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

Mortality is the greatest concern in assessing risks of modern reversible contraception. The problems identified with older oral contraceptives (OCs) have decreased with the lower doses in current OCs. These problems include cardiovascular and thrombotic effects, changes in lipid metabolism, breast cancer, liver cancer, increased risk of chlamydia cervicitis, no protection against sexually transmitted diseases (STDs) and HIV, and interferes with breast feeding. On the other hand, OCs protect against anemia, menstrual disorders, ectopic pregnancy, acute pelvic inflammatory disease (PID), and ovarian and endometrial cancer. Since the contraceptive implant, Norplant, has no estrogens, it does not have the cardiovascular risks associated with OCs. Possible risks from Norplant use include changes in carbohydrate, liver, and lipid metabolism but they tend to be clinically insignificant and no protection against STDs/HIV. Menstruation disorders are the major side effect. Apparent benefits of Norplant are protection against anemia and ectopic pregnancy and no effect on lactation. The injectable contraceptive, Depo-Provera, causes menstrual changes, may slightly increase the risk of breast cancer, may decrease bone density, and does not protect against STDs/HIV. It protects against endometrial cancer. It has no effect on metabolism. Risks associated with the IUD include PID, perforation, anemia, increased menstrual bleeding, and pregnancy. IUDs do not affect the quantity of composition of breast milk. They are best suited for women in a mutually monogamous, long-term relationship. Barrier methods provide some degree of protection against STDs/HIV and PID. Condoms provide the most protection. They do not affect lactation. Their major complications are contraceptive failure and risks associated with pregnancy. For all women, especially those in high risk categories, one must balance the risks of modern contraceptive use with the risks of childbearing and with their benefits.
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PMID:The safety of modern contraceptives. 784 6

The MAP of the University of Miami/Jackson Memorial Medical Center/Highland Park Pavilion is a comprehensive inpatient and outpatient chemical dependency rehabilitation program that serves mostly lower socioeconomic, African-American perinatal substance-abusing women. The multidisciplinary treatment team incorporates a broad spectrum of group and individual therapeutic modalities, including 12-step, psychoeducational, and RP components. Within MAP programs, significant attention is given to issues and experiences that are unique to this population and that must be addressed if rehabilitation is to be successful. These topics include, but are not limited to, physical, emotional and sexual abuse, empowerment, family and parenting concerns, and HIV prevention and coping skills for HIV-seropositive women.
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PMID:A description of the Maternal Addiction Program of the University of Miami/Jackson Memorial Medical Center. 820 34

The current literature on the transmission of HIV and the use of oral contraceptives (OCs), injectables, IUDs, spermicides, and the female condom was reviewed. Some of the methodological difficulties involved study design (observational studies, cross-sectional, case control, and prospective studies) and confounding factors (age, marital status, sexual partners). The impact of OC use on HIV transmission is likely to be minor, but some factors contributing to transmission include cervical ectropion, which enhances HIV transmission. Nevertheless, in a 1990 Nairobi study of 4404 women no such association was detected. Sexually transmitted diseases (STDs) have been risk factors in HIV transmission. OCs that decrease irregular bleeding may protect against HIV. Progestin-only pills could act on the risk of HIV transmission by thickening cervical mucus and thinning the vaginal epithelial layer. 21 epidemiological studies were identified on the use of OCs and transmission. Except for a 1990 Nairobi study among prostitutes none of them reported a significant association between OC use and HIV seropositivity. Injectables (Depo Provera) could theoretically increase HIV transmission, but no such conclusive evidence has surfaced. Increased risk of transmission or seropositivity has been reported with IUD use, but this needs confirmation by prospective studies. Among spermicides the nonoxynol-9 sponge slightly increased HIV seroconversion in 139 sex workers in Nairobi in a 1992 study. However, this trial was contradicted by other prospective studies conducted in Cameroon and Zambia. Nonoxynol-9 kills HIV but also damages the cervical and vaginal mucosa enhancing HIV transmission. In 1992 in vitro activity in 26 out of 131 other spermicides screened inhibited HIV. The female condom was tested in 104 women in a 1993 prospective study in the US and no recurrences of trichomonas occurred in 20 women who used it consistently over a 6-week period. More prospective epidemiological studies are needed, and the risk of HIV infection should be part of counseling on contraceptives.
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PMID:Contraceptive methods and the transmission of HIV: implications for family planning. 820 68

