Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article, intended for use by practitioners in India, summarizes the US Centers for Disease Control's recommendations for the management of sexually transmitted diseases (STDs). The STDs presented are chancroid, genital herpes, granuloma inguinale, lymphogranuloma venereum, syphilis, urethritis, chlamydia, gonococcal infection, bacterial vaginosis, trichomoniasis, vulvovaginal candidiasis, pelvic inflammatory disease, epididymitis, human papillomavirus infection, warts, hepatitis B, and ectoparasitic infections. For each STD, information is provided on treatment, follow up, and special circumstances such as pregnancy and concomitant HIV infection.
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PMID:1998 management recommendations for sexually transmitted diseases. 1229 52

Current research efforts are addressing the potential use of nonoxynol-9 and other spermicides as an effective female-controlled contraceptive method. In the laboratory, nonoxynol-9 is lethal to organisms that cause gonorrhea, syphilis, trichomoniasis, genital herpes, and HIV, but findings of human studies have been inconsistent. Carrageenan, a compound derived from red seaweed, has been combined with nonoxynol-9 in an effort to develop a spermicide that will protect against HIV and pregnancy. A novel gel formulation that contains low amounts of octoxynol-9 and benzalkonium chloride is scheduled to enter a Phase III trial. The first part of the trial will determine the product's effectiveness in preventing pregnancy and halting the transmission of chlamydia and gonorrhea; the second will focus on HIV. Another Phase III clinical trial is testing a bioadhesive contraceptive gel that contains nonoxynol-9. Also under study is a vaginal sponge that contains low levels of nonoxynol-9 and benzalkonium chloride. Finally, researchers are evaluating the potential for precoating diaphragms and cervical caps with a spermicide.
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PMID:Spermicides examined in microbicide research. 1229 64

At present, about 250 million new cases of sexually transmitted diseases (STDs) occur in the world each year. This statistics includes 120 million cases of trichomoniasis, 50 million cases of chlamydia, 30 million cases of genital warts, 25 million gonorrhea cases, 20 million cases of genital herpes, 3.5 million syphilis cases, 2.5 million case of hepatitis B virus, 2 million cases of chancroid, and 1 million infections with human immunodeficiency virus (HIV). Among the adverse health sequelae the STDs are sterility, infertility, stillbirth, miscarriage, blindness, brain damage, and cancer. The greatest incidence of STDs is in the 20-24-year age group, followed by persons 15-19 years of age. The finding that lesions caused by some STDs can increase the risk of HIV infection by more than 300% has led governments concerned with control of acquired immunodeficiency syndrome (AIDS) to take a more aggressive stance toward the prevention and treatment of STDs. There are many obstacles to STD prevention, however, including the development of treatment-resistant strains, inadequate infrastructure for diagnostic testing and penicillin treatment, resistance to changing sexual behavior, increased travel and migration, and the practice of exchanging sex for drugs. Even in some developed countries where the rate of STD infection has finally stabilized, the level remains unacceptably high and STDs cannot be considered as under control. In developing countries, STDs have reached epidemic levels and the number of new infections reported annually shows a pattern of steady increase. The World Health Organization is urging governments to intensify STD prevention activities through funding research, health education, and more accessible clinic services.
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PMID:Sexually transmitted infections increasing -- 250 million new infections annually. 1231 65

Health officials began neglecting sexually transmitted diseases (STDs) (syphilis, gonorrhea, chlamydia, trichomoniasis, and chancroid) when the AIDS epidemic began. They now refocus efforts on STDs because data indicate that STDs facilitate HIV transmission. Even though the risk of HIV transmission is lower in people with nonulcerative STDs than those with genital ulcers (0-4 vs. 2-5 times), the link between nonulcerative STDs and HIV transmission is a greater problem since nonulcerative STD cases occur more often than genital ulcers. Many AIDS control programs execute STD control activities. Countries must improve existing STD control programs. They should strengthen STD surveillance. Viet Nam has established surveillance sites at STD clinics in 4 cities. Training different health providers in STD control would make STD services accessible to more people. These providers include nurses, midwives, pharmacists, and even traditional healers and should be based at pharmacies and primary health care, maternal and child health, and family planning clinics. Primary health care workers should use symptoms to diagnose and treat STDs rather than laboratory tests. 1 drawback of this syndromic approach is that about 50% of women do not exhibit STD symptoms. STD control programs must guarantee a steady reserve of drugs. In Zimbabwe, primary health clinics receive STD drugs from a decentralized drug distribution system (5-8 warehouses) rather than the older centralized system (1 warehouse). This has reduced the waiting time from 6 months to 4-6 weeks. Programs need to encourage individuals to seek early treatment of STDs via health education campaigns (e.g., mass media), outreach to high risk groups such as prostitutes and the patron, and contact tracing. STD counselors should promote condom use. An STD program in Nairobi, Kenya informs patients to use a condom during sex with any causal sex partner, shows patients how to put on and take off the condom, and tells them where they can obtain condoms.
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PMID:The other STDs. Linked with HIV transmission, they are attracting new attention. 1231 33

