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

In order to plan education programmes against sexually transmitted diseases (STDs) and HIV infection, a population-based survey on partner relations was conducted on 2,115 Singaporean men and women aged between 15 and 49 years. Of the 605 (60.1%) sexually experienced men and 647 (58.3%) sexually experienced women, 510 (84.3%) men and 644 (99.5%) women were married. Of the marrieds, 465 (76.9%) men and 638 (98.6%) women had their first sexual encounter with the person who was or later became their spouse. Of the sexually experienced men, 97 (16%) engaged in casual sex in the previous year, of which 76 (78.4%) were encounters with commercial sex workers. Of these encounters 55 (72.4%) were unprotected or partially protected by condoms. A history of casual sex in the previous four weeks was given by 18 men, of whom 14 (77.8%) were married. Nine (64.3%) of these married men had sex concurrently with both their wives and commercial workers. Persons at high risk were those who started sexual activity early, unmarried, sexually active men with no or low education, and persons who travelled. Of the sexually experienced respondents, 1,242 (99.2%) had heard about condoms, and 431 (34.4%) were currently using them as contraceptive devices. Attitudes towards condoms and willingness to use them to prevent STDs and HIV infection were favourable. Men were more permissive in their attitudes towards sex. The level of permissiveness in men and women was not corroborated by their reported behaviour, an indication of either under-reporting and/or a disparity between attitude and practice.
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PMID:A survey of sexual behaviour of Singaporeans. 129 9

This study sought to investigate the patterns of sexual behavior in men and women with genital ulcer disease (GUD) and their relevance to HIV-1 transmission. Participants were 100 Zulu men and 100 Zulu women at the City Health Sexually Transmitted Disease Clinic. King Edward VIII Hospital, in Durban, South Africa; a sexual behavior questionnaire was administered by the same interviewer to all of the above participants who were also included in a study of the microbial etiology of GUD. 36% of the men and 36% of the women continued with sexual intercourse despite GUD. Patients with donovanosis and secondary syphilis were more likely than those with other causes for their GUD to have intercourse despite ulcers. During swab collection, bleeding was observed from ulcers in 59 women and 26 men. Prostitutes were not identified and were rarely named as source contacts. Men had more sexual partner (190) than women (122) during the previous 3 months. Condom use was minimal. Men who migrated between urban and rural areas appeared to have the most sexual partners. Urban women had more partners than women from rural areas. The authors concluded that men and women with GUD are practicing risky sexual behavior and could benefit from behavior modification programs. In this community, men who travel between rural and urban areas and who present late with GUD that bleeds easily are probably the most important high-frequency HIV transmitter core group. A significant potential risk of blood-to-blood contact during sexual intercourse exists in patients with GUD.
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PMID:Sexual behaviour in Zulu men and women with genital ulcer disease. 139 60

Public health researchers followed a cohort of 322 homosexually active male clients enrolled at a community health center in Boston, Massachusetts between January 1985-April 1987 at 6-month intervals to examine cross-sectional and longitudinal data on perceptions of sexual behavior change among initially asymptomatic and homosexually active men. Only 262 completed the questionnaire addressing perceptions of behavior change. 40% of the 60 students who did not complete the questionnaire tested positive for HIV compared with 22% of those who did complete the questionnaire (p.01). High risk included unprotected anogenital contact with multiple partners. HIV status was not associated with behavior change. Behavior change was associated with alcohol or drug use during sex for men of low or modified high risk at baseline (p=.01). 96% of 262 men achieved sexual behavior change after learning about AIDS. 58% hoped to make additional changes. 47% thought that they could always sustain the changes. Men who were not consistent in practicing behavioral changes were more likely to want to make more changes (p.001). Men who perceived themselves to practice inconsistent behavior did indeed practice high risk behavior (p=.005). Those who perceived themselves to consistently practice lower risk behavior at follow up were 2.07 times more likely to practice safer behavior than those who did not see themselves as practicing consistent behavior. Follow up data showed that men were somewhat more likely to return to risky behavior than change to safe behavior (p=.07). In fact, men who at baseline participated in high risk behavior were 1.57 times likely to continue the high risk behavior. For men who at baseline participated in low risk behavior tended to continue that behavior (odds ratio=8.88). The researchers concluded that perceived maintenance of behavior change could help health professionals determine which people are at a risk of reverting to risky sex behavior.
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PMID:Maintenance of behavioral change in a cohort of homosexually active men. 141 85

