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

Acupuncture is a treatment modality that is particularly applicable for homeless clients because of its low cost and portability as well as because of its effectiveness in treating the symptomatology of pain syndromes, substance abuse, and human immunodeficiency virus infection. A two-part descriptive study was conducted to determine the response to acupuncture of homeless persons at the Chicago Health Outreach Clinic. Part 1 of the study consisted of a retrospective chart review of 45 patients to assess acupuncture treatment effectiveness. Part 2 of the study consisted of using a numerical rating scale report form to assess treatment effectiveness of 30 patients. Part 1 of the study indicated that 51% had a positive response to treatment, 42% were indeterminate or lacked documentation of response, and 7% had no response to treatment. Part 2 of the study demonstrated that 97% had a positive response to treatment, with 3% reporting no response to treatment. Acupuncture treatment did effectively decrease the symptomatology of the homeless clients seen in the Chicago Health Outreach Acupuncture Clinic. Further research should involve follow-up of these clients to assess the length of symptom relief to further determine long-range effectiveness and cost of treatment.
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PMID:An evaluation of the treatment effectiveness of the Chicago Health Outreach Acupuncture Clinic. 819 74

Lifetime and current alcohol and drug use and sexual risk acts were examined among 154 male and 148 female runaways, aged 11-19, predominantly Black and Hispanic, residing at four residential shelters in the New York City area. Most runaways reported alcohol (71%) and drug use (46%), with about a quarter (27%) using either alcohol or drugs at least once a week during the past 3 months. Physical symptoms of substance abuse were reported by 47%; 17% reported addiction. Current substance use was higher among males and Hispanics, and increased with age. Substance use was significantly related to reporting more sexual partners and less frequent condom use. The results suggest that HIV/AIDS prevention programs must target the reduction of alcohol and drug use as well as sexual risk acts.
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PMID:Alcohol and drug use and sexual behaviors placing runaways at risk for HIV infection. 819 97

The empowerment and affirmation of lesbian, bisexual, and gay students is long overdue. This article explores how human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS), substance abuse, violence and hate-related crimes, suicide, and heterosexism all adversely affect the physical and emotional health of nonheterosexual college students. College health services must expand their current scope and practice and assume a leadership role in combating all forms of oppression by actively incorporating and addressing the unique health issues and needs of the lesbian, bisexual, and gay population. This article provides a brief overview of the relevant healthcare issues for lesbians, bisexuals, and gays; examples of heterosexism in college health services; and recommendations for institutional and personal and professional change.
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PMID:Challenging heterosexism in college health service delivery. 820 Nov 34

An elementary model of sociogeographic network structure in an urban minority community suggests externally applied stress, particularly that which triggers frequent individual or family moves of increasing distance, may cause a sudden 'phase change' resulting in disconnection of previously integrated subgroups from the community. Such 'community meltdown' would seriously disrupt mechanisms for social control, economic opportunity and socialization of youth, while intensifying substance abuse and indiscriminate and frequent sexual activity, particularly among the very young. 'Phase change' of this nature would seem to preclude success of programs to control spread of HIV infection, particularly in heterosexual populations. The possibility is explored that programs of 'community recrystalization' in disintegrated urban area might likewise need to exceed some threshold of investment and organizing activity before becoming effective. However, if supported to levels above threshold, this work implies such programs might have very great impact in a very short time. The possibility of interaction between behavioral pathologies resulting from the initial meltdown and further consequent deterioration in sociogeographic network structure leads to speculation that the threshold for recrystalization may become significantly and progressively greater than for meltdown. Implications of these matters for diffusion of HIV into the general population are discussed.
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PMID:Social disintegration and the spread of AIDS--II. Meltdown of sociogeographic structure in urban minority neighborhoods. 821 7

The objectives of this study were to assess attitudes, knowledge, and behavior related to human immunodeficiency virus (HIV) antibody testing of adolescents and young adults undergoing treatment for alcohol and drug problems. Setting and subjects were 101 adolescents and young adults enrolled in a New England substance abuse rehabilitation program. All subjects had heard about acquired immunodeficiency syndrome (AIDS) and 84% desired an HIV antibody test if it were anonymous and confidential. If found to be HIV positive, 83% stated that they would be less likely to continue substance-abuse treatment, 64% would be more likely to continue drug use, and 62% would be more likely to continue alcohol use. The likelihood of continuing school would decrease for 60%. Sixty percent would be more likely to increase use of condoms. Males were more likely than females to want to leave treatment and school, return to alcohol and drug use, and increase risk-taking behavior (p < 0.02). These findings suggest that teenagers undergoing treatment for substance-abuse problems require careful and comprehensive pre- and post-test counseling and follow-up when undergoing HIV antibody testing. Deciding when to test for HIV may impact on the success of substance-abuse treatment, as well as ability to control spread of HIV infection.
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PMID:A survey of attitudes, knowledge, and behavior related to HIV testing of adolescents and young adults enrolled in alcohol and drug treatment. 824 Dec

A process of urban decay, coupled with forced displacement and behavioral problems, affecting an increasing number of neighborhoods in large U.S. cities. The resulting social disintegration has intensified a nexus of deviant behaviors and conditions, including substance abuse, that are related to transmission of HIV and resurgence of other contagious diseases. These diseases will diffuse, or are already diffusing, along the transportation hierarchy from larger into smaller central cities, and radially from the central cities into the surrounding areas. A widespread program of urban reform is a critical precondition for the control of contagious disease in the United States. It also is important for housing, social services, housing-related public services, and public health across urban and suburban jurisdictions.
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PMID:The coming crisis of public health in the suburbs. 824 48

