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 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between January 1987 and December 1990, 179 patients (131 men, 48 women) infected with human immunodeficiency virus type 1 (HIV-1) were admitted 408 times to St James's Hospital, Dublin. One hundred and thirty-two (73.7%) patients were intravenous drug users. The commonest cause of admission was bacterial lower respiratory tract infection (84 patients, 21%). At the time of study 95 (53%) patients fulfilled Centers for Disease Control (CDC) criteria for stage IV disease. HIV antibody status in 26 of these patients with stage IV disease was unknown prior to their admission to hospital with symptomatic disease. Pneumocystis carinii pneumonia was the most frequent stage IV defining diagnosis. The mean length of hospital stay for patients with CDC stage II/III and stage IV disease was 8.5 (median 7) and 13.5 (median 8) days respectively.
Int J STD AIDS
PMID:Admission for HIV-1 related disease in a Dublin hospital 1987-1990. 178 35

Researchers conducted a pilot study of homosexual behaviors and HIV infection risks in 49 men who attended 4 sexually transmitted disease clinics in northwestern India. They compared the results with those of a nonclinic sample of Australian homosexual men. Kissing (dry [23.7%] and wet [19.61%]) was the predominant sexual behavior in the Indian sample then anal insertive (18.4%) and oral insertive (12.2%) sex. Australian men had significantly higher levels of wet kissing (p.002), mutual masturbation (p.001), receptive (p.001) and insertive oral sex (p.008), and rectal digital insertion (p.001) than Indian men. Further Indian men did not practice analingus, brachioproctic acts, or sex under the influence of drugs other than alcohol. australian men tended to be older (mean 30.19 vs. 27.17) and to have more sexual partners (4.42 vs. 2.13) than the Indian men (p.05). Indian men were much more likely to have had sex with a female as well as a man in the 2 months prior to the survey than Australian men (65.3% vs. 12.72%; p.0001). Indeed 55.3% were married. This resulted suggested that marriage is emphasized in the Indian culture and no homosexual subculture exists in India. When the researchers compared the number of female partners of the 2 groups, however, no significant differences existed. Of the Indian men who practiced anal and oral with other men, 93% never used condoms. Further 78% never used a condom with women. Since oral sex has been associated with a low risk of HIV transmission, unprotected anal sex was the most common dangerous sexual activity for Indian men. The findings on lack of condom use with female partners highlighted the probability of HIV spreading quickly to both heterosexual and homosexual groups. In conclusion, homosexual behavior between Australian and Indian men were indeed different which may reflect cultural differences.
Int J STD AIDS
PMID:Sexual behaviour and HIV infection risks in Indian homosexual men: a cross-cultural comparison. 178 37

This article reviews papers presented at the 7th International Conference on AIDS in Florence which reflected the theme of the relationship between knowledge and behavior change. Many of the cases presented were descriptive and lacked rigorous hypothesis testing, but were in the direction of smaller scale hypothesis testing. Abstracts MD4041, 4069, and 4045 reported a lack of a relationship between good knowledge and behavior change among South African university students, English STD clinic attenders, and California family planning (FP) clinic clients. Neither perception nor lack thereof of risk related to behavior change. Abstracts MD4049 and 4053 identified factors which may be related to translating risk perception to behavior change: presence of a permanent relationship among gay men, and self affirmation among gay men. Among injecting drug users, other risk factors were low socioeconomic status (MD 4035), lack of self efficacy among men (MD4031) and women (MD4077), machismo (MDMD4007), nitrites, cannabis, and alcohol (MD4071), and education level MD4085). Social skills and self efficacy were repeatedly the more important intervening variables. Education and skill building intervention (MD4135) were related to increased skills in prevention of risky sexual and drug behavior among California high school students. Counseling interventions were difficult to assess in terms of behavior impact (MD 4281, 4026, 4203). Associations rather than causal links were found in many studies (WD1,4,4130). In 1 study the stage of readiness to stop high risk behavior was a critical component of self efficacy. Some studies found behavior changes over time that were inconsistent or incomplete but were unable to explain why. MD4039 found that the number of salient messages was related to prevention behaviors. WD4275 found the AIDS education has short term effects only on attitudes and knowledge. WD4102 found no correlation between knowledge or attitudes prediscussion, post, or 3 months later. WD4111 found no relation after safe sex workshop stressing condom use. WD4123 compared multiple and intensive interventions and found reduction in risky sexual behavior. Risk reduction with seropositive HIV clients was effective in short term sexual behavior changes (WD4050). Health workers needed retraining and supervision (WD4031).
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PMID:Factors affecting information and education, and behaviour change. 178 77

