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

HIV infection in children is mainly the result of a mother-to-child transmission. The contamination during pregnancy is well known but intrapartum vertical transmission may also occur through ascending infection, blood exchange between mother and child, or direct contact with vaginal or cervical secretions. In addition HIV can be transmitted via breast milk. The reported rates of vertical transmission are highly variable: 14.4% in a European study, 18.3% in a French survey, 20 to 25% in the USA, 35 to 50% in Africa. It is unclear whether such a large variation of the rate of transmission is due to methodological differences or to different distributions of risk factors in the populations. There are some known predictive factors of HIV transmission such as low CD4 cells count, positive p24 antigenaemia and elevated concentrations of virus. The role of other factors is still debated: prematurity, virus (CMV, HTLV-1, HVB, HVC), C section prior labour, rupture of membranes. The prevention of HIV infection in infants is mainly based on contra-indication of pregnancy in infected women, desinfection of the vagina at the beginning of labour, early protection of the newborn by avoiding skin lesions and immediate washing, preventive treatment by zidovudin during pregnancy.
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PMID:[Maternal-fetal transmission of HIV]. 773 51

An exploratory study was conducted in Malawi to determine whether a correlation exists between human immunodeficiency virus (HIV) and traditional practices involving the intravaginal application of substances such as herbs and pulverized stone. Included in the survey were 6603 consecutive consenting volunteers who presented at the prenatal clinic of an urban hospital from October 1989-October 1990. The median age of study participants was 24 years. Although only 11% reported having had a sexually transmitted disease (STD) in the three years preceding the interview, laboratory analysis revealed the presence of such an infection in 46%. HIV infection was found in 1502 (23%). A total of 2953 (45%) of these pregnant women reported use of vaginal agents or vaginal incision, either for the treatment of discharge or itching or for the enhancement of sexual pleasure through vaginal tightening. Concerns have been raised that the placement of desiccants, irritants, and astringents in the vagina can induce certain physiological changes that increase the risk of HIV infection. Demonstrated in this survey was a slight association between HIV seropositivity and the use of vaginal agents for self-medication but not for vaginal tightening. In the univariate analysis, this finding persisted only for pregnant women without past or current STD infection. In the multivariate analysis, users of vaginal agents for treatment had a small increased risk of HIV in addition to--and independently of--the risk conferred by an STD history. It is possible, however, that the use of vaginal agents for self-medication is a marker for the presence of genital tract inflammation--a co-factor for HIV transmission. Given the extent of this traditional practice and its potential risk, more research is urged on the type of vaginal agents used and their effects on vaginal tissue.
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PMID:Traditional vaginal agents: use and association with HIV infection in Malawian women. 775 19

As of August 12, 1993, a total of 2804 cases of acquired immunodeficiency syndrome (AIDS) had been required in South Africa, however, this statistic is an understatement of the scope of the epidemic since AIDS is not a notifiable disease. Most cases are concentrated in the 20-39 year age group, with equal numbers of males and females infected. Present AIDS cases represent infections transmitted 5-10 years ago, and current human immunodeficiency virus (HIV) seroprevalence rates suggest that there will be a dramatic upsurge in AIDS in the years ahead. This trend mandates more aggressive implementation of South Africa's AIDS strategy, especially in rural areas. In need of attention is the African sex practice of inserting a herbal mixture or Colgate toothpaste in the vagina before intercourse to contract, dry, or heat it. Dry sex has been associated both with increased rates of HIV transmission and reduced condom use. Studies as to whether male circumcision reduces the risk of HIV infection have reached opposite conclusions, so no recommendation has been issued regarding this practice. Encouraging has been the achievement of a safe blood supply in Zambia and Uganda. In Uganda, the HIV infection rate dropped between 1989 and 1993 among voluntary donors from 13.5% to 4.8% and among replacement donors from 24.1% to 9.6%. Uganda's program includes an emphasis on voluntary donors, counseling, assessment of HIV risk factors, identification of low-risk populations, and retention of blood donors through the organization of "Life Givers" clubs.
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PMID:AIDS: an impending disaster. 817 1

A female condom has been developed which is effective in preventing pregnancy and sexually transmitted diseases (STDs), including HIV infections. The condom is a soft, loose-fitting polyurethane sheath which has a closed inner ring which covers the cervix and an open outer ring, which protrudes visibly from the vagina and covers the labia. The female condom may be more effective than the male condom in preventing transmission of HIV and herpes. The polyurethane is stronger and probably less likely to tear than the latex used in male condoms. In a 6-month trial of use in 240 US women, 12.4% became pregnant with "typical" use and 2.6% with "perfect" use. These rates are comparable with other female barrier contraceptives. Some aspects of the female condom are unacceptable to some women, including the protrusion from the vagina and the fact that it covers the clitoris. Other women found that the device enhanced clitoral sensation. Problems with the condom being pushed into the vagina or pulled out during intercourse may be addressed by the application of additional lubrication. A substantial number of users reported that the female condom was an acceptable method of contraception. It is the only female-controlled contraceptive which provides protection against pregnancy and STDs. It will cost approximately US $1.25 for family planning clinics and $2.50 for individuals.
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PMID:The female condom. 826 4

