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

To slow the spread of AIDS, it may be important for substance abuse treatment programs to give priority admission to patients who are HIV-infected and infectious. A new program is described that provides methadone maintenance treatment to opiate addicts who are "AIDS affected"--heroin addicts diagnosed with AIDS, AIDS-related complex (ARC), or other significant symptoms of HIV infection. The program aims to protect the health of patients and to protect the general public by slowing the spread of the human immunodeficiency virus (HIV). This article describes the program's history and goals, its referral and patient admission process, methods of assessment and treatment planning, medical care, counseling procedures, tolerance for misbehavior, philosophy toward eventual detoxification, and procedures that maintain confidentiality.
J Subst Abuse Treat 1989
PMID:Methadone maintenance program for AIDS-affected opiate addicts. 274 16

One hundred of 101 applicants for outpatient treatment for cocaine abuse consented to voluntary HIV-antibody testing when the testing was offered as an option within the medical assessment at intake. Twelve applicants tested HIV-antibody positive; eight of these had injected drugs parenterally with syringes and needles used by other addicts and four had never taken drugs intravenously. There were no significant differences between HIV-antibody positive and negative applicants regarding the percentages who completed the evaluation, began treatment, and completed four weeks of treatment. A subgroup of 48 patients were interviewed regarding their knowledge of HIV infection, AIDS, and risk factors associated with transmission of HIV. All 48 patients had heard of HIV, AIDS, and recommendations that they use condoms as well as clean syringes and needles. None of the 48 patients reported that they used condoms; 10 reported reduced sexual activity and number of sexual partners; and none of those who shared needles reported that they had discontinued sharing other addicts' drug paraphernalia. The authors conclude that on-site, voluntary HIV-antibody testing for drug abusing patients entering treatment appears feasible and is not a deterrent to persons entering and continuing in treatment for drug abuse. The finding that persons at risk for HIV infection have knowledge of risk factors and have not changed risk-taking behaviors associated with HIV contagion points out the urgent need for further education and counseling.
J Subst Abuse Treat 1988
PMID:Acceptance of HIV-antibody testing by persons seeking outpatient treatment for cocaine abuse. 323 88

Human immunodeficiency virus (HIV) infection produces a spectrum of clinical syndromes, progressing in severity from asymptomatic infection through the life-threatening diseases of the acquired immunodeficiency syndrome (AIDS). Current knowledge about the epidemiology, virology, and clinical manifestations of HIV infection and AIDS are reviewed.
Adv Alcohol Subst Abuse 1987
PMID:AIDS update--1987. 332 48

Over the past five years, the proportion of AIDS cases among gay and bisexual men in New York City has fallen as the proportion of AIDS cases has risen among IV drug abusers, the major channel of HIV infection to children and heterosexuals in New York City. By 1991, there will be over 40,000 cumulative AIDS cases in New York City, with close to 30,000 deaths. Controlling the spread of HIV infection among drug addicts, children, and heterosexuals requires education, outreach, and exploration of strategies such as increasing the legal availability of sterile needles and syringes. For at least the next several years, massive programs of public health education and voluntary, confidential risk-reduction counseling and HIV antibody testing will remain our critical weapons for reducing the spread of HIV infection among people engaged in high-risk behavior as well as among the general public.
Adv Alcohol Subst Abuse 1987
PMID:Current and future trends in AIDS in New York City. 344 93

The effort to prevent further HIV infection for high risk populations has been largely limited, in practice, to health education efforts. Prevention policy must utilize techniques which, in combination with health education efforts, works to decrease behaviors which are implicated in HIV transmission. It is argued that this approach to prevention will work best if it is designed with an understanding of the conditions under which individuals decline to comply with risk-reduction guidelines. It appears that the use of drugs and alcohol during sexual contact is one such condition. Three prevention strategies are suggested which, in addition to health education efforts, might be used to minimize HIV transmission related to the use of drugs and alcohol during sexual activity among gay men. It is hoped that the approach suggested in this paper for the prevention of further HIV infection might also be adopted to develop prevention strategies for other populations at risk of HIV infection.
Adv Alcohol Subst Abuse 1987
PMID:The prevention of HIV infection associated with drug and alcohol use during sexual activity. 344 94

The dual diagnosis of AIDS and substance abuse raises serious clinical and ethical issues for health care providers. Often, there are barriers to the diagnosis and referral for substance abuse treatment in people with HIV infection. Countertransference is one such barrier. Important educational needs of patients can be overlooked or not fully addressed. Essential information needs to be conveyed, regardless of whether or not a patient seeks substance abuse treatment. Early intervention and treatment are essential to minimize risk for HIV infection and transmission to others. Specific clinical issues that practitioners often address for patients with AIDS or ARC are appropriate interventions for denial of the HIV-related diagnosis coupled with the denial of substance abuse, difficulties in pain management, the difficulties of family and loved ones, the need for substance abuse relapse prevention, and the need for coordination of care among agencies.
Adv Alcohol Subst Abuse 1987
PMID:Treatment of substance abuse in patients with HIV infection. 348 40

