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

The relationship between human immunodeficiency virus type 1 (HIV-1) viral RNA and proviral DNA load in vagina and cervix and that found in the plasma and peripheral blood mononuclear cells (PBMC) was investigated in 28 HIV-1-infected women. Of the patients, 64% had > or = 1 HIV-1 RNA-positive genital sample, while 71% had > or = 1 DNA-positive sample. The higher the cervical HIV load, the more widespread was the virus in the genital tract. A strong correlation was found between viral RNA load in plasma and the genital tract, whereas the association between proviral DNA load in PBMC and the genital tract was less evident. Cervical HIV-1 DNA correlated with a viral RNA load > or = 50,000 copies/mL. Cervical HIV-1 RNA levels ranged from 10% to 100% of the plasma levels. Thus, a continuous transmission risk from untraumatized genital epithelium exists in the majority of HIV-1-infected women at all stages of infection.
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PMID:Distinct determinants of human immunodeficiency virus type 1 RNA and DNA loads in vaginal and cervical secretions. 959 6

Clinical studies of nonoxynol-9 (N-9) products such as vaginal sponges link the spermicide to vaginal and vulval irritation, even at low doses. Since such irritation may facilitate infection with sexually transmitted diseases (STDs), the chief of the US National Institute of Allergy and Infectious Diseases' STD branch does not recommend that women use the product in their vaginas. Existing products containing N-9 continue to be tested against STDs and HIV, while new ways to prevent STDs and HIV infection are progressing to early clinical trials. New topical, nonirritating microbicides for preventing STDs are promising and will be featured at the May meeting of the American Society of Microbiology as products which could offer women safe, convenient, and almost undetectable protection. Examples include PRO 2000, a naphthalene sulphonate polymer; the "invisible condom," a gel; GEDA Plus, a gel; protegrins; and a "vaginal vitamin," a gelatin suppository. While condom use must continue to be encouraged and STDs treated, placing something into the vagina to either prevent or cure infection is within the realm of existing medical science.
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PMID:Easing the way to safer sex. 973 55

"Dry sex" may aid in the transmission of HIV-1. Many women in southern Africa willingly insert herbal aphrodisiacs, household detergents, and antiseptics into their vaginas before sex to increase friction, despite the concurrent pain it will cause. Neetha Morar (Medical Research Council, Durban) states that the practice has been reported in many countries. In Zaire, women use leaves and powders to heighten sexual pleasure. A cross-sectional study of women in Malawi reports the use of traditional substances to tighten the vagina before coitus. 86% of women interviewed in a Zambian study practiced dry sex. Phillip Kubukeli, President of the Herbalists and Spiritual Healers Association in the Western Cape, states that dry sex is most prevalent in KwaZulu-Natal, which has the highest rate of HIV/AIDS. In the first descriptive study of its kind in South Africa, Morar found that at least 80% of 150 prostitutes between the ages of 15 and 45 years, working at truck stops in the midlands of KwaZulu-Natal, practiced dry sex. Morar believes that the substances used by the women may disrupt the uterine and vaginal membranes and that the excessive drying may lead to abrasive trauma during coitus. The practice may also compromise the effect of condoms. According to South African Deputy President Mbeki, in an address to the nation on October 9, 1998, in which he launched a campaign against AIDS, there are more than 3 million persons infected with HIV-1 in South Africa; 1500 are infected each day.
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PMID:Concern voiced over "dry sex" practices in South Africa. 978 73

Lactobacilli are ubiquitous gram-positive anaerobic rods present in the normal bacterial flora of the mouth, vagina and gastrointestinal tract. Although they are usually non pathogenic, serious infections have occasionally been described in transplant recipients or severely ill patients. Only 4 cases have been reported involving AIDS: one had predisposing conditions other than AIDS, and none of the others had pure growth of lactobacilli. We report a case of community-acquired Lactobacillus casei pneumonia in a CD4 lymphocyte-depleted AIDS patient. Lactobacillus was isolated in pure growth in repeated blood cultures in an outpatient with no preexisting lung diseases and no known risk factors for Lactobacillus infections (dental procedures, complicated deliveries, gastrointestinal diseases, cardiac prosthetic valves) or consumption of unusual dairy products. Although uncommon, lactobacilli are possible pathogens in HIV-infected patients with very low CD4 counts, and their isolation in clinical specimens must not be neglected. Susceptibility tests are essential because of the variable antibiotic-resistance patterns of these bacteria.
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PMID:Lactobacillus casei pneumonia and sepsis in a patient with AIDS. Case report and review of the literature. 985 77

