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

The femoral head is the main location of avascular osteonecrosis. The lesion remains asymptomatic for several months or years before causing non specific hip pain. Risk factors have been identified, mainly femoral neck fractures, corticosteroid therapy and related conditions (lupus erythematosus, organ transplantations), alcohol abuse, dyslipidemia, sickle cell disease, HIV infection, caisson workers, Gaucher's disease, male sex. When typical radiological signs are lacking, MRI is the best investigation. Progression toward hip joint damage highly depends on the necrotic volume assessed at MRI. The combination of plain radiographs which help staging the severity of osteonecrosis, and MRI which indicates the prognosis of the lesion, determines the therapeutic options: symptomatic pain relief therapies or surgical treatment (core decompression, osteotomy or total hip replacement).
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PMID:[Osteonecrosis of the femoral head]. 1200 11

Approximately 400,000 individuals in the United States are co-infected with hepatitis C virus (HCV) and human immunodeficiency virus type 1 (HIV-1) and it is likely that almost one in two of these subjects consumes alcohol. The majority of these patients suffer an accelerated course of liver disease as manifested by the onset of cirrhosis within 5 to 10 years of developing HCV infection, as well as an increased risk of developing hepatocellular carcinoma (HCC). It is thought that chronic alcohol abuse mediates liver damage as a result of increased production of free radicals and proinflammatory cytokines. In the setting of chronic HCV infection, alcohol ingestion has an additional effect of diminishing immune clearance and increasing viral burden to hasten the onset of cirrhosis and HCC. Likewise, chronic HCV and HIV-1 co-infection results in a net increase in HCV burden; higher prevalence rates of HCV transmission to sexual partners and offspring, as well as an accelerated progression to end stage liver disease as compared to individuals with HCV infection alone. Thus, the synergistic effects of alcohol abuse and HIV-1 greatly impact on the morbidity and mortality for patients with HCV coinfection. Ultimately, this cumulative disease process will require far more aggressive management with abstinence and counseling for alcohol abuse; highly active antiretroviral therapy (HAART) for HIV infection and combination anti-viral therapy for HCV infection to stem the rapid progression to end stage liver disease.
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PMID:Hepatitis C virus (HCV) and human immunodeficiency virus type 1 (HIV-1) infections in alcoholics. 1208 18

Both alcohol abuse and human immunodeficiency virus (HIV) infection have deleterious effects on brain structure, metabolism and function. In individuals with both afflictions these effects are doubtless additive and may interact to produce synergistic adverse effects. Further, the normal processes of aging produce brain degeneration that leaves older people especially vulnerable to the untoward effects of alcohol abuse and HIV infection. Advances in in vivo brain imaging now make practical the clinical study of the interaction of alcoholism and HIV infection and the potential of increased vulnerability produced by advancing age. In addition to structural magnetic resonance imaging (MRI), which provides quantitative assessments of brain macrostructure, are diffusion tensor imaging (DTI), which assesses microstructural integrity, magnetic resonance spectroscopy (MRS), which provides assessment of brain chemical moieties related to neuronal viability, and functional magnetic resonance imaging (fMRI), which provides assessment of localized blood oxygenation state association with performance of specific cognitive or motor tasks. Here, we first review postmortem observations on patients with HIV infection and with alcoholism to identify the cell types and brain regions most affected by the end stage of the disease. We then review in vivo neuroimaging studies of brain changes associated with HIV infection, chronic alcohol use, their interaction, and the potentiating effects of age. While there are many studies of people with either HIV infection or chronic alcohol use alone currently little has been published on the interactive effects of these variables, despite the high prevalence of overlap. We conclude with a consideration of the methodological issues such studies must address.
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PMID:Alcoholism and AIDS: magnetic resonance imaging approaches for detecting interactive neuropathology. 1217 Jan 14

Using epidemiological and social network research methods, this study examines gender differences in HIV risk and protective behaviors and social network characteristics among 193 young injection drug users (IDUs) and 127 referred members of their social networks. Respondents reported on their drug use, sexual behavior, and relationships within three types of social networks: hang out (i.e., friendship); drug use; and sexual networks. Most respondents were homeless and had experienced numerous life stressors. Females' social networks consisted more predominantly of drug injectors, and members more frequently appeared multiple networks. Females reported needle sharing more frequently than males, but also reported more protective behaviors such as needle exchange use and carrying clean syringes. Young female IDUs may compound their risk by having sex and injecting with higher risk partners. However, their propensity to practice protective behaviors may provide an opening for interventions to reduce their HIV risk and that of their social network members.
Am J Drug Alcohol Abuse 2002
PMID:Gender differences in HIV risk behaviors among young injectors and their social network members. 1221 60

Crack use is an important risk factor for HIV infection because of its association with unsafe sexual practices. We investigated factors promoting the initiation of crack cocaine use; the sexual behaviour of crack users; and their rehabilitation care seeking behaviour in Trinidad and Tobago. We conducted 40 in-depth interviews with drug users. Respondents frequently reported a history of parental desertion, alcohol abuse, and physical abuse within the family. They perceived peer pressure and drug use in the family as important factors promoting first drug use. Exchanging sex for drugs was common, and practising oral sex was considered safe. Female drug users rarely seek rehabilitative care because of stigmatization and lack of care for their children. In Trinidad, attitudes towards drugs in society and families need to be changed. Campaigns promoting safer sex should emphasize the risk of oral sex. Rehabilitation facilities caring for female drug users should offer child care.
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PMID:Drug use and HIV risk in Trinidad and Tobago: qualitative study. 1223 Sep 28

