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

This study compared homeless mentally ill chemical abuser (MICA) clients (n = 342), male and female, sequentially assigned to either of two modified therapeutic community programs (TC1 and TC2) and to a treatment-as-usual (TAU) control group. Follow-up interviews were obtained at 12 months postbaseline and at time F (on average more than 2 years postbaseline) on a retrieved sample of 232 (68%) clients and 281 (82%) clients, respectively. Outcome measures assessed five domains: drug use, crime, HIV risk behavior, psychological symptoms, and employment. Individuals in both modified TC groups showed significantly greater behavioral improvement than TAU at 12 months and time F, and the modified TC2, with lower demands and more staff guidance, was superior to modified TC1. Completers of both TC programs showed significantly greater improvement than dropouts and a subgroup of TAU clients with high exposure (i.e., more than 8 months) to other treatment protocols. The present findings support the effectiveness and longer term stability of effects of a modified TC program for treating homeless MICA clients.
Am J Drug Alcohol Abuse 2000 Aug
PMID:Modified therapeutic community for homeless mentally ill chemical abusers: treatment outcomes. 1097 69

Women prostituting in Vilnius City, Lithuania, were studied with regard to their socioeconomic background, drug and alcohol abuse, conditions for prostituting and for the carrier rate of sexually transmitted infectious agents. The 73 women studied represented a group of low-socioeconomic prostitutes with a great age span, i.e. 14-52 years. Forty-five per cent had one or more children. Roughly one-third were part-time prostitutes. Some had been trafficking for more than one decade. Some started trafficking at the age of 13, while the other extreme was a woman who began to prostitute at 51 years of age. This group of Vilnius street walkers had few customers per day. Eighteen were intravenous drug users and almost all abused alcohol. All, but one, had one or more sexually transmitted infections (STIs). Syphilis was diagnosed in 8 (13%) and another 10 (16%) had a serological scar of such an infection. HIV infections were not diagnosed. Condoms were not consistently used during their social contacts.
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PMID:Characteristics of Vilnius street prostitutes. 1123 71

Hepatitis C virus (HCV) is the major cause of chronic liver disease in hemophiliacs. To determine the effect of human immunodeficiency virus (HIV) on the natural history of HCV infection, we evaluated end-stage liver disease (ESLD) in 157 hemophiliacs (85 HIV positive and 72 HIV negative) with HCV infection for an average of 24 years. After adjusting for age at HCV infection, past or current hepatitis B surface antigen positivity, and history of alcohol abuse, we determined that the rate of ESLD was significantly greater among HIV-positive than among HIV-negative hemophiliacs (relative risk [RR], 3.72; 95% confidence interval [CI], 1.25-11.09), as was the adjusted RR for death due to ESLD (RR, 3.81; 95% CI, 1.19-12.16). Among HIV-positive hemophiliacs, crude RR for ESLD was lower, but not significantly so, with antiretroviral treatment (RR, 0.19; 95% CI, 0.03-1.14; P=.069) and increased with each decade of HCV infection (RR, 2.26; 95% CI, 1.42-3.59; P=.0006) and HIV infection (RR, 2.18; 95% CI, 1.36-3.49; P=.0013). These findings suggest that HIV accelerates HCV disease progression.
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PMID:Impact of human immunodeficiency virus infection on progression to end-stage liver disease in individuals with hemophilia and hepatitis C virus infection. 1123 38

This is an open-label, single-arm, phase 3b study (part of phase 3 development) to evaluate the efficacy and safety of Fortovase-soft gelatin formulation (saquinavir-SGC), combined with zidovudine (ZDV) and lamivudine (3TC), human immune deficiency virus type 1 in (HIV-1)-positive, antiretroviral-naive individuals. Forty-two HIV-1-positive adults with plasma HIV RNA >10,000 copies per milliliter (Roche Amplicor HIV Monitor assay) and CD4 cell count >100 cells/mm(3) were treated with SQV-SGC, 1200 mg three times per day; ZDV, 300 mg; and 3TC, 150 mg each twice per day for 48 weeks. High proportions were drug users (26%), demonstrated psychiatric disorders (alcohol abuse [14%]/depression [14%]), or were inadequately housed (5%). At 48 weeks, 50% of patients achieved viral suppression <400 copies per milliliter with 43% <20 copies per milliliter using an intent-to-treat analysis (missing values counted as virological failures). Corresponding proportions for patients remaining on therapy at 48 weeks were 91% <400 copies per milliliter and 78% <20 copies per milliliter. Most adverse events were mild. Saquinavir-SGC combined with ZDV and 3TC, achieved potent and durable HIV RNA suppression and was well tolerated over 48 weeks in an antiretroviral-naive population including high proportions of individuals considered difficult to treat, such as drug users, people with psychiatric problems and homeless individuals.
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PMID:Challenges of antiretroviral treatment in transient and drug-using populations: the SUN study. 1131 25

