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

The proportion of total reported cases of acquired immune deficiency syndrome (AIDS) in US women increased annually between 1988 and 1994 from 10% to 18%, indicating an urgent need for prevention measures. Interventions designed to reduce unsafe sex and drug-using behaviors in women have been limited. Barriers to human immunodeficiency virus (HIV) prevention for women include a disproportionately low investment of resources, inadequacy and inaccessibility of substance abuse treatment programs, the crack/cocaine epidemic and resulting unsafe sex behaviors, lack of a woman-controlled method to prevent sexual transmission of HIV, and unique social and cultural factors that limit women's power in sexual decision making. Some interventions have been successful in reducing women's risk behaviors. Expanding prevention efforts targeted to women is necessary in order to stem the rising rate of HIV infection.
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PMID:Prevention of HIV infection in women: overcoming barriers. 765 51

This review focuses on the prevalence, causes, evaluation, and treatment of headache in individuals infected with human immunodeficiency virus type 1 (HIV-1). Headaches, one of the commonest medical complaints in the general population, occur frequently in patients infected with the HIV-1. HIV-related headaches can occur at any time during the infection: at seroconversion, during the incubation period, in patients with symptomatic HIV-1 infection, or after an AIDS-defining illness. Causes of HIV-related headaches include HIV-1 itself, opportunistic conditions, or HIV-specific medications. Migraines, tension-type headaches, depression, and substance abuse enter into the differential diagnosis, particularly in the early stages of disease. The headaches seen in this population reflect a complex web of interactions imposed by immune competency, multiple etiologies, treatments, and premorbid conditions. Prompt recognition and early treatment of headache is essential since it may improve quality of life and, depending on the diagnosis, prolong survival. Physicians need to be alert and adaptable when assessing HIV-infected individuals with headache since multiple causes can exist in the same patient and new syndromes, complications, and investigational drugs are continually being identified.
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PMID:Headache and the human immunodeficiency virus type 1 infection. 777 85

A review of the literature in this relatively new field highlights the legitimacy of gender-specific research on substance abuse in women. Consistent findings compared to men include a higher physical vulnerability to alcohol, a higher risk of assortative mating, the reported association of traumatic events with the onset of substance abuse, a higher psychiatric comorbidity and a shorter interval between first problem and first treatment episode. Intravenous drug use remains the major source of growth of HIV infection among women. Family assessment and treatment as well as the involvement of female role models are critical to the recovery process. Gender-specific services may be recruiting women who might not otherwise have sought treatment for their substance abuse. Further investigation is required in order to distinguish the relative significance of the genetic versus environmental vulnerability of women, the impact of rapidly changing social mores on the onset, pattern and course of substance abuse, possible gender-specific alcohol typologies, the validity of the recall of traumatic events as well as the program variables required in reaching out and engaging women on the path to recovery.
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PMID:Alcohol and polysubstance abuse among women. 778 21

As part of a 3-year federal demonstration project, San Francisco health clinics provided case management services to chemically dependent individuals who were low-income and often homeless. Many of those participating in the project had also been diagnosed with HIV infection and/or mental illness. The intent of the demonstration project was to use case management as a mechanism for strengthening the linkages between substance abuse treatment and primary care systems. Case management was adopted as the catalyst for increased communication between medical personnel and other service providers to develop a more comprehensive approach to responding to the myriad of client needs. A specially designed management information system (MIS) was developed to help document client information and case management activities, as well as provide a tickler system to improve client continuity. This report integrates both qualitative and quantitative findings to provide a context for understanding case management activities, client problems and successes, and the systemic problems facing clients and case managers in linking primary care, substance abuse treatment, and mental health services.
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PMID:A case management program for chemically dependent clients with multiple needs. 779 39

A review of the literature indicates that the association between human immunodeficiency virus (HIV) and prostitution varies by geographic region and can be altered substantially by well-planned public health interventions. In most African countries and in Asian countries such as Thailand, the rate of HIV infection among female prostitutes is substantially higher than the rate in the general population. Relatively few commercial sex workers in South and Central America are HIV-positive; however, their extremely high rates of infection with sexually transmitted diseases indicates the potential for future epidemic spread of HIV. In Europe and North America, HIV infection is most prevalent among drug-injecting or crack-using prostitutes. Neglected has been research on the high incidence of HIV among male transvestite and transsexual prostitutes. The lowest levels of condom use in commercial sex encounters have been recorded in regions in developing countries with the highest HIV prevalence. Also of concern are high condom breakage rates (20-50%) among female prostitutes who use petroleum-based lubricants and male prostitutes who practice anal sex. Valuable would be quantification of the additional HIV risk resulting from sex with a prostitute. Other recommended research areas include estimates of the number of male and female prostitutes working in certain geographic areas, mechanisms for monitoring condom use and substance abuse among prostitutes, the impact of HIV infection on movement into and out of prostitution, the dynamics of prostitute-client condom negotiation, and profiles of the clients of male prostitutes.
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PMID:Prostitution and HIV: what do we know and where might research be targeted in the future? 771 99

The problem of illicit drug abuse has of course not spared Austria. In fact, considering only the increase in the official figures on drug-related deaths over the past few years, this problem has dramatically worsened in Austria. Drug-related deaths represent the most serious consequence of substance abuse, but according to the Pompidou Group classification such deaths are only one of eight indicators in assessing the extent of drug abuse in a community. We analyzed reports on all postmortems classified as drug-related deaths according to the official definition of the Austrian Federal Ministry of Internal Affairs undertaken at the Institute of Forensic Medicine in Vienna between 1984 and 1993. The annual number of drug-related deaths increased nearly ten-fold during the study period. In about a third of the cases accidental single substance overdosage (of mainly a morphine-containing drug) was the cause of death. In the majority of the corpses more than one drug, including alcohol, was detected. During the past 10 years there was an evident trend towards a multisubstance abuse pattern. Since the plateau reached in 1988, the incidence of HIV-1 infection among decreased drug injectors has decreased.
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PMID:[Drug fatalities from the forensic medicine viewpoint. 10 years experiences of the Vienna Institute of Forensic Medicine]. 781 Jan 54

