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

Counselors of HIV-afflicted substance abusers not only must apply counseling strategies directed toward curbing drug use, but also are called upon to assess suicide risk, attend to the promotion of social support, treat adverse affective reactions, and respond to spiritual and existential concerns. The present study attempted to explore systematically the self-reported feelings, thoughts, and behaviors of counselors as they confront such demands. All counselors reported experiencing increased stress as a result of working with HIV-afflicted clients, and cognitive distortions were sometimes noted in counselor responses. However, more generally, thoughts seemed clearly formulated, and planned behaviors appeared directed toward rendering the best treatment possible.
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PMID:A cognitive-existential analysis of counselor responses to HIV-positive substance misusers in an outpatient methadone program and a residential therapeutic community. 131 75

We have stably expressed in CD4+ lymphoid cells the herpes simplex virus type 1 thymidine kinase (HSV1-TK) gene under the control of the human immunodeficiency virus (HIV) promoter and transactivation response element sequences. Upon HIV infection these regulatory sequences were transactivated, switching on high-level expression of HSV1-TK. This in turn caused the death of HIV-infected cells when they were cultured in the presence of acyclovir, a nucleoside analog that becomes toxic after phosphorylation by HSV1-TK. The elimination of HIV-infected cells resulted in the arrest of HIV spreading in the culture. Complete protection of HSV1-TK-expressing cells was obtained using acyclovir concentrations that are commonly detected in the plasma of patients treated for HSV1 infection. Thus, expression of this DNA construct generates a pool of CD4+ booby-trapped cells that, as a population, are resistant to HIV infection. Our data provide a rationale for the use of suicide genes in the design of gene therapy of HIV infection.
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PMID:Selective killing of CD4+ cells harboring a human immunodeficiency virus-inducible suicide gene prevents viral spread in an infected cell population. 134 66

Psychosocial problems of persons with HIV disease require knowledge and skill in psychosocial assessment, suicide risk assessment, crisis intervention and various other therapeutic modalities, provision of social and community resources, and spiritual care. Neuropsychiatric problems require knowledge and skill in neurologic, cognitive, and behavioral assessment and supportive care. Families and partners have needs commensurate with those of the person with HIV disease.
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PMID:Psychosocial and neuropsychiatric care. 138 86

In order to cooperate with voluntary screening programs aimed at the surveillance of the HIV epidemic in Finland, we have studied medicolegal autopsies for HIV antibodies since 1986 using an enzyme immunoassay on postmortem sera. The investigation covered 47.4% and 39.2%, respectively, of all deaths under the age of 65 years in the metropolitan areas of Helsinki and Turku--two cities on the densely populated southern coast of Finland from which most HIV infections have thus far been detected. Nine HIV-positive cases (0.12%) were detected among the 7305 medicolegal autopsies tested in 1986 to 1990. This figure is higher than the prevalence of 0.01 to 0.03% in voluntary screening programs for the general population would suggest. Seven of our cases had previously tested positive, and two were previously unknown cases, indicating that people at high risk are clustered in the medicolegal autopsy series. Of the six cases in an early stage of infection, three committed suicide suggesting the importance of HIV-screening in suicide cases in tracing symptomless HIV carriers. Five of the cases were detected in 1990, a year when the number of new HIV infections had more than doubled compared to the previous two years. This suggests that testing of medicolegal autopsies as surrogate tests for the population gives useful information even in low-prevalence areas like Finland. Such testing has none of the ethical problems of many other back-up surveys, and may be particularly sensitive to early changes in epidemiology.
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PMID:Surveillance of human immunodeficiency virus (HIV) antibodies in medicolegal autopsies in Finland--monitoring early changes in HIV-seropositivity among risk groups and average population. 140 51

Potential availability of transplantable organs from different types of injury fatalities was studied. Factors examined included target organ damage or disease, age of potential donor, duration of survival before circulatory arrest, and universal rejection factors such as sepsis, HIV infection, or systemic malignancy. Motor vehicle fatalities yielded the greatest proportion of potentially viable organs. Delay in discovery and universal rejection factors were important exclusionary issues for fatalities from suicide, homicide, and non-motor vehicle unintentional injury. There was no difference in organ damage or in duration of survival with higher speeds in fatal crashes, suggesting that states with 65 mph speed limits--and consequently higher death rates--may have greater potential availability of donatable organs than do those with 55 mph maximum. The increase in deaths at higher speeds, however, vastly outweighs the benefits of any possible increase in the potential for donor organs.
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PMID:Potential availability of transplantable organs according to factors associated with type of injury event. 155 28

This paper explores how symptoms of mental health problems influence acquired immune deficiency syndrome-related risk behaviors, and how changes in those symptoms relate to risk behaviors engaged in by young adults. Repeated interviews with 602 youths since 1984 provide a history of change in behaviors. Mental health symptoms during adolescence (alcohol/drug [r = .28]; conduct disorder [r = .27]; depression [r = .16]; suicide [r = .14]; anxiety [r = .16]; and posttraumatic stress [r = .09]) are associated with higher numbers of risk behaviors (specifically, prostitution, use of intravenous drugs, and choice of a high-risk sex partner) during young adulthood. Changes in mental health symptoms between adolescence and young adulthood are related to the number of risk behaviors engaged in by young adulthood (total number of symptoms [B = .10], alcohol/drug abuse or dependence [B = .34], depression [B = .20], suicidality [B = .35], anxiety [B = .13], and posttraumatic stress [B = .14]). Changes in symptoms of mental health problems are associated specifically with those risk behaviors that are initiated primarily in young adulthood: intravenous drug use, prostitution, and choice of risky partners. The findings show that prevention and treatment of mental health problems are important components of preventive interventions for human immunodeficiency virus infection in high-risk teens and young adults.
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PMID:The influence of mental health problems on AIDS-related risk behaviors in young adults. 158 74

