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

This paper reports on the patterns of cocaine use among subjects (N = 427) admitted to a methadone maintenance treatment demonstration project designed to reduce risk for HIV. Assessments were conducted at intake and at approximately 18-24 months after treatment admission. Self-reported data on cocaine use was compared with results of urinalysis tests at both intake and follow-up; 29 subjects who falsely reported no use were recorded as users. Over one-third used some form of cocaine at both intake and follow-up, while approximately 30% abstained at both points. Approximately 20% ceased as well as initiated cocaine use between intake and follow-up. Use of powder cocaine, either alone or combined with heroin in "speedballs," decreased at follow-up, whereas crack use increased. Discriminant function analyses were performed to determine the predictors of the different patterns of cocaine use by type. Receipt of enhanced methadone treatment compared with standard methadone treatment, treatment duration, or average duration of counselor contact appeared unrelated to cocaine use. Cocaine use at follow-up was associated with polydrug and alcohol use, illegal activity, a negative emotional state, and sex work. Crack users were more likely to be African American than nonusers; continuous users of powder cocaine were more likely to also be using heroin than were nonusers; and continuous speedball users were more likely to be women sex workers with high levels of depression. This analysis demonstrated that cessation or continuation of cocaine use after entry into methadone maintenance treatment is not uniform across different types of cocaine.
Am J Drug Alcohol Abuse 1997 Feb
PMID:Patterns and predictors of cocaine and crack use by clients in standard and enhanced methadone maintenance treatment. 904 45

We studied the value of contrast-enhanced CT in the detection of aneurysms in immunocompromised patients suffering from inflammatory diseases eventually complicated by hemorrhage. Contrast-enhanced spiral CT was applied in three patients with immunocompromise due to chemotherapy, alcohol abuse or HIV. They suffered from invasive aspergillosis, chronic pancreatitis with pseudocyst formation, and acute pancreatitis together with HIV-associated lymphadenopathy. Complicating hemorrhage was present in two cases. Contrast-enhanced CT showed aneurysms complicating the underlying inflammatory disease in all three cases. The feeding vessels were identified and the patients with signs of bleeding were subsequently referred for angiography and embolization. Contrast-enhanced spiral CT is suited to detect aneurysms in immunocompromised patients suffering from inflammatory disease. It is recommended in these patients prior to angiography and intervention.
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PMID:Aneurysms complicating inflammatory diseases in immunocompromised hosts: value of contrast-enhanced CT. 908 48

There is wide variation in reported risk factors for HIV incidence among injecting drug users by community. Available HIV seroprevalence and incidence data indicate that nearly 60% of HIV infection is associated with injecting drug use in Connecticut and 48% in Massachusetts. Using 12-month follow-up data on 354 initially HIV-negative New England (Massachusetts and Connecticut) methadone treatment clients, we assessed the association between baseline drug use practices, sexual behavior, partner behaviors, and client-reported HIV infection during follow-up. Variables that predicted client-reported positive HIV antibody test results were modeled by Cox proportional hazards regression. HIV infection among those tested was 14.2 per 100 person years (PY) [95% Confidence interval (CI) = 9.5 to 21.3]. For each injection the relative risk (RR) was 1.1 (95% CI = 1.1 to 1.2), for males 3.0 (95% CI = 1.2 to 7.3), for blacks 5.0 (95% CI = 1.6 to 15.5), for Hispanics 3.6 (95% CI = 1.2 to 10.5). Men who used more than one unclean needle per day and had an HIV-infected steady partner had an RR of 28.4 (95% CI = 4.4 to 176.4). For women, using speedball (RR = 6.1, 95% CI = 1.2 to 38.8) and being black (RR = 4.4, 95% CI = 1.0 to 19.8) predicted self-reported HIV infection; having a steady partner who ever injected increased this risk substantially (RR = 65.3, 95% CI = 4.0 to 1046.5). These findings for IDUs in Massachusetts and Connecticut indicate that risk factors for HIV infection for men are consistent with expected transmission by unclean needles with an HIV-infected partner, but a preference for using speedball predicted HIV infection among women IDUs.
Am J Drug Alcohol Abuse 1997 Aug
PMID:HIV infection risks, behaviors and methadone treatment: client-reported HIV infection in a follow-up study of injecting drug users in New England. 926 88

In 200 forensic autopsies, which had been randomly selected, the accuracy of macroscopic diagnosis of alveolar pneumonia was controlled by histological follow-up examination. Only 11 out of a total of 14 cases of alveolar pneumonia, which had been diagnosed macroscopically, could be confirmed microscopically. Moreover, histological examination revealed ten other cases of alveolar and one case of interstitial pneumonia. The rate of wrongly diagnosed cases of alveolar pneumonia was 47.6 per cent, of the total number of cases (200) it was 6.5 per cent. Most cases with confirmed pneumonia belonged to a risk group (survival time of more than 24 h, drug addition, HIV-infection, alcohol abuse, homelessness), where the frequency of alveolar pneumonia was 23.5 percent. An increased weight of the lungs correlated with the frequency of pneumonia. A point system was developed by taking into account predictive factors in pneumonia. By reaching a certain number of points histological examination should be performed, which considerably improved diagnosis of pneumonia.
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PMID:Diagnosis of alveolar pneumonia used as an example for quality control in legal medicine--macroscopy versus microscopy. 929 94

