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

In the US and globally women are contracting the human immunodeficiency virus (HIV) and developing the acquired immunodeficiency syndrome (AIDS) the fastest. Worldwide, HIV is transmitted primarily through heterosexual intercourse. In the US, the proportion of women who have contracted AIDS by heterosexual transmission has increased from 11% in 1984 to 34% in 1990. Women are at a greater risk than men for transmission by heterosexual intercourse as the ratio of women to men who acquire AIDS by heterosexual transmission is 3 to 1. Furthermore, 25% of AIDS cases caused by heterosexual transmission or iv drug use occurs in women. Although women often develop HIV-related serious gynecologic problems, including cervical cancer and refractory vaginal candidiasis, these conditions do not fall within the Centers for Disease Control definition of AIDS. Women who have gynecologic symptoms are not diagnosed as having AIDS, are not eligible for AIDS benefits, and live half as long as men do once they are diagnosed as being HIV infected. Little is known about the characteristics of HIV infection or AIDS in women. Sexually transmitted diseases (STDs) seem to act as cofactors for HIV infection. The human papilloma virus or genital warts, the herpes simplex virus, syphilis, chancroid, recurrent vaginal candidiasis, abnormal Pap smears, cervical neoplasias, and pelvic inflammatory disease have been associated with HIV infection in women. HIV infection should be considered in all women with symptoms of any of these disorders. Nurses must first become aware of the clinical manifestations of HIV infection specific to women. Nursing interventions should educate about safer-sex including condom use with nonoxynol 9, and the risks of sharing needles. Strategies must be developed that provide empowerment skills and are sensitive to the women's cultural, religious, and ethnic background, beliefs, and values.
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PMID:Issues concerning women and AIDS: sexuality. 140 53

From April 1988 through December 1989, sera obtained for syphilis testing from consecutive patients attending 98 sexually transmitted disease (STD) clinics in 37 metropolitan areas were tested for antibodies to human immunodeficiency virus (HIV) in an unlinked (blinded) survey. HIV seroprevalence in STD clinics ranged from 0 to 38.5% (median, 2.3%), with the highest rates found in the Mid-Atlantic states, Florida, and Puerto Rico. The highest median rates were found in men who have sex with men (36.1%) and heterosexual intravenous (IV) drug users (4.1%). For heterosexual persons who do not report IV drug use, median rates were highest in the 35- to 39-year-old age group for men (6.4%) and the 30- to 34-year-old age group for women (0.9%). Among persons who do not report risk behaviors for HIV infection, men had substantially higher median rates of HIV infection than women (P less than 0.001, Wilcoxon Signed Rank test), and rates were positively correlated with HIV infection rates in IV drug users in the same clinic (Pearson correlation coefficient [r] = 0.8; P less than 0.001). Among heterosexual STD clinic patients who do not report IV drug use, the median HIV infection rate for blacks (1.8%) was at least 2 times higher than the median infection rates for hispanics (0.9%) and whites (0.7%). The results of this study show that HIV infection in STD clinic patients varies by geographic area, sex, race and ethnic group, and risk behavior.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sentinel surveillance of human immunodeficiency virus infection in sexually transmitted disease clinics in the United States. 141 39

Researchers analyzed 1991 data on 678 12-45 year old women attending either a university-based family planning clinic, 8 Planned Parenthood clinics, or the private practice or health maintenance organization clinic of 8 physicians in southeast Texas to determine the characteristics of these women who accepted Norplant shortly after its approval in the US and their overall attitude towards Norplant. Most acceptors were 25 years old (64.1%) and not married (67.4%). In fact, 45% were 21 years old which was higher than expected. Norplant was 1 of the first contraceptives used by 44% of the women. Further, these women had only recently chosen to prevent unplanned pregnancy. The mean family size was 1.2. 35 of the women did not want any more children. The remaining 67% used Norplant to space births. 32.5% of the women had experienced at least 1 abortion, which was significantly higher than the national adjusted rate. The leading reasons for choosing Norplant included dissatisfaction with previous methods (55.5%), its convenience (38.7%), and confidence in its effectiveness (20.8%). 44% of the women were not concerned about Norplant. The main concerns of the other women were pain during insertion (21.9%), menstrual changes (17.9%), and hormonal effects (16.2%). Further, 11.8% were worried about Norplant's effect on future pregnancies. Most women (61.1%) had previously used oral contraceptives (OCs). 5.3% had used no method in the last 3 months. 42.2% had used condoms either alone or with a spermicide. Yet, 48% of them would now either stop using them or use them sometimes. They constituted 40% of the unmarried women. This resulted in an increased risk of acquiring a sexually transmitted disease or HIV among 25% of the sample. Medicaid patients paid nothing for Norplant or its insertion. Patients who received Norplant via the physician training program paid nothing for Norplant but did for its insertion. Some clinic patients made required copayments of $9-$100. Private practice patients paid $500-$750 for Norplant and its insertion.
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PMID:Characteristics and attitudes of early contraceptive implant acceptors in Texas. 142 82