The article examines the expanding role of drug abuse treatment professionals in the AIDs epidemic, including the utilization of predictive models to help focus prevention, intervention, and treatment efforts for IV drug users, who are the second largest at-risk group for HIV contagion after homosexual males, as well as adolescents. More specifically, the article addresses such issues as the needle-sharing ritual, the "teach and bleach" method of community-based outreach prevention, some of the cofactors involved in immunosuppression, the controversy surrounding drug maintenance programs and free needle distribution, safer-sex guidelines and sex education, HIV antibody testing and confidentiality. This article postulates that it is crucial for chemical dependency treatment programs to appraise themselves, on an ongoing basis, of both individual and organizational guidelines regarding AIDS and to develop AIDS and chemical dependency treatment components within their programs in order to keep drug abuse treatment itself from being compromised.
Adv Alcohol Subst Abuse 1987
PMID:The role of substance abuse professionals in the AIDS epidemic. 348 42

This study explored whether homosexually active men who were sexually abused in childhood were more likely to engage in HIV-risk sexual behavior than men who were not sexually abused. Participants were 182 adult men of Puerto Rican ancestry living in New York City who had had sex with other men or with men and women. Quantitative and qualitative methods of exploration were used. Three groups were determined: (a) Abuse group (AB), formed by men who before age 13, had sex with a partner at least 4 years their senior and who felt hurt by the experience and/or were unwilling to participate in it; (b) Willing/not hurt group (W), consisting of men who had an older sexual partner before age 13 but did not feel hurt by the experience and were willing to participate; and (c) No-older-partner group (NOP). The results showed that men in the AB group were significantly more likely than men in the NOP group to engage in receptive anal sex and to do so without protection. Men in the W group were ranked between the other two groups in terms of their unsafe behavior. Age and education were cofactors both for receptive anal sex and for unprotected receptive anal sex. It is concluded that given the need to improve HIV prevention among Puerto Rican men who have sex with men, sexual abuse in childhood may constitute a marker to identify men at increased risk.
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PMID:Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. 766 39

This article reviews the complex issues surrounding the anonymous HIV testing of newborns to monitor the prevalence of HIV infection in women of childbearing age. This serosurveillance of newborns has become a topic of legislative debate focusing on disclosure of currently anonymous results of HIV antibody tests of newborns, thus revealing the serostatus of the mother. This, in effect, would mandatorily test women without their consent. The discussion includes the following topics: (a) the historical demographics of incidence rates of AIDS, (b) current political and legislative issues raised by serosurveillance, (c) professional and ethical issues confronting health care providers, and (d) why HIV testing of newborns is a mandatory testing of all women of childbearing age. It is recommended that principles of patients right of self-determination be respected, that mandatory testing would be counterproductive and would disproportionately impact on minorities. The integration of education, counseling, and voluntary testing will result in the most effective way to get both women and children into the health care system.
J Subst Abuse Treat
PMID:HIV serosurveillance of newborns. A clinician's perspective on legislative, political, and ethical issues. 775 94

To investigate patterns of cocaine use, a total of 440 injection drug users (IDUs) in two consecutive cohorts were recruited from a methadone maintenance program in New York City. IDUs who had injected cocaine more frequently during the prior year were more likely to be found HIV positive than IDUs who had injected cocaine less frequently, even after controlling for age, gender, and ethnicity. The study investigated noninjecting cocaine use among IDUs, such as snorting and smoking cocaine, which is often overlooked in epidemiological research investigating the relationship between HIV infection rate and drug use behaviours among IDUs. This study revealed that older IDUs were more likely to use IV cocaine and speedball, whereas younger IDUs were more likely to use crack or snort cocaine. In the 1987 cohort, after statistically controlling for age, analyses revealed that Hispanic IDUs snorted cocaine more frequently than other groups, and that black female IDUs used crack more frequently than other groups. Future research should investigate whether these crack and cocaine users, particularly black and Hispanic female IDUs, have changed their drug behaviors because of an awareness of the high risk of IV drug use for HIV infection, or whether they have started using these drugs as stepping stones for future IV cocaine and speedball use.
J Subst Abuse 1994
PMID:Patterns of cocaine use and HIV infection among injection drug users in a methadone clinic. 780 16


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