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Target Concepts:
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Query: UMLS:C0019693 (
HIV
)
170,526
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Since crack cocaine appeared in urban areas in the United States in the mid-1980s, reports have suggested that crack smokers may be at increased risk of sexually transmitted diseases (STDs), including infection with
HIV
, because they have multiple sex partners, trade sex for money or drugs, and rarely use condoms. A cross-sectional survey is being conducted in urban neighborhoods in Miami, New York and San Francisco--where crack use is common--to explore these issues. Indigenous street outreach workers are recruiting men and women who are either current regular crack smokers or who have never smoked crack; each group is further stratified according to whether participants had ever injected drugs. Participants were interviewed about their sexual and drug-use practices. Overall, crack smokers, whether injectors or not, engaged in higher-risk sexual behaviors than nonsmokers, reported greater numbers of sex partners than nonsmokers, and were more likely than nonsmokers to have exchanged sex for money or drugs or to have had an
STD
. Differences between crack smokers and nonsmokers were generally greater among non-injectors than among injectors, and generally greater among women than among men. Condom use, although somewhat more common with paying than nonpaying partners, was infrequent overall. Most of the subjects had not been in substance abuse treatment in the preceding 12 months, and a majority had never been in substance abuse treatment. Education and prevention programs specifically targeted at crack smokers not currently in substance abuse treatment are needed to reach these high-risk persons.
...
PMID:High-risk sex behavior among young street-recruited crack cocaine smokers in three American cities: an interim report. The Multicenter Crack Cocaine and HIV Infection Study Team. 149 Dec 85
A study was conducted to examine the relationship between coital frequency and risk behavior in relation to the number of coital partners and contraceptive/protective behavior and to study changes in contraceptive/protective techniques from 1st to most recent sexual intercourse. Data were gathered from 3000 Norwegians aged 17-19 years in anonymous self-administered questionnaires. A 63% response rate was achieved. 51% reported having used condoms at 1st intercourse, while 7% used contraceptive pills. 31%, however, used condoms most recently, while 38% employed the pill. Contraceptive pills were used most commonly among respondents with high coital frequency and few partners. Condom use was not particularly widespread among those with relatively large numbers of coital partners. Concerning beliefs about the ability of condoms to protect against sexually transmitted diseases (STD),
HIV
, and pregnancy, no significant differences were observed between those planning to use condoms and those not planning to use them at next coitus. In sum, results indicate that the majority of youths use condoms to protect against pregnancy, not
STDs
. The tendency toward serial monogamous relationships increases dependence upon the pill at the expense of the condom and makes sexually active teens less prepared to protect themselves against
STDs
in certain situations. Teens need to be taught about the protective value of condoms, with greater condom availability ensured where youths congregate.
...
PMID:Use of birth control pills and condoms among 17-19-year-old adolescents in Norway: contraceptive versus protective behaviour? 149 44
Between June 1987 and August 1989, physicians enrolled 323 tuberculosis (TB) patients and 116 health employees at the Arua Regional Hospital in a rural district of northern Uganda in a case control study. They wanted to look at the link between TB and
HIV infection
. TB patients were more likely to be
HIV
seropositive than the employees (18.3% vs. 7.7%; p .005).
HIV
seropositive individuals tended to be men (71.2% vs. 54.9% for controls; p .05) whose mean age was 27.69 years. Most
HIV
/TB patients lived in the town of Arua (50% vs. 7% in rural areas peripheral to Arua and 1.6% in a rural area near the district border; p .0001).
HIV
seropositive TB patients were more likely to have a
sexually transmitted disease
(
STD
) than
HIV
seronegative TB patients (47.4% vs. 12.5%; odds ratio [OR] = 6.32; p .0001), especially gonorrhea (p .0001). They also tended to have had more than 5 sexual partners in the past 2 years (mean number of partners among
HIV
seropositive TB patients = 10.6; 35.6% vs. 9.5%; OR = 9.24; p .0001).
HIV
seropositive TB patients were more likely to have participated in prostitution and to have had a blood transfusion than
HIV
seronegative TB patients (33.9% vs. 3.8%; OR = 13.03; p .001 and 6.8% vs. 1.1% OR = 6.33; p .05). Skin piercing, widely practiced in rural areas, appeared to have a protective effect against
HIV infection
(OR = .33; p .0005).
