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

The case of an HIV-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to HIV infection. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple STDs could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.
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PMID:Multiple sexually acquired diseases occurring concurrently in an HIV positive man: case report, diagnosis and management. 150 24

This article reports the findings of a study of HIV and STDs prevalence among long-distance truck drivers from East and Central Africa. Similar to prostitutes, truck drivers and a highly mobile population, characterized by having multiple sex partners. The researchers established a tent clinic at the Athi River Weighbridge Police Station near Nairobi, Kenya, where convoys of trucks stop for 3-5 days. 331 men from several East and Central African countries participated in the study. The participants completed a standard questionnaire about their medical history, knowledge, attitudes, and sex practices, and underwent a physical examination and blood test. Their ages ranged from 18-61 years, with a mean age of 31 years. 18% of the participants tested positive for HIV. Additionally, 4.6% tested positive for syphilis, and 4.5% and 4.3% suffered from urethral discharge ranked as the highest risk factor, followed by lack of circumcision. The study found no difference in the HIV prevalence rate between married and single men. The prevalence rate was far higher among Central Africans (31.75%) than among East Africans (16.65%), possibly explained by the hypothesis that says that HIV was first introduced in Central Africa, from where it spread to East Africa. Older drivers where more likely to be infected with HIV than younger drivers, with the age group of 40-49 having the highest prevalence rate. Researchers suspect that this is due to the fact that older drivers have been exposed longer and have more money with which to purchase sex. The report concludes that truck drivers constitute a high risk group, and should be targeted accordingly, with education and condom use campaigns.
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PMID:Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases (STDs). 175 21

Researchers took blood samples from 4228 adults aged 15 years in The Gambia to determine the prevalence of HIV-2 infection and risk factors. HIV-2 infection was more prevalent than HIV-1 infection. HIV-2 prevalence stood at 39% for females and 31% for males, but the difference was insignificant. Individuals 25 years old were more likely to be HIV-2 seropositive than those 25 (p.01). Further, HIV-2 prevalence was significantly higher in the small towns of Soma and Farafenni on the Trans-Gambia Highway than other areas of the country (p.01; 3.2% vs. 1.3% for Greater Banjul and 1.4% for the remainder of the country). It also was greater for people who had their blood samples taken at a health center than those who gave theirs elsewhere (p.01). HIV-2 infection was more prevalent for people born in Guinea- Bissau and in the Manjago tribe which originated from Guinea-Bissau than those born in The Gambia or elsewhere (p.025 for place of birth and p.01 for tribe). Marital status played an insignificant role in seropositivity for men, but divorced and widowed women had a significantly greater infection rate than other women (p.001; odds ratio [OR] 10.4 vs. 1-20). Further, infection significantly increased as the number of husbands women had had increased (p.05; OR 6.8). HIV- 2 positivity was significantly higher among women who reported using a condom at least once during the past year with casual partners (p.01; OR 16.7). Skilled manual laborers, businessmen, and traders were more likely to be infected with HIV-2 than farmers, unskilled laborers, and while collar men (p.05). Men with at least a secondary education were at significantly lower risk than men with less than a secondary education (p.01; OR .1 VS. .7-1.6). Men who had had at least 2 cases of urethral discharge had a significantly higher infection rate than those who did not (p.005; OR 4.8 vs. .8-1).
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PMID:Risk factors for HIV-2 infection in The Gambia. 193 Jul 76

Sera from 500 (496 male and 4 female) consecutive patients with sexually transmitted diseases (STD) were examined for the presence of HIV1 antibodies. The serological tests were done using the ELISA (Wellcozyme) and confirmed by the western blot (Biorad). Sixty (12%) of the 500 patients were HIV-1 antibody positive. Seropositivity varied with the type of STD. A positivity rate of 16% seen with genital ulcer disease is significantly higher than the 7% prevalence rate seen in STD patients with urethral discharge. Infection with more than one kind of STD increases seropositivity significantly. Of the potential risk factors identified during the interview it seems that only shaving at barbers' shop is positively associated with seroprevalence. This study suggests that the presence of STDs is associated with an increased HIV-1 seroprevalence. Therefore, any effort to reduce HIV-1 infection should aim at the control of STDs.
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PMID:Prevalence of HIV-1 antibodies in patients with sexually transmitted disease. 206 May 8

