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

Questions have arisen about the implications of notifying drug abusers of their HIV serostatus. One major concern is that awareness of HIV infection would have a negative impact on abstinence from drug abuse. In order to ascertain the effects of serostatus notification, the authors reviewed the clinical records of 73 methadone patients who learned of their serostatus within 20 weeks after enrolling in the clinic and thereafter remained in treatment for at least 1 year. They found that, at serostatus notification, seropositive patients were more likely to be socially disadvantaged and were younger than the seronegatives at first opiate use. After serostatus notification, seropositives had more "fair hearings" for noncompliance with program norms and used more cocaine. Although the patients notified of HIV infection may have more behavioral problems, further research is needed to determine whether or not this reflects antecedent behavior patterns and drug use.
Am J Drug Alcohol Abuse 1995 Feb
PMID:The impact on behavior of notifying methadone patients of their HIV serostatus. 776 43

Inner-city male adolescents in jail in New York City (N = 427) were interviewed to examine correlates of cocaine or crack use. Twenty-three percent had used cocaine or crack in the month before arrest and 32% reported lifetime use. Substantial rates of robbery, murder, other violent crime, weapons possession, and drug dealing were found. However, type of crime, including violent crime, was not related either to cocaine/crack use or to drug dealing. Current cocaine/crack users were more likely to use alcohol, marijuana, and intranasal heroin; to have multiple previous arrests; to be out of school; to be psychologically distressed; to have been sexually molested as a child; to have substance abusing parents; and to have cocaine/crack-using friends. They were also more likely to have frequent sex with girls, to be gay or bisexual, and to engage in anal intercourse. The findings should be considered in developing more effective drug abuse prevention and treatment interventions, and HIV prevention education, for incarcerated at-risk adolescents.
Am J Drug Alcohol Abuse 1994 Nov
PMID:Correlates of cocaine/crack use among inner-city incarcerated adolescents. 783 77

Our objective was to assess the effects of methadone use on immune parameters. A convenience sample of men and women drug injectors who knew their HIV serostatus were enrolled in a longitudinal observational study of HIV illness. During analysis of baseline data, differences were noted in immune parameters among Methadone users. Study participants were recruited in Manhattan, New York, from a methadone maintenance clinic, and infectious disease clinic of an inner city hospital, and a drug-free community center. The participants were 220 men and women, current or former drug injectors, approximately half of them HIV-antibody positive and the rest HIV-antibody negative. Candidates with opportunistic infections and secondary neoplasms were excluded. Methadone users were compared to nonmethadone users for absolute and percentage counts of CD4, CD8, and activated T lymphocytes; CD4/CD8 ratio; an HIV symptom check list; and medical staging. The results discussed in this paper were formulated after data collection was complete. Our data indicate that methadone treatment, while not significantly affecting absolute CD4 lymphocyte count, is associated with a lower CD4 percentage and CD4/CD8 cell ratio, and with a higher CD8 absolute count and percentage. These differences are present regardless of HIV serostatus. Our findings should be interpreted with caution since we did not set out to investigate the effects of methadone on the immune system. Nevertheless, if it is corroborated that methadone has a detrimental effect on the immune system, finding alternatives to methadone-maintenance treatment for drug injectors will be a necessity.
Am J Drug Alcohol Abuse 1994 Aug
PMID:The effect of methadone on immunological parameters among HIV-positive and HIV-negative drug users. 797 17

Rapid progression of infection with human immunodeficiency virus type 1 (HIV-1) to AIDS after seroconversion is rare; it has been associated with coinfection by cytomegalovirus or human T lymphotrophic virus type I. We describe an alcoholic patient whose condition progressed to AIDS 3 months after HIV-1 seroconversion occurred. Culture of peripheral blood mononuclear cells yielded a syncytium-inducing variant of HIV-1. T lymphocytes showed no spontaneous cytotoxic activity against HIV-infected cells, nor could such activity be demonstrated following stimulation with HIV-1 antigen in the presence of recombinant interleukin-2. We hypothesize that our patient's accelerated course was due to alcohol abuse, which may have suppressed T cell function and stimulated HIV replication.
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PMID:Alcoholism and rapid progression to AIDS after seroconversion. 798 12