The US Food and Drug Administration (FDA) is expected to soon approve the Reality female condom (polyurethane sheath lining the vagina) which will be distributed to sexually transmitted disease (STD) and family planning clinics instead of retail outlets. The importer and eventual manufacturer, Wisconsin Pharmaceutical Company in Jackson, Wisconsin, aims to educate providers first. It plans to sell Reality to clinics at about half the commercial price which is $2.50. The FDA's Obstetrics and Gynecology Devices Advisory Panel asked the manufacturer for the results of a contraceptive efficacy study in January 1992 before it would grant its full recommendation for approval which it did in December 1992. Reality had a contraceptive effectiveness rate of 88% with typical use and of 95% with perfect use. Since the study was only 6 months, the panel requested the manufacturer to include on the label that the clinical data are limited. The study revealed that there was only a 2.8% probability of exposure to semen due to rips, tears, and outer ring movement. Reality had a lower rate of breaks and tears than the male condom 1% vs. 4%). Health workers did not note any sperm or vaginal trauma or change in bacterial flora in women who used the female condom on multiple occasions. None of the Reality users who had earlier had trichomoniasis became infected again while almost 15% of women in a control group and in a group of intermittent Reality users became reinfected with trichomoniasis. Neither HIV nor the hepatitis B virus could pass through the female condom. No one has claimed significant allergic reactions to or side effects from Reality. Overall, women liked Reality, the most common complaint being the outer ring rests outside the vagina.
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PMID:Clinics first to receive female condom. 1231 87

Each year 250 million new cases of sexually transmitted diseases (STDs) have the potential to cause pelvic inflammatory disease, infertility, blindness, and death. Sometimes the onset of these STDs is symptomless, but the following conditions indicate the presence of an STD: genital discharge, sores, wounds, or blisters; swollen glands in the groin; cauliflower-like growths on the genitals; skin rash; lower abdominal pain in females; painful swelling in the testicles; alopecia; discharge from the eyes; and pain during intercourse. The 5 most common STDs which can be cured with antibiotics are chancroid, chlamydial infection, gonorrhea, syphilis, and trichomoniasis. By the end of 1994 in Uganda, 390 primary health units will be available for STD treatment, and most health workers will be trained in STD patient management. Since patients will receive the minimum amount of treatment needed to cure the STD, they will be well advised to use the drugs provided. Notification of all recent sex partners is also essential, and sex partners should be evaluated even if they are asymptomatic. Patients are advised to engage in safe sex behavior, including remaining faithful to a monogamous relationship and using condoms, and to seek medical advice if they develop STD symptoms or are exposed to STD. The AIDS virus is also transmitted through sexual intercourse as well as through blood transfusions, from mother to child, and through the use of contaminated needles. HIV infection progresses from a stage where it cannot be detected to an asymptomatic stage to a symptomatic stage. Chronic diarrhea, fever, and weight loss are the major symptoms. There is no treatment for HIV infection, but zidovudine (AZT) can delay progress of the disease. The most important treatment available is counseling and understanding. The Uganda AIDS Commission works to control the disease through education, treatment of STDs, provision of safe blood for transfusion, monitoring, counseling patients, and promoting research. The primary objective in the care of AIDS patients is to improve the quality of their life as much as possible.
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PMID:Telling signs and symptoms. 1231 60