Prison populations throughout the Unites States are growing; the 1990s saw an average 6.5% per year increase. Average inmate age is increasing, as are both the number and rate of inmate deaths. Aging inmates experience health concerns typical of the general, free, aging population. Inmates have higher incidence of health complications associated with various circumstances, risk behaviors, and associated medical conditions. These circumstances include prison violence, incarceration-related constraints on exercise, and diet. Inmates are more likely to have a history of alcohol abuse, substance abuse or addiction and sex industry work. Risk-behavior conditions include human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), hepatitis B and C, liver disease, tuberculosis, endocarditis, and cardiomyopathy. Hospice is increasingly the preferred response to the health and care needs of terminally ill inmates. Implementing hospice behind bars has some unique challenges in addition to those inherent in hospice work. This series will provide an in-depth look at four hospice programs for inmates in the United States.
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PMID:Hospice care for the incarcerated in the United States: an introduction. 1224 79

This paper reviews reproductive health-related legislation introduced and acted on in the 50 states of the US to August 31, 1992. California, Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Wisconsin had not, however, closed session as of the end of August, and the legislatures of Arkansas, Montana, Nevada, North Dakota, Oregon, and Texas did not convene in 1992. Subjects addressed include abortion, family planning services, sex education, teenage pregnancy, adoption, infertility, maternal and infant care, and sexually transmitted diseases/AIDS. Specifically under abortion, the paper considers the status of legal abortion, parental consent, informed consent and waiting periods, and clinic licensing and harassment of providers. Subtopics on family planning, NORPLANT, welfare reform, sex education, and teen pregnancy prevention are then presented, followed by a review of current issues in adoption, infertility, and surrogacy contracts. Prenatal and infant care, perinatal drug and alcohol abuse, and family/medical leave are also covered. Closing section address HIV testing, consent, and notification; education and prevention strategies; treatment, insurance coverage, and discrimination.
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PMID:Overview. 1228 4

While few adolescents world-wide have AIDS, it is estimated that half the people infected with HIV became infected when they were 15-24 years old. Health professionals assert that HIV exists in adolescent populations that are marked by sexually transmitted diseases and/or adolescent pregnancies. Research has revealed that most young people worldwide first experience sexual intercourse while they are in their teens. This situation has been exacerbated by rural-urban migration and the breakdown of traditional sources of information, by the risk-taking nature of adolescence that leads to drug and alcohol abuse, by cultural norms that lead young women to preserve their virginity by engaging in anal sex, by the poverty that causes youth to trade sex for survival. The HIV/AIDS prevention efforts aimed at young people have been successful in increasing their knowledge about transmission of the infection but not in changing their risky behavior. In order to change adolescent social norms, influential young people should be used as peer educators, parents and teachers should be enlisted in prevention efforts, young people should be involved in the planning of the programs, and all of the needs of the adolescents should be addressed. In addition, HIV/AIDS programs must provide services for those youth who are already infected. It is difficult for prevention programs to engage in safer sex training because of a lack of consensus about whether to give adolescents information only or to provide condoms. The AIDS epidemic has at least provided an opportunity for societies to address how sex education should proceed and has given rise to the innovative idea that adolescents require their own health services.
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PMID:AIDS and adolescents: protecting the next generation. 1228 28

Despite the mistaken belief in Central America that AIDS is primarily a disease of male homosexuals, some 21% of reported cases in Guatemala have been women 15-44 years old. Many Guatemalan women are at risk of AIDS and other sexually transmitted diseases (STDs) because of their lack of sexual bargaining power and negotiating skills, the widespread acceptance of male infidelity in marriage, tolerance of bisexual relations and frequenting of prostitutes, and ignorance of women about sexuality. Condom use is infrequent in Guatemala. Most men and women lack knowledge of AIDS and other STDs and have no perception of their own vulnerability. Male alcohol use and violence against women diminishes the ability of women to protect themselves. Sex education and information about STDs should be provided for both men and women to slow the spread of AIDS. AIDS educators should direct their messages to women toward promoting condom use, increasing knowledge of AIDS and STDs, providing basic sex education, questioning stereotypes of AIDS patients as persons with disordered lifestyles, encouraging realistic assessment of risks, and assisting women to increase their negotiating ability in sexual relations. Three crucial ways of helping women protect themselves are by making them aware of the influence of gender roles in their reproductive lives, teaching them communication and negotiating skills, and providing strategies for them to confront alcohol abuse and gender violence. Survey results indicate that Guatemalan women were extremely motivated to protect their children and secondarily to maintain their homes and be good wives. Motivational messages for AIDS prevention should be related to children and the family. Men were found to be concerned about their families as well and to fear the stigma of HIV infection. Educational techniques for AIDS prevention should be accessible to the illiterate and should focus on life stories or similar methods that make AIDS seem less abstract to those who have had no direct experience with the disease.
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PMID:[Women of Guatemala City: facilitating AIDS prevention in a vulnerable group]. 1229 Jun 22

Alcohol consumption has been consistently associated with HIV-risk behaviors over time, with significantly higher rates of HIV infection generally found among samples of alcoholics and individuals who meet the criteria for alcohol dependence than in the general public. Research on HIV infection among alcoholics in treatment who use few other drugs has found 2.5-10% to be HIV-infected in cities where HIV is prevalent. Alcohol use and abuse may particularly compound the HIV-infection risk of those already in situations of high risk for HIV/STD infection in developing countries, such as women in households where alcohol abuse is common, prostitutes, runaway and homeless youth, and men in occupations which require them to travel long distances. HIV/STD prevention interventions should include alcohol harm reduction while alcohol treatment interventions should be bolstered with HIV/STD risk reduction measures. Harm reduction strategies and research opportunities are described.
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PMID:Decreasing HIV / STD risk in relation to alcohol use: a research agenda. 1229 65


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