnancy; birth; birth attendants; the construction of infancy and the politics of child survival; rethinking the demographic transition; networks of nurturance; and meanings of menopause. The medicalization of reproduction is a central issue of studies of birth, midwifery, infertility, and reproductive technologies. Scholars have also analyzed different parts of the female life-cycle as medical problems. Other issues worth analysis include the internationalization of adoption and child care workers; the crisis of infertility of low-income and minority women who are not candidates for expensive reproductive technologies; the concerns of women at high risk for HIV whose cultural status depends on their fertility; questions of reproduction concerning, lesbians and gay men (artificial insemination and discrimination in child rearing); the study of menopause; and fatherhood. New discourse analysis is used to analyze state eugenic policies; conflicts over Western neocolonial influences in which women's status as childbearers represent nationalist interests; fundamentalist attacks on abortion rights; and the AIDS crisis.
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PMID:The politics of reproduction. 1228 61

The formation of antibodies to human sperm may be one possible reason for demonstrated infertility in some women. Women with antisperm antibodies have also been found to possess sperm agglutinins that immobilize spermatozoa. This report discusses antisperm antibodies and autoimmunity parameters in human sperm and what, if any, relationship might exist to HIV-positive men. The predominant immunoglobulins (Ig) formed are IgA, IgG, and IgM. IgM levels are normally elevated in sera of HIV-positive patients. Three types of methods have been used to detect antisperm antibodies: 1) those that cause sperm agglutination; 2) those that cause sperm immobilization; and 3) those that detect sperm-specific antibodies. Sperm plasma membrane antigen can be recognized by antisera. This recognition could lead to the identification of sperm antibodies particular to HIV infections. This is possible, but difficult, because HIV is an intracellular agent that prevents a classic antibody reaction, which in turn could lead to a positive identification and possible HIV neutralization.
Arch STD HIV Res 1994
PMID:Immunopathogenesis and immunological parameters of human semen. 1228 75

Regional estimates prepared by the World Health Organization of the prevalence of HIV infections and curable sexually transmitted diseases (STDs) reveal that the HIV epidemic parallels STD incidence and is likely to undergo explosive growth in areas such as Asia where the ratio of HIV to STDs is currently low. HIV has had an especially severe impact on young women, and quickly moves into a general population through the gateway presented by sexually active youth. The impact of HIV has been severe in Africa where it has negated advances in child survival in some countries and created hundreds of thousands of orphans in others. The impact of curable STDs is also severe and is greatest among women who suffer from infertility and in children who develop ocular infection. The sex behavior that places individuals at risk of HIV or STDs is better understood today than ever before as are biological factors such as the increased risk of acquiring HIV for individuals infected with a genital ulcer. The biological and behavioral link between HIV and STDs is so close that the same strategies are important for prevention of both. The adoption of safe sex practices, especially promotion of condom use, is an important goal, and development of a female-controlled method of prevention (especially one that could not be detected by the male partner) would be a valuable alternative to the male condom. The second major prevention strategy is early diagnosis and treatment of STDs through a syndromic approach to diagnosis. Syndromic management will improve with advances in sensitivity and specificity, health-seeking behavior, and partner notification, but the approach still faces major problems caused by the overuse of antibiotics and the asymptomatic nature of many infections in women. While STD incidence is dropping in many countries, the mixture of HIV subtypes is increasing as is the resistance of STDs to antibiotics. With a significant worldwide decline in STDs within reach, complacency must be avoided and additional tools for STD/HIV prevention and control must be developed to avoid a backslide. Research and development of vaginal microbicides, STD diagnostic tests for use in resource-limited settings, HIV vaccines, and new antibiotics must continue.
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PMID:Sexually transmitted diseases and AIDS: global and regional epidemiology. 1229 Nov 96

Although considerable global attention and effort have been devoted to preventing and controlling the spread of HIV/AIDS, comparatively little focus has been given to controlling other sexually transmitted diseases (STD). However, since HIV, like other STDs, may be transmitted through unprotected sexual intercourse, measures implemented to check the spread of HIV through sexual contact also help to limit the transmission of other STDs. Gonorrhea, chlamydia, trichomoniasis, genital herpes, syphilis, and human papillomavirus infections cause infertility, cervical cancer, and adverse outcomes of pregnancy such as spontaneous abortion, prematurity, and stillbirth. Many people, however, remain unconvinced that STD infection has important adverse effects upon the health of women and their infants. There are enormous morbidity, mortality, and health care costs associated with these STDs. The author discusses how women are at increased risk relative to men, as well as primary, secondary, and tertiary prevention.
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PMID:Women, children and STDs: addressing the other STD epidemic. Opinion. 1229 53

About half of all HIV infections worldwide occur among people 25 and younger, according to World Health Organization data. In industrialized countries 2 of every 3 STDs afflict people under 24 years old, and this proportion is even higher in developing countries. Over 10% of all births each year occur to women 15-19 years old, according to the Population Reference Bureau. The risk of maternal mortality is 2-4 times higher for pregnant adolescents than for pregnant women over age 20. Infant mortality is typically 30% higher for infants born to women 15-19 years old than for those born to women 20 or older. In developing countries approximately 2 million adolescent women resort to unsafe abortion each year and one-third of all women seek hospital care for abortions complications are under age 20. Health problems from unsafe abortion can include infection and injuries from the procedure: perforated uterus, cervical lacerations, or hemorrhage. Long-term complications include increased risk of ectopic pregnancy, chronic pelvic infection, and the possibility of infertility.
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PMID:Adolescent reproductive health. Introduction. 1229 97


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