Currently, more than 50% of married women of childbearing age are using a form of contraception. Between 1960-65 and 1985-90, the number of contraceptive users in all developing countries increased from 31 to 381 million, in East Asia from 18 to 217 million, in Latin America from 4 to 44 million, in South Asia from 8 to 94 million, and in Africa from 2 to 18 million. WHO has recently estimated that over 500,000 women die each year from causes related to pregnancy and childbirth. With a worldwide estimate of 36-53 million induced abortions performed each year, between 125,000 and 170,000 women die each year because of unsafe abortions. According to data from the World Fertility Survey, short spacing between births raises the average chances of offspring dying in infancy by 60-70% and the chances of dying before the age of 5 years by about 50%. WHO's minimal estimate for yearly incidence of bacterial and viral STDs (excluding HIV infection) is 130 million. Most STDs have more serious sequelae in women than in men and lead to pelvic inflammatory disease (PID), permanent infertility, and the risk of ectopic pregnancy. African countries with high incidence of STDs have the lowest prevalences of contraceptive use. A recent examination of the WHO international data base of 22,908 IUD insertions and 51,399 woman-years of follow-up indicates that the occurrence of PID in IUD users is most strongly related to the insertion process and to background STD risk and suggests that PID is an infrequent occurrence after the insertion period. A WHO Scientific Working Group review confirmed the beneficial effects of oral contraceptives in reducing the risk of ovarian cancer, endometrial cancer, and biopsy-proven benign breast diseases. A WHO collaborative study in 5 centers in Kenya, Mexico, and Thailand provided assurance that women who used DMPA for a long time and who initiated use many years previously are not at increased risk of breast cancer.
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PMID:Contraception and women's health. 832 13

During May 10-July 20, 1993, clinic staff interviewed 3136 women aged 12-45 attending 13 family planning clinics in southeastern Texas so researchers could determine the frequency of condom use for prevention of sexually transmitted diseases (STDs) in women using other forms of contraception for pregnancy prevention. 30% had had unprotected intercourse at least once in the last month. Clients who planned to always use a contraceptive method in the future increased from 58% to 83% after counseling. After counseling, 31% planned to always use a condom in the future. Before the visit, 10% had always used a condom. After counseling, condom use with oral contraceptives, IUD, diaphragm, cervical cap, implants, Depo Provera, or sexual sterilization increased from 28% to 42%. 35% of clients used condoms when they thought that protection was needed. 72% were currently in a monogamous relationship. 10% considered themselves not at risk of HIV. Women with one sexual partner tended to think that they were not at risk of HIV or not concerned about HIV. They were much less likely to intend to use condoms in the future with another method than their counterparts. Three women had HIV infection. 4% had genital herpes. 13% had had another STD. 260 women (8%) had had intercourse with partners engaging in risky behavior. 47% of clients had at least one risk factor for HIV (e.g., recent STD). After counseling, condom use increased among clients with risk factors for HIV. These same clients were also more likely to use condoms than those with no risk factors. 17% of these clients planned to reduce condom use in the future, however. 22% of clients planned to decrease condom use in the future and use a contraceptive method to protect against pregnancy rather than STDs. These findings show that many women at risk for STDs who request contraception do not protect themselves from STDs, indicating an additional unmet need. The researchers suggest that there should be research and development for intervention methods for women at risk for STDs who stop using condoms when they receive another contraceptive method.
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PMID:A cross-sectional survey of condom use in conjunction with other contraceptive methods. 858 24

The third variable region (V3) of the feline immunodeficiency virus (FIV) surface glycoprotein is predicted to have similar physical properties to that of HIV and has been shown to contain immunodominant and neutralizing epitopes. Immunological characteristics of this region were investigated further using a peptide corresponding to the middle of the putative FIV V3 loop. The peptide was recognized in ELISA by sera from the majority of naturally FIV-infected cats, and absorbed a significant fraction of the virus neutralizing activity from a pool of sera of cats naturally infected with FIV, confirming the immunogenic nature of this region. A sheep immunized with an octameric form of the peptide (multiple antigenic peptide; MAP) in Freund's complete adjuvant generated neutralizing antibody to a higher titre than infected cats. However, immunization of cats with the same MAP in an acceptable adjuvant formulation (Quil A) induced antibody and cytotoxic T-cell responses to the immunizing peptides but only minimal neutralizing activity. These responses did not significantly alter the kinetics of infection or the proviral load after challenge with a homologous strain of FIV, compared with naive controls. While the potential efficacy of peptide vaccines to lentiviruses remains to be determined, this study shows that the immune response evoked may be highly dependent on the delivery and adjuvant regime used.
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PMID:Immunogenicity of a peptide from a major neutralising determinant of the feline immunodeficiency virus surface glycoprotein. 891 Oct 3

