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

A case control study was conducted during February 1992-April 1993 in Bangkok, Thailand, among 62 couples of which both partners were HIV seropositive (concordant couples [cases]) and 46 couples of which the man was HIV seropositive and the woman was HIV seronegative. The subjects were patients in the Immune Clinic in Chulalongkorn Hospital and in 15 drug detoxification (IDU) clinics. Couples in the immune clinic were more likely to be HIV seroconcordant than those in the IDU clinics (69% vs. 48%; 67% vs. 27%, after excluding females who were intravenous [IV] drug users; p 0.01). HIV-1 serotype B (subtype B) was more common among men in the IDU clinics while HIV-1 serotype A (subtype E) (79%) was more common among men in the immune clinic (92%). Seroconcordance was much more common when HIV-1 was of serotype A than when it was of serotype B (70% vs. 52%; odds ratio [OR] = 2.1; p 0.05). Further, when the researchers did not include couples of which the woman was an IV drug user, the difference in concordance was even greater (70% vs. 26%, OR = 6.8; p 0.01). These differences in concordance suggest that HIV-1 serotype A may be more efficiently transmitted than HIV-1 serotype B. The multivariate logistic regression analysis showed that independent risk factors of HIV seroconcordance were HIV-1 serotype A of male partners (adjusted OR = 3.1) and history of IV drug use in female partners (AOR = 4.8). HIV-1 subtype E may be linked to a higher risk of heterosexual transmission than subtype B. If so, the predominance of HIV-1 subtype E in Thailand could explain the rapid spread of HIV infection in Thailand.
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PMID:HIV-1 subtypes and male-to-female transmission in Thailand. 771 40

During mid-1987 to mid-1988 and mid-1990 to mid-1991, researchers conducted cross sectional serological surveys at the STD clinic in Port of Spain in Trinidad to examine trends in HIV-1 prevalence among 2019 and 1606 STD patients, respectively. They also conducted a case control study of risk factors for HIV-1 infection among heterosexual STD patients (131 cases and 173 age- and sex-matched controls) in 1992-1993. Between 1987-1988 and 1990-1991, HIV-1 seroprevalence increased markedly (3% to 13.6%). It increased more in women than in men (9- vs. 4-fold). During 1987-1988, men were more likely to be infected with HIV-1 (odds ratio [OR] = 3.1), but by 1990-1991, gender was no longer a significant risk factor (OR = 1.3). In 1990-1991, significant risk factors for HIV-1 infection were urban residence (OR = 2.2), HTLV-1 infection (OR = 3.1), and being at least 40 years old (OR = 1.8). None of these risk factors were significant in 1987-1988. HIV-1/HTLV-1 coinfection increased between the two surveys (0.05% to 1.5%). Significant independent HIV-1 risk factors in men identified in the case control study were: used crack cocaine in the past 6 months (adjusted OR [AOR] = 6.2; p = 0.0001); ever had anal sex (AOR = 7.2; p = 0.003); ever had syphilis (AOR = 3.2; p = 0.02); current genital ulcer disease (AOR = 5.2; p = 0.0001); and current genital warts (AOR = 3.9; p = 0.02). Significant independent HIV-1 risk factors in women were: less than 14 years old at first sex (OR = 4.8; p = 0.01); ever been a commercial sex worker (AOR = 5.7; p = 0.02); and ever had nongonococcal cervicitis (AOR = 4.1; p = 0.005). These findings suggest that sexual exposure to HIV-1 through ulcers for men and inflammatory STD and/or prostitution for women, all fueled by the crack cocaine epidemic, account for much of HIV-1 exploding in Trinidad. Public health interventions to prevent, detect, and treat STDs and crack cocaine addition may greatly reduce HIV-1 transmission.
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PMID:HIV-1 prevalence and risk factors among sexually transmitted disease clinic attenders in Trinidad. 779 44

