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

The frequency of HIV transmission to children and adolescents through sexual abuse is unknown. Because the incidences of HIV infection and of reported sexual abuse are both increasing, the transmission of HIV to children through sexual abuse may also be increasing. Social workers may have expanding roles in the decision-making process for testing and subsequent management of children infected with HIV through sexual abuse. This article discusses the benefits of identifying children who have been infected with HIV through sexual abuse and reviews guidelines for testing. Social workers can contribute to test decision making in instances when perinatal HIV transmission is a possibility, when it may be possible to test the assailant, and when parents or legal guardians insist on testing the child. Other issues discussed include family education and coping, physical education and support, social casework and research with pedophiles, and service needs for care and follow-up of children found to be HIV infected as a result of sexual abuse.
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PMID:Testing the sexually abused child for the HIV antibody: issues for the social worker. 836 74

This study assessed the situational and sociodemographic characteristics of children infected with human immunodeficiency virus (HIV) from pediatric sexual abuse. A letter of inquiry was sent to 2147 professionals across health and social service disciplines involved with child abuse assessment, treatment, and prevention. Respondents working in programs where HIV antibody testing of abuse victims occurs and who had identified HIV infection in one or more abused children were sent a survey to assess the demographics of victims, the family/living situation where abuse occurred, alternative risks for HIV infection, bases for diagnosis of sexual abuse and for HIV antibody testing, and profiles of the perpetrator and type of abuse. Of 5622 estimated HIV antibody tests conducted during 113,198 sex abuse assessments, 28 children were infected with HIV and lacked any alternative transmission route to that of sexual abuse. A total of 41 HIV-infected children with a history of sexual abuse were identified. Thirteen cases had alternative risk factors and were excluded from analysis. Sixty-four percent of the 28 victims with sexual abuse as the sole risk factor were female and 71% were African-American. The mean age was 9 years. Coinfection with another sexually transmitted disease (STD) occurred in 9 (33%) cases. Sexual abuse was diagnosed on the basis of a victim disclosure in 21 (75%) cases. The basis for HIV antibody testing was physical findings suggestive of HIV infection in 9 (32%) cases, HIV-seropositive or high-risk perpetrator in 6 (21%) and 2 (7%) cases, respectively, and the presence of another STD in the victim in 4 (14%) cases. Perpetrators were a child's parent in 10 (42%) cases and another relative in 6 (25%) cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Situational and sociodemographic characteristics of children infected with human immunodeficiency virus from pediatric sexual abuse. 841 4

Recent data suggest that the homeless and those with chronic mental illness may be at increased risk for HIV infection. A review of the recent literature reveals insufficient rigorously collected data to identify with confidence any particular subgroup of chronically mentally ill patients at increased risk. Nonetheless, it seems reasonable to suspect that those with acute psychosis, a history of substance abuse, or a history of sexual abuse may be at higher risk. Conversely, some data currently support the conclusion that homeless persons are at increased risk for infection due to human immunodeficiency virus (HIV). Clinicians of all disciplines should be aware of these findings and be particularly vigilant when patients are members of both aforementioned groups. Future research should focus upon improving service delivery to the homeless and mentally ill, particularly with regard to sex education and substance abuse intervention. Also, continued research into causal influences of homelessness will ultimately lead to more definitive intervention.
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PMID:Risk of HIV infection in the homeless and chronically mentally ill. 845 64

To address the unique manifestations of human immunodeficiency virus (HIV) among adolescents aged 13 through 21 years, a comprehensive evaluation and treatment program for high-risk and HIV-positive adolescents was developed in New York City in 1987. Among HIV-infected youth, mean age of testing was 18.2 years. One third of the HIV-positive patients were female and four fifths were African-American or Hispanic. No significant differences were found between HIV-positive (n = 50) and HIV-negative (n = 43) patients for age at first intercourse, injecting or other illicit drug use, history of sexually transmitted diseases, or survival sex (exchange of sex for money or drugs). HIV-positive males were more likely than HIV-negative males to have engaged in anal intercourse and to report a history of sexual abuse. Among infected females, 82% acquired HIV through heterosexual intercourse. Almost half (48%) of HIV-positive adolescents had significant immune dysfunction at the time of their initial visit (CD4 < 500/mm3) and were eligible for zidovudine. Many HIV-positive adolescents continued high-risk behaviors such as intercourse without condoms, particularly those with ongoing dependence on drugs or alcohol. With the epidemic of HIV infection increasing nationwide among adolescents, specialized, comprehensive programs are needed to counsel and treat HIV-infected adolescents and youth in high-risk situations.
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PMID:Human immunodeficiency virus-infected adolescents: the first 50 patients in a New York City program. 829 70

The purpose of this article is to sensitize clinicians working in the field of childhood physical/sexual abuse to the connection between untreated childhood traumatization and HIV high-risk behaviors. The characteristic abuse symptoms of chronic depression, sexual compulsivity, revictimization, and substance abuse are identified as barriers to HIV education and intervention for survivors. An overview of the existing HIV/child abuse connection research, an illustrative case history and a discussion regarding the clinical implications of these connections are offered.
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PMID:HIV vulnerability and the adult survivor of childhood sexual abuse. 847 81