Beginning in January 1989, consecutive female admissions to the ARTC MMTP Clinics in NYC were interviewed about their medical, drug, sexual and social experiences during 6 distinct historical years. Bloods were drawn and each sample tested for HIV via ELISA and Western Blot analysis. The data for 256 females was analyzed. The sample was predominantly Black (56%) and Hispanic (36%). Fifty-four percent (140) were between the ages of 31 and 40; 35% (91) were between the ages of 18 and 30; and 10% (27) were 41 or older. The majority, 179 (69%), had less than a high school education, while 79 (31%) had a high school education or greater. The seropositivity for this sample of females was 60.4%. Aside from the common types of illnesses often seen in gay men infected with the HIV virus (i.e., pneumonia, night sweats, sore throat and swollen glands) our sample of females presented with symptoms such as abnormal discharges from the vagina, infections or abscesses of the veins, kidney or bladder infections, bleeding from the bowels and hepatitis infections. The most commonly reported risk factors among our sample of HIV positive females were sharing injecting materials (38%); injecting drugs in the veins (37.2%); dividing an injection (24.3%); and blood transfusions (10.9%). Of our HIV positive females, 42 of 97 (43.3%) reported having sex with a man they shared needles with only one time so that having sex with a man who is potentially infected with the HIV virus only once may be enough for a female to seroconvert. One limitation of this data is that there is no knowledge of when the HIV positive women seroconverted. Some of the behaviors reported could be due to exposure to AIDS education, and not to the knowledge to their HIV serostatus.
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PMID:Demographic, medical history and sexual correlates of HIV seropositive methadone maintained women. 829 33

A microbiologist at Loma Linda University in California used T7 (100 nm), a virulent bacteriophage of Escherichia coli, and the poliovirus type 1 (PC-1) (27 nm) to compare the efficacy of the viral barrier of latex and new thermoplastic elastomer (TPE) condoms. The scientist used a passive test and a simulated intercourse model to compare the 2 condom types. The simulation consisted of a condom-covered disposable centrifuge tube with 4 ml of virus which was inserted into an outer condom with 2 ml of virus-free medium. This apparatus was withdrawn and inserted 30 times within 30 seconds into a commercially produced latex vagina. The tests with T7 used 15 condoms of each brand. The tests with PV-1 used 14 condoms of each brand. The only TPE condom brand was Tactylon. Latex condom brands were Shiek, Trojan-Enz, and Lifestyles. No virus passed through the barrier during the passive test. T7 leaked through 2 latex condoms (13.3%) of the same brand (Trojan-Enz) during the simulated intercourse test. On the other hand, PV-1 did not leak through any of the condoms. Tactylon effectively prevented the passage of both T7 and PV-1. These findings confirmed that latex condoms tend to block passage of both small and large viruses. They indicated that TPE condoms also block passage of small and large viruses. Thus, the effective maximum pore size in all of the TPE condoms and in all but 2 of the latex condoms was too small to let HIV (80-120 nm) and hepatitis B virus (about 42 nm) filter through. Clinical trials have indicated the breakage rate of TPE condoms is not significantly different from that of latex condoms. Advantages of the TPE condom are its ability to resist environmental effects, e.g., ultraviolet light and heat, which deteriorate the latex condom and it does not have antioxidants and accelerators the latex condom has which cause allergic reactions, e.g., dermatitis.
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PMID:Efficacy of thermoplastic elastomer and latex condoms as viral barriers. 839 26

In the summer of 1991, a project director, codirector, and a US nursing student observed infection control practices of obstetric nurse and midwives before, during, and after vaginal deliveries and Cesarean sections at 12 health facilities in the North and South Birim districts in rural eastern Ghana to gather baseline data which the Ministry would use to design intervention strategies to reduce puerperal infections. Most of the midwives and obstetric nurses did not use aseptic techniques. They did not wash lancets for hemoglobin testing between uses and stored them in small glass containers or in disinfectant, but the disinfectant was often moldy. Reusable instruments were washed with a bar of soap rather than with detergent. The predominant disinfection technique was boiling, but the staff did not time the boiling or fully immerse the equipment. They often used Dettol to disinfect equipment, yet this is ineffective. The hospital had an autoclave, but it was often used incorrectly. The facilities had an inadequate supply of needles, syringes, and gloves. Staff reused needles and syringes and did not wear gloves when they were available. Even though 81% knew that exposure to blood placed them at risk of hepatitis B virus and HIV, just 69% thought that they should wear gloves. Physicians prescribed antibiotic prophylaxis too late and too long for Cesarean section patients. 47% of the women in the area place herbs or spices in the vagina within a week after delivery, but the health workers did not tell the discharged mothers not to insert anything into the vagina. The nurses and midwives did not give the women adequate discharge instructions about umbilical cord stump care, yet most women did not bring their newborns back to the facility for such care.
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PMID:Obstetric infection control in a developing country. 847 37