Sexually transmitted diseases (STDs) are infections which are spread through sexual contact. Common STDs include syphilis, gonorrhea, chlamydia, herpes, AIDS, genital warts, chancroid, and trichomoniasis. Some STDs are caused by bacteria, while others are viral. Antibiotics can often effectively defeat bacterial infections, but few treatments are effective against viral infections. The viral STDs herpes and warts are painful and/or unsightly, while HIV infection is fatal. STD infection may be acquired through sexual contact with the penis, vagina, anus, mouth, and throat. Sexual abstinence, mutual monogamy with a non-infected sex partner, and sexual intercourse with the consistent, proper use of a latex condom are ways to avoid contracting and transmitting STDs through sexual intercourse. If one uses IV drugs, it is important to not share injecting equipment. If a partner refuses to use a male condom, a female condom may be used. Polyurethane condoms are also available on the US market for people who are allergic to latex. Male and female condoms are available over the counter in drug stores, supermarkets, and convenience stores. It remains unclear whether nonoxynol-9, the active ingredient in most US spermicides, prevents or facilitates HIV infection. STD infection is often asymptomatic in women. An individual who suspects being infected with HIV should seek attention by a health care provider.
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PMID:Sexually transmitted diseases (STDs), risk of HIV infection, and condoms: what you need to know. 1232 Feb 24

More and more women are becoming infected with HIV. While the use of male condoms greatly reduces the transmission of HIV, the condoms must be used correctly and consistently in order to confer protection against contracting an infection, and their use is not controlled by women. Female condoms are a barrier method which women can use, but there use may be objectionable to some men, who can see the condoms' outer ring. However, women can easily control the use of vaginal microbicides. Several such products are being researched. Some use nonoxynol-9 or other surfactants, while others include acid buffering gels; natural products such as lactobacillus crispatus, antimicrobial peptides, magainins, or plant extracts; inhibitors of viral entry; post-binding fusion inhibitors; and reverse transcriptase inhibitors. While in vitro tests have found that spermicides containing nonoxynol-9 (N-9) kill organisms which cause gonorrhea, genital herpes, trichomoniasis, syphilis, and AIDS, the disruptive effect of N-9 upon the vaginal epithelium raises questions upon the merit of their use and their overall effectiveness in preventing disease transmission. The ideal microbicide should be effective against HIV/STDs, nonirritating, long-acting, inexpensive, readily available, and easy to use. It should be available in spermicidal and nonspermicidal formulations.
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PMID:Vaginal microbicides needed for female-controlled prevention. 1232 62

This article discusses some of the issues involved in the prevention and control of STDs, particularly as it affects HIV transmission. As research studies have revealed, STDs -- especially those that cause genital ulcers -- may increase the chance of HIV transmission by as much as 50 times in a single act of intercourse. In most cases, genital ulcers are usually the result of chancroid or syphilis, infections that are generally less common than STDs that do not cause genital ulcers, such as chlamydia, gonorrhea, and trichomoniasis. The relation between nonulcerative STDs and HIV has yet to be assessed; nonetheless, experts agree that prevention of HIV requires a global initiative for the prevention and control of STDs. Because of the new and more crucial dimensions of STD infections, focus has shifted away from special treatment and referral centers to primary health care clinics and health education. The new grassroots level effort centers around the so-called "syndrome-based" approach to diagnosis and treatment of STDs. Instead of concentrating on the causative agents involved, the approach focuses on groups of signs and symptoms -- syndromes. The syndrome-based approach allows treating large numbers of people with limited resources. But in order for the approach to work, local health care workers must know which STDs are present in the country or region and how the STDs respond to various treatment regimens, which in turn requires research. The article reports some of the prevalence rates presents in different parts of Africa. While syphilis and chancroid can be easily treated with penicillin-based antibiotics, gonorrheal strains are becoming increasingly resistant to such treatment. And so far, not drug treatment exists of viral infections such as HIV and herpes.
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PMID:What should you know about STDs? 1234 57

Sexually transmitted diseases (STDs) are major public health problems which often lead to serious complications and sequelae, including infertility. Infection with STDs also facilitates the transmission of HIV, making the early diagnosis and care of STDs integrated into other services one of the most cost-effective strategies to prevent the spread of HIV. The direct and indirect costs of STDs worldwide are considerable. Sub-Saharan Africa ranks first in STD yearly incidence compared to other world regions. The World Health Organization has estimated that every year in Africa there are 3.5 million cases of syphilis, 15 million cases of chlamydial disease, 16 million cases of gonorrhea, and 30 million cases of trichomoniasis. STDs are a high public health priority especially because of their widespread prevalence and treatability. Herpes simplex virus infection and human papillomavirus infection are growing problems in sub-Saharan Africa. While STDs are caused by more than 20 microorganisms, they present themselves mainly in 4 syndromes and may therefore be treated syndromically. Africa must implement effective and comprehensive integrated activities against the STD epidemic. Elements of such a strategy will include disease prevention, screening and case finding, and the early diagnosis and treatment of cases.
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PMID:Sexually transmitted diseases in Africa: time for action. 1234 88


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