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

We determined the immunogenicity and safety of reimmunization with the 23-valent polysaccharide pneumococcal vaccine in patients infected with human immunodeficiency virus type 1 (HIV-1). Patients immunized >5 years earlier (initially within 1 year of HIV-1 seroconversion) were randomized to receive vaccine (n=57) or placebo (n=30). Persons with recent HIV-1 seroconversion (n=14) were immunized for the first time. Preimmunization levels of capsule-specific immunoglobulin G were similar in all groups. Reimmunized patients showed a significantly lower frequency and magnitude of antibody responses compared with persons with recent HIV-1 seroconversion. Reimmunized patients did not show adverse virologic or immunologic changes, but some reported local discomfort (15%) or fever (8%). Thus, the limited responses after reimmunization of HIV-1-infected patients with the current 23-valent vaccine mandates the need for a more effective reimmunization schedule, more immunogenic vaccines, or other behavioral and therapeutic interventions.
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PMID:Reimmunization with 23-valent pneumococcal vaccine for patients infected with human immunodeficiency virus type 1: clinical, immunologic, and virologic responses. 1185 Aug 63

Pruritus, or generalized itch, is a source of serious discomfort and distress in a significant minority of people living with AIDS. Anecdotal reports suggest hypnosis might be a useful treatment, leading to reductions in distress and improvements in the condition. But empirical examination of the question is notably lacking. This time-series study reports results of a 6-session self-hypnosis treatment (relaxation, deepening, imagery, and home practice) for 3 HIV-positive men suffering from pruritus, related to disease progression and/or HIV medications. Posttreatment, all 3 patients reported significant reductions in daily itch severity and extent of sleep disturbance due to itch. One patient also evidenced significantly less itch distress. Another also experienced significantly less time bothered by itch. For the 2 patients on which 4-month follow-up data were available, treatment benefit across variables was stable or further improved.
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PMID:The efficacy of hypnosis in the treatment of pruritus in people with HIV/AIDS: a time-series analysis. 1193 76

Faecal specimens were collected from patients complaining of diarrhoea and abdominal or epigastric discomfort at two hospitals. Information obtained by questionnaires completed at the time of specimens collection, included demographic and clinical data. Specimens were preserved in 10% formalin and polyvinyl alcohol (PVA) and examined, as wet mounts and stained with Wheatley's Trichrome, Weber, modified acid-fast and hot safranin stains. One hundred patients were examined, in 30 of them parasites were detected. The most common organism identified was Cryptosporidium parvum, in specimens of five patients, followed by Entamoeba histolytica/E. dispar in four patients. The recently described "emerging parasites" were detected. Helminth eggs were found in two patients only. HIV status was not known for most of the patients, and the parasites commonly proliferate in the immuno-compromised individuals were not frequently found.
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PMID:Survey of faecal parasites in patients from western Kenya. 1204 46

1988-89 surveys of youths in major Brazilian cities revealed a high degree of misinformation on AIDS, as well as errant attitudes about physical contact, affection, and sexual relations. In response, the Oswaldo Cruz Foundation made ZIG-ZAIDS, a game designed to educate youths aged 10-14 years. ZIG-ZAIDS is a board game with question cards on the immune system, transmission patterns, treatment, and prevention. It emphasizes the need for cooperation and solidarity in human relationships, and also helps players reflect upon the psychological and social consequences of AIDS. The game does not attempt to instill panic, and is careful to not associate sex with death. A leaflet is included for parents and teachers with discussion questions on the difficulty and discomfort they may feel about talking about sex, the belief that such talk promotes sexual activity, and the importance of hearing what youths feel and think about sex. A condom and minidictionary of words referring to sexual organs, sexual relations, and sexually transmitted diseases are also included in the game. 34 9-14 year old students at 4 schools in Rio de Janeiro state evaluated the game favorably. Positive change was also realized in student ideas and attitudes about HIV transmission, prevention, and treatment. Health and education departments in some Brazilian states are currently implementing ZIG-ZAIDS in AIDS educational programs.
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PMID:Country watch: Brazil. 1228 12