A total of 85 HIV seropositive subjects among consecutive new registrants in the STD Department were given health education measures directed at avoiding high risk behaviors and also the events with a high potential for transmission of infection. The emphasis was on use of condoms, discontinuing promiscuous behavior, abstaining from homosexual acts, and avoiding pregnancy; advice against marriage was also provided for those contemplating it. The Health Education Program was delivered individually to each subject over 2-3 sessions, each lasting for 30-45 minutes. At the time of followup (1-24 months), 42% of subjects had become nonpromiscuous. There was good compliance on the advice against marriage and pregnancy, 7 infants born during followup were seronegative. The use of the condom was not found to be acceptable. The prostitutes comprised the most resistant group to education. Among the factors that influenced the behavior change favorably were the absence of earlier STD or a short duration of the current STD. Literacy, marital status, or awareness of AIDS did not influence the outcome of education. The study demonstrated the feasibility of health education at the individual level in the clinical setting of an STD department. A longer followup may indicate the sustainability of a behavior change in the subjects.
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PMID:Behaviour change in HIV infected subjects following health education. 179 40

This article is a revision of a 1983 position paper of the Society for Adolescent Medicine with inclusion of the newest medical advances in research on adolescent sexuality; i.e., contraceptive compliance, promotion of behavior change, relationships of ethnicity and pregnancy, and male reproductive health. The issues for the 1990's will be sexually transmitted diseases' morbidity and mortality. Topics identified are sexual activity and adolescent pregnancy, care of the pregnant teen, sexually transmitted diseases, HIV infection, the male adolescent, sexual abuse in adolescents, gay and lesbian youth, interventions, reproductive health care of adolescents with disabilities and chronic illnesses, and training of primary care physicians. The HIV/AIDS epidemic has focused attention on the reproductive behavior of males. Sexual activity varies by racial/ethnic group. Interventions to delay sexual initiation needs to be examined, although condom use has increased among 17-19 year olds from 21% to 58% in metropolitan areas. However condom use is lowest among the group of men at highest risk of STDs: those who had ever used drugs, those who had ever had sex with a prostitute, and those that had 5 or more partners/year. Male beliefs about contraception have been infrequently examined. There are misconceptions about heterosexual transmission of HIV. Better screening is needed for STD detection. Fathers are more involved in prenatal care and postnatal intervention programs. 7% of children have been subjected to nonvoluntary sexual intercourse between the ages of 18-21. ; i.e., 12.7% of white women, 9% of black women, 1.9% of white males, and 6.1% of black males. Risk factors for white women were living apart form parents at 16 years, poverty, physical and emotional limitations, parental alcohol and smoking and drug use. Sexual assault was associated with hitchhiking and alcohol and drug use in 1 study cited. Physicians need to be sensitive to this issue and probe for information. The sexual needs of those unsure of orientation or who a re homosexual or lesbian are gradually becoming recognized. Among 12th graders. 1% of males and 1% of females viewed themselves as mostly or completely homosexual or lesbian, and 10% were unsure. Psychological and medical problems are encountered. Interventions needed are reproductive and STd information, multiple approaches in a variety of settings, adolescent clinics, and outreach.
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PMID:Society for Adolescent Medicine Position Paper on Reproductive Health Care for Adolescents. 183 15

In response to the risk of occupationally acquired infection with hepatitis B and human immunodeficiency virus, the State of Oklahoma enacted legislation which provided for a system of notification of emergency medical personnel who sustain risk exposures to blood or other potentially infectious body fluids. The system is based on the immediate report of the exposure to the STD/HIV Division of the Oklahoma State Department of Health. Between January 1, 1989, and December 31, 1990, emergency response facilities reported 115 exposures to blood or other body fluids. There was a mean delay of 12 days between exposure and report to the STD/HIV Division. Only 10 (9%) of the exposed workers had been previously vaccinated against hepatitis B, and universal precautions were in use only 40% of the time. Forty-eight reports (41.7%) indicated exposures that did not pose a risk of disease transmission. These data indicate that emergency response facilities are in need of further education directed at the risk and prevention of transmission of bloodborne pathogens.
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PMID:Occupational risk exposure reports among first responders in Oklahoma, January 1989-December 1990. 183 55

