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

Sexually transmitted diseases (STDs) may be transmitted during sexual assault. In children, the isolation of a sexually transmitted organism may be the first indication that abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. In this review I discuss the issues of the transmissibility and diagnosis of STDs in the context of child sexual abuse. Rectal or genital infection with Chlamydia trachomatis among young children may be the result of perinatally acquired infection and may persist for as long as 3 years. A major problem with chlamydia testing in the context of suspected sexual abuse in children has been the inappropriate use of non-culture tests. Although the new generation of nucleic acid amplification tests have shown high sensitivity and specificity with genital specimens from adults, data on use of these tests on any site in children are practically non-existent. Bacterial vaginosis (BV) has been identified among children who have been abused and among those who have not been abused. However, many of the methods used to diagnose BV in adults have not been evaluated in children. Recent studies of perinatal infection with human papillomavirus (HPV) have been inconclusive. HPV DNA has been detected at various sites in children who have not been abused. The relation to the development of clinically apparent genital warts is unclear. Although HIV can be acquired through sexual abuse in children, the exact risk to the child and which children should be screened is still controversial.
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PMID:Sexually transmitted diseases in sexually abused children: medical and legal implications. 984 50

Sexually transmitted disease (STD) treatment services in low-income communities offer an effective arena for accessing those at greatest risk for HIV infection. This study evaluated an intensive HIV risk reduction program implemented in publicly funded STD clinics in Maryland, Georgia, and New Jersey (US). After completion of a 90-minute interview on HIV risk behaviors, condom use self-efficacy, and condom outcome expectancies, the 472 study participants were randomly assigned to either a 10-hour behavioral intervention designed to increase condom use self-efficacy through modeling and skill building or routine brief counseling. The average age of respondents was 30.1 years; they reported an average of 3.2 lifetime STDs. Participants in both the intervention and control groups reported significant reductions in the number of sexual partners and unprotected sexual encounters and significant increases in condom use at the 90-day follow-up interview, with no significant differences between groups. Four possible moderators of behavior change--gender, crack or heroin use, alcohol problems, and child sex abuse--were not significant. The possibility that the baseline interview, not the intervention, motivated the observed changes in sexual behavior merits consideration.
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PMID:Effects of an HIV risk reduction project on sexual risk behavior of low-income STD patients. 988 84

HIV and AIDS is a growing health risk for heterosexual women, particularly women of color (Centers for Disease Control and Prevention, 1997). Our research identified 5 types of HIV sexual risk taking in 3 independent samples of adult women from a New England Community: Group A women were noted by low to moderate levels of the 4 risk markers (i.e., unprotected vaginal sex, perceived partner-related risk, number of sexual partners, and unprotected anal sex); Group B women reported very high frequency of unprotected vaginal sex; Group C women were characterized by unprotected anal sex; Group D women had high perceived partner risk; and Group E women reported extremely high levels on all 4 HIV risk markers. Sexual risk groups were validated by demonstrating significant differences among groups on relevant behaviors, interpersonal experiences, and attitudes. Compared to other women, higher risk types reported greater behavioral risk practices (substance use, prostitution, diverse sexual experience), interpersonal risk experiences (sexual abuse, violence), initiation sexual assertiveness, and attitudinal risks (psychosocial distress). They reported less interpersonal assurance (surety of own and partner's HIV status), sexual assertiveness (for condom use and partner communication), psychosocial strengths (sexual self-acceptance), and transtheoretical readiness for change (condom use efficacy, readiness to consider condoms). Results provide additional support for the multifaceted model of HIV risk and the transtheoretical model. Suggestions for specifically focused interventions are given, depending on the pattern of sexual risk taking.
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PMID:Women HIV sexual risk takers: related behaviors, interpersonal issues, and attitudes. 991 47