Over a 12 month period, 32 teenage girls attended the sexually transmitted disease clinic in the Mater Misericordiae Hospital, Dublin for the first time, accounting for 17.8% of all first visits. Their mean age was 18.2 years (range 15-19 years). Twenty-four (75%) were from social class V. Five (15.6%) were abusing drugs. The mean age of first coitus was 16.1 years (range 13-19 years). The mean number of sexual partners was 1.8 (range 1-5). Four (12.5%) had been sexually abused in the past. Fourteen (43.8%) had never used contraception. Twenty-three (71.9%) were nulligravidae: 2 were diagnosed as being pregnant in the clinic. Twelve (37.5%) were unaware of cervical cytology screening. Of 29 having intercourse without condoms, none considered themselves to be at risk of contracting HIV from their present partner. A total of 26 diagnoses were made in 23 patients (71.9%). The most common diagnosis was ano-genital condylomata acuminata (6, 18.8%); Chlamydia trachomatis was located in 2 patients and Neisseria gonorrhoea in one. Mild to moderate dyskaryosis was reported in 4 cervical smears (12.5%). This data highlights the need for priority targeting of this high risk group.
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PMID:Teenage girls attending a Dublin sexually transmitted disease clinic: a socio-sexual and diagnostic profile. 142 69

Control of Trichomonas vaginalis is assuming higher priority because recent studies have suggested that trichomoniasis enhances susceptibility to human immunodeficiency virus infection and the risk for delivery of low-birth weight infants. In a cross-sectional study, 50 cases were identified among 447 men attending a sexually transmitted disease clinic. As previously reported, trichomoniasis was associated with nonchlamydial nongonococcal urethritis. Other risk factors included sexual contact with an infected woman or prior treatment for trichomoniasis or nongonococcal urethritis. Urethral and first-void urine cultures were positive in 80% and 68% of positive cases, respectively. When combined, these two cultures diagnosed 49 (98%) of 50 cases. These data suggest that criteria for selection of men for culture should include presence of nonchlamydial nongonococcal urethritis, recent exposure to trichomoniasis, or a history of trichomoniasis or nongonococcal urethritis. In addition, combining urethral and urine sediment cultures may prove accurate for evaluating T. vaginalis infection.
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PMID:Risk assessment and laboratory diagnosis of trichomoniasis in men. 143 Dec 54

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

The range of clinical presentations of HIV-related disease in Africa has not been adequately described, despite the fact that many hospitals have to rely heavily on clinical diagnosis. Six hundred adult medical patients seen in the Casualty Department of the main Government hospital in Nairobi were enrolled in a study of the presentation and outcome of HIV-related disease: 506 of these patients were admitted, of whom 19 per cent (95) were HIV seropositive. The remaining 94 were dealt with as outpatients: 11 percent (10) of these were seropositive. A history of prior treatment for sexually transmitted disease and, if male, being uncircumcised, were associated with being seropositive. Three presentations were strongly associated with HIV infection: acute fever with no focus except the gastrointestinal tract (enteric fever-like illness), acute cough with fever (community-acquired pneumonia) and chronic diarrhoea with wasting. The WHO clinical case definition (CCD) for AIDS missed a substantial amount of HIV-related morbidity (sensitivity 39 per cent) and misidentified many seronegative patients (positive predictive value 59 per cent). In comparison with the Centers for Disease Control surveillance definition for AIDS, the CCD was specific (91 per cent) and sensitive (79 per cent) but only had a positive predictive values of 30 per cent: the CCD may therefore be a poor surveillance tool for AIDS. Seropositive patients were much more likely to die than were seronegative patients (39 per cent vs. 15 per cent mortality). Enteric fever-like illness was the presentation which most commonly proved fatal. A wider spectrum of disease is associated with underlying HIV immunosuppression than has previously been described in Africa.
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PMID:The presentation and outcome of HIV-related disease in Nairobi. 143 66