Although the AIDS pandemic has catastrophic implications for all levels of South African society, it can be viewed as an opportunity to face the inevitability of human mortality with dignity rather than fear and denial and to rebuild shattered communities. This article discusses issues pertaining to counseling HIV-infected persons, the counselors themselves, and families and social groups affected by AIDS-related deaths. Counseling of HIV/AIDS patients is supportive in nature, with a focus on here-and-now issues such as unfinished business, reconciliation with family members, finding meaning in daily activities, and preserving a sense of personal control. This process can be obstructed, however, by distrust of authority figures, anger at experts who fail to cure the disease, and an internalized sense of shame and inferiority. The effectiveness of AIDS counselors depends on their ability to recognize and resolve personal conflicts triggered by HIV-positive clients, including feelings about death, helplessness, overidentification, and discomfort with sexual issues. Most South Africans will face bereavement and have to go through a mourning process for friends and relatives. Complicated and delayed grief reactions triggered by new and continuous losses can be expected. Involvement of community members in the grieving process, whether as helpers, volunteers, professionals, or recipients of service, offers South African society an opportunity for development of a new culture of compassion.
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PMID:Crisis as challenge: counselling counsellors, persons living with HIV / AIDS and survivors. 1229 92

At a time when the burden placed by HIV/AIDS on health systems, communities, and individual families is steadily increasing, policies such as structural adjustment and health reform are reducing health budgets. HIV-related chronic illness and deaths among health workers have further exacerbated pressures in the health sector and remaining staff suffer from stress and burnout. Factors contributing to stress among health workers in Africa and other developing countries include inadequate knowledge and support for treating HIV-related illnesses, lack of a safe blood supply, the terminal nature of HIV infection, lack of training in dealing with death and dying, discomfort discussing sexuality with patients, the social stigma associated with HIV/AIDS, and fears of occupational exposure to HIV. Since AIDS affects all areas of life, it requires a coordinated response from the health sector, education, social services, legal institutions, and religious and community groups.
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PMID:Coping with the burden. 1229 11

This paper discusses the gender dynamics of sexually transmitted diseases (STDs) and HIV/AIDS based on the relationship between gender violence, reproductive health, sexuality, STD and HIV/AIDS. This approach highlights AIDS as an increasingly female concern, a consequence of the social makeup of female and male sexuality, and the result of inequalities that characterizes many heterosexual relationships. Gender violence is considered as the most intimate enemy among most women with an extremely high indirect cost to development. Not only that, it also causes more death and disability among women aged 14-44 years, having greater risk from their husbands, fathers, and neighbors or colleagues. Moreover, the link between gender violence and HIV/AIDS and STD can be observed through the rising incidence of these infections among women particularly during unprotected vaginal intercourse. Also, these women often bear the pain and discomfort associated with STD because of social constraints. The study calls for further research into behavior change interventions that address gender dynamics to prevent the fatal intimacy of women's vulnerability to STD and HIV, the intimate enemy of gender violence and the fatal encounter with AIDS. Lastly, the paper includes information about the work of the Pacific Women's Resource Bureau and its pioneering initiative on the Pacific multi-site study on violence against women.
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PMID:New Caledonia: fatal intimacy: gender dynamics of STD and HIV / AIDS. 1229 69

Despite increasing need for HIV prevention research and intervention programs, the voices and stories of Asian and Pacific Islander men who have sex with men (API MSM) have remained absent from HIV prevention literature. Five focus groups with API MSM (N = 38) were conducted to identify psychological, social, and cultural factors related to HIV risk and protection. Six themes were identified based on focus group discussion: (a) dual-identity status, (b) coming out and disclosure issues, (c) relationships and dating, (d) substance use, (e) sexual risk reduction strategies, and (f) health and social services. Narrative data indicate that multilevel HIV prevention intervention strategies are necessary for addressing the unique psychosocial and behavioral HIV risk factors among API MSM, such as dual stigma stemming from homophobia and racism, discomfort with sexuality, power dynamics and stereotypes in relationships with White men, substance use, and low utilization of health and social services.
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PMID:HIV risk and prevention among Asian/Pacific Islander men who have sex with men: listen to our stories. 1263 May 96

