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

The relations between psychopathology (or psychological morbidity) and stress (measured by the GHQ-30 and VOEG-13) and HIV-risk injecting behaviour were investigated among 151 and 166 drug users, respectively, participating in a HIV study in Amsterdam, The Netherlands. Scores indicative of psychopathology were obtained by 72% of respondents. Drug users with psychopathology are older, long-term polydrug users and injectors, who experience considerable stress. Drug users in the sample also have higher stress levels than the general population, but, in contrast to the general population, stress does not increase with age. Stress is associated with long-term polydrug use, with cocaine use and with the female sex. Among HIV-positive injecting drug users (IDU's) no positive relation was found between psychopathology or stress and lending of used needles to others. Among HIV-negative IDUs only psychopathology is associated with an increased HIV risk. Our findings suggest that HIV-risk reduction programmes should consider more seriously the role of psychopathology in attempts to persuade drug users to reduce their risks.
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PMID:Psychopathology, stress and HIV-risk injecting behaviour among drug users. 152 29

Up to June 1991 a total of 6,604 AIDS cases were reported to the central AIDS-registry at the Federal Health Office. As typical for "pattern I" countries most of the AIDS-cases are homo/bisexual men (70%), followed by i.v. drug users (IDU, 13%). However, the proportion of homo/bisexual men is constantly decreasing since 1986 while the proportion of IDU's is increasing. As also observed in other industrialized countries a flattening off in the AIDS incidence curve is seen since 1989. Probable reasons for this observation are a decrease of new infections since 1984/85 (due to early saturation of the populations at highest risk and to the early onset of prevention campaigns in these populations) and improved therapeutic strategies in the prevention of AIDS indicating diseases. However, since about 60,000 people are estimated to be HIV infected in the FRG today AIDS incidence will remain on a stable level for the next years regardless the number of new infections occurring today. Since 1988 major changes in the distribution of AIDS indicating diseases are seen. While Kaposi's sarcoma is constantly decreasing non Hodgkin lymphomas, HIV encephalopathy and wasting syndrome are increasing. Due to the effective primary prophylaxis of pneumocystis carinii pneumonia (PCP) by pentamidine the proportion of PCP as AIDS-indicating opportunistic infection decreased from more than 60% in 1988 to 41% in 1991. The second most frequent opportunistic infection is now toxoplasmosis (19%). The changes in the distribution of AIDS-indicating diseases and the increasing proportion of IDU's have major implications on patient care as well as diagnostic and therapeutic procedures.
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PMID:[The epidemiology and acquired immunodeficiency syndrome--status and trends]. 172 53

Using modelling techniques derived from behavioural ecology, unnamed identifier data from a variety of partial samples of injecting drug users [IUDs] were used to estimate the prevalence of this population in Glasgow during 1989. The model yielded an estimate of 9424 [95% confidence interval +/- 2460] which represents a prevalence rate of 15 per 1000 population aged 15-55. The estimated male:female ratio was 2.64:1 and the modal IDU aged 20-24. These figures should facilitate assessment of the service requirements of this group and provide a basis from which the number of IDUs infected with HIV and the number likely to progress to AIDS can be determined. As the methodology required to facilitate reliable prevalence estimates utilizes relatively easy to obtain information it could be repeated in other urban centres where drug injecting is known to occur.
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PMID:A new method of estimating prevalence of injecting drug use in an urban population: results from a Scottish city. 817 7

A single-page computer spreadsheet can be used to back-calculate the size of the population at risk from the reported number of AIDS cases and HIV seropositivity levels for that population. However, Cohen (1988:35) has cautioned that "this method requires some heroic assumptions, and is, therefore, fraught with difficulty." Slight variations in the definition of AIDS, in the progression rate, and in reported seropositivity rates used as data in the spreadsheet can make enormous differences in the results obtained through back-calculation. Despite the limitations of the method, an estimate of the possible size of the IDU population can be derived from back-calculation, with careful consideration of ethnographic realities taken into account. In San Francisco, the present authors believe that there were approximately 13,000 heterosexual IDUs as of the end of 1989. Further demographic divisions by ethnicity, age, sex, and even neighborhood could be made using the same techniques, if AIDS cases and seropositivity levels could be obtained for each variable. Table II predicts a cumulative 705 AIDS diagnoses among San Francisco heterosexual IDUs by the end of 1993, or nearly six times as many as reported through 1988. This prediction is based on an assumption of 2.5% seroconversion per year (1989-1993) and on modest progression-rate increments of 5%, 5%, 4%, 3%, and 3% in the eleventh through fifteenth years after HIV infection. Thus, it shows the magnitude of the epidemic that San Francisco will shortly face and emphasizes the need to act vigorously to prevent further HIV contagion among IDUs as well as from them to their heterosexual partners (drug using or not).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A spreadsheet for AIDS: estimating heterosexual injection drug user population size from AIDS statistics in San Francisco. 228 68

Prevalence of HIV and HCV was studied among 507 IDUs in Yunnan Province. The results reveal that sharing needles with other IDUs is one of the primary pathways to transmit both HIV and HCV. The rates of HIV and HCV infection in the IDU group is 66.5% and 94.9% respectively, which is significantly higher than those in the non-IDU group. There is a direct correlation between the rates of HIV and HCV antibody positive. 97.5% HCV (+) subjects are also HIV (+); and 57% HIV (+) subjects are HCV (+). It is suggested that all IDUs should be encouraged to stop using drugs to prevent HIV and HCV transmission.
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PMID:[Prevalence of HIV and HCV among injecting drug users (IDUs) in Yunnan, China]. 752 68

