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

The Report of the Working Group on the Short-Term Prediction of AIDS/HIV (the Cox Report) is reviewed mainly to assess its calculations of the numbers of people in England and Wales who are infected with the human immunodeficiency virus (HIV). Two main methods are used in the report to estimate this total--the direct method and the back projection method. The direct method estimates the number of people infected with HIV by attempting to specify the numbers of people in various at-risk groups, and the percentage infected in those groups. Of particular significance are the estimates given for male homosexuals. The Cox Report suggests that between 4.0% and 4.7% of the male population aged between 16 and 59 are homosexual, and that between 1.9% and 4.5% of these are HIV antibody-positive. The basis on which these estimates are made is not substantiated by the Report, and it is quite possible that the upper limit given for HIV prevalence in male homosexuals represents an understatement of the actual number by a factor of 2.5 or more. The back projection method estimates HIV prevalence from the numbers of cases of the acquired immunodeficiency syndrome (AIDS) and the incubation function, the relationship between HIV infection and the probabilities of AIDS in each of the years following infection. Using this method the Cox Report fails to produce results that are in accordance with our knowledge of how the epidemic developed during the 1980s. As a consequence of this the various calculations of numbers of HIV antibody-positives to 1987 given in the Cox Report are all almost certainly underestimates.(ABSTRACT TRUNCATED AT 250 WORDS)
Int J STD AIDS 1990 Jan
PMID:Short-term prediction of HIV infection and AIDS: a critique of the Working Group's Report to the Department of Health. 209 93

The hazards of ultraviolet radiation (UVR) include immunosuppression, activation of human immunodeficiency virus (HIV) type 1 expression, and photocarcinogenesis particularly in immunosuppressed individuals. Fifty-eight male homosexuals positive for HIV antibody and 61 controls not at risk for HIV infection answered a questionnaire on their attitudes and exposure to natural and artificial sources of UVR. Controls were matched for sex but were not from an at-risk group for HIV infection. Mean ages were similar for both groups. HIV seropositives had greater recreational UVR exposure than controls: 12/58 versus 4/61 had regular use of a sunbed (P less than 0.05), and experienced 11.6 weeks versus 9.5 weeks of prolonged natural UVR exposure (P = 0.056) over a four-year period. One reason for this difference may be the misconception present in two-thirds of the HIV seropositive group that a suntan would improve their health and the outcome of their HIV infection. Those with HIV infection must be made aware that there is a potential for further immunosuppression and viral activation from UVR and they should be advised to avoid undue recreational exposure.
Int J STD AIDS 1990 Jan
PMID:Potential risks of ultraviolet radiation in HIV infection. 209 98

Infection by human immunodeficiency virus type 2 (HIV-2) has not previously been described in North or East Africa. We examined over 1200 sera of high-risk individuals from three North/East African countries for antibodies to HIV-2. Results indicated that 17 were repeatedly reactive by ELISA; 4 were confirmed by Western blot. Of the 4 confirmed, 2 produced strong reactions to the envelope antigens of HIV-2 but not of HIV-1. One of these subjects was a foreigner from Senegal who was tested while in Egypt and one was a Djiboutian prostitute who was infected presumably prior to October 1987. We conclude that HIV-2 has been introduced into this region and that specific testing of selected individuals for HIV-2 is warranted.
Int J STD AIDS 1990 Jan
PMID:Serological evidence for human immunodeficiency virus type 2 in east Africa. 209

Prostitutes from Madras were found seropositive for HIV infection in 1986, and are the 1st such cases identified in India. A national serosurveillance program and reference centers were subsequently created, finding a total 44 known AIDS cases through March 31, 1990. While this number of cases may seem small in the general context of India's large population size, increasing levels of seropositivity are being detected, and give cause for concern. Where recent studies of seropositivity in IV-drug users have created serious concern, serosurveillance has nonetheless been largely limited to prostitutes, STD patients, pregnant women, blood donors, and contacts of seropositive individuals. Ignorance and stigmatization of seropositive individuals and persons with AIDS persist both in the general public and the medical community. Doctors, nurses, and staff therefore are in special need of proper orientation to treat and counsel such clients. Indian health authorities are overwhelmingly challenged by how to care for AIDS cases, and do not know what to do with those who are seropositive. Hospitals and facilities for supportive treatment will be identified. Seropositive individuals especially need psychological support and counseling. Guidelines for counseling are therefore greatly needed. Those identified as seropositive must also be ensured that their status will remain confidential. Introductory comments are made regarding the seriousness of AIDS as a global pandemic, its initial identification and description, and the various patterns of epidemic spread observed throughout the world.
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PMID:Acquired immunodeficiency syndrome (AIDS) 210 93

Of 3450 women tested for antibodies to human immunodeficiency virus HIV-1 and HIV-2 between September 1985 and July 1989, 61 were positive (1.8%). Twenty-seven of these (44%) were presumed to have acquired their HIV infection by heterosexual contact and 23 (38%) were intravenous drug addicts. In geographical origin, 23 (38%) of the patients were from the UK and 19 (31%) from Africa. Amongst these 61 women, 2 (3%) have since died, one committed suicide and one was suspected of committing suicide.
Int J STD AIDS 1990 Sep
PMID:Risk factors of female HIV-seropositive patients attending the clinic for sexually transmitted diseases at St Mary's Hospital, London. 204 8