A retrospective study of all children admitted with the diagnosis of acquired immunodeficiency syndrome (AIDS) at Jos University Teaching Hospital (JUTH) between August 1995 and October 1996 was carried out. Forty three (1.5% out of a total of 2793 children were diagnosed with HIV infection during the study period. However, only the records of 23 out. Of the 43 positive cases were available for analysis. Of the 23 cases whose records were available, 8 presented in 1995, while the remaining 15 presented between January and October 1996. The ages of the children ranged between 1 and 15 years (Mean 3.0 +/- 4.1 Years). There were 12 males and 11 females (M:F = 1:1). Sixteen (69.6 percent) out of the 23 patients were aged between 1 month and 2 years. Sixteen (69.6%) of the 23 patients acquired the infection vertically, 2 (8.9%) acquired the infection through blood transfusion, 1 (4.3%) from sexual abuse, while in 4 (17.4%) the source of infection could not be established due to inadequate data. Majority of the children presented with weight loss, chronic diarrhoea and fever, while the common findings included wasting, oralthrush, pallor, hepatosplenomegaly and lymphadenopathy. Six (26.1 percent) out of the 23 children died, 8 (34.8 percent) were discharged against medical advice and have not been seen since, 9 (39.1%) improved and were discharged to out-patient clinic followup, but all except 2 of these have been lost to follow-up. It is concluded that AIDS is increasingly becoming a major cause of childhood morbidity and mortality in our environment. All children in our environment who present with features of malnutrition should be screened for AIDS. Campaigns aimed at preventing vertical (maternal-child) transmission, including health education of young men and women on the risk of unprotected sex must be vigorously pursued and sustained.
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PMID:Paediatric AIDS in Jos, Nigeria. 992 Oct 95

A 19-year-old homeless youth presented to the emergency department with right arm pain at the site of previous intravenous line and abdominal pain following a fight. Several days previously he had been treated for an unwitnessed grand mal seizure. The patient stated his history of seizure disorder, cardiac arrhythmia, reactive airway disease, and HIV infection (he reported CD4 count of 350 cells/mm(3)), and physical and sexual abuse. Upon admission, his CD4 count and percent were normal and HIV antibody test was negative. He refused to accept those results and kept none of his follow-up appointments. The case was consistent with factitious HIV disorder in adolescents.
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PMID:Multiple Health Issues in a Homeless Adolescent. 1035 94

This paper aims to expand upon recent research addressing the relationship between power and cultural stories of illness. It does this by exploring the stories of 'healing' and 'survival' produced by people who have undergone traumatic experiences such as childhood sexual abuse and a HIV positive diagnosis. The liberating and/or repressive potential of cultural stories of illness are defined in accordance with their capacity to produce 'minimal' or more 'reflective' selves, as characterised by Lasch [Lasch, C., 1985. The Minimal Self. Picador, London.] and Giddens [Giddens, A., 1991. Modernity and Self-identity: Self and Society in the Later Modern Age. Polity Press, Cambridge.], respectively. Two predominant stories of survival are identified in this paper: the 'healing' story and the 'normalising' story. Each of these are explored in an attempt to address the question: How do we distinguish between 'liberating' and 'repressing' technologies of the self with regard to the telling of illness stories? [Frank, A., 1998. Stories of illness as care of the self: a Foucauldian dialogue. Health 2(3), 329-348, forthcoming.]. Through an examination of survivors' attempts to overcome their traumatic experiences via the appropriation of various illness stories, it is concluded that this question can only be answered in the practical and social context of each individual's life.
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PMID:Stories of illness and trauma survival: liberation or repression? 1040 Feb 66

This paper presents a model developed to advance the understanding of the relationship between sexual abuse and HIV risk among women. It is proposed that the relationship is mediated by many of the long-term sequelae of sexual abuse. The process of mediation is believed to occur through various causal pathways propelled by specific underlying mechanisms that increase the likelihood of HIV risk. The following causal pathways are proposed: (1) initiation of and/or increasing reliance on drug use as a method of coping with the sexual abuse experience, (2) problems with sexual adjustment related to sex risk taking, and (3) psychopathology (e.g. depression) which increases the likelihood of an individual participating in HIV risk behaviours. These hypothesized pathways are based on the characteristics and behaviours of individuals with histories of sexual abuse and do not take into account the influence of the individual's social environment. Increasingly, evidence suggests that understanding the social context of HIV risk is crucial to the development of preventive interventions. Therefore, a final pathway is explored which suggests that specific social network characteristics (e.g. network membership type, social support, and social isolation) influence HIV risk exposure opportunities among women with sexual abuse histories.
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PMID:A model to explain the relationship between sexual abuse and HIV risk among women. 1043 79

