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

One-hundred-and-fifty injecting drug users were interviewed about their sexual behaviour, and types of sexual relationships and partners in the past year. The aims of the study were to assess the extent of changes in sexual HIV-risk behaviour patterns and to understand aspects of respondents' sexual relationships, as well as HIV/AIDS knowledge. We found few changes in sexual behaviour. The ability to assess personal HIV-risk varied widely across the sample and intoxication during sexual activity was widely reported. Whilst the use of condoms was infrequent, young respondents were more likely to use condoms, but have more sexual partners, hence a likely erosion of any net gain may have occurred. Over half of the respondents were in sexually monogamous relationships and there were no significant gender-related differences in respect of regular partners' IDU-status. Estimated rates of seroprevalence in Perth are low and with the effectiveness of deterrence dependent on visible negative outcomes, it may be difficult to ensure safer-sex messages are heeded. These concerns are raised and facilitation of safer-sex among IDUs are discussed. Further areas of research are recommended.
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PMID:A bridge too near? Injecting drug users' sexual behaviour. 794 87

A prospective STD surveillance system was developed in Italy in 1990. Newly diagnosed cases of sexually transmitted disease (STD) are reported by a network of 45 sentinel STD clinics throughout the country. A total of 10,253 patients were reported between September 1990 and December 1991. The most frequent diagnoses were genital warts (30.8%), non-specific genital infection (male) (12.8%), and non-specific genital infection (female) (11.5%). All patients were asked to undergo an HIV test; 68.4% accepted, of whom 9.3% were seropositive. During the 16-month study period HIV prevalence decreased among IDUs and homo-bisexuals, but increased among non-IDU heterosexuals. These data suggest that STD patients may represent a useful early warning system to detect changes in the epidemic and in the spread of the virus among low-risk heterosexuals. A better counselling programme is needed to improve the acceptance rate of HIV testing among STD patients, and to draw more attention to at-risk sexual behaviours.
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PMID:The national STD surveillance system in Italy: results of the first year of activity. STD Surveillance Working Group. 803 25

This report describes experiments assessing the effectiveness against HIV of potential disinfecting agents that are commonly available to IDU when they are sharing syringes. We exposed cell-free HIV, HIV-infected cells, and HIV-infected blood containing known quantities of HIV to household cleaning agents, alcohols, peroxide, and highly acidic materials for 1 min, in order to examine the effects of these materials on the infectivity of the HIV. Undiluted liquid laundry bleach and dilute liquid dish detergent reduced the number of culturable HIV to an undetectable level under the experimental conditions used. Diluted bleach was not completely effective. Other potential disinfecting agents, including ethanol, isopropyl alcohol, and hydrogen peroxide, were unable to disinfect high numbers of HIV-infected cells or infected blood. Liquid dish detergent warrants further study as a possible acceptable alternative to bleach. Our data provide support for recommendations to IDU that they disinfect shared syringes every time between users with full-strength liquid laundry bleach to reduce their risk of acquiring or transmitting HIV. When bleach is not available, liquid dish detergent or other available disinfecting agents such as rubbing alcohol, hydrogen peroxide, or high alcohol content beverages are more effective than water at disinfecting HIV, recognizing that these materials are less effective than bleach. Although these materials are effective, they should not be viewed as a substitute for decreased sharing of injection equipment by IDU, or increased availability of sterile needles and syringes.
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PMID:In vitro activity of readily available household materials against HIV-1: is bleach enough? 820 58

Drug use will soon become the major risk for transmission of HIV infection in the United States, which will result in near equal incidence of the disease in men and women and more affected children. This has serious implications for the health care community and for the community at large. Thus, it is necessary to pursue aggressively risk reduction strategies targeted for difficult-to-reach populations such as illicit drug users and commercial sex workers. This will involve a vigorous public health campaign to bring education messages about safer sex practices, safer injection techniques, and enhanced drug treatment services to these groups. Prevention strategies include consideration of needle exchange as a public policy for IDUs. There are appropriate concerns in the larger community that needle exchange might send a mixed message or promote drug use, but there is no scientific evidence to support this view. To the contrary, there is a growing body of evidence that suggests drug users change behavior in response to education messages and that clean needles may reduce disease risk. Currently, stable seroprevalence rates in some IDU populations suggest that education messages about injection practices are heeded. Unfortunately, sexual practices have not shown similar changes. Most, if not all, HIV-infected persons will experience neurologic complications during their illness, especially as improved medical therapy ameliorates systemic complications. The approach to diagnosis and management requires a thorough understanding of the diverse clinical syndromes that may occur and a systematized approach to investigation of the cause.
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PMID:HIV infection. 837 46