The demographic, behavior, and background characteristics of 4,804 participants in 17 national demonstration projects for HIV medical and/or psychosocial support services were coded for an index of "service need" or possible under-representation in the traditional healthcare system. Fifteen items were coded including status as a person of color, lack of private insurance, unemployment/disability, problem drinking, crack cocaine use, heroin use, other illicit drug use, less than 12 years of education, criminal justice system involvement, children requiring care while the patient receives services, sex work, being the sex partner of an injection drug user, unstable housing, primary language not English, and age less than 21 or over 55 years. Most (87.7%) of the program participants had four or more of these factors present. Through CHAID modeling, those groups with the highest levels of service need and vulnerability were identified. These data suggest that these projects, designed to attract and serve individuals potentially underrepresented in the health services system, had in fact achieved that goal. Implications of the changing demographics of the HIV epidemic for the health service delivery system are discussed.
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PMID:Finding the underserved: directions for HIV care in the future. 1135 66

This exploratory study was conducted to determine whether sexual abuse might be a risk factor or marker for other risk factors for Human Immunodeficiency Virus (HIV) infection. Twenty-five HIV-positive adolescents were assessed for a variety of possible risk factors for HIV infection, including prior history of sexual abuse. Fifteen (60%) had a history of sexual abuse. A history of sexual abuse may be a risk factor for HIV infection directly, or it may be associated with or predispose one to other risk factors. The latter mechanism may be related to the long-term negative outcomes of some individuals with a history of sexual abuse. These may include same-sex sexual experiences as an adolescent, re-victimization with additional episodes of abuse, multiple consensual sexual partners, and drug and/or alcohol abuse. Preventive interventions aimed at reducing the risk of HIV infection must take a history of sexual abuse into account. Patients with such a history deserve intensive psychological counseling to help prevent adverse behavioral outcomes that can result in HIV infection.
Pediatr AIDS HIV Infect 1995 Oct
PMID:Is sexual abuse in childhood or adolescence a predisposing factor for HIV infection during adolescence? 1136 91

Persons with HIV may have previous or concurrent liver impairment as a result of injection drug use, hepatitis, alcohol abuse, and damage from medications. Additional stress is placed on the liver by low-grade opportunistic infections and hemophilia. It is especially important that persons with HIV care for their liver to help this organ remain physiologically normal during chronic and acute management of HIV infection. Although modern pharmaceutical medicine does not provide liver tonics or supportives, herbal medicines have been used to ease liver stress for ages. Readily available liver protectants and their actual mechanism of action, including thioctic acid, glycyrrhizin, and Silybum marianum, are described.
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PMID:Liver function and HIV-1 infection. 1136 18

A U.S. District Judge in New Jersey granted default judgment for a patient who was refused dental treatment because of his HIV status. The dentist, [name removed] [name removed], refused to disclose information necessary to the trial. Upon learning of the patient's HIV status, the dentist abruptly canceled a tooth extraction that was in progress, refused further treatment, and referred the patient to a special clinic that treats the mentally ill and indigent. The emotional and physical consequences to the patient were significant, and included weight loss, depression, and alcohol abuse. The judge found that any individual health-care provider's refusal to treat an HIV-positive patient could inhibit that patient from seeking subsequent, and potentially lifesaving medical services. The judge cited four out-of-court settlements as precedent for his decision, and awarded the patient $50,000 in damages. [Name removed] was also ordered to pay the patient's attorney's fees and was enjoined from further discriminatory acts against people with HIV.
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PMID:Dentist ordered to pay $82,000 for denial of care. 1136 5

A California appeals court reversed a $275,000 jury award to [name removed] [name removed] who claimed he was fired by Delta Airlines because he had AIDS. The jury found that [name removed] breached [name removed]'s privacy by putting his name on a list of HIV-positive employees. The jury did not find that [name removed] discriminated against [name removed], but agreed that it violated State law requiring reasonable accommodation for workers returning after drug or alcohol abuse rehabilitation. The California Supreme Court reversed the Court of Appeal decision that the case ended with [name removed]'s death. The appeals panel ruled that [name removed]'s claims were filed after the one-year statute of limitations and that [name removed] had failed to exhaust his administrative relief under the California Labor Code. Throughout the case, [name removed] maintains that the late Mr. [Name removed] was terminated because he used cocaine, in violation of a company zero-tolerance policy.
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PMID:For a second time, court overturns jury award in HIV case. 1136 80

The Ninth International Nursing Conference on Ending Violence Against Women highlighted the theme that women who are victims of intimate partner violence are the same women whom healthcare providers see for other health-related concerns. The healthcare system may be the only outlet they have for seeking help. In 1994, approximately 250,000 American women sought medical treatment following assaults by partners and this number is increasing. Women who reveal a positive HIV status to a partner are at a significantly greater risk of becoming abuse victims. In addition, drug and alcohol abuse are complicating factors in abusive relationships. Results from enhanced intervention approaches for women in prenatal clinics and a sexually transmitted disease project were reported. Sessions discussed the various roles of the healthcare provider, cultural differences, and specific experiences with African-American and Latina women. Contact information is provided.
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PMID:Women, violence, & healthcare. 1136 58


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