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

Seroprevalence surveys of incoming inmates provide useful sentinel information on human immunodeficiency virus (HIV) infection rates among groups that practice HIV-associated high-risk behaviors. In addition, such data are beneficial to corrections officials in the formulation of institutional policies to prevent HIV infection. Inmates entering the Michigan corrections system from December 1987 to March 1988 participated in blind, anonymous serosurveys for HIV infection. Eight of 802 entering inmates (1.0 percent) were seropositive; most seropositive persons reported intravenous drug use. The most common risk behaviors reported by study participants were intravenous drug use (20.0 percent), multiple sexual partners (37.1 percent), and infrequent (that is, never or seldom) use of condoms (82.6 percent). Women reported the highest rates of intravenous drug use (35.1 percent) and needle-sharing (19.4 percent). Results from this study indicate that in spite of wide-spread HIV-associated risk behaviors, the extent of HIV-seropositivity among incoming inmates in Michigan is relatively low. Such data suggest that there is still time to impact the course of the AIDS epidemic among high-risk groups in States where the prevalence of HIV infection is relatively low. The data also indicate that the potential for HIV spread in correctional facilities is noteworthy and that HIV prevention education and substance abuse treatment services are needed in corrections facilities.
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PMID:Sentinel surveillance of HIV infection among new inmates and implications for policies of corrections facilities. 212 Jul 29

Substance abuse and psychiatric disorders commonly occur together. This form of dual diagnosis is notable because it complicates assessment and makes treatment more difficult for both psychiatric and drug abuse problems. Drugs can cause psychiatric disorders and can also be used as an attempt to "cure" them by self-medication. The spread of the human immunodeficiency virus (HIV) among drug users has added a third potential clinical problem, that of the acquired immunodeficiency syndrome, to the difficulties already presented by drug abuse and psychiatric disorders. Patients with this triple diagnosis pose challenges to primary care physicians as well as addiction medicine specialists or psychiatrists. Assessment should include a drug abuse history, preferably corroborated by others, evaluation of the mental state, and examination focusing on signs of drug abuse and HIV infection. Treatment should include the management of HIV disease, abstinence from drug abuse, and access to psychiatric care. New systems of health care service, including interdisciplinary case management, may be needed to manage patients with a triple diagnosis.
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PMID:Drug abuse, psychiatric disorders, and AIDS. Dual and triple diagnosis. 219 Apr 23

Over 28 million Americans have admitted to abusing a substance in the last year alone, at a direct purchase price of over 79 billion dollars. Substance abuse and addiction have grave consequences on our existing social systems, effecting crime rates, hospitalizations, child abuse, and child neglect, and are rapidly consuming limited public funds. The intravenous drug abuser represents the fastest growing vector of HIV virus. This report focuses on the social and economic implications of substance abuse and addiction and discusses the merits and limitations of several popular solutions to the problem.
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PMID:The impact of drug abuse and addiction on society. 220 15

Ninety-two substance abusers were surveyed about AIDS-related risk behaviors. The questionnaire administered elicited information on demographics, sexual practices, substance abuse, and risk behaviors involving the use of needles. Results indicated an appropriate base of prevention knowledge and patients' efforts to modify vulnerability to HIV exposure. Nevertheless, patients continue to engage in behaviors resulting in HIV exposure and transmission.
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PMID:AIDS-related risk behaviors among substance abusers. 222 37

This paper reports an outcome evaluation and needs assessment conducted by the AIDS and Substance Abuse Program (ASAP) of the San Francisco AIDS Health Project. The study was designed to: 1) evaluate effectiveness of a hospital based intervention and referral service for HIV affected substance abusers, and 2) gather information from this population regarding accessibility and barriers to drug treatment. Participants were 86 individuals consecutively referred to ASAP over an 8-month period. All received a brief needs assessment interview in addition to the standard ASAP evaluation protocol. Agency follow-up contacts were made for those individuals referred by ASAP to extended substance abuse treatment, with information limited to whether or not the client contacted the designated referral resource. Source of referral to ASAP, interest in treatment, and prior sexual risk behavior change were significant predictors of intervention outcome. Personal unreadiness and treatment program waiting lists were the most frequently reported obstacles to treatment. While most participants reported changing risk behavior in response to the AIDS epidemic, patterns of change differed according to intravenous drug use history.
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PMID:Evaluation of a hospital based substance abuse intervention and referral service for HIV affected patients. 229 29

Perinatally transmitted HIV infection is an emerging public health problem, particularly in communities impacted by substance abuse. This article presents an overview of clinical presentation and management throughout the various stages of infection. Recent advances in antiretroviral therapy have the potential to improve quality of life and increase survival for infected children. Nursing intervention is required for all children and families regardless of the severity of disease. Family education and support can be integrated within existing health care systems to assure delivery of competent and comprehensive care.
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PMID:HIV infection in children. 236 35