Survival from the time of AIDS diagnosis to death was determined retrospectively among Thai patients (> or = 13 years old) who attended a public tertiary care infectious disease hospital in a suburb of Bangkok, Thailand, from February 1987 through February 1993. An AIDS diagnosis was based on the 1987 Centers for Disease Control (CDC) definition, except Penicillium marneffei infection was included as an AIDS-defining condition. Of 329 AIDS patients, 152 (46.2%) had died. The median age at diagnosis was 31.5 years (range, 18-74) 306 patients (93.0%) were males. Reported risk categories were heterosexual contact (55.2%), injecting drug use (IDU, 22.6%), male homosexual or bisexual contact (9.5%), and unidentified risk or other (12.7%). Median survival time (Kaplan-Meier) for all patients was 7.0 months; 1-year survival probability was 39.2% (95% confidence interval [CI] = 31.5-46.9%). Cox's proportional hazards model showed three factors associated with survival: age, reported risk category, and presenting diagnosis. Patients aged 26 to 35 years survived longer (median survival time, 10.6 months; relative hazard [RH] = 0.61, 95% CI = 0.44-0.85, referent: others), as did patients in sexual risk categories (median survival time, 7.3 months; RH = 0.59, 95% CI = 0.40-0.78, referent: IDU and other categories). A single presenting diagnosis of extrapulmonary tuberculosis was also associated with longer survival (median survival time, 19.9 months, RH = 0.55, 95% CI = 0.35-0.86, referent: other diagnoses). AIDS patients in the early phase of the epidemic in Bangkok have much shorter survival times than patients in developed countries, in part perhaps because they are often diagnosed late in the course of HIV infection. Increased attention should be given to the early diagnosis and treatment of these patients.
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PMID:Survival of AIDS patients in the emerging epidemic in Bangkok, Thailand. 852 36

Since 1984/1985 a cohort of homosexual men (HM; n = 770 initially HIV-seronegative) and one of injecting drug abusers (IDU; n = 675 initially seronegative) are being followed in Amsterdam, in order to assess the HIV epidemic in these high-risk groups. The HIV incidence in HM fell from 7.2/100 person years in 1985 to 1.0 in 1989, due to safer sexual behaviour. In 1990 there was a temporary rise in HIV incidence coinciding with an increase in gonorrhoea and syphilis in homosexual/bisexual men (not in the cohorts) attending a sexually transmitted diseases outpatient clinic. The rise was due to a relapse in unsafe sexual behaviour. After 1990 the HIV incidence dropped again and it remained at 1/100 person years in 1995. In IDU, in whom a reduction was found in both injecting and sexual risk behaviour, the incidence fell from 8.9 in 1986 to 2.0-3.6/100 person years in 1991-1995. In order to follow the future course of the HIV epidemic, it is argued to open the cohorts particularly for young HM and IDU.
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PMID:[HIV incidence in a cohort of homosexual men and a cohort of injecting drug users in Amsterdam, 1985-1995]. 883 Feb 94

Reports on autopsies of 279 persons infected with human immunodeficiency virus (HIV) were reviewed retrospectively to determine changes in survival rates and infections and to identify differences between prison inmates and nonincarcerated patients. The 78 cases from 1984 through 1988 were compared with 201 from 1989 through 1993, on the basis of use of antiretroviral therapy and (after 1988) prophylaxis against Pneumocystis carinii pneumonia (PCP). Risk factors for HIV infection were homosexuality/bisexuality (30%), injection drug use (IDU; 22%), transfusion (5%), heterosexual contact (4%), and combinations of the above or unknown factors (38%); 95% of patients were males and 41% were state prison inmates in Texas. IDU was more common and homosexuality/ bisexuality was less common among inmates than among nonincarcerated patients. Mean survival time was 12 months in the first period studied and 23 months in the later period (P < .05). Cytomegalovirus infection was the most common type in both periods. The number of cases of PCP declined and the number of cases of bacterial infections increased significantly in the later period. Tuberculosis was significantly more common in inmates than in nonincarcerated patients. Tuberculosis and disseminated histoplasmosis (noted at autopsy) and deaths due to disseminated Mycobacterium avium complex and histoplasmosis were significantly more common among injection drug users than among homosexuals/bisexuals. Invasive candidiasis was more common in homosexuals/ bisexuals and in those who survived > 3 years. Antiretroviral therapy, prophylaxis for PCP, and risk factors for HIV infection appear to influence the mortality rate and prevalence of certain infections found at autopsy.
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PMID:Changing patterns of infections in patients with AIDS: a study of 279 autopsies of prison inmates and nonincarcerated patients at a university hospital in eastern Texas, 1984-1993. 884 58