In the US. condoms for males are made of either lamb cecum or latex. Lamb cecum condoms are less elastic than latex condoms. Thus, they can come off the penis making them less effective form of protection from sexually transmitted diseases (STDs). They are also more expensive. Condoms come in several varieties (reservoir end and lubricated with a spermicide, nonoxynol 9) and in several sizes (standard and large). Their contraceptive effectiveness ranges from 64% to 97%. Study design, patient characteristics, and socioeconomic status may explain this broad range. Breaking, improper use, and inconsistent use account for contraceptive failures. Use with vaginal foam reduces the failure rate to 1 to 3%. Some advantages identified by consumers and health workers were peace of mind, ease of use, convenience, preventing, STDs, arousing to put on, easily obtained, safe and effective, no side effects or toxicity, inexpensive, medical supervision not required, and can be used as a backup contraceptive. Some disadvantages include reduced sensation, breakage or slippage and improper use. Men and women sometimes suffer allergic reactions from the lubricants, spermicides, or chemicals used in manufacturing. Pharmacists could advise consumers to switch to another condom brand. If this does not stop the irritation, the consumer should see a physician because an STD may be causing the irritation. In vitro studies indicate that nonoxynol 9 kills or inactivates many STD pathogens including herpes simplex virus and HIV. A female condom should be available by the end of 1992. Trials show it to protect effectively against pregnancy and STDs. Even though neither the female condom nor diaphragm cause vaginal trauma, the condom does not change the vaginal flora significantly. Pharmacists should familiarize themselves with the different types of male and female condoms and be able to adequately counsel customers about their correct use and safe sex practices.
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PMID:Choosing condoms. 144 56

Less is known about the effects of primary relationships on psychological health for homosexual men and women than for heterosexual men and women. Given the HIV/AIDS epidemic, the primary relationships of homosexual men are especially important to examine at the present time. Using questionnaire data collected from 259 homosexual men, this study examined the effects of status and quality of relationship on psychological health. Analysis indicated that homosexual men who are in primary relationships experience fewer depressive symptoms and greater well-being than other homosexual men but that being in a relationship does not predict changes in these outcomes over time. Men who report high quality of relationship show improvements over time in psychological health. These findings are discussed in light of the HIV/AIDS epidemic.
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PMID:Primary relationships affect the psychological health of homosexual men at risk for AIDS. 152 44

Baseline data on a cohort of 612 homosexual and bisexual men were analyzed in order to examine the interrelationships between sociodemographic, knowledge, and attitude factors and sex behavior. Men were recruited for a randomized control study of small group AIDS risk reduction education in Toronto, Canada: The Talking Sex Project. Questionnaire validity and reliability checks were conducted. The development of knowledge and attitude scores is provided and includes reliability checks. Chi square and analysis of variance (ANOVA), Turkey's Studentized range Test, Pearson product moment correlations, and stepwise logistic regression analyses were performed. Population characteristics included a mean age of 32 years; 1.8% were teenagers, 2.8 had AIDS, and 6.2% had HIV-related diseases. Sociodemographic, health and life style, and sexual behavior characteristics were also reported. The univariate description of scaled knowledge and attitude variables is given. Knowledge is fairly high including knowledge or risk. Both scales had skewing toward the higher ends of the scale. 16.3% reported no sexual activity, but 52.6% reported 1 or more sexual activities in the last 3 months, excluding kissing or masturbation, which was the most common activity. 88.4% reported insertive oral-genital intercourse. 61.5% reported receptive of insertive anal sex. 42.2% had oral-anal sex. 4.1% participated in hand-anal sexual practices. Those with high school or less education had significantly lower scores on knowledge. Higher scores on knowledge of risk were found among men who had safer or protected sex than those who had unprotected anal intercourse. The relationship of background variables to sexual behavior showed that bisexuality was found to be associated with men under 24 years of age. 50% of bisexual men under 24 years reported unprotected anal intercourse vs. 24.4% of homosexual men. Alcohol or drug use was associated with sexual behavior, and men with reported safer sex consumed slightly less. Men practicing safer sex were more likely to report impulse control difficulties, had a stronger belief in the efficacy of condoms, and rated sexual practices safer. The logistic model correctly classified 94.5% of safer sex cases and 54.9% of unprotected sex. Efficacy of condoms was the best predictor of safer sex, as well as lower drug use, not being in a relationship, greater enjoyment of safer sex, being older, having fewer sexual partners, and lower, more cautious self-rating of knowledge of risk. Bisexuality needs further exploration.
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PMID:The Talking Sex Project: descriptions of the study population and correlates of sexual practices at baseline. 157 82

