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

Intravenous drug use is the single largest exposure category among women with AIDS in the United States (51%). Tragically, there may be insufficient appreciation of the issues unique to IV drug usage among women. Few drug treatment programs are specifically designed for women, and fewer still are aimed at HIV positive women. Treatment models relevant to women in light of the AIDS epidemic should: include changes in admission criteria and treatment methods; provide comprehensive services (including parenting and employment skills workshops and access to health care); and incorporate research and evaluation components with planned dissemination of results.
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PMID:HIV and chemically dependent women: recommendations for appropriate health care and drug treatment services. 131 74

Thailand had its first case of AIDS in 1984, but HIV transmission remained rather low during 1984-86 (0-10 HIV positive cases, 1 AIDS case for 1984 and 1985 and 0 in 1986, and 0-8 cases of AIDS-related complex [ARC]). Beginning in 1987, however, the number of HIV positive, ARC and AIDS cases grew very rapidly (from 194 to an estimated 5384 [1987-end of 1989]). At the end of June 1989, 7978 people (91% male and 9% female) were either HIV positive or had AIDS or ARC. These infections were most prevalent in 20-29 year olds (3797 cases) followed by 30-39 year olds (2946 cases). 19 children (0.2%) were infected. HIV had infected people in all 73 provinces by June 1989. Drug use was by far the leading risk factor of HIV infections in Thailand (91.3% or 6889 cases) followed by heterosexual intercourse (502 cases, 406 of whom were women). HIV prevalence rose considerably among iv drug users. Between 1985 and 1987, it was less than 1%, but by 1988, it rose to 9.5% to 42%, based on a study of 14 provinces. The government has been increasing funds for HIV prevention and control activities. If the epidemiologic trend were to continue, Thailand would have 100,000 HIV-infected cases and 1400 AIDS cases in 1996. 5 Working Committees address prevention, treatment, and rehabilitation; health worker training; public education; coordination; and knowledge of HIV infection. Strategies they have developed to reduce HIV transmission are creation of a central group to monitor, control, and evaluate future projects; coordination of projects between public and private sectors; establishment of an information center; creation of clinics specializing in treatment of patients infected with HIV; health personnel training; and research.
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PMID:HIV infection control in Thailand. 140

The basic epidemiological characteristics of HIV infection and AIDS among children are described with a particular reference to HIV vertical transmission. The HIV transmission pattern identified in our community is described according to the WHO classification scheme. To describe the epidemic, as well as its temporal evolution, 1.933 cases reported to the population based registry of Catalonia and 287 seropositive children and their mothers are used. We have quantified the importance of intravenous drug usage by the parents in relationship to HIV transmission; 54.7% of the mothers of HIV positive children were intravenous drug users. We predict that during the coming years there will be a continuous increase in AIDS cases as a result of vertical transmission.
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PMID:[Vertical transmission of HIV infection: descriptive epidemiology, risk factors and survival]. 145 17

Tissue-typing for HLA-A, B, and DR antigens was carried out on 53 babies, 47 of them unrelated, born to mothers known to be HIV-infected from intravenous drug usage or sexual contact with drug users. These babies were followed up to assess whether HLA phenotype was associated with vertical transmission of HIV infection or disease progression. Of the 47 unrelated babies, eight became infected with HIV. The frequency of HLA-DR3 was three times higher in the HIV-positive infants compared to the HIV-negative infants (43 per cent vs 15 per cent) in our study population. Conversely, HLA-A3 was three times less common in the HIV-positive infants (12.5 per cent vs 42 per cent). A comparison of HLA antigens between our study group babies and babies born to healthy mothers unselected for HIV status revealed higher proportions of HLA-B18, B7, and DR2 in the study group. Moreover, the combination, A3, B7, DR2 was four times commoner in our study population relative to controls (RR = 3.9; p less than 0.003), but was found only in babies who were not HIV infected. The combination A1, B8, DR3, in contrast, was found less often than expected in our study group (RR = 0.39) and was disproportionately represented amongst the infected babies. We have observed an unexpectedly low (6 per cent) mother-to-infant transmission rate of HIV among prospectively studied intravenous drug users. We speculate that the unusually high ratio of the common antigen combinations (often halotypes), A3, B7, DR2 to A1, B8, DR3 in this population may be contributory.
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PMID:HLA antigen frequencies in children born to HIV-infected mothers. 174 42