The authors' primary purpose was to identify home healthcare needs of adults (N = 244) living with HIV disease/AIDS. The study followed a retrospective chart review of a stratified random sample of cases discharged during 1991 from a certified home health agency (CHHA) in New York City. Frequently observed signs and symptoms included dyspnea, weakness, fatigue/lethargy, pain, ataxia, cough, skin lesions, and memory deficit. Additional problems identified included inadequate nutrition, issues related to compliance with prescribed medications, inadequate in-home support systems, inadequate facilities/utilities in the home, financial concerns and lifestyles that included drug/alcohol abuse and tobacco use. The results suggest that the health care needs of people living with HIV disease/AIDS in the home care setting are multifaceted and extend beyond the clinical manifestations of HIV disease.
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PMID:Home healthcare needs of adults living with HIV disease/AIDS in New York City. 803 11

Despite the central role played by female intravenous drug users (IVDUs) in the worsening AIDS statistics of states in the northeastern United States, the relative paucity of research into the HIV risk behaviors--particularly risky needle practices--of female drug injections has left significant gaps in researchers' understanding of how and to what extent such women may differ in their risks from their better-studied male counterparts. This study, derived from a sample of 769 out-of-treatment IVDUs residing in an area (Paterson, New Jersey) characterized by high levels of AIDS and HIV infection among drug users, attempts to address this lacuna in the research literature by comparing the drug usage, AIDS knowledge, and needle and sexual behaviors of male and female IVDUs that place them at risk for HIV infection. In this sample, gender was found to be unrelated to HIV serostatus, injection frequency and injected drug of choice, and to most dimensions of knowledge about AIDS and the means of HIV transmission. Overall, it appears that the average Paterson female IVDU may be at greater risk for HIV infection as a result of involvement with a drug-using sex partner than because of especially risky needle practices, for females in this sample were significantly more likely than males to report injecting with a sex partner in the previous 6 months, and female IVDUs with one sex partner were more than twice as likely as males with one partner to report that this individual was an IVDU. Condom use was relatively rare, particularly among those with one partner. Moreover, female IVDUs were significantly more likely than males to be daily users of crack cocaine, and significantly more likely to report poorer health. However, current needle and sexual practices were found to be unrelated to HIV seropositivity among both males and females. In logistic regression analysis, only length of IV drug involvement was found to be independently associated with HIV seropositivity for both sexes. Implications of the data for future prevention efforts aimed at female IVDUs are discussed.
Am J Drug Alcohol Abuse 1994
PMID:A comparison of male and female intravenous drug users' risk behaviors for HIV infection. 804

The objectives of this study were to investigate HIV-1 seroprevalence and risk factors, disease progression, and awareness of HIV-1 serostatus in a population of inner city, substance using, psychiatric inpatients. To pursue these goals, we tested 118 (103 M, 15 F) dually diagnosed, acute care inpatients for HIV-1 antibodies and administered structured interviews. Twenty-seven (23%, including 24 M and 3 F) of the subjects were HIV-1 seropositive. Seropositivity was twice as great among intravenous drug users and men who had sex with other men as among patients not belonging to either of these two groups. Logistic regression analysis among male subjects revealed a significantly elevated HIV-1 risk associated with a primary diagnosis of depression (odds ratio adjusted for age, race, and presence of an AIDS risk behavior = 4.2, 95% confidence interval = 1.1, 16.5; p = 0.04). Less than half of the seropositives knew their HIV-1 status prior to this study, one had AIDS and four had two or more constitutional symptoms of AIDS. The high rate of seropositivity in this indigent, dually diagnosed population presents challenges to the health-care community. That few individuals had HIV-1 related symptoms may have implications for other treatment settings.
Am J Drug Alcohol Abuse 1994
PMID:HIV-1 among inner city dually diagnosed inpatients. 819 29