Young Aboriginal men face marginalization distinct in cause but similar in pattern to those seen among men who have sex with men (MSM) and may be at increased risk for HIV infection. We compared sociodemographic characteristics and risk taking behaviours associated with HIV infection among MSM of Aboriginal and non-Aboriginal descent. Data for this comparison were gathered from baseline questionnaires completed by participants in a cohort study of young MSM. Data collection included: demographic characteristics such as age, length of time residing in the Vancouver region, housing, employment, income and income sources; mental health and personal support; instances of forced sex and sex trade participation and; sexual practices with regular and casual male sex partners. Data were available for 57 Aboriginal and 624 non-Aboriginal MSM. Aboriginal MSM were significantly less likely to be employed, more likely to live in unstable housing, to have incomes of <$10,000 and to receive income assistance than non-Aboriginals (all P<0.01). Aboriginals also had higher depression scores (P<0.01), were more likely to report non-consensual sex (P=0.03), sexual abuse during childhood (P=0.04) and having been paid for sex (P<0.01). In the past year they were no more likely to have had sex with a male partner they knew to be HIV positive, to have had more than 50 male partners or to have unprotected anal insertive or receptive intercourse with their male partners (all P>0.05). Our data indicate that among MSM, Aboriginal men are at increased risk of antecedent risk factors for HIV infection including sexual abuse, poverty, poor mental health and involvement in the sex trade.
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PMID:HIV-associated risk factors among young Canadian Aboriginal and non-Aboriginal men who have sex with men. 1049 24

Despite the significant emergence of research on female addiction over the last two decades, specific research on African-American women substance abusers, particularly crack cocaine users, is limited. The identification of meaningful subgroups of substance abusing populations, particularly minority women is important both clinically, and because of their over-representation in the epidemiological data on crack cocaine use in many urban centers across this country. An extensive battery of instruments was administered to 110 women entering treatment in an intensive outpatient substance abuse treatment program in Philadelphia, serving women who are primarily indigent, African-American, and whose primary substance of abuse is crack cocaine. Factor analysis and cluster analysis procedures were utilized to classify women into subgroups across relevant clinical, behavioral, and background concerns relevant to studying substance abusing populations. Five conceptually meaningful subgroups emerged which classified women across various indicators such as HIV sex risk factors, personality traits/Axis II dimensions, clinical syndromes, psychological symptomatology, lifetime and recent drug and alcohol use, prior physical and sexual abuse, and social context variables such as parental addiction, and whether they live with a substance abuser. Attempts to classify women into identifiable clinical subtypes is essential in order to better inform treatment initiatives designed to serve this group, as well as prevention and community outreach intervention strategies which attempt to bring them into treatment.
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PMID:An exploratory attempt to distinguish subgroups among crack-abusing African-American women. 1050 81

High rates of human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs) are seen in women prisoners. These high rates may be related to the nature of their lives, which may include violence, substance abuse, promiscuity, prostitution, and exchange of sex for drugs--all of which increase their risk for acquiring HIV. The purpose of this study was to examine the HIV-related risk behaviors and protective practices of women prisoners in a rural southern state and factors related to these behaviors. The sample included 57 women incarcerated in a medium-to-maximum security prison. Key findings included high rates of substance abuse, extensive past and current violent experiences including sexual abuse, high percentage of multiple partners, and low use of condoms. Additionally, women in this sample did not perceive themselves to be at risk for HIV infection. Practical suggestions for reducing the HIV risks of incarcerated women are offered.
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PMID:The lives of incarcerated women: violence, substance abuse, and at risk for HIV. 1054 75


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