Nonoxynol-9 (N-9) vaginal contraceptive film, a square that dissolves quickly and easily in the vagina and may be used without the partner's knowledge, represents a potential woman-controlled method of contraception and sexually transmitted disease (STD) prevention. 520 of 1292 Cameroonian sex workers, enrolled in a clinical trial of the capability of N-9 contraceptive film to prevent HIV transmission, were interviewed about their experiences with this method. The clinical trial failed to demonstrate an additional protective effect of N-9 film against HIV or other STDs when used with a condom. During the study period, 50% of participants reported they always used a condom and 45% always used the film. 59% of those who did not always use a condom claimed it was because clients or partners objected. In contrast, only 15% of women who sometimes did not use the film cited partner objection. Over 80% of sex workers indicated they would use N-9 film with both clients and regular partners if it were shown to be effective and were available. With a regular partner, 66.5% would use the film alone and 15.6% would also use a condom. With clients, 46.5% would use the film alone and 39.8% the film and condom together. Sex workers liked the fact that the method was under the woman's control, could be used without the male partner's knowledge or agreement, allows direct contact between partners, and provides back-up protection in the event of condom breakage. These findings suggest a woman-controlled method, such as a vaginal film, with demonstrated safety and effectiveness, would be readily accepted by sex workers in Cameroon.
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PMID:Views of Cameroonian sex workers on a woman-controlled method of contraception and disease protection. 986 84

Men who have sex with men (MSM) in gay male communities do not always use condoms when having anal sex. Reasons for such risky behavior include men's objections to the lack of spontaneity demanded from condom use, decreased sensation, and condom breakage. Reality, a polyurethane pouch designed to line the vagina, was developed mainly to provide women with a contraceptive and STD prevention option. A removable inner ring and fixed outer ring keep the device in place. Some MSM use Reality when having anal sex. 750 free Reality kits were distributed by the STOP AIDS Project in San Francisco at venues frequented by MSM. Kits included 2 female condoms, instructions, a self-administered questionnaire on the users' experiences with Reality, and a stamped return envelope. 108 surveys were returned, with 100 MSM reporting use of Reality during the past 6 months in 147 episodes of insertive and 187 episodes of receptive anal sex. 86 men reported that they would use Reality again, and 54 said they would rather use Reality than conventional male condoms. Generally most liked about Reality were its heightened sensitivity and spontaneity, while insertion difficulties and high cost were the factors least liked. Acceptability was higher among MSM who were HIV-positive, in nonmonogamous relationships, or who had serodiscordant sex partners. Negative experiences included difficulty inserting (33%), irritation (17%), bunching up (12%), unpleasant texture (10%), and noise (9%). Breakage was reported 3 times in 334 episodes of use. Reality appears to be a welcome alternative for some MSM who do not consistently use penile condoms. Although use of the method probably reduces HIV transmission compared to unprotected anal sex, more research is needed to definitively assess its effectiveness as a risk reduction method for MSM.
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PMID:Experiences of 100 men who have sex with men using the Reality condom for anal sex. 1007 May 90