The human immunodeficiency virus (HIV) epidemic has created a multidimensional crisis that is challenging the health care system. Individuals with or without risk behaviors have anxieties about acquired immunodeficiency syndrome (AIDS) and need support and counseling. Once symptoms of HIV infection develop, crisis intervention and support need to be integrated into ongoing medical care. A biopsychosocial approach enables persons with AIDS to develop strategies for coping, to improve adherence, and to prevent transmission and suicide. Persons with AIDS are confronted with severe illnesses, neuropsychiatric disorders, discrimination, and death. Each person deserves the best medical and psychologic care available and the services of other disciplines where indicated. Caregivers, anxious about contagion, are devastated by the complexity, severity, and multiplicity of the illnesses that comprise AIDS and the lack of adequate resources to combat the epidemic. AIDS is a paradigm of a medical illness that requires a biopsychosocial approach. Psychiatric sequelae complicate the HIV epidemic, affecting both the uninfected and infected. The psychiatric manifestations of the uninfected include anxiety, phobia, factitious disorder, delusions, and Munchausen's AIDS. Psychiatric disorders associated with HIV infection include organic mental disorders, substance abuse disorder, affective disorders, adjustment disorders, anxiety disorders, and personality disorders. The consultation-liaison (C-L) psychiatrist is in a unique position to clarify and treat the psychiatric complications and to provide leadership for multidisciplinary programs. The biopsychosocial approach enables persons with HIV infection, their loved ones, and caregivers to meet the challenges of the HIV epidemic with compassion, optimism, and dignity.
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PMID:Biopsychosocial approach to the human immunodeficiency virus epidemic. A clinician's primer. 240 16

The potential role of substance abuse, especially cocaine and alcohol as co-factor in HIV infection and in the development and expression of AIDS has been suggested, but the possible biological role of substance abuse in the development of AIDS is not known. In order to better understand immune system function in chronic cocaine abuse, we have assessed primary B cell responses to helper T-cell independent (TI) and dependent (TD) antigens in inbred Fisher male rats injected with 1.25-5 mg cocaine/kg body weight for 10 days. The ability of cocaine-exposed animals to mount primary in vivo splenic plaque-forming cell (PFC) and serum antibody responses to the TI antigen, pneumococcal polysaccharide type III (SIII), was elevated several-fold when compared with controls. The degree of elevation of humoral antibody responses seemed to be directly related to the dose of cocaine. Primary in vivo B cell responses to the TD antigen, sheep red blood cells (SRBC), was elevated at lower concentrations of cocaine (1.25-2.5 mg/kg) and was found to be significantly suppressed after chronic exposure to the higher concentration (5.0 mg/kg). The elevated primary splenic immunostimulation to TI (SIII) may be attributed to a combination of loss of T suppressor cell control and direct B cell stimulation. Elevated immune responses to SRBC at lower concentrations were attributed to stimulation of T helper cells as well as loss of T suppressor cells. Immunosuppression to SRBC observed in response to 5.0 mg/kg of cocaine was most probably due to loss of T helper cell subset functions. These findings were further tested by in vitro methods, where splenic lymphocytes from cocaine-exposed animals were examined for their ability to respond to concanavalin A (Con A) in terms of the induction of antigen non-specific suppressor T cells. The addition of Con A-stimulated splenic lymphocytes from cocaine-treated animals did not inhibit the primary antibody responses of SRBC as compared with saline-treated controls, indicating that suppressor T cells malfunction after cocaine exposure. Lymphocyte subpopulation analysis using fluorescein-labelled monoclonal antibodies showed a significant increase in the B cell populations at doses of 1.25-5 mg/kg. A reciprocal change in T cell populations also took place. No significant numerical change in macrophage (NSE+) and T cell subset, T helper and T suppressor was noticed, suggesting that cocaine probably directly effects mature T cell subset functions but does not affect their differentiation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Functional analysis of lymphocytes subpopulations in experimental cocaine abuse. I. Dose-dependent activation of lymphocyte subsets. 252 33

The Defense Mechanism Inventory (DMI) and The Risk Behavior Inventory (RBI) were administered to substance abusers hospitalized on a drug detoxification service. The groups were categorized on the basis of self-reported IV versus non-IV substance abuse. Significant between-group differences were obtained on the DMI and RBI. The non-IV group responded less often than the IV group with the Turning Against Object (TAO) response option, resulting in higher scores when Turning Against Self (TAS), Reversal (REV), Principalization (PRN) and Projection (PRO) were summed into a single score. Significant within-group differences were obtained for DMI response levels and defenses. Both groups relied less on TAO at the thought level and more on PRN and REV as primary defenses. The IV group reported twice as many risk behaviors as the non-IV group and risked HIV exposure through needle use and sexual transmission modes. Consideration was given to the role of principalization and denial within the addicted individual's defense structure and the relationship of these defenses to HIV-related risk behavior.
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PMID:DMI-measured defenses and HIV-related risk behaviors in i.v. compared to non-i.v. substance abusers. 259 7

Little has been written about the treatment of substance use disorders among seropositive HIV patients or high-risk seronegative substance abusers. Demographic and clinical characteristics, along with treatment issues, were examined based on experience with 18 patients in a substance abuse program in a university medical center (3 AID, 3 ARC, 9 seropositive only, and 3 seronegative high risk). Scores on a substance abuse rating scale were extremely high. Most of them abused three or more different substances, had used drugs parenterally, had more than 50 sex partners, and/or had received previous substance abuse treatment. Affective disorder, suicide attempt, and antisocial personality were frequent in this group. About half of the patients complied with treatment and showed improvement in their substance disorder. Several common themes in the management of these patients are described.
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PMID:AIDS-related illness and AIDS risk in male homo/bisexual substance abusers: case reports and clinical issues. 843 29


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