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

The HIV and AIDS incidences each year for homosexual men in San Francisco are estimated from data. A computer simulation model for HIV transmission dynamics and progression to AIDS is used to reconstruct the HIV epidemic. Using some a priori parameter estimates, simulations are found that give good fits to the incidence data. In the stimulations the populations is divided into risk groups whose sexual activities are found to be strongly connected. There is saturation in the high-risk group, but changes in sexual behavior are more important in obtaining adequate fits. The simulation modeling yields useful parameter estimates, but the remaining uncertainty in parameter values implies that the simulation forecasts are also uncertain. Changes in HIV incidence lead to changes in AIDS incidence about 6-10 years later. Simulation models with and without zidovudine treatment both fit the incidence data; thus the effects of therapy on AIDS incidence are unclear. The fits of the simulation model are most sensitive to the yearly migration rate, the number of stages in the progression to AIDS, and the average number of new sexual partners per month; thus better estimates of these parameters would be desirable.
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PMID:A simulation model of AIDS in San Francisco: II. Simulations, therapy, and sensitivity analysis. 180 3

Compartmental models of infectious diseases readily represent known biological and epidemiological processes, are easily understood in flow-chart form by administrators, are simple to adjust to new information, and lend themselves to routine statistical analysis such as parameter estimation and model fitting. Technical results are immediately interpretable in epidemiological and public health terms. Deterministic models are easily stochasticized where this is important for practical purposes. With HIV/AIDS, serial data on both HIV prevalence and AIDS morbidity have been available from San Francisco. Assuming the distribution of the incubation period to be biologically stable, statistical analysis is quite feasible in other regions, even those with no reliable HIV data. Transmission rates must be estimated locally. It is also often possible to estimate the effective size of a population subgroup at risk, from population data on AIDS morbidity only. Computer simulation provides estimates of the evolving pattern of both HIV prevalence and AIDS morbidity. Some public health questions can be answered only by appropriately formulated stochastic models.
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PMID:The use of operational modeling of HIV/AIDS in a systems approach to public health decision making. 180 26

The Department of Pediatrics of the San Juan City Hospital participated in a collaborative clinical trial, placebo controlled, designed by NICHD with the purpose of determining if the use of gamma immunoglobulin is effective in preventing serious infections in symptomatic children infected with HIV. Of the 372 children randomized, 33 were from San Juan City Hospital. Of the 16 children on placebo, 9 (56%) developed 23 episodes of serious infections and 4 of 15 children on IVIG developed 5 episodes. A total of 24 hospitalizations occurred in the placebo group and six in the IVIG group. The mortality in our center was 12% (4/31). No adverse reactions were registered from the infusions in our center. Intravenous gamma immunoglobulin demonstrated to be effective in preventing bacterial infections and decreasing the number of hospitalizations in a subgroup of children infected with HIV.
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PMID:[Experience with the use of immune intravenous immunoglobulin in symptomatic children with human immunodeficiency virus infection]. 181 6

We examined the psychological impact of HIV antibody testing in 107 homosexual men in San Francisco. Seventy-eight percent of the seropositives but only 43% of the seronegatives correctly anticipated their results. Twelve months after notification (but not earlier), notified seropositives reported significantly greater increases in total distress than nonnotified controls. However, notified seronegatives demonstrated significantly lower levels of hopelessness than nonnotified controls at every follow-up assessment. Thus, knowledge of HIV antibody status appears to dispel a sense of gloom in persons who incorrectly believe themselves to be infected with HIV, but does not appear to induce significant distress in those whose expectation of a positive result is confirmed. Both groups reported lower distress than men with ARC or AIDS, suggesting that distress was related more to symptomatology than knowing antibody status. These results suggest the benefits of HIV testing for the considerable proportion of seronegative subjects believing themselves to be seropositive and should be weighted against the more limited induction of distress in seropositives who receive confirmation of their test result expectation. The benefits of testing are also supported by increasing knowledge of the usefulness of early intervention in HIV disease.
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PMID:Results of a one year longitudinal study of HIV antibody test notification from the San Francisco General Hospital cohort. 185 91

To evaluate whether host genotype influences disease progression among persons infected with human immunodeficiency virus type 1 (HIV-1), molecular techniques were used to determine genotypes at immune response loci for 114 HIV-1-infected homosexual/bisexual white men in the San Francisco Men's Health Study. Candidate genes evaluated were HLA-DQA1 and -DRB1, complement C4A and C4B, alpha- and beta-interferons, and the heavy chain of immunoglobulin gamma 1. Of the 114 men, 29 were asymptomatic, 21 were symptomatic men and AIDS patients (p = 0.02). Specifically, the HLA haplotype DRB1*0702-DQA1*0201 was associated with absence of symptoms (p = 0.003). Conversely, the frequency of the complement C4B-L allele was higher among patients with symptoms or with AIDS than among asymptomatic subjects (p = 0.02). These results suggest that genes in or near the major histocompatibility complex may influence the rate of disease progression among HIV-1-infected men.
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PMID:Influence of host genotype on progression to AIDS among HIV-infected men. 185 93