Sexually transmitted diseases (STDs) contributed to reductions in fertility and population size in many Micronesian islands between the late 1800s and early 1900s. This paper explores the potential health threat of AIDS to an indigenous village population of 1250 on the Butaritari Atoll, Kiribati. Study results are based upon observations, surveys, and interviews exclusively with women in the community over 12 months in 1990-91. This population is of Catholic faith and high fertility, with a low biomedical contraceptive acceptance rate and near universal marriage by age 25. Marriage in this culture may be either socially formalized and permanent or consist solely of temporary relations between married men and nonmarried women while men are employed on other islands away from wives. Generally, those who cohabit and have sexual relations are considered married. Little premarital sexual activity takes place in this community; women are expected to be virgins at marriage. Men, however, are encouraged to gain premarital sexual experience. Since young men only infrequently succeed in having sex prior to marriage, most sexual activity occurs within marriage. Women are passive in all aspects of the sexual relationship are dare to discourage their spouses' sexual advances only during menstruation, in advanced pregnancy, after birth, and when they are ill. Female marital infidelity is not tolerated, though married men are known to seek attention from the limited pool of nonmarried women in the population. At most, men may secure the attention of five such women over the course of their lives. Anal sex is not practiced within heterosexual relationships and homosexuality is very rare and not tolerated. Despite these relatively conservative sexual norms, HIV threatens to enter and spread within this community through heterosexual intercourse. Men from Kiribati work off-island on foreign ships for months at a time. While away, they have been known to have sex with foreign prostitutes and may contract STDs. On vacation and when contracts expire, these men return to the island to recommence their usual sexual relations. Both married women and the small percentage of unmarried sexually available women may be infected by these men. HIV may then spread among other married couples and single individuals in the community. The frequent practice by women of inserting vaginal agents and cauterizing their genitals to dry and tighten the vagina also increases the potential for mucosal tearing and subsequent HIV infections. In closing, the reader is cautioned to not infer that observations from this community are universally applicable within Micronesia; Kiribati historically has suffered less than other regional islands from STDs.
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PMID:Sexually-transmitted disease risk in a Micronesian atoll population. 1014 57

The SIV/Rhesus macaque model of HIV transmission has led to an increased understanding of the interactions between virus and host during the sexual transmission of HIV. SIV can be transmitted across the intact mucosa (stratified squamous epithelium) of the foreskin and glans of the penis of Rhesus macaques. SIV-infected cells can be found at all levels of the male Rhesus macaque reproductive tract and SIV can infect cells in the mucosal epithelium of the foreskin of the penis. SIV can be transmitted to female Rhesus macaques by infusing a cell-free virus suspension into the vaginal canal through a soft plastic pediatric nasogastric feeding tube. There does not appear to be any correlation between inoculation at any particular point in the menstrual cycle and the susceptibility of an animal to infection. Furthermore, the surgical removal of the cervix and uterus did not affect the dose of cell-free virus required for the genital transmission of SIV. Thus, target cells for SIV are present in the vaginal mucosa. In chronically-infected female Rhesus macaques, SIV-infected cells are present in the uterus, cervix and vagina. SIV-infected CD1a+ and p55+ Langerhans cells are also found within the stratified squamous epithelium of the vagina. Taken together these results are consistent with the hypothesis that the virus initially infects antigen-presenting cells in the vagina (macrophages and Langerhans cells) and then subsequent rounds of replication occur in the draining lymph nodes prior to spreading to more proximal lymphoid nodes and finally to the bloodstream and distant lymphoid tissue.
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PMID:Localization of Simian immunodeficiency virus-infected cells in the genital tract of male and female Rhesus macaques. 1021 21

As a general rule, genital condylomas present as localized lesions and large masses of warts are observed only during pregnancy. In this report we describe a giant anogenital condyloma in a non-pregnant 18-year-old Centrafrican woman. Soft papillomas completely covered the anterior and posterior perineum and obstructed the vagina. Clinical findings were suggestive of vulvar Buschke and Loewenstein tumor. The extent of the lesions and a history of unprotected relations with several sex partners raised suspicion of HIV infection which was subsequently confirmed. The CD4+ lymphocyte count was 540/min3. Surgical removal led to complete cure after healing of the surgical wound. Histological findings showed that the lesions were benign and ruled out malignant vulvar tumor. This case documents the link between florid genital condylomas and HIV infection with no change in immune status.
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PMID:[Giant anovulvar condyloma acuminata revealing hiv-1 seropositivity in a Centrafrican patient]. 1039 98

The AIDS epidemic has an increasingly female face, and the need for women to use effective contraceptive and infection prevention methods has taken on a new urgency. Consistent, proper condom use is the most effective method of preventing sexually transmitted disease. Research shows that condom breakage most commonly results from latex deterioration or incorrect use. Spermicidal cream or gel containing nonoxynol 9 is effective in preventing sexually transmitted diseases that cause genital ulcers and cervicitis. Spermicides cause genital tract irritation in some people, however, increasing their risk of STD infection. Diaphragms can protect against pregnancy, but since the devices only protect the cervix and a small area of the vagina, HIV or STD transmission may still occur. Oral contraceptives do not protect against STDs, nor do injectable and implantable contraceptives.
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PMID:Building barriers to HIV. 1057 33


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