Condoms have been used for thousands of years to prevent transmission of sexually transmitted diseases (STDs) and pregnancy. They have been made of various materials including oiled silk paper (in China) and muscle sheaths of enemies (in Ancient Rome). In the 1840s, vulcanization of rubber led to mass production of reliable and inexpensive condoms which made them widely available. In 1873, the US Congress passed the Comstock bill outlawing any information on contraception including condoms. Rather than issue condoms to troops during World War I, the Army lost about 7 million days of active duty due to STDs. In the 1930s, condoms began to be made with latex and the Food and Drug Administration (FDA) released its first quality control standards for condoms. The Army distributed condoms during World War II despite objections by church groups. Oral contraceptives and changing mores in the 1960s hurt the condom market. STD incidence increased. AIDS brought condoms back to the forefront during the 1980s. In 1987, the FDA began to test latex condoms for leaks which resulted in improved quality condoms. Nevertheless, condom use does not equal protection from STDs, HIV, and pregnancy and largely depends on correct and consistent use. Some people are allergic to the latex, lubricants, and perfumes, however. A female condom is expected to reach the market soon. In many countries, groups are promoting by using colorful and humorous marketing gimmicks. For example, an animated condom donning a soccer jersey entertained audiences at the world cup games. Sweden and Thailand use Proud Pete, a condom clad penis, to promote condom use. In the US, schools, AIDS activists, and clergy distribute condoms to prevent HIV transmission. Today there are at least 108 different condoms brands in the US with catchy names such as Blacky, Skin Less Skin Crown, and Rough Rider.
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PMID:A condom sense approach to AIDS prevention: a historical perspective. 143 22

By September 1991 Cameroon had reported 650 cases of the acquired immune deficiency syndrome (AIDS). The results from the sentinnel surveillance system showed a seroprevalence of human immunodeficiency virus (HIV)1 of 1.3% among pregnant women, 2.5% in people attending sexually transmitted disease clinics and 3.5% in tuberculosis patients in 1990. The estimated number of persons infected with HIV varies between 10,000 and 30,000. The World Health Organization projection model was used to make a short-term projection of HIV infection and AIDS cases; it indicated that the number of persons infected with HIV will double by the year 1995, with an estimated 8500 AIDS cases. Even in a low prevalence country such as Cameroon, the impact of the HIV epidemic is important and will result in a burden for the health care system.
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PMID:A short term projection of HIV infection and AIDS cases in Cameroon. 144 Aug 29

In the US. condoms for males are made of either lamb cecum or latex. Lamb cecum condoms are less elastic than latex condoms. Thus, they can come off the penis making them less effective form of protection from sexually transmitted diseases (STDs). They are also more expensive. Condoms come in several varieties (reservoir end and lubricated with a spermicide, nonoxynol 9) and in several sizes (standard and large). Their contraceptive effectiveness ranges from 64% to 97%. Study design, patient characteristics, and socioeconomic status may explain this broad range. Breaking, improper use, and inconsistent use account for contraceptive failures. Use with vaginal foam reduces the failure rate to 1 to 3%. Some advantages identified by consumers and health workers were peace of mind, ease of use, convenience, preventing, STDs, arousing to put on, easily obtained, safe and effective, no side effects or toxicity, inexpensive, medical supervision not required, and can be used as a backup contraceptive. Some disadvantages include reduced sensation, breakage or slippage and improper use. Men and women sometimes suffer allergic reactions from the lubricants, spermicides, or chemicals used in manufacturing. Pharmacists could advise consumers to switch to another condom brand. If this does not stop the irritation, the consumer should see a physician because an STD may be causing the irritation. In vitro studies indicate that nonoxynol 9 kills or inactivates many STD pathogens including herpes simplex virus and HIV. A female condom should be available by the end of 1992. Trials show it to protect effectively against pregnancy and STDs. Even though neither the female condom nor diaphragm cause vaginal trauma, the condom does not change the vaginal flora significantly. Pharmacists should familiarize themselves with the different types of male and female condoms and be able to adequately counsel customers about their correct use and safe sex practices.
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PMID:Choosing condoms. 144 56


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