In Puerto Rico between October, 1990 and August, 1991, 342 intravenous (IV) drug users at 3 detoxification clinics serving San Juan and its environs were interviewed, and blood samples were taken. Researchers wanted to determine the behavioral risk factors linked to HIV infection in a population of IV drug users in drug treatment. Most (84.9%) of the IV drug users were male. The HIV seropositivity rate was 29.5% (28.7% for males and 34% for females), which was lower than that for out-of- treatment IV drug users in metropolitan San Juan (47.5%). A stepwise logistic regression model revealed that having sexual intercourse with an IV drug user within the last 6 months (42.5% vs. 26%; adjusted odds ratio [AOR] = 1.9; p = .046), having used IV drugs for more than 5 years (32.4% for 6-10 years and 47.5% for 10 years vs. 8.8%; AOR = 4.69 and 9.64, respectively; p .001), and shooting up with used needles while imprisoned (56.8% vs. 26.2%; AOR = 3.59; p = .002) were significant behavioral risk factors of HIV infection. The significant risk factor of having sex with an IV drug user within the last 6 months suggests that sexual transmission of HIV among IV drug users in Puerto Rico is becoming as important an HIV-transmission mode as needle sharing. Since a considerable proportion of this IV drug use population in a treatment program (54.9%) has been incarcerated, and since needle sharing while in prison has an independent significant effect on HIV transmission, public health officials in Puerto Rico need to implement innovative and aggressive interventions in correctional institutions to induce risk reduction behaviors particular to IV drug inmates.
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PMID:Behavioural risk factors and HIV infection of injection drug users at detoxification clinics in Puerto Rico. 796 Mar 88

Between February 1990 and March 1993, 759 female commercial sex workers who attended sexually transmitted disease (STD) clinics in Dakar, Thies, and Mbour, Senegal, were interviewed and underwent a general physical and detailed gynecologic examination so researchers could ascertain the influence of HIV-1 and HIV-2 infection on the prevalence of cervical human papillomavirus (HPV) and squamous intraepithelial lesions (SIL) in this high-risk population. Most lesions were low-grade SIL. 619 had neither HIV-1 nor HIV-2 infection. 9%, 8%, and 2% had HIV-1, HIV-2, and concurrent HIV-1 and HIV-2 infection, respectively. Polymerase chain reaction revealed that 43% had HPV infection, while Southern transfer hybridization found only 7%. HIV-1 infected women faced a significant increased risk for HPV (adjusted odds ratio [AOR] = 2.9) as also did HIV-2 infected women (AOR = 1.7). Both these groups also faced an increased risk for SIL (AOR = 1.8 and 2.9, respectively), but the increased risk was not significant. Similarly, women infected with both HIV-1 and HIV-2 faced an increased risk of HPV and SIL (AOR = 4.9 and 5.2, respectively). Among women with HIV infection, women with HPV had a lower CD4 count and CD4/CD8 ratio (854 vs. 1033 million/l, p = 0.08, and 0.88 vs. 1.17, p = 0.05, respectively) than women with no detectable HPV. HIV-positive women with SIL had a lower CD4/CD8 ratio than HIV-positive women without SIL (0.65 vs. 1.03; p = 0.003). HIV-2 women exhibited lower immunosuppression than HIV-1 women. These findings show that both HIV-1 and HIV-2 infection were associated with HPV and SIL. The researchers expressed interest in longitudinal studies designed to examine the risk of high-grade SIL, the direct precursor of invasive cervical cancer, among HIV-infected women.
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PMID:HIV-1, HIV-2, human papillomavirus infection and cervical neoplasia in high-risk African women. 872 46

During June 1991 to December 1992, 68.8% of all men who gave informed consent for HIV testing at a public health clinic in Mexico City and for participation in this study had ever had sexual intercourse with men. The final sample size was 2758 men. The study examined the reported frequency of rectal bleeding, the determinants of rectal bleeding, and the interactions between rectal bleeding and other risk factors with HIV infection among homosexual/bisexual men. It also aimed to determine whether rectal bleeding is an independent risk factor for HIV transmission. 32.8% had HIV infection. 39% reported some rectal bleeding during anal intercourse. 8% experienced rectal bleeding during at least 50% of intercourse episodes. Overall, bleeders were more likely to be HIV infected than nonbleeders (42% vs. 28%; p 0.0001; adjusted odds ratio [AOR] = 1.8 for men who bled in more than 50% of anal intercourse episodes; AOR = 1.3 for men who sometimes bled). The odds ratios increased as the frequency of reported rectal bleeding increased (p = 0.001). Condom use during receptive anal intercourse did not affect the association between rectal bleeding and HIV infection. 9% of all HIV infections were attributable to rectal bleeding. 42% of HIV infections among bleeders were attributable to rectal bleeding. In the multivariate analysis, men with both rectal bleeding and anal warts were more likely to have HIV infection than men who had neither (67.9% vs. 27.2%; AOR = 3.5). Significant predictors of rectal bleeding were older age (i.e., =or 30) (AOR = 1.5), more education (AOR = 1.4-1.5), more receptive anal intercourse than insertive intercourse (AOR = 5.3-16.1), receptive digital-anal contact (AOR = 1.6), anal warts (AOR = 1.9), and genital ulcers (AOR = 2). These findings show that rectal bleeding is an independent risk factor for HIV infection. Rupture of anal warts is an especially effective portal of HIV transmission.
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PMID:Human immunodeficiency virus infection in Mexico City. Rectal bleeding and anal warts as risk factors among men reporting sex with men. 889 Jun 60