In this article, we present data obtained with the psychosocial interview instrument, HEADSS (Home, Education, Activities, Drug use and abuse, Sexual behavior, Suicidality and depression) that was administered to High Risk Youth Clinic clients at their initial visits during a 1-year period. Of the 1,015 new patients, 63% were homeless/runaway youths and 37% were living with their families. Utilizing the HEADSS interview instrument, we compared homeless/runaway youths to nonhomeless youths in a number of areas, including risks for human immunodeficiency virus (HIV) infection. Our results showed that homeless teens tended to be younger, female, and white compared to their nonhomeless counterparts. They were more likely to have dropped out of school and were far more likely to be depressed and actively suicidal. They demonstrated all forms of drug abuse. They engaged in first sexual intercourse at an earlier age, and experienced a higher incidence of sexual abuse and prostitution. They were 6 times more likely to be at risk for HIV infection.
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PMID:HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth. 177 92

Standardized survey interviews (n = 325) and guided in-depth interviews (n = 22) were conducted with injection drug users (IDUs) in Long Beach, California, to document drug usage and injection patterns, sexual practices, perceived risk of HIV infection, sources of health information, and knowledge and attitudes about AIDS. Most IDUs reported sharing needles (87.9%), and a large minority reported regular sterilization of needles/syringes (40.3%). Lower rates of needle sharing were reported among cocaine users than among heroin and speedball users. HIV seroprevalence was 5.7 percent (11/194). Sexually active female (60.7%) and male (20.5%) IDUs reported exchanging sex for money or drugs. Overall, 48.3 percent of IDUs reported having made changes in their injection practices and one-third reported modifying their sexual behavior in order to avoid HIV infection. Differences in drug use, sexual practices, and drug treatment history were found with regard to gender, ethnicity, age, and type of drug injected. Implications of findings for the development of AIDS risk-reduction programs are presented.
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PMID:Risk behaviors and perceptions of AIDS among street injection drug users. 228 75

Now that models of care for numerous HIV-related conditions have been defined, a knowledge base exists for developing protocols of appropriate, high-quality care for HIV-infected patients. Bronx Municipal Hospital Center in New York City plans to implement a monitoring and evaluation program for HIV-related care that would establish protocols and indicators of quality and appropriateness, monitor compliance with protocols, and generate recommendations for improving care. At present, Bronx Municipal's AIDS consultation service has drafted guidelines for developing indicators of appropriate diagnosis, clinical course, and drug usage for HIV-infected patients, as well as guidelines for reviewing medical records.
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PMID:Quality assurance for HIV-related care. 249 26

We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment.
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PMID:Cocaine use and HIV infection in intravenous drug users in San Francisco. 276 95

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.
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PMID:A comparison of male and female intravenous drug users' risk behaviors for HIV infection. 804

Drug use will soon become the major risk for transmission of HIV infection in the United States, which will result in near equal incidence of the disease in men and women and more affected children. This has serious implications for the health care community and for the community at large. Thus, it is necessary to pursue aggressively risk reduction strategies targeted for difficult-to-reach populations such as illicit drug users and commercial sex workers. This will involve a vigorous public health campaign to bring education messages about safer sex practices, safer injection techniques, and enhanced drug treatment services to these groups. Prevention strategies include consideration of needle exchange as a public policy for IDUs. There are appropriate concerns in the larger community that needle exchange might send a mixed message or promote drug use, but there is no scientific evidence to support this view. To the contrary, there is a growing body of evidence that suggests drug users change behavior in response to education messages and that clean needles may reduce disease risk. Currently, stable seroprevalence rates in some IDU populations suggest that education messages about injection practices are heeded. Unfortunately, sexual practices have not shown similar changes. Most, if not all, HIV-infected persons will experience neurologic complications during their illness, especially as improved medical therapy ameliorates systemic complications. The approach to diagnosis and management requires a thorough understanding of the diverse clinical syndromes that may occur and a systematized approach to investigation of the cause.
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PMID:HIV infection. 837 46


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