Participants in the study were drivers and turnboys who passed through a transport depot in Kampala, Uganda, in November 1986. Each participant answered a questionnaire aimed at determining basic demographic data, countries visited within the previous 3 years, level of prostitute contact within those countries, and whether they had had a history of urethral discharge or genital ulceration. A total of 45 drivers and 23 turnboys with a mean age of 38 and 26 years, respectively, were interviewed and blood samples were taken. Serological controls were selected from people of the same age as the study group from individuals donating blood. Serum immunoglobulin (Ig) antibodies to HIV were determined by a competitive enzyme-linked immunosorbent assay and a competitive ELISA using recombinant HIV core and envelope proteins. All serological results were verified by immunoblot assays or were prepared by electrophoretic separation of U937 cell lysates infected with a Ugandan HIV-1 isolate. Antibodies to Treponema pallidum were detected by a hemagglutination test. They were of Ugandan (66.2%) or Kenyan (33.8% ) origin. All were sexually active, and all denied homosexuality and intravenous drug use. The overall HIV-1 seropositivity rate was 35.2%, compared with the control group of 9.2% (24 out of 68 versus 12 out of 130; p 0.01). Using the antigen detection systems, 7 of the seronegative sera proved to be antigen positive. In addition, 4 out of the 24 seropositive sera (16.6%) also proved to be antigen positive. 36.7% of the population admitted more than 50 lifetime sexual partners. Of the remainder, 83.7% had had more than 10 lifetime sexual partners. The level of urethral discharge and genital ulceration revealed a significant difference (p 0.01) between seropositive and seronegative individuals. The overall level (55.8%) of T. pallidum antibodies among drivers and turnboys was significantly higher than in the control group (p 0.01). The drivers had the highest level of T. pallidum antibodies (62.2%) compared with turnboys (43.8%), reflecting the older average age and, thus, the greater sexual experience.
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PMID:Prevalence of HIV-1 in east African lorry drivers. 251 82

In Indonesia, interviews with 401 16-65 year old clients of low-price sex workers in Bali were conducted to examine knowledge, beliefs, and practices related to sexually transmitted diseases (STDs) and AIDS. They had had a high number of paid sexual partners (mean, 1.9) in the week before the survey. They rarely used condoms (8%). The level of a history of STDs among the clients was high (50%). For example, 34% reported urethral discharge, 20% a genital ulcer, and 25% had a history of syphilis. Almost 20% had had intercourse with a sex worker while experiencing symptoms during their most recent episode. The most common treatment was self-treatment with antibiotics (35-46%). Perceived STD and AIDS prevention strategies were partner selection based on cleanliness or lack of mouth or body odor and prophylactic medications. Most clients (95%) were familiar with STDs. High level of education and previous experience with an STD were positively correlated with STD knowledge (p 0.01 and 0.05, respectively). Most clients (almost 75%) had heard of AIDS, but few had accurate knowledge about HIV transmission. For example, 33% believed that medication would prevent HIV infection. AIDS knowledge level was positively associated with age (p 0.001), education (p 0.001), and never having been married (p 0.05). Five or more sex worker partners in the previous month and never use of a condom with a sex worker were positively associated with having recent STD symptoms (relative risk = 3.34 (for syphilis) and 2.41, respectively; p 0.01). These findings indicate a need for developing a comprehensive STD control program consisting of educational campaigns, condom promotion, and improving case management by health providers. Specific messages for campaigns should revolve around recognition of STD symptoms, possibility of asymptomatic infection, need for medical consultation at onset of STD symptoms, inefficacy of existing STD prevention strategies, and consistent use of condoms.
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PMID:STD knowledge and behaviours among clients of female sex workers in Bali, Indonesia. 783 64

Between November 1992 and April 1993, interviews were conducted with 400 patients (169 men, 231 women) aged 14-52 years at the sexually transmitted disease (STD) clinic of the Institut d'Hygiene Sociale in Antananarivo, Madagascar, to determine the pattern of STDs and to improve treatment of the leading STDs. The 400 patients presented with 434 syndromes. 124 men had urethral discharge. 210 women had cervicovaginal discharge. 43 men and 18 women had genital ulcers. Clinicians could not establish a diagnosis in 33 patients. 171 patients had more than one infection. Chlamydia infection was the most common infection associated with another STD (gonorrhea in 22% of men and 11% of women with discharge, trichomoniasis in 2.4% of men and 13% of women, candidiasis in 1.6% of men and 9% of women, and bacterial vaginosis in 15% of women with discharge). Gonorrhea was the most common etiology for male discharge (69%) while chlamydia infection was for female discharge (52%). Women with discharge were more likely than men with discharge to have chlamydia infection (52% vs. 42%), trichomoniasis (30% vs. 9%; p 0.00001), and candidiasis (32% vs. 12%; p 0.00001). 37% of women with discharge had bacterial vaginosis. Chlamydia infection was the most common STD in this population (45%). 32% of male and 71% of female gonorrhea cases also had chlamydia infection. 70 patients had syphilis. 36 of them had secondary stage syphilis. No one had HIV-1 or HIV-2 infection. The most efficacious antibiotics for gonorrhea were ampicillin, ciprofloxacin, and spectinomycin (100% susceptibility). 31% and 26% of isolates were susceptible to tetracycline and cotrimoxazole, respectively. Public facilities in Madagascar do not have the capabilities to diagnosis chlamydia, resulting in many untreated chlamydia cases. These findings stress the need to improve combined treatment of gonorrhea and chlamydia infection and for educational efforts to increase awareness of genital ulcer disease.
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PMID:Pattern of sexually transmitted diseases in a Malagasy population. 787 44