In an attempt to elucidate the potential association between genital infections and low birth weight (LBW) births, 51 women with LBW neonates were identified and compared to 51 women with normal birthweight (NBW) neonates. Both groups were matched according to age and parity. All women were subjected to interviews regarding socioeconomic background and obstetric history. The were examined clinical and tested regarding serum haemoglobin, malaria parasitaemia, syphilis and HIV serology. Cultures were taken from the vagina, endocervix, amniotic fluid and from various sites of newborn, including the conjunctivae and the stomach and from the interior of the placenta. Whilst socioeconomic background factors did not differ among cases and referents, previous neonatal death did. Significant differences were also found in mid-upper-arm circumference (OR 3.08) and body mass index (OR 6.00). The prevalence of alleged risk factors according to the antenatal card was similar among cases and referents. Birthweight < 2,000 g was significantly more often associated with chorioamnionitis than birthweight between 2,000 and 2,499 g (OR 5.46). Bacteriological findings did not show significant differences in cases and referents. Haemoglobin values and prevalence of malaria parasitaemia were similar as was the neonatal mortality. It is concluded that LBW births is difficult to predict by use of alleged risk factors in existing antenatal cards.
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PMID:Low birth weight and genital infections. An incident case-referent study. 852 52

Women with prelabour fetal death in the third trimester were recruited in order to study the association between intra-uterine death and maternal genital colonization of bacteria. Fifty-eight women with verified fetal death were compared with a group of 58 women matched for age, parity and gestational length (the first referent group) and with women delivering liveborn neonates (second referent group). Cultures from the vagina, the endocervix, the amniotic fluid, the placenta, the conjunctivae of the newborn and the secretion of gastric aspirate of the newborn were carried out. Blood was taken for haemoglobin, thick film (malaria) and syphilis and HIV serology. Cases were more affected by previous stillbirths than first referents (OR = 11.88). Preterm delivery was significantly more common in cases than in second referents (OR = 57.70). Cases had significantly more often < 3 ANC visits (OR = 2.81). Cases had a lower body mass index than first referents (OR = 2.38). Temperature > or = 37 degrees C was 12 times more frequent in cases than in first referents (OR = 21.20) and four times more frequent than in second referents (OR = 6.60). Average birth weight among stillborns was 1954 g and in liveborns 3223 g (P = 0.001). The corresponding prevalence of LBW was 78% in cases and 0% among second referents (P < 0.001). Histological chorioamnionitis was significantly prevalent in cases than in second referents (OR = 4.97). Syphilis was significantly more common in cases than in first (OR = 7.71) and in second referents (OR = 5.30).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Genital infections in the aetiology of late fetal death: an incident case-referent study. 853 Dec 55

Heterosexual intercourse accounts for 80% of HIV transmission in sub-Saharan Africa. Factors facilitating cross-infection may include sexual practices such as the vaginal use of herbs/substances to dry, contract and heat the vagina for enhancement of sexual pleasure. The behavioural-analytic study investigated the use of different types of herbs/substances used by 75 HIV positive and 76 negative sexually active females and the perceived effects of these agents. Individual in-depth interviews were conducted. 99% of all subjects admitted using herbs/substances mainly to contract (94%), dry (58%) and heat (28%) the vagina. There was no significant difference in the pattern of use of herbs and reasons given for using the agents by HIV positive and negative women. 69% of HIV negative and 80% of positive subjects had used a mean of 4 difference types of herbs and/or substances during the last 5 years. 39% negative and 25% positive subjects had experienced intra-vaginal pain and lower abdominal pains during and after sexual intercourse, laceration of the vagina and excessive vaginal secretions after using herbs. These effects were attributed to Wankie (herb or substance) in 70% of the complaints. 14 HIV positive subjects compared with 7 in the negative group had used Wankie. The role of Wankie and similar substances in transmitting HIV cross-infection requires further investigations. From the point of view of AIDS prevention, expectations of a dry and contracted vagina in sexual intercourse may reduce acceptability and use of female and male condoms.
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PMID:The vaginal use of herbs/substances: an HIV transmission facilitatory factor? 865 98


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