Thrombocytopenia in persons infected with HIV is prevalent and has numerous causes. To study the occurrence, associations, and effect on survival of thrombocytopenia in HIV-infected persons, we used surveillance data from a longitudinal survey of the medical records of 30,214 HIV-infected patients who received medical care from January 1990 through August 1996 in more than 100 medical clinics in 10 U.S. cities. Thrombocytopenia was defined as a physician diagnosis of thrombocytopenia or a platelet count of < 50,000 platelets/ microliter. Analysis of associations of thrombocytopenia was conducted using logistic regression. In HIV+ patients, the 1-year incidence [corrected] of thrombocytopenia was 8.7% in persons with one or more AIDS-defining opportunistic illnesses (clinical AIDS), 3.1% in patients with a CD4 count < 200 cells/mm3 but not clinical AIDS (immunologic AIDS), and 1.7% in persons without clinical or immunologic AIDS. The incidence of thrombocytopenia was associated with clinical AIDS (adjusted odds ratio [AOR] 2.2; 99% confidence interval [CI] 1.7-3.0), immunologic AIDS (AOR 1.5, CI 1.0-2.1), history of injecting drug use (AOR 1.4, CI 1.0-1.9), anemia (AOR 5.0, CI 3.8-6.7), lymphoma (AOR 3.7, CI 1.3-10.6), and black race (AOR 0.7, CI 0.5-0.9). After controlling for anemia, clinical AIDS, CD4 count, neutropenia, antiretroviral therapy, and Pneumocystis carinii pneumonia prophylaxis, thrombocytopenia was significantly associated with decreased survival (risk ratio 1.7; 95% CI, 1.6-1.8). Thrombocytopenia in HIV-infected persons is an important clinical condition associated with shorter survival.
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PMID:Surveillance for thrombocytopenia in persons infected with HIV: results from the multistate Adult and Adolescent Spectrum of Disease Project. 911 81

The objective of this study was to identify factors associated with frequent needle exchange program (NEP) attendance by injection drug users (IDUs) in Vancouver, Canada. Data were examined from a case control study of recent HIV infection. IDUs with documented HIV seroconversion after January 1, 1994 (n = 89) and seronegative controls with two documented HIV-negative test results in the same period (n = 192) were asked about demographic and social information, drug injection and sexual behavior, and NEP attendance. Logistic regression was used to examine the effect of multiple variables on NEP attendance while adjusting for HIV status and other potential confounders. Frequent (> 1 time/week) versus nonfrequent (< or = 1 time/week) NEP attenders did not differ with respect to gender, age, ethnicity, education, or HIV serostatus. For men, multivariate analysis showed that frequent cocaine injection was the only variable independently associated with NEP attendance (adjusted odds ratio [AOR] = 3.9; 95% confidence interval [CI] = 1.8-8.3); for women, independently associated variables were frequency of any drug injection (AOR = 5.5; 95% CI = 1.7-17), shooting gallery attendance (AOR = 11.5; 95% CI = 2.2-66), and having a nonlegal source of income (AOR = 3.4; 95% CI = 1.0-12). Borrowing used needles was associated with frequent NEP attendance in the univariate analysis. The NEP in Vancouver attracts IDUs who are frequent injectors (especially men using cocaine) and who have high-risk behaviors or an unstable lifestyle. This finding reinforces the role of NEPs as potential focal points for intervention in this hard-to-reach population.
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PMID:Factors associated with frequent needle exchange program attendance in injection drug users in Vancouver, Canada. 947 18