At the Oxford Haemophilia Centre at Churchill Hospital in Oxford, England, psychiatrists compared data on 37 HIV seropositive hemophiliacs (31 asymptomatics and 6 symptomatics) with data on 36 HIV seronegative hemophiliacs to determine the prevalence of psychosocial conditions in HIV seropositive men and factors related to those conditions. HIV seropositive men had much higher Present State Examination scores than did the HIV seronegative men (5.9 vs. 2.2; p=.005). This was true for both symptomatic and asymptomatic HIV seropositive men (7.3 and 5.7, respectively). Nevertheless, these levels of psychological disturbance were basically the same as the general outpatient medical population as was also the case with depression scores (POMS). Still symptomatic HIV seropositive men were more likely to be depressed than HIV seronegative men (6.4 vs. 3.6; p=.02). The most important finding was that both symptomatic and asymptomatic HIV seropositive men felt significantly higher levels of hopelessness than did the HIV seronegative men (6.5 vs. 2.6; p=.0004, asymptomatic-5.8 and symptomatic=9.7). Hopelessness indicated an increased risk of suicide which is independent of depression. Past psychiatric history (r=0.38), hopelessness (r=0.55), and poor social adjustment (r=0.55) accounted for 49.8% of the variance (p.001). HIV seropositive men exhibited more psychosexual dysfunction especially premature and delayed ejaculation (30% vs. 4% and 20% vs. 0, respectively; p.05) than HIV seronegative men. Among the men who had a sexual relationship, HIV seropositive men tended to always use condoms during intercourse (79% of asymptomatics and 100% of symptomatics vs. 25% of HIV seronegatives; p=.0004). Even though they used condoms, HIV seropositive men were more likely to worry about infecting their partners than HIV seronegative men (p=.02).
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PMID:The psychosocial impact of HIV infection in men with haemophilia: controlled investigation and factors associated with psychiatric morbidity. 161 81

Construction of a DNA plasmid that expresses a diphtheria toxin A chain (DT-A) gene under control of human immunodeficiency virus (HIV-1) proteins Tat and Rev has been described. Here the generation of HeLa cell clones containing integrated, HIV-regulated DT-A sequences is reported. Five such clones were identified by their decreased expression of a luciferase reporter gene transiently cotransfected with Tat- and Rev-encoding plasmids. The decreased luciferase expression most probably was due to activation of the integrated DT-A gene because higher luciferase activity could be restored by introducing either DT antitoxin or a gene encoding a mutant, DT-resistant elongation factor 2 (the intracellular target for DT-A). Analysis by polymerase chain reaction (PCR) indicated that all clones expressed DT-A encoding RNA. The clones were then transfected with an HIV proviral clone and were tested for HIV production; all five clones demonstrated substantially impaired HIV production compared with parental HeLa cells, as shown by p24 assays of culture supernatants. Our success in generating these cell lines indicates that extremely low basal expression has been achieved in view of the high cellular lethality of DT-A. HIV-regulated expression of DT-A may be applicable as a gene therapy approach for the acquired immune deficiency syndrome (AIDS), to bring about selective suicide of HIV-infected cells before production of viral progeny.
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PMID:Inhibition of HIV production in cells containing an integrated, HIV-regulated diphtheria toxin A chain gene. 173 39

AIDS-related stressors were studied in relationship to suicidal ideation and suicide intent among 778 gay and bisexual men (none with AIDS). Over the previous six months, 27% (n = 212) reported suicidal ideation. Subjects who reported suicidal ideation (compared to those who did not) were more likely to report recent (last 6 months) bereavement of partner, recent ARC diagnosis, and multiple close friends with ARC. Suicide ideators were divided by a median split on a self-report scale of suicide intent into low (n = 105) and high (n = 107) intent suicide ideators. News of HIV seropositivity was specifically related to low intent suicidal ideation. High intent suicidal ideation was associated with having a partner with AIDS or ARC, or multiple close friends with AIDS, or having ARC. Generally speaking, while temporally discrete AIDS-related events were associated the report of suicidal ideation, ongoing stressors which may more greatly challenge adaptational capacities were more associated with high intent suicidal ideation.
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PMID:AIDS-related factors predictive of suicidal ideation of low and high intent among gay and bisexual men. 179 14

46 subjects infected with human immunodeficiency virus (HIV) were followed up to determine psychiatric morbidity, both prior to and after information regarding their HIV status was revealed to them. Among these patients, 4 had AIDS syndrome while 42 individuals were HIV carriers. The preinformation morbidity in the AIDS group included 2 individuals who presented with delirium and 1 with an adjustment disorder. The psychiatric diagnosis among the HIV carriers revealed 1 patient with major depression, 4 with adjustment disorders, and 4 with alcohol dependence syndrome. The additional morbidity after the diagnosis was revealed and included major depression and adjustment disorders which could be managed by psychological intervention and counseling in most instance. The individual who later developed major depression committed suicide. The study, though preliminary in nature, suggests that it may be beneficial to include psychiatric management as past of the general care of individuals with HIV infection.
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PMID:Psychiatric morbidity in HIV infected individuals. 185 20


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