HIV
seropositive TB patients were significantly more likely to have a persistent cough of more than 4 months duration (p .001), fever lasting for more than 1 month (p .05), oral thrush (p .0001), lymphadenopathy (p .0005), and amenorrhea (fertile women only, p .005). 27 or 28 TB patients had AIDS. At the time of submission of this study for publication, 18
HIV
seropositive TB patients died during treatment. The case fatality rate was indeed higher among
HIV
seropositive TB patients than among
HIV
seronegative TB patients (30.5% vs. 8.7%; p .0001). The TB-AIDS survival rate was 46.4% at 6 months, 32.1% at 12 months, and 21.4% at 16 months. Median survival time was 5 months.
...
PMID:Tuberculosis and HIV infection association in a rural district of northern Uganda: epidemiological and clinical considerations. 149 36
Three hundred and fourteen homosexual/bisexual men at risk for human immunodeficiency virus (HIV) infection (170 seroprevalent HIV-positive, 144 seronegative) were prospectively studied over 8 years to assess rates of
HIV infection
and disease progression, in conjunction with cellular and HIV serological markers. In HIV-positive subjects, CD4+ lymphocyte counts rose strikingly during the period surrounding seroconversion, then fell progressively over the intervening period to a mean level of 300 cells/mm3 when AIDS developed. Changes in CD8+ lymphocyte counts were less consistent. The trend for HIV serological markers over the study period was of progressive decline in the proportion of subjects with anti-p24 antibody, associated with an increase in the proportion of subjects with detectable HIV antigenaemia. However, only 45% of subjects tested had lost anti-p24 antibody by the time of AIDS diagnosis, and HIV antigen was detectable up to 4 years before this. Different HIV serological patterns were also observed in subjects presenting either with Kaposi's sarcoma or opportunist infections. Our data support the continued use of cellular and virological markers in the evaluation of
HIV disease
; however, the variability observed in this study highlights their limited ability in predicting specific clinical events. Care should therefore be taken to encompass both clinical and laboratory information in the medical assessment of the HIV-infected individual.
Int J
STD
AIDS
PMID:Eight year prospective study of HIV infection in a cohort of homosexual men--clinical progression, immunological and virological markers. 150 57
The prevalence of hairy leukoplakia was determined among 176 symptomatic
HIV
seropositive patients seen at the outpatient department of the Institute of Tropical Medicine in Antwerp, Belgium. Moreover, systematic tongue biopsies were performed during postmortem examination of 21 patients with AIDS, 100
HIV
seronegative immunocompromised patients with haematologic or other malignancies and 100
HIV
seronegative non-immunocompromised patients who died at the University Hospital Antwerp. Hairy leukoplakia was observed in 52 (29.5%) of the outpatients, but only in one (5%) of the AIDS patients in the postmortem study (P = 0.03). An explanation for this difference may be that significantly more AIDS patients who died had received either acyclovir or ganciclovir during the 3 months prior to the postmortem examination than the
HIV
seropositive outpatients during the 3 months prior to examination. Hairy leukoplakia occurred more often in Caucasian homosexual men with
HIV infection
(38%) than among heterosexual Africans with
HIV infection
(17%) (P = 0.06). Hairy leukoplakia was observed in none of the
HIV
seronegative patients.
Int J
STD
AIDS
PMID:The prevalence of hairy leukoplakia in HIV seropositive and HIV seronegative immunocompromised patients. 150 55
A significant proportion (10%) of notified AIDS cases in Portugal are due to HIV-2 infection as a result of the close connections of Portugal with Western African Countries (ex-Portuguese colonies) where there is a high
HIV
-2 seroprevalence. We conducted a seroepidemiological study of
HIV
-1 and HIV-2 infection in 1400 women attending family planning and antenatal clinics in a health centre in Lisbon with the objective of analysing whether there was evidence of
HIV
-2 spread in this population. The seroprevalence for
HIV
, as determined by ELISA and confirmed by Western Blot, was 0.42% (6 cases) and 50% of these were of HIV-2 infection. Analysis of the epidemiological inquiries reveals that out of the 6 seropositive cases, only one was a drug addict (
HIV
-1) and another a western African black woman (
HIV
-2). The other 4 cases (2
HIV
-2 and 2
HIV
-1) were white Portuguese women with no history of travelling to Africa or previous blood transfusions, and the only risk factor was a history of multiple sexual partners (in 3 out of 4).