This study aimed to identify risk factors for squamous intraepithelial lesions (SIL) in women with known HIV status and to explore the association between SIL, HPV subtype, and HIV-induced immunosuppression. The study population consisted of women with known HIV serological status who were attending a network of 16 clinical centres in Italy. Detailed behavioural data, clinical and laboratory parameters, and samples for diagnosis of SIL by Papanicolau smear and HPV infection using a polymerase chain reaction (PCR) were obtained from each study participant. The strength of the association between SIL and possible risk factors was assessed calculating crude and adjusted odds ratios derived from univariate analysis and multivariate models. We enrolled 236 women, of whom 135 (57.2%) were HIV-infected. SIL was diagnosed in 57 women (24.1%); of these, 48 (35.6%) were HIV-infected and 9 (8.9%) were HIV-negative. HPV-DNA was detected in 41 (72%) women with SIL and in 45 (25%) women without SIL. HPV-DNA was more often detected among HIV-infected women than among HIV-negative women (40% vs. 32%), but the difference was not statistically significant. Women infected with high-risk types or with low-risk-uncharacterised types of HPV both had a higher risk of SIL compared with HPV-negative women (respectively, AOR: 17.53 and AOR: 2.89). HIV-infected women with severe or moderate immunosuppression were more likely to have SIL than HIV-negative women (respectively, AOR: 7.29 and AOR: 3.09) also independently from HPV infection. Women reporting use of a contraceptive pill had a 2.5 times higher risk of SIL compared with those who never used hormonal contraceptives. The results confirm that high-risk HPV types are strongly associated with SIL, and that HIV infection may strengthen the effect of HPV at cervical level. The use of oral contraceptives may slightly increase the risk of SIL in women with at-risk behaviour for HIV infection.
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PMID:Determinants of squamous intraepithelial lesions (SIL) on Pap smear: the role of HPV infection and of HIV-1-induced immunosuppression. DIANAIDS Collaborative Study Group. 947 25

Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 January, 1994 (n = 89), or repeatedly tested HIV-seronegative after this date (n = 192). Interviewer-administered questionnaires focused on drug use, sexual behaviours, source of needles and depression. Subjects were asked if they had "ever been forced to have sex" as a child, youth or adult. Logistic regression identified determinants of borrowing needles. After controlling for HIV serostatus, factors independently associated with borrowing were injecting > 4 times/day, polydrug use, and ever experiencing non-consensual sex (AOR = 3.4, 95% CI: 1.8, 6.5). Depression was associated with borrowing, although not independently so. Homosexual activity was independently associated with borrowing among males, whereas living with a sexual partner was an independent predictor for females. Access or barriers to clean needle use were not associated with borrowing. Social determinants, particularly a history of sexual abuse, are among the most significant predictors of needle borrowing among Vancouver's IDUs. Early identification of these factors should be a component of HIV prevention programmes.
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PMID:Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada. 948 50

Data from a cohort of young HIV-negative gay and bisexual men were analyzed to identify determinants of sexual risk-taking at baseline. Gay/bisexual men aged between 18 and 30 completed a self-administered questionnaire including demographics, depression, social support, substance use, and consensual versus nonconsensual sex. Risk-takers were defined as those who had unprotected anal sex with casual male sex partners in the previous year; non-risk-takers were defined as those who reported consistent condom use during anal sex with all male partners in the previous year. Logistic regression was used to identify independent predictors of sexual risk-taking. Of 439 men studied, risk-takers had less education, a higher depression score, less social support, and were more likely to report nonconsensual sex and recreational drug use relative to non-risk-takers. Independent predictors of sexual risk-taking were low education, nitrite use, low social support (adjusted odds ratio [AOR]=1.65; 95% CI, 1.04-2.59), and nonconsensual sex experienced as a youth or adult (AOR=1.85; 95% CI, 1.15-2.96). Young gay/bisexual men reporting nonconsensual sex, low social support, or nitrite use were significantly more likely to have recently had unprotected anal sex with casual partners. HIV prevention programs aimed at young gay/bisexual men should include sexual abuse counselling and foster community norms supporting safer sex practices.
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PMID:Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. 973 71


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