In the twenty-five years since its introduction as a treatment for opiate addiction, methadone maintenance has generated considerable controversy regarding both its appropriateness as a treatment modality and its efficacy in diminishing opiate abuse. Given current concerns regarding the spread of HIV amongst IV drug abusers, the role of methadone maintenance may be more important than ever. The present study was designed to examine continued illicit substance abuse by 229 patients enrolled in methadone treatment as a function of time in treatment (three months to over 10 years). Patients' urinalysis results collected over a 3 month period indicated that (a) cocaine use is a problem amongst methadone maintained individuals and does not appear to be related to length of time on the program, (b) cocaine use did not lead to escalated opiate and other illicit drug abuse, and (c) opiate abuse decreased significantly with time in treatment. Specifically, while 35% of the patients enrolled for less than 12 months were opiate free for the 3 month period, that value increased to 71% for patients enrolled for more than 4 years, and 85% for patients remaining in treatment for over 10 years. These results based on urinalysis support the conclusion of Ball and Ross (1991), based on ASI scores and criminality data, that methadone is an effective treatment modality for opiate addicted individuals.
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PMID:Diminished illicit drug use as a consequence of long-term methadone maintenance. 829 39

Designing an effective, outpatient, community-based neuropsychiatric program for persons infected with human immunodeficiency virus-1 (HIV) is challenging because the affected population is diverse. The individuals must cope with a multitude of complications while anticipating a shortened life span. Behavioral and emotional complications are common and may be reactive, idiopathic, or organic. An effective program must provide neuropsychiatric evaluations and give access to ongoing supportive and psychotherapeutic services that take into account problems unique to HIV-infected individuals. Neuropsychiatric evaluations were performed on 80 infected patients. The HIV-seropositive individuals (n = 60) were compared with patients with acquired immunodeficiency syndrome (AIDS) (n = 20) using several clinical measures. Patients in the early stages of HIV infection suffered from more frequent major depressive episodes and ongoing substance abuse than patients with advanced disease. Cognitive impairment and psychosis, however, were primarily related to AIDS.
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PMID:A neuropsychiatric program for HIV-infected individuals. 837 29

The feasibility of on-site primary care services and their use by human immunodeficiency virus HIV-seropositive and seronegative injecting drug users within an outpatient methadone maintenance program are examined. A 16-month prospective study was conducted within an ongoing cohort study of HIV infection at a New York City methadone program with on-site primary care services. The study group consisted of 212 seropositive and 264 seronegative drug injectors. A computerized medical encounter data base, with frequencies of primary care visits and with diagnoses for each visit, was linked to the cohort study data base that contained information on patients' demographic characteristics, serologic status, and CD4+ T-lymphocyte counts. Eighty-one percent of the drug injectors in the study voluntarily used on-site primary care services in the methadone program. Those who were HIV-seropositive made more frequent visits than those who were seronegative (mean annual visits 8.6 versus 4.1, P < .001), which increased with declining CD4+ T-lymphocyte counts; 79 percent of those who were seropositive with CD4 counts of less than 200 cells per cubic millimeter received on-site zidovudine therapy or prophylaxis against Pneumocystis carinii pneumonia, or both. Common primary care diagnoses for patients seropositive for HIV included not only conditions specific to the human immunodeficiency virus but also bacterial pneumonia, tuberculosis, genitourinary infections, asthma, dermatologic disease, psychiatric illness, and complications of substance abuse; those who were seronegative were most frequently seen for upper respiratory infection, psychiatric illness, complications of substance abuse, musculoskeletal disease, hypertension, asthma, and diabetes mellitus. Vaginitis and cervicitis,other gynecologic diseases, and pregnancy were frequent primary care diagnoses among both seropositive and seronegative women.
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PMID:Utilization of on-site primary care services by HIV-seropositive and seronegative drug users in a methadone maintenance program. 839 79

There is an increased attention to preconception care and counseling (PCC) in the US. Midwives should include it into their practice. Even though the PCC concept is new, many midwives already know and/or practice its components, including risk assessment, health promotion, psychological and medical interventions, and follow-up. Opportunities for PCC are gynecology visits, postpartum visits, school-based programs, occupational health centers, and local health departments. Midwives can help women decide whether they are psychologically prepared for motherhood through group discussions and family-timing scenarios. They should refer women to substance abuse counseling and address physical abuse. A medical history and physical exam followed by an evaluation of any medical problems are also important. Preconception screening should include laboratory tests for hemoglobin or hematocrit, Rh factor, rubella titer, urine dipstick (protein and sugar), Pap smear, gonococcal culture, syphilis ...... and hepatitis B test. Midwives should offer women an illicit drug screen and an HIV serodiagnostic test. Additional tests recommended for some women include a tuberculosis screen, chlamydia culture or rapid screen, toxoplasmosis, herpes simplex, cytomegalovirus, varicella, hemoglobinopathies, Tay-Sachs, and karyotype. Factors which may affect sperm morphology are cigarette smoking, alcohol drinking, vitamins A and E, linoleic acid, and zinc. Other male factors which may affect pregnancy outcome are advanced age, sexually transmitted diseases, HIV, and exposure to drugs and chemicals. Midwives should determine the need to refer women for genetic counseling. They can help establish a positive environment for conception by conducting a nutritional history and counseling; promoting vitamin supplementation; by counseling about dangers of cigarette smoking, alcohol drinking, and drugs; and by keeping up to date on reproductive toxicology, environmental pollutants, and occupational hazards. Midwives should take a menstrual, contraceptive, and sexual history. Menstrual charting can help detect ovulation. Other issues needing to be addressed are infertility and choosing a care provider and birth place.
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PMID:Preconception care. An opportunity to maximize health in pregnancy. 841 Mar 47


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