The risk factors for HIV transmission from infected male blood donors to their regular female sex partners were investigated in a cross-sectional study conducted in Chiang Mai, Thailand, in 1992-95. During the 3.5-year study period, 405 couples were recruited. 98% of male blood donors reported a history of sex with female prostitutes. Only 28 men (7%) were aware of their seropositivity prior to notification by the blood bank, and just 1.5% always used condoms with their regular sex partner. 187 (46%) of the 405 female sex partners--none of whom had HIV risk factors other than sexual contact with their husbands--were HIV-positive at baseline. In the multivariate analysis, three variables were associated with a significantly increased risk of HIV in female partners: history of genital herpes (odds ratio (OR), 3.46; 95% confidence interval (CI), 1.50-8.78), history of gonorrhea or chlamydia (OR, 2.71; 95% CI, 1.39-5.53), and a stable relationship of at least 2 years' duration (OR, 2.28; 95% CI, 1.02-5.09); consistent condom use in the past 2 years was significantly associated with a decreased risk of HIV (OR, 0.10; 95% CI, 0.01-0.79). Medroxyprogesterone acetate injection and oral contraceptive use were not associated with HIV risk. These findings confirm a high risk of HIV transmission through monogamous sexual relationships in Thailand. Recommended are campaigns to increase regular condom use among married couples.
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PMID:Risk factors for HIV-1 transmission from HIV-seropositive male blood donors to their regular female partners in northern Thailand. 938 12

Here we report that IL-4 specifically enhances cell surface expression of CXCR4 on resting peripheral and cord blood T cells. Whereas polarized Th2 clones express variable levels of CXCR4, expression of this receptor is undetectable on polarized Th1 clones but can be induced on the latter cells as well, following short-term culture in the presence of IL-4. The IL-4-induced CXCR4 is functional since interaction with its ligand, stromal-derived factor (SDF)-1, activates the p42 MAP-kinase ERK-2. In addition, although CXCR4 expression is down-regulated following stimulation of T cells and T cell clones via CD28 or CD3 and CD2 cell surface molecules, respectively, it is re-induced by IL-4. These data indicate an important role for IL-4 in rendering CD4+ T cells susceptible to infection with HIV via CXCR4, as well as in promoting SDF-1-induced migration of these cells.
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PMID:IL-4 induces functional cell-surface expression of CXCR4 on human T cells. 957 13

Risk testing for HIV serostatus is unlikely to detect more than 20% of HIV-positive pregnant women. Of the 11 pregnant women discovered to be HIV-infected at Port Moresby General Hospital in Papua New Guinea in 1994-95, only four had more than two sexual partners since 1992 and none was an intravenous drug user. The deleterious effect of pregnancy on HIV disease progression appears to be small but variable, with more serious effects in the later stages of disease. The risk of vertical transmission increases when viral loads are high, the general maternal condition is poor, and delivery is preterm. In developing countries, where HIV-infected pregnant women are likely to be malnourished and to have concomitant infections such as malaria and tuberculosis, the risks of preterm labor, small-for-gestational age infants, and chorioamnionitis are increased. HIV-related gynecologic conditions such as pelvic inflammatory disease, vulvovaginal candidiasis, and cervical neoplasia may be resistant to treatment and tend to recur. Pregnancy prevention through effective contraceptive methods such as Depo-Provera and tubal ligation may be more important to HIV-infected women than prevention of viral transmission, especially when both partners are seropositive.
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PMID:HIV infections in obstetrics and gynaecology. 979 61

The case presented in this paper suggests that the levonorgestrel intrauterine system may be an excellent contraceptive method for HIV-positive women. At presentation to a UK family planning clinic, a 32-year-old nulliparous woman was using Depo-Provera for contraception; however, she was bleeding irregularly and complained of acne and lack of vaginal lubrication. The Mirena intrauterine system was considered because it offered lighter menstrual periods or amenorrhea, no need for regular clinic visits, reliable contraception, and fewer systemic side effects than other progestogen-only methods. At follow-up 6 weeks after Mirena insertion, the woman reported one light period, pain on the day of fitting only, and no progestogenic side effects. The reduced blood loss associated with this method is beneficial if mild anemia is present and may reduce exposure of an HIV-negative male partner to infected blood. Moreover, the system's effectiveness is not compromised by the broad-spectrum antibiotics or liver enzyme-inducing drugs taken by women with HIV/AIDS.
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PMID:Successful use of levonorgestrel intrauterine system in a HIV positive woman. 1022 47


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