Clinicians caring for sexually active adolescents are likely to be called on to diagnose and treat many of the STDs discussed in this article. A variety of other STDs not covered here also may be observed, including lymphogranuloma venereum, granuloma inguinale, molluscum contagiosum, scabies, pediculosis, and hepatitis A, B, and C. Some of the special issues related to gay and lesbian youth are discussed in the article by Drs Bidwell and Deisher (see "Adolescent Sexuality: Current Issues," pp 293-302). Nonetheless, it should be mentioned that the same STDs occur in homosexual youths as in their heterosexual counterparts. However, the prevalence rates for many STDs differ between the two groups, and some STDs are rarely seen in heterosexual males. These discrepancies may be explained by a number of determinants including anatomic and physiologic factors (eg, lesbian women have lower rates of STDs), differences in sexual practices (eg, genital-anal and oral-anal contact), and numbers of sexual partners, although this last factor may be less important in adolescents as compared with adult gay men. Discovery of one STD should always prompt a search for others because multiple concurrent infections is the rule rather than the exception. A serologic test for syphilis and a discussion of the potential for HIV infection (possibly testing for HIV as well) should take place at each new encounter for an STD. Some patients, including those with multiple partners, have an increased chance for acquisition of an STD. However, the reality is that any adolescent who has had sexual intercourse could have an STD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sexually transmitted diseases in adolescents: update 1991. 186 93

Persons with AIDS (PWAs) are 100 times more likely to develop tuberculosis (TB) than the general population. The TB incidence rates in PWAs in the US range from 4-21%, especially among intravenous drug users and Haitians. In Florida, 60% of Haitian AIDS patients also had TB compared to 2.7% of non-Haitian AIDS patients. At a hospital in London, England, 25% of PWAs also had TB and 42% of all AIDS patients at this hospital were members of racial groups with a high prevalence of TB. In developed countries, reactivation of a latent TB infection is generally what occurs in AIDS patients. The absolute number of AIDS patients with TB in these countries is low and unlikely that it will spread to non-HIV seropositive patients. On the other hand, 30-60% of adults have been infected with Mycobacterium tuberculosis in central Africa and HIV seroprevalence is also high. So many AIDS patients here can develop TB through reactivation or exogenous primary infection. This situation significantly increases the risk of TB for HIV seronegative persons. In fact, TB is 1 of the most frequent opportunistic infections in PWAs in developing countries, such as central Africa. In patients at an early stage of HIV infection, TB manifests itself classically. The clinical presentation in patients in the late stages includes fever, weight loss, malaise, productive cough accompanied with labored breathing, an atypical chest radiograph, and extrapulmonary TB. This atypical pattern often results in delays of diagnosis and treatment. Many sputum samples do not test positive for M. tuberculosis therefore if a physician suspects TB, treatment should begin immediately. Some studies demonstrate that isoniazid prophylaxis substantially decreases the incidence of TB in HIV seropositive patients in Zambia. There is no conclusive evidence of the harm or effectiveness of the BCG vaccine in HIV children and adults.
Int J STD AIDS
PMID:Tuberculosis in HIV infection. 186 45

Sera obtained in 1987 from 63 male and 632 female Singapore prostitutes were screened for antibody to human T-cell leukaemia virus (HTLV)-I with a particle agglutination test. Of the 3 males and 4 females who were positive one had antibody to HTLV-I core and envelope antigen on Western Blot. Two subjects had presumptive antibody to HTLV-I core antigen and a third subject had such antibody on a repeat specimen in 1989. These sera were negative for HIV-1 antibody. There is evidence of infection with HTLV-I or a variant virus in this population. The infection is likely to have been sexually transmitted.
Int J STD AIDS
PMID:Evidence of HTLV-I infection in Singapore prostitutes. 186 47

The risk of contracting HIV infection as a result of rape is unknown. We describe 4 female patients who were found to have antibodies to HIV-1 following rape, only one of whom had another recognized risk factor for HIV infection. The need for careful follow-up of rape victims, and the potential for HIV acquisition by the assailant is discussed.
Int J STD AIDS
PMID:Rape and HIV. 186 49


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