The aim of this study was to evaluate terminal care among hospitalized children who died of HIV/AIDS. The design was a retrospective chart review of the terminal hospitalization. The setting was a public, secondary and tertiary children's hospital in Cape Town, South Africa (SA). The patients included a consecutive series of in-patient deaths from HIV-related causes. The main outcome measures included: documentation of do not resuscitate (DNR) orders and comfort care plans, intensity of diagnostic and therapeutic interventions in the last 24 hours of life, and presence of pain and distress in last 48 hours of life. The results are based on the review of 165 out of 167 in-patient deaths. Of those, 79% of patients died in general wards. Median age and length of stay were 4 months and 6 days respectively. A total of 84% of patients had a DNR order. DNR orders appeared simultaneously in only 41% of medical and nursing notes. Only 44% of patients had a comfort care plan. Pain and distress in the last 48 hours was documented in 55% of patients who died in the general wards. Respiratory symptomatology and painful skin conditions accounted for most discomfort. Half (36/72) the patients with pain and distress, including 16 with a comfort care plan, received no analgesia. Conclusions drawn found that, despite clinical uncertainty, doctors made tough end of life decisions that included DNR orders and comfort care plans. The lower rate of comfort care plans suggests doctors had difficulty making the transition from curative to palliative care. Many comfort care plans were incoherent and included interventions unlikely to promote patients' comfort. In light of the HIV/AIDS pandemic in SA, reforms are needed to integrate palliative care within mainstream hospital medicine. However, without adequate human resources including trained interpreters, doctors and nurses will struggle to deliver optimal terminal care in acute hospitals.
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PMID:End of life care in HIV-infected children who died in hospital. 1287 69

The assessment of quality of life (QoL) is central to understanding how people's lives are affected by HIV infection. A reliable and valid measurement tool developed for cross-cultural use will be important in evaluating the global impact of the disease. This paper reports on the development and preliminary assessment of the WHOQOL-HIV pilot instrument that is designed for use with the WHOQOL-100 for persons living with HIV and AIDS (PLWHA). In this study, 900 people with a mean age of 32 from six culturally diverse sites completed the WHOQOL-100 along with 115 HIV specific items. Respondents were HIV asymptomatic (23%), HIV symptomatic (23%), had AIDS (20%) or were well (34%). Analyses to select the best items from the piloted instrument resulted in the inclusion of 33 items covering 12 new facets for a field trial version of the WHOQOL-HIV instrument; e.g. symptoms of HIV, body image, social inclusion, death and dying, and forgiveness. The results indicate excellent internal consistency for the scale (alpha=0.98) and its domains (alpha=0.87-0.94). For PLWHA, pain and discomfort, positive feelings, dependence on medication, sexual activity, financial resources and spiritual connection were particularly poor, indicating that the severest impact of HIV extends beyond physical well-being to the psycho-social-spiritual and environmental areas of QoL. Comparisons using ANOVA showed that persons who are at later stages of HIV infection, or are currently ill report poorer QoL than those that were well (p<0.01). Women report poorer QoL than men for almost every facet (p<0.01) and older persons (>30) reported lower negative feelings, and better social inclusion, spiritual connection, forgiveness and spiritual experience than younger persons. Finally, those with no education, or only primary education showed some of the poorest means. It is concluded that these new items and facets add value for measurement of QoL in PLWHA.
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PMID:Preliminary development of the World Health Organsiation's Quality of Life HIV instrument (WHOQOL-HIV): analysis of the pilot version. 1289 9


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