Attending physicians and residents at a southeastern rural teaching hospital specializing in family practice and pediatrics, as well as local family practice physicians and pediatricians, were surveyed with regard to their counseling of adolescents about sexuality, including abstinence. The physicians were asked to complete an original 67-item questionnaire describing their attitudes and practices. More than 60% of physicians reported regularly addressing the issues of HIV, STD, pregnancy prevention, and responsible sexual behaviors. About 35% of the physicians reported regularly counseling adolescents regarding 17 other issues pertaining to pregnancy and disease prevention, sexual abuse, or related medical aspects of sexuality. No respondents felt "very effective" in their counseling. Some agree they would be helped by additional training.
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PMID:Sexual abstinence counseling of adolescents by physicians. 858 30

College women who report childhood sexual abuse were compared with women who do not report abuse on a number of variables concerned with problems in living. Multivariate Analysis of Variance revealed that, compared with nonabused women, sexually abused women reported significantly more negative attitudes about sexuality, less sexual assertiveness about birth control or refusing unwanted sex, less efficacy concerning HIV prevention, more anticipation of a negative response from a partner concerning safer sex, more hard-substance use, and more sexual victimization in adulthood. These results support and extend previous work in this area and argue for greater attention to relational issues for interventions with sexually abused women. Limitations to the study and future directions for research are discussed.
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PMID:Childhood sexual abuse linked with adult substance use, victimization, and AIDS-risk. 870 40

The extent, nature, causes and consequences of child sexual abuse in Matabeleland. Zimbabwe, are explored by an intersectoral working group consisting of health, legal and AIDS prevention workers who were struck in the course of their work by the regularity with which they saw sexually abused children infected with HIV and STDs. Methods used in this study are record review, focus group discussions, structured and in-depth interviews. Child sexual abuse cases form between 40-60% of the rape cases brought to the attention of hospitals, police and court and many more are believed to remain unreported. Half of the sexual abuse in children is detected through STDs and some have HIV. The majority of offenders are mature men known to the child. Factors influencing child sexual abuse are male dominance in society, men's professed inability to control sexual desire, and magic beliefs. Victims are traumatized by the abuse itself as well as by subsequent problems in family, health and in court. Since child sexual abuse may endanger the life and well-being of the child, it is a serious problem that requires urgent action.
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PMID:Child sexual abuse in Matabeleland, Zimbabwe. 874 69

This study assessed HIV risk behaviors in a sample of homeless youth in a large urban area and examined factors associated with these behaviors. Self-reported behaviors were assessed via interviews with 196 homeless youth in Chicago in all 10 urban shelters serving this group and in 5 street locations. Overall, 83.7% reported at least one of these risk factors: multiple sex partners; high-risk partners; inconsistent condom use; history of sexually transmitted disease; anal sex; prostitution; and/or intravenous drug use. An index of these behaviors was associated with being male, having unmet personal needs, being interviewed in street locations, and having a history of sexual abuse. Findings suggest that strategies that may decrease risk behaviors among homeless youth include the elimination of their need to rely on illicit activities for income, provision of basic needs, education regarding existing services, increased outreach efforts, and early identification of and protection from childhood sexual abuse.
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PMID:Self-reported risk factors for AIDS among homeless youth. 887 48

Migration has a complex effect on health, and women migrants face health problems that are exacerbated by their inferior social status as well as by their unique biological characteristics. The magnitude of migration appears to be increasing, and labor migration has become age- and sex-selective. Family cohesion is threatened by migration policies and contemporary migration patterns. Women migrants face barriers to economic mobility when they migrate, especially when they lose the status attached to their family positions. Migrant women also face sexual abuse by employers in receiving countries and from personnel and inhabitants in refugee camps. Migration also fuels the sex tourism industry in countries as diverse as the Netherlands and Thailand. Adverse health conditions may result from voluntary and forced migration because of administrative obstacles to care, a lack of awareness about available services, linguistic barriers, failure to make health issues a priority, and the inferior social status of women. Pregnancy outcomes and perinatal health indicators suffer as well, and crude death rates of refugees are higher than baseline rates in their countries of origin. Rape and prostitution among migrant women become key factors in transmission of HIV/AIDS and sexually transmitted diseases. Breast-feeding practices may be compromised by the indiscriminate distribution of milk powder and supplementary foods in refugee camps or by adoption of the more "modern" habits of urban areas. Families are disrupted when women are impeded from supplying their usual care, and household conflicts occur when women define new roles for themselves in receiving countries. Among women, the stress of migration and resulting cultural shock has also led to occurrences of unexplained nocturnal death (Hmong), psychosomatic blindness (Cambodians), and feelings of alienation.
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PMID:Women and migration: a public health issue. 905 Jan 96


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