Patterns of HIV infection and IV drug use in 697 Essex and Hudson Counties, New Jersey, 1986-1987 Medical Examiner (ME) cases, aged 15-59 years, were examined. All cases had toxicology tests for drugs and had been autopsied. Postmortem stored sera were blind-tested and confirmed for the presence of HIV-1-antibody by the New Jersey Department of Health. All cases and IV drug users were dichotomized according to the presence/absence of HIV-1-antibody and were then analyzed for differences in demographic and postmortem characteristics. Subjects were predominantly Black men aged 30-44 years; the 119 HIV(+) cases were even more likely to be Black or Hispanic and in the 30-44 age group. Evidence of IV drug use and HIV(+) status were very highly correlated; 86 of 181 IV drug users were HIV(+). There was a low rate of suicide among HIV(+) cases and IV drug users. Only 3 of 63 suicide victims were HIV(+), and they were the only IV drug users whose manner of death was certified as suicide. Cases with toxicology findings of both heroin and cocaine were most likely to be HIV(+), followed in order by those with heroin or cocaine alone present. Cocaine alone was the illicit drug most often present in toxicology tests on all cases. Among IV drug users, heroin with cocaine was most often present.
Am J Drug Alcohol Abuse 1993
PMID:HIV infection and i.v. drug use: medical examiner cases in Essex and Hudson Counties, New Jersey. 821 94

As of June 30, 1991, 182,834 AIDS cases in the United States had been reported to the Centers for Disease Control, of which 58,879 (32.2%) were associated with illicit drug use. Of these, 39,904 (70.0%) were in both women and heterosexual men reported as injecting drug users (IDUs), 11,823 (20.7%) in men who have sex with men who are also IDUs, 5,305 (9.3%) in sex partners of IDUs, and 1,847 (3.1%) in children whose mothers were either IDUs or sex partners of IDUs. From 1989 to 1990, the increase in the number of United States AIDS cases associated with IDU either directly or indirectly was higher in all regions compared with the Northeast. The highest percentage increases were in the South, U.S. territories, and the North Central. From 1989 to 1990, the percentage of AIDS cases attributed directly to IDU increased in women and men (15.3 and 5.9%, respectively); however, the increase in sex partners of IDUs was much larger (34.5% in men and 29.1% in women). Increases were also higher in sex partners of IDUs than in IDUs when compared by race/ethnicity and by region of residence. Because HIV can spread rapidly among IDUs and their sex partners, there is an immediate need for targeting effective HIV prevention messages to all IDUs and their sex partners in communities with high HIV infection rates.
Am J Drug Alcohol Abuse 1993
PMID:Acquired immunodeficiency syndrome in the United States associated with injecting drug use, 1981-1991. 827 62

Thirty-seven nondemented HIV-seropositive and 17 seronegative control subjects were administered the Sternberg speed of memory scanning task, a procedure frequently employed to study mental slowing in patients with subcortical dementing disorders. Experimental and control subjects did not differ in speed of memory scanning, as indexed by the slopes of set size-reaction time functions, nor on mean 0-intercepts for the RT functions, which index stimulus detection and motor response time. Intercept values were significantly greater for subjects with a positive alcohol abuse history and for subjects with greater self-reported depression, but slopes were not significantly correlated with substance abuse history or psychological distress. Cognitive slowing in early HIV-1 infection is not a nonspecific effect observed across all measures of information processing speed. Underlying component functions measured must be carefully considered when selecting reaction time tasks for study with HIV-seropositive subjects. The term "subcortical" dementia may be too general a descriptor, and RT task performance may provide an alternative basis for classification of dementia types.
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PMID:Speed of memory scanning is not affected in early HIV-1 infection. 849 53


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