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults in increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorders included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.
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PMID:Homeless youths and young adults in Los Angeles: prevalence of mental health problems and the relationship between mental health and substance abuse disorders. 933 67

To review the natural history of HIV infection in older women, a retrospective review of women enrolled in the HIV Outpatient Program based at the Medical Center of Louisiana in New Orleans was performed. Eighty-four of the women were at least 40 years of age. Older women were more likely to be diagnosed with selected psychosocial illnesses (e.g., injection drug use, alcohol abuse, anxiety, depression, psychosis, dementia) compared with women <40 years of age. There was no association with age and other opportunistic processes or HIV-related symptoms, but cervical dysplasia and chlamydia cervicitis were less common in older women. In a multivariate proportional hazards model, characteristics predictive for death among older women included a CD4 cell count <200 cells/mm3 (relative risk [RR], 2.86; 95% confidence interval [CI], 1.18, 6.86; p < .02), a diagnosis of an opportunistic process (RR, 3.25; 95% CI, 1.24, 8.55; p < .02), antiretroviral combination therapy (RR, 0.36; 95% CI, 0.12, 1.13: p < .08), and hormone replacement therapy (HRT) (RR, 0.28; 95% CI, 0.07, 1.10; p < .06). HRT should be considered in the management of postmenopausal HIV-infected women for its known documented benefits shown in populations of persons not infected with HIV. Prospective studies to better evaluate risks and benefits of HRT in HIV-infected women are warranted.
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PMID:Clinical manifestations and predictors of survival in older women infected with HIV. 934 53

This study examined characteristics of injecting drug users (IDUs) who want treatment and the features that differentiate them from IDUs who do not want treatment. Data were collected as part of a community-based HIV prevention project in San Antonio, Texas. Interviews were administered to 1,100 IDUs between February 1993 and May 1995. Interview topics included sociodemographics, drug use history, current drug use, treatment history, injection-related HIV risk behavior, sexual behavior, and previous contact related to HIV prevention. Multiple logistic regression analysis identified four factors independently associated with wanting treatment in the multivariate model. These were: (1) 30 or more injections per month; (2) being eligible for methadone maintenance; (3) 2 or more previous treatment admissions; and (4) being recruited after the first year of the project. Implications of these findings are discussed.
Am J Drug Alcohol Abuse 1997 Nov
PMID:Injecting drug users who want treatment. 936 70

This study compared 96 HIV-Positive (HIV+) and 357 HIV-Negative (HIV-) crack users who were participating in the same drug-free, residential treatment program. Comparisons were made on sociodemographic, health, criminal justice, psychosocial, and recovery motivation variables. As predicted, the HIV(+) participants were more apt than the HIV(-) participants to be female and recently homeless. Also as predicted, HIV(+) participants had poorer subjective health, had more convictions for various criminal offenses, and were less apt to acquire employment during treatment when compared to the HIV(-) participants. Contrary to prediction, HIV(+) participants reported more social support, were not less committed to abstinence or 12-step groups, and were not less apt to complete the treatment program in comparison to the HIV(-) participants. These results suggest that HIV(+) crack users can be successfully treated in a rigorous treatment program. Future research should examine post-treatment outcomes among HIV-infected persons.
Am J Drug Alcohol Abuse 1997 Nov
PMID:A comparison of HIV-positive and HIV-negative crack users enrolled in a residential addiction treatment program. 936 74

Crack use has been associated with increased risk for HIV seropositivity. This study was undertaken to examine HIV-related risk behaviors among crack users in East Harlem, New York and Philadelphia, Pennsylvania, two northeastern communities which have reported extensive crack use. Crack users recruited in East Harlem (n = 1434) and Philadelphia (n = 694) were compared on demographics, drug and sex-related risk behaviors, health-related behaviors, and HIV serostatus. Many significant differences were found, and seropositivity was higher in the New York sample (25% vs. 11%, chi 2 = 36.28, p < .001). Being a recent drug injector was a significant predictors of seropositivity in both communities, and differences between communities were found in additional predictors of serostatus. Results suggest that tailored HIV interventions may be needed for different communities. In addition, aggregate data across communities, even those that may be in geographical proximity, may obfuscate differences important to incorporate in developing prevention/intervention efforts.
Am J Drug Alcohol Abuse 1997 Nov
PMID:Crack users in east Harlem, New York and Philadelphia, Pennsylvania: HIV-related risk behaviors and predictors of serostatus. 936 73

Hepatic lesions were analyzed in 33 patients with HIV-infection. The patients were divided into two groups by the disease stage: early (stage IIB, IIIA, n = 12) and late (stage IIIB and IIIC, n = 21). Markers of hepatitis A, B and C were found in 42.4% of patients. Patients of group 1 had acute and chronic viral hepatitides (75%), hepatic alcoholic damage. Patients of group 2 developed combined hepatic lesions resultant from generalized bacterial, fungal and parasitic infections (66.7%), chronic hepatitides and viral cirrhoses (33.3%), alcohol abuse (33.3%). Elevated levels of the enzymes (AsAT, AlAT, LDG) at early stages of HIV-infection were brought about by hepatic involvement while at late stages by polyorganic abnormalities.
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PMID:[The etiological structure and characteristics of liver involvement in patients with HIV infection]. 948 42


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