The Youth AIDS and Drugs (YAD) Study is a study of young people who inject drugs, and their risk of the transmission of HIV through needle sharing and/or unsafe sex. One hundred and five people, aged less than 21, 75% of whom were current or recent injectors, undertook in-depth interviews which were tape recorded, transcribed and analysed qualitatively. This paper focuses on the ways in which the young people in the group attempted to manage the risk of needle sharing. Needle sharing in the study group was not common behaviour. Almost all injectors employed one of four major Risk Management Strategies some of which included the possibility of sharing unbleached needles with a friend or a lover. These strategies were strongly related to beliefs that such friends and lovers were well enough known by the individual for there to be very little risk. The implications of these findings for health promotion with young people who inject drugs in Perth, a city of low IDU seroprevalence, are outlined.
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PMID:Friends and lovers: needle sharing in young people in Western Australia. 757 9

This study was set up to compare risk behaviours between IDU and no-IDU inmates and among IDUs and to elicit the differences of preventive and risk behaviours according to sex. It was carried out in the Baumettes Prison, France, from November 16 to December 21, 1992; 295 male and 137 female inmates were interviewed using a self-questionnaire checked by the medical staff. Twenty per cent of participants (85/432) declared to be IDU (heroin); half of them reported needle sharing. After adjustment for age and sex, the number of sexual partners during the last year was significantly higher among IDU inmates (more than two partners: 19% vs 9.5%); similarly, sexual intercourse with an IDU during the last five years was reported more frequently by IDUs (47% vs 5%). After adjustment for the number of sexual partners, the proportion of IDUs who declared using always condoms was higher than that of non-IDUs (30.5% vs 13%). IDUs reported a prior HIV testing more often than no-IDUs (93% vs 49%). Multidimensional analysis showed that IDU female inmates reported having been HIV tested (100% vs 88%), had sexual intercourse with an IDU (73.5% vs 25.5%) and practised needle sharing (62% vs 43%) more often than male IDU inmates. This survey shows that, beyond drug taking which is the main risk factor for HIV infection in the carceral population, sexual behaviours could be an additional risk factor among IDU inmates, especially among women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Risk behaviours of inmates in south-eastern France. 763 90

The relatively high numbers of patients with IDU-related HIV in Scotland has resulted in considerable management difficulties not previously experienced by other medical units. Chronic physical ill health in drug users is becoming commoner with the advent of HIV and other centres are now experiencing the type of problems that the Regional Infectious Disease Unit (RIDU) in Edinburgh has faced over the last 10 years. Very little has been published concerning the difficulties of managing patients who use drugs and have a physical illness in medical units in the UK. This paper presents examples of common problems together with the RIDU's experience of management in the hope that it will help others to deliver effective and efficient physical and mental health care to patients with drug problems.
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PMID:Injection drug use-related HIV healthcare--problems and management in Edinburgh. 764 22

In a pilot study, 130 methadone maintained subjects with a six-month history of good treatment performance were assigned randomly, for a one-year study period, to an experimental condition (once per month non-random urine screen, counseling session and doctor visit, two times per month methadone pick up, a quarterly true random urine screen, and participation in a diversion control program), or they were assigned to a control condition of staying under standard conditions for six months and then being transferred to the experimental condition for six months. Three out of four subjects (73%) completed the year in good standing with no differences between control and experimental conditions. Subject satisfaction was such that the Institutional Review Board judged that return to standard conditions would be a hardship. A Study of Medical Maintenance (SMM) continues and extends the pilot study with two protocols: (1) for new subjects and (2) for subjects entered from the pilot study. SMM requires a once per month random urine screen and extends the experimental condition to two years but is otherwise identical to the pilot study; 71 of 107 S's (66%) entered protocol 1 and are in good standing. Pilot subjects (N = 75) are holding their good performance, some for over four years. The reduced levels of services in these studies free up resources which can be applied to entering IDU's into treatment thereby contributing to a slowing of the HIV epidemic.
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PMID:Medical maintenance: an interim report. 773 60

Our primary objective during this pilot work has been to determine if the computerized RAB can be used in place of the paper-and-pencil version with an IDU population. As stated, reliability estimates in the form of correlations of risk scores between the two versions ranged from .82 to .94, and percentages of exact agreement of the scoreable items ranged from 88% to 100%. These correlations indicate that the C-RAB is comparable to the RAB in its psychometric properties. Further, subjects' positive ratings of the computer program and perceptions that it would better protect confidentiality indicate that this population would participate in assessments involving computer interactions. While these self-reports may be biased on clients' desire to be cooperative and the novelty of the assessment approach, the high level of approval ratings suggest that a majority of participants do prefer completing assessments on the computer. Similarly, participants' demonstrated ability to use the computer and their rating of the program as easy to use suggest that the C-RAB has potential to be a reliable and efficient tool in assessing risk behaviors among IDUs enrolled in HIV vaccine trials.
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PMID:Preparations for AIDS vaccine trials. An automated version of the Risk Assessment Battery (RAB): enhancing the assessment of risk behaviors. 786 19


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