This study examined the impact of social support and HIV-related conditions on depression among 508 gay men participating in the San Francisco Men's Health Study, a population-based prospective study of single men aged 25-54 years. The number of HIV-related symptoms experienced significantly predicted depression cross-sectionally and 1 year later. Satisfaction with each of three types of social support (emotional, practical, informational) was inversely correlated with depression. Men who were more satisfied with the social support they received were less likely to show increased depression 1 year later. Degree of satisfaction with informational support appeared especially critical in buffering the stress associated with experiencing HIV symptoms. These findings offer valuable insight in understanding the psychological needs of gay men confronting the AIDS crisis and have important practical implications for designing mental health services to meet those needs.
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PMID:Social support, AIDS-related symptoms, and depression among gay men. 161

From the San Francisco Men's Health Study (SFMHS) and the San Francisco General Hospital Cohort we derived partially population-based estimates of zidovudine (ZDV) use in San Francisco from 1987 to 1989. Data from the SFMHS alone were used to make estimates of aerosol pentamidine (AP) use in 1989. From 1987 to 1989, zidovudine use increased from 36 to 68% in participants with AIDS. In participants with symptomatic HIV infection without AIDS and in those with less than 200 CD4 cells, ZDV use increased initially but then leveled off (from 6 to 25% and 24 to 55%, respectively). Zidovudine use with more than 500 CD4 cells increased from 0.5 to 4%. In 1989 AP use with less than 200 CD4 cells was 42% and with AIDS was 44%. Whereas 50% of participants with AIDS and less than 200 CD4 were using both ZDV and AP, only 14% of those without AIDS but with less than 200 CD4 cells were using both. Surprisingly few members of these cohorts are using therapies proven effective in reducing the morbidity and mortality of HIV infection.
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PMID:Population-based estimates of zidovudine and aerosol pentamidine use in San Francisco: 1987-1989. 167 79

We evaluated and compared four staging classification systems for HIV infection in a population-based cohort: (1) a staging based on prodromal clinical criteria; (2) the Walter Reed Staging Classification (WRSC); (3) the immunologic staging system (ISS), and (4) a simple staging based on oral disease and CD4+ T-cell depletion. The staging systems were applied to 386 HIV-infected men in the San Francisco Men's Health Study cohort who did not have AIDS at the baseline examination. After 48-56 months of follow-up the cumulative incidence of AIDS and the cumulative mortality by stage was determined for each staging. Unlike the other systems, the WRSC could not classify a substantial proportion of HIV-infected men (51.9%). The WRSC and ISS include one or more stages which did not appear to be associated with a prognosis substantially different from that of adjacent stages. The simplified staging system based on CD4+ T-cell depletion and oral disease may be the most effective of the systems studied. A more complete understanding of the pathophysiology during the evolution of HIV infection will be required to define a more detailed staging of this disease.
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PMID:The natural history of HIV-1 infection: staging classifications of disease. 167 78

As of January 1990, 933 persons with human immunodeficiency virus type 1 (HIV-1) infection were clinically evaluated at Wilford Hall US Air Force (USAF) Medical Center. The Walter Reed HIV staging system was used in these evaluations to describe disease status and progression. Most persons were diagnosed through mandatory HIV testing in the USAF and were asymptomatic at the time of diagnosis. As of May 1990, 161 HIV-positive seroconverters (estimated overall seroconversion rate of 0.156/1000 person-years between 30 June 1988 and 1 July 1990) had been identified among active-duty USAF personnel, as they had previously tested negative for antibody to HIV. Men constitute 95% of the USAF HIV-positive population. An in vitro T helper cell functional assay was assessed to predict rate of CD4+ T cell decline over the subsequent year (mean, 15 months) in patients with greater than 200 CD4+ T cells/mm3. This assay may prove useful for prognostication and comparisons of patients in clinical trials of anti-HIV interventions.
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PMID:Human immunodeficiency virus infection in the US Air Force: seroconversions, clinical staging, and assessment of a T helper cell functional assay to predict change in CD4+ T cell counts. 168 Jan 34


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