Int J
STD
AIDS
PMID:Prevalence of HIV-2 infection in a family planning clinic in Lisbon. 150 61
Evidence of reduced levels of needle sharing among injecting drug users (IDUs) has largely been confined to IDUs attending needle exchanges or receiving treatment. In this paper we present the results of a serial cross-sectional study of needle sharing conducted in Glasgow using a multisite sampling strategy. Of the estimated 9400 IDUs in the city, 503 were interviewed in 1990 and 535 in 1991. The proportion of IDUs reporting injecting with, or passing on used needles and syringes in the last 6 months fell significantly as did the number of individuals from whom equipment was received or passed on to. The impact of this level of sharing has been limited in terms of
HIV
transmission; the prevalence of
HIV
among the 1990 sample was 2.0% and 1.1% for the 1991 sample. However, the fact that third of IDUs in Glasgow continue to inject, even occasionally, with used equipment gives cause for concern in view of the other pathologies known to be associated with poor injecting hygiene.
Int J
STD
AIDS
PMID:Reduction in needle sharing among community wide samples of injecting drug users. 150 63
The case of an
HIV
-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to
HIV infection
. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple
STDs
could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.
...
PMID:Multiple sexually acquired diseases occurring concurrently in an HIV positive man: case report, diagnosis and management. 150 24
Compared with both industrialized countries and other less developed parts of the world, most of sub-Saharan Africa suffers inordinately from sexually transmitted diseases (STDs). It has high prevalence rates of traditional STDs, such as gonorrhea and syphilis, and if accurate seroprevalence surveys were to be done, it would probably prove to have the highest
HIV
seropositive incidence in the world. Unlike the pattern in the West, AIDS is primarily a heterosexually transmitted disease in Africa. This appears to be largely because of the prevalence of other untreated or improperly treated STDs. Therefore to lower the incidence of STDs would be to curtail the spread of
HIV infection
. The problem becomes how exactly to accomplish this. Most
STD
cases are never even presented at biomedical health facilities; they are presented to traditional healers. Both healers and their patients seem to believe that traditional
STD
cures are more effective than 'modern' cures, although the former are probably biomedically ineffective. While there is scant ethnomedical literature on STDs in Africa, the present paper presents Swaziland findings and related evidence from other African societies that the ultimate cause of several common STDs is believed to be the violation of norms governing sexual behavior, requiring traditional rather than biomedical treatment. Traditional healers therefore need to be a central part of any scheme to lower the incidence of STDs.
...
PMID:Sexually transmitted disease, ethnomedicine and health policy in Africa. 150 1
A network of surveys of
HIV
seroprevalence in American Indians and Alaska Natives (AI/AN) was begun in 1989. From July 1, 1989 through June 30, 1991, 37,681 serologic specimens were collected from prenatal and
sexually transmitted disease
patients in 58 facilities operated or funded by the Indian Health Service. Specimens from AI/AN women receiving initial prenatal care showed an overall
HIV
prevalence of 0.3/1,000, while specimens obtained during the third trimester of pregnancy showed an overall prevalence of 1.0/1,000. The rate for rural third trimester prenatal patients (0.9/1,000) was similar to that for urban patients (1.1/1,000).
HIV
rates among third trimester AI/AN patients in three western states were 4 to 8 times higher than rates observed in childbearing women of all races in those states. The overall
HIV
seroprevalence in AI/AN seeking care for sexually transmitted diseases was 4.5/1,000 for males (urban 10.8/1,000; rural 2.0/1,000) and 0.7/1,000 for females (urban 0.9/1,000; rural 0.6/1,000). Approximately 1,210 to 4,250 (midpoint of range = 2,730) AI/AN in the U.S. are projected from survey findings to be currently infected with
HIV
. The presence of
HIV
in multiple specimens from rural areas and the similarity of
HIV infection
rates for female patients from rural and urban locations provides evidence of diffusion of the
HIV
epidemic to rural AI/AN, and emphasizes the need for effective
HIV
prevention for this population.
...
PMID:HIV infection in American Indians and Alaska Natives: surveys in the Indian Health Service. 151 65
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