To evaluate the success of the Ryan White CARE Act in meeting HIV-related service needs, we surveyed HIV-infected clients (n = 1,056) at San Francisco CARE-funded agencies. Most CARE clients were male (85.1%), 51.7% were nonwhite, 84.9% were uninsured or underinsured, and 43.9% had a most recent CD4+ count < 200 cells. The most common HIV risk groups were gay/ bisexual male noninjection drug user (IDU) (53.3%) and gay/bisexual male IDU (22.1%). Health care needs were high for medical (85.5%), dental (70.2%), and mental health care (69.7%); need for basic necessities was great for food (57.2%) and living expenses (55.5%). Unmet health care needs were common for dental care (41.0%), home health care (39.9%), and alternative therapies (38.6%); unmet needs for basic necessities were frequent for childcare (59.5%), household help (52.3%), and transportation (47.9%). Unmet needs for medical care (5.8%) and food (14.7%) were low. Poor persons, those with dependents, and gay/bisexual male IDUs had greater unmet needs. Women and racial/ethnic minorities did not consistently have greater unmet needs. The CARE Act is serving those it intended to reach, is successfully meeting two important service needs, and has equalized access to services for women and racial/ethnic minorities. Remaining unmet needs require continued funding and strategies to increase access to care.
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PMID:Meeting the service needs of HIV-infected persons: is the Ryan White CARE Act succeeding? 898 10

The aim of the study was to measure HIV prevalence and risk behaviour in 185 Irish Intravenous Drug Misusers. Information was obtained by application of a standardised WHO questionnaire covering HIV risk behaviour in the preceding 6 months. HIV serostatus was obtained by saliva/blood sample testing. One hundred and 3 (55.7 per cent) shared and 114 (61.6 per cent) lent used injecting equipment in the previous 6 months. 97 (94.2 per cent) of those who shared always cleaned the needles before use but only 48 (49.5 per cent) of these always cleaned in an efficient manner. One hundred and 14 (79.2 per cent) males and 28 (68.3 per cent) females reported heterosexual activity in the preceding 6 months. On examination sexual risk behaviour was found to be high. 50.5 per cent of males and 63 per cent of females never used condoms with regular partners. 32.6 per cent of males never used condoms with casual partners. The large majority of partners of male I.D.U'.s (both regular and casual) were non injectors. Therefore there is potential for sexual spread of HIV into the non-injecting heterosexual population. Conversely the vast majority of partners of female IDU's were injectors. This suggests that female IDU's are at higher risk of HIV infection than their male counterparts. HIV prevalence in the study group was 8.4 per cent. Implications of results for future intervention are discussed.
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PMID:HIV risk behaviour in Irish intravenous drug users. 939 73

We prospectively collected data on deaths in the Edinburgh City Hospital HIV cohort of patients (60-70% acquired via injection drug use) from October 1986 to September 1994. Sixty-four patients (25% of all HIV deaths or 2.5/100 person-years) had died without an AIDS diagnosis, and 42 (66%) of these had autopsy data available. Some pre-AIDS deaths (20% or 0.5/100 person-years) were the expected consequence of underlying medical conditions diagnosed during life: the remainder (80% or 1.98/100 person-years) were sudden or unexpected. Examining the underlying conditions, drug overdoses accounted for 45% or 1.1/100 person-years; bacterial sepsis, 25% or 0.6/100 person-years; liver disease, 26% or 0.6/100 person-years; and an undiagnosed AIDS condition, 9% or 0.2/100 person-years. Drug overdoses were the commonest cause of pre-AIDS death in this cohort of patients predominantly infected via IDU, but many of the sudden deaths had significant underlying pathology, which may have increased their susceptibility to an overdose of drugs. In future, death before an AIDS diagnosis should be classified into Medical or Expected Non-AIDS (MNA or ENA) and Sudden Non-AIDS (SNA).
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PMID:Pre-AIDS deaths in HIV infection related to intravenous drug use. 941 43


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