Data on HIV risk behavior, condom use, and HIV/AIDS awareness were obtained through a survey and interviews with 200 randomly selected truck drivers, 21 highway prostitutes, and 27 male prostitutes in Delhi and nearby areas during October 1990-December 1990. 302 randomly selected truck drivers were tested for HIV infection; none of the highway prostitutes consented to the HIV antibody test. A survey was again conducted among 100 randomly selected truck drivers in November 1991 and November 1992 to assess the levels of current HIV awareness and risk behavior. The drivers were aged 20-40 years, wayside prostitutes aged 32-40 years, and part-time male prostitutes aged 16-34 years. 60% of the drivers were married with families, as were all of the wayside prostitutes, and none of the male prostitutes. 78% of drivers admitted having multiple heterosexual partners, including prostitutes, and 5% admitted to regular homosexual sexual encounters. Only 20% of the drivers in 1990, however, had heard about HIV/AIDS. 25% of this subgroup was aware that HIV may be transmitted sexually, 28% of promiscuous drivers used condoms regularly, none admitted taking IV drugs, 35% reported histories of either urethral discharge or genital ulcers, and 3 of the 302 men tested were found to be infected with HIV. None of the 21 highway prostitutes had heard about AIDS, although 21 of the 27 male prostitutes had. All highway prostitutes admitted having at least one episode of unprotected sex with their sex partners in the previous fortnight, while all of the male sex workers would allow unprotected sex if their partners desired. Some male prostitutes were also paid blood donors. None of the prostitutes consented to having an HIV antibody test. The authors note that while HIV awareness improved in subsequent years, the practice of safe sex did not. 42% and 56% of the drivers had heard about HIV/AIDS in 1991 and 1992, respectively, but 77% and 68% were nonetheless engaging in occasional unprotected sex. Truck drivers engaging in unprotected sexual intercourse with multiple partners in rural India could be major vectors of HIV infection.
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PMID:Long distance truck drivers in India: HIV infection and their possible role in disseminating HIV into rural areas. 803 17

Malawi is one of the countries that has been most affected by the HIV epidemic with an estimated national HIV seroprevalence rate of 10% in the age group over 15 years and 32% among pregnant women who attended prenatal clinics in Blantyre in 1993. Queen Elizabeth Central Hospital (QECH) is the district hospital in Blantyre, Malawi, and the tertiary referral hospital for Malawi's southern region. About 11,000 patients were admitted there in 1993. The aim of this cross-sectional study was to determine the prevalence of sexually transmitted diseases (STDs) in inpatients under general medical care in view of the limited examination facilities in the wards. All patients who were in the general medical wards on June 23, 1994, were enrolled for the study. After obtaining informed consent, external genital lesions were identified visually noting the presence of ulcers, warts, and urethral discharge in men. The patients' case notes were reviewed to identify those with known current STDs. A total of 123 patients were examined: 62 males (age range 20-90 years) and 61 females (age range 16-65 years). There were 6 (9.7%) males vs. 8 (13.1%) females with discrete ulcers; no males vs. 2 (3.3%) females had nondiscrete ulcers; 3 (4.8%) males and 6 (9.8%) females had genital warts; 6 (9.7%) males had urethral discharge; and 13 (21%) males vs. 14 (23%) females had one or more lesions. One man had Kaposi's sarcoma of the glans penis. The survey showed that STDS are common in general medical patients in Blantyre with an overall prevalence of 22%. This percentage is an underestimate given the fact that the limited facilities precluded the diagnosis of trichomoniasis, gonorrhea, and chlamydia in women. Of the 123 patients, 14 (11.4%) who had discrete genital ulcers received treatment with erythromycin and penicillin to cover the main possible causes (chancroid, syphilis, and lymphogranuloma venereum). In view of the known link between STDs and the risk of HIV transmission, treatment of STDs may be more effective in preventing sexual transmission of HIV.
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PMID:Prevalence of genital infections in medical inpatients in Blantyre, Malawi. 852 42

An integrated STD (sexually transmitted disease) and HIV control program is vital to tackling the major public health problem of STDs and HIV/AIDS. The World Health Organization estimates that there are 333 million new STD infections and 15-20 million new HIV infections each year. The two basic principles common to all STD control programs worldwide include prevention of STDs, their complications, and sequelae and the interruption and reduction of their transmission. These principles also apply to bringing about the reduction of the incidence of HIV infection. Primary prevention strategies, which should be accessible to all sexually active adults and youth, include health education and information, education, and communication (IEC). Secondary prevention strategies include promotion of health care seeking behavior, case management of people with an STD, and early detection and treatment of asymptomatic infections through case finding and screening. In developing countries especially, the most realistic and cost effective way to treat STD patients is the syndromic approach. This approach uses algorithms based on common signs and symptoms (e.g., genital ulcer, urethral and vaginal discharge). It can be used either with or in the absence of laboratory support. The two most common causes for genital discharge are syphilis and chancroid, so, given no laboratory support, the health provider would provide treatment for both STDs. The algorithm for urethral discharge is similarly clear cut. That for vaginal discharge is not so discriminating, since this symptom is very common and non-specific with multiple non-sexually acquired etiologies possible. Since most chlamydial and gonococcal infections in women are asymptomatic, active case finding, screening, and partner notification are very important in women-focused STD control programs.
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PMID:Sexually transmitted diseases control in developing countries. 869 72


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