The arrival of AIDS/HIV infection in the UK has conferred a new significance upon genitourinary medicine which is necessarily involved in all aspects of patient care, surveillance and prevention. HIV should now be considered a relevant issue for discussion with all presenting patients who are at-risk of contracting any sexually transmitted disease. Targetting education at individuals together with the successful implementation of other control strategies through genitourinary medicine clinics provides exceptional opportunities to inhibit the further spread of HIV infection and to reduce morbidity from other STD and related pathology in the wider community.
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PMID:The genitourinary physician and AIDS. 217 12

Aspects of sexually transmitted diseases (STDS) peculiar to the developing countries in South America and sub-Saharan Africa are discussed. The most common STD infections are N. Gonorrhoeae, Chlamydia trachomatis, T. pallidum and T. vaginalis. Vertical transmission, particularly of syphilis among prostitutes, and of Chlamydia and gonorrhea after ophthalmia neonatorum, are common. Chlamydia is also a common respiratory tract infection in African neonates. Late complications of STDs, infertility and ectopic pregnancy, and particularly pelvic inflammatory disease, are responsible for a high proportion of hospitalizations. Antibiotic resistant gonorrhea strains are common, a result of poorly managed antibiotic treatment. Genital ulcer diseases (GUD), which predispose to HIV infections, are more common in Africa than in developed countries, not only herpes but chancroid, donovanosis and lymphogranuloma venereum. Chancroid, caused by Haemophilus ducreyi, causes 36-49% of ulcers in 2 reports. The L1-L3 strains of Chlamydia trachomatis cause lymphogranuloma venereum, the agent responsible for ulcers in 3.6-6.1% of 2 clinic populations. HIV infections have an equal sex ratio in Africa, with a younger age incidence in women and a high vertical transmission rate, while in Latin America, bisexual men, and increasingly, heterosexual transmission by intravenous drug users is reported. There is also an HIV-2 virus, whose virulence is in question, common in West Africa.
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PMID:The epidemiology of sexually transmitted diseases in Africa and Latin America. 220 6

Having reviewed the interrelation between HIV infection and other STDs, the author concludes that enough evidence exists to designate some STDs -- especially genital ulcer diseases (GUD) -- as a risk factor for HIV transmission. Additionally, the evidence suggests that sub-Saharan Africa's rampant heterosexual transmission of HIV, which depends contact between raw body tissue of infected and uninfected individuals, is mainly due to the high prevalence of ulcerative STDs in the region. Studies have shown a connection between the presence of HIV and past history of STD. In one such study in Zaire, 50% of AIDS cases had a past history of STDs, compared to 14% of controls. In Tanzania and Rwanda, the prevalence of a pst STD history among AIDS cases were 35% and 70%, respectively. Unlike the US and Europe, where homosexual intercourse and intravenous drug use are the major risk factors for HIV, heterosexual intercourse is the major mode of HIV transmission in sub-Saharan Africa. While studies in the US show that male to female transmission of HIV occurs in 1 out of every 500 sexual exposures, the rate is far higher in sub-Saharan Africa. Researchers have identified various possible risk factors for heterosexual transmission of HIV, and the only contrasting difference between sub-Saharan Africa and the US and Europe is the high prevalence of STDs -- including IUDs -- in Africa. Not all STDs may facilitate HIV transmission. A study at a London STD clinic suggests that gonorrhea does not appear to act as a cofactor of HIV transmission. The author concludes that these findings indicate that AIDS control activities in Africa require corresponding STD control programs.
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PMID:Inter-relationships between HIV infection and other sexually transmitted diseases. 222 31

Epidemiologic studies in Nairobi and elsewhere in Africa, have shown that men infected with HIV-1 more commonly have a history of genital ulcer disease compared to uninfected men. In one study, HIV infected men were three times as likely to have a recent history of genital ulcers. In a prospective study of seronegative men, those presenting with chancroid had a five-fold risk of seroconversion during follow-up compared to men presenting with urethritis. Uncircumcised men had an increased risk of seroconversion which was independent of their risk of genital ulcer disease. Over 95% of attributable risk in men with STD was either genital ulceration or the presence of a foreskin. Genital ulcers are a major risk factor for HIV infection among prostitutes. The increased risk is about 10-fold among prostitutes with ulcers compared to a cohort who did not. We hypothesize from these studies that genital ulcers are the major portals of entry for HIV infection and also increased shedding of virus infected cells into the vaginal secretions. HIV seropositive prostitutes are more susceptible to chancroid with a two-fold increase in the prevalence of genital ulcers as compared to HIV negative women. The use of condoms by their clients prevents both genital ulcer disease and HIV acquisition among prostitutes. Chancroid is more difficult to treat in HIV infected men with one-third of patients failing single dose treatment regimens as compared to less than five percent of men without HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Human immunodeficiency virus, genital ulcers and the male foreskin: synergism in HIV-1 transmission. 226 93

A non-clinic cohort of 525 homosexually active men from London and South Wales were recruited in 1988 for a study by interview of sexual behaviour. A sample of blood was tested for HIV-1 antibodies. Seropositivity in London was 9.2% compared with 3.4% in South Wales. Men who were not regular STD clinic attenders had a lower rate of seropositivity than did those who were regular attenders. Men who were seropositive reported more sexual partners with whom they had anal intercourse and also reported more episodes of syphilis. Overall, rates of seropositivity were lower than those reported by studies from STD clinics.
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PMID:Seroprevalence of HIV-1 infection in a cohort of homosexually active men. 226 39


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