The present article highlights the mental health needs of children living with loved ones who have AIDS or HIV infection. In addition the article describes an intervention program which is being developed to meet the needs of the children and their families. Children who live in families affected by AIDS and HIV infection, like children who live with other life-threatening illnesses, are vulnerable to psychological distress. They experience numerous separations from parents, changes in the nature and predictability of emotional nurturing, concerns about loss, disruptions in routine and contact with peers, and economic hardship. AIDS and HIV infection present the additional stressors that stem from discrimination, stereotyping, and social ostracism. Finally, many families living with AIDS or HIV infection are disenfranchised, living under the pall of poverty and substance abuse. The intervention program described is being implemented in an urban community mental health clinic to meet the diverse mental health needs of the children living in these families. Preliminary implications of the program are discussed so as to begin a dialogue with other agencies who are challenged to meet the needs of this heterogeneous population.
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PMID:Identifying the mental health needs of children living in families with AIDS or HIV infection. 783 43

High rates of unprotected sexual behaviors and the exchange of sex for crack have been reported among female crack cocaine users. This subpopulation of drug users is at significant risk for contracting and transmitting HIV and AIDS. To date, there has been no research comparing crack- and opioid-abusing women, particularly regarding their involvement in high-risk behaviors and other key background indicators for different subgroups of drug-abusing women. Sixty-one crack-abusing African-American women who recently entered an intensive outpatient treatment program were compared to 64 matched women whose primary drug of abuse was heroin. The opioid subgroup represented both those who were involved in methadone maintenance and those who were out of treatment. Higher rates of high-risk sexual behaviors were reported by the crack subgroup, including prostitution, number of sexual partners, and infrequency of condom use. As expected, i.v. drug use and high-risk behaviors associated with needle use were much higher among the opioid subgroup. Other significant differences were found between the two groups across key indicators. Individuals in the crack subgroup were younger, cared for more children, were less employable, were less likely to be married, and had more extensive lifetime substance abuse. Quantitative and qualitative background and clinical data are also presented. The nature of crack versus heroin abuse is also discussed, particularly in relation to high-risk sexual behaviors. Finally, the impact of the findings on developing appropriate treatment interventions for both groups is addressed.
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PMID:High-risk behaviors for HIV: a comparison between crack-abusing and opioid-abusing African-American women. 784 52

In 1994, the Alan Guttmacher Institute conducted a survey of 30 health care facilities that received grant monies under Title IIIb of the Ryan White Comprehensive AIDS Resource Emergency Act, 19 family planning clinics that have some HIV services, and 2 family planning clinics that also received monies from Title IIIb. It aimed to examine integration of reproductive health services with HIV/AIDS services which in turn would indicate how well the needs of women infected with HIV, suffering from AIDS, or at risk of HIV infection are being met. Most Title IIIb grantees had used some Title IIIb funds to provide HIV testing (25) and counseling (24), but they were likely to consider reproductive health and sexually transmitted disease (STD)/HIV services as 2 different categories. Most common services of Title IIIb grantees were mental health services and referrals (28), pelvic exam (26), substance abuse counseling and referrals (26), Pap smears (25), testing for and treatment of urinary and vaginal infections (25), and diagnostic evaluation of gynecologic tumor (25). All 19 family planning clinics, with a few exceptions, provided gynecologic care, HIV testing and counseling, pregnancy testing, options counseling, STD testing and treatment, and reversible contraceptive services. Overall, family planning providers did not consider reproductive health services to be an integral part of HIV/AIDS services regardless of a woman's HIV status. The 2 family planning clinics that also received Title IIIb funds considered themselves to be primary health care providers from a woman's perspective. They perceived that their clients needed HIV/AIDS services. These findings illustrate a need to eliminate the perceptual distinctions between reproductive health services and STD/HIV services and to consider reproductive health services as integral components of HIV/AIDS prevention. We need a more integrated system of assisting women with HIV/AIDS and those at risk of HIV infection.
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PMID:Reproductive health and AIDS-related services for women: how well are they integrated? 786 74

Investigated was the prevalence of human immunodeficiency virus (HIV) among mentally ill criminal offenders admitted to Thailand's Nitichitawej Hospital for Forensic Psychiatric Services from September 1988-February 1989. There were 325 admissions; the average age was 32.4 years. 47% had committed murder or acts of grievous bodily harm, 33% were confined for offenses against property, and 6% were arrested for drug possession. In terms of psychiatric diagnoses, the majority (78%) were schizophrenic. 18 (5.6%) had a primary diagnosis of drug addiction, but 92 (28.3%) indicated they were substance abusers. Only 6 cases (1.8% prevalence) of HIV infection were found in this population. Four of the HIV-infected prisoners had a primary diagnosis of drug addiction; the remaining two were diagnosed with schizophrenia, but both these men had a history of substance abuse. When the HIV prevalence rate was recalculated for mentally ill patients who acknowledged a history of substance abuse, it increased to 33.33%; moreover, it rose to 35.29% when computed among those arrested on drug charges. These rates are consistent with those recorded among non-institutionalized drug abusers in Thailand (around 30%). It is recommended that forensic psychiatric units take precautions to prevent the spread of HIV through homosexual activity among inmates.
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PMID:The prevalence of HIV infection among mentally ill offenders in Thailand. 786 8


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