The apparent detection of human immunodeficiency virus (HIV-1) DNA by the polymerase chain reaction (PCR) in seronegative individuals has been the subject of great concern. In this study, 324 seronegative participants in the San Francisco Men's Health Study were evaluated for evidence of infection using a PCR testing algorithm with multiple amplifications targeting different regions of the HIV-1 genome. While most PCR reactions were negative, 8.6% of the specimens showed weak reactivity with one or more primer sets. However, all were negative with at least one primer set and no definitively positive specimens were identified. This study addressed the possibility that some of these PCR reactions might represent latent infection or abortive exposure, leaving residual integrated DNA, rather than false-positive reactions. The frequency of such reactions was determined in homosexual men who have been at risk for HIV-1 infection and in exclusively heterosexual men who have little or no past exposure. The results demonstrate an identical frequency and distribution of equivocal PCR reactions in both populations. Assuming that there is minimal HIV-1 infection among seronegative heterosexual men in San Francisco, we conclude that PCR testing does not provide evidence for a reservoir of occult HIV-1 infection in seronegative homosexual men.
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PMID:An evaluation of the polymerase chain reaction in HIV-1 seronegative men. 185 94

In June 1988, researchers analyzed data from 1235-1882 questionnaires concerning AIDS knowledge, attitudes, and behavior among inner city, junior high school students [90% ethnic minorities, especially Blacks (61%)] in San Francisco, California to get baseline data so educators could design relevant AIDS prevention programs geared toward minorities. Asians knew less about AIDS than Blacks (p.001), Latinos (p.001), and Whites (p.001). Most students knew what activities were high risk for acquiring HIV, but up to 50% often thought HIV could also be transmitted via casual contact. The students who had such beliefs were more likely to believe that students with AIDS should not be allowed to come to school (p.001-.05). Boys (42%) were more likely to have had sexual intercourse than girls (18%; p.001). Further they tended to use street drugs more (11% vs. 5%; p.001). More Blacks claimed to have sexual intercourse than Latinos (p.001), Asians (p.001), or Whites (p.01). On the other hand, whites reported significantly higher drug use than Blacks (p.001), Asians (p.001), and Latinos (p.01). More boys believed condoms hindered pleasure than girls regardless of level of sexual activity. 25% of the boys found it difficult to find places that sells condoms compared to 18% of girls (p.01). 59% of all students, especially girls (p.001), said that their often was disagreement about using condoms or not with their sex partners. Sexually active students who believed condoms prevent transition of HIV (80%) used them more often than those who believed they work a little (47%; p.01). 89% wanted AIDS education in school, especially those who believed it unlikely or not possible to contract AIDS from casual contact (p.001). In conclusion, AIDS education course designers should consider anxiety about peer pressure and sexual matters since anxiety could hinder acquiring and retaining information about AIDS prevention thereby preventing adolescents from planning for the consequences of sexual contact and drug use.
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PMID:AIDS knowledge, attitudes, and behavior among inner city, junior high school students. 185 6

To establish the prevalence of HIV-related oral lesions, we performed oral examinations of members of three San Francisco epidemiological cohorts of homosexual and bisexual men over a 3-year period. Hairy leukoplakia, pseudomembranous and erythematous candidiasis, angular cheilitis, Kaposi's sarcoma, and oral ulcers were more common in HIV-infected subjects than in HIV-negative subjects. Among HIV-infected individuals, hairy leukoplakia was the most common lesion [20.4%, 95% confidence interval (CI) 17.5-23.3%] and pseudomembranous candidiasis was the next most common (5.8%, 95% CI 4.1-7.5%). Hairy leukoplakia, pseudomembranous candidiasis, angular cheilitis and Kaposi's sarcoma were significantly more common in patients with lower CD4 lymphocyte counts (P less than 0.05). The prevalence of erythematous candidiasis and Kaposi's sarcoma increased during the 3-year period. Careful oral examinations may identify infected patients and provide suggestive information concerning their immune status.
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PMID:The prevalence of oral lesions in HIV-infected homosexual and bisexual men: three San Francisco epidemiological cohorts. 186 3

2 research studies of changes in condom use among homosexual males in San Francisco for the period 1984-88 are discussed. The 1st study examined attrition and cohort bias effects on self-reported condom use in a longitudinal cohort and multiple sample investigation. An initial baseline sample of 500 self-identified gay men was sampled and interviewed by telephone as the longitudinal cohort, with 3 cross-sectional samples later surveyed for comparison. The frequency of receptive or insertive anal intercourse with and without condoms with primary and secondary sex partners was queried for the 30-day period prior to the survey in both studies. This 1st study found a 4-fold increase in condom use over the period 1984-87 to be neither effected by repeated assessments of the longitudinal cohort, nor respondent attrition. As determinants of condom use in this population for the period 1984-88, the 2nd study examined the influence of formal and informal social support for sex behavior change, being in a mutually monogamous sexual relationships, knowing the primary partner's HIV-antibody status, knowing one's antibody status, and the expected consequences of condom use on one's self-worth, sexual pleasure, health, and perceptions of one's sex partner. Research was based on AIDS Behavioral Research Project data obtained through recruitment in bathhouses and gay bars. 529 predominantly white, while collar, college-educated men of mean age 39 years remained in the study through 1988. While condom use increased by almost 4-fold, these men have been slower to change condom use behavior than respondents in the 1st study. Informal support and knowing one's HIV status are strong predictors of condom use 1 year later. Men always using condoms were found to have more social support from informal sources, more positive expectations of condoms, positive interpersonal and personal consequences, and were more likely to be HIV-positive than occasional or non-users. Programs best suited to effect condom use changes will focus on social support, sexual pleasure, self-worth, and relationship issues. Attention should also be placed upon the erotic/pleasure dimension of using condoms, changing community norms, and factors influencing HIV-negative people to take precautions against HIV infection. Methodological limitations are discussed regarding result reliability and validity, with further research encouraged.
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PMID:Changes in condom use among homosexual men in San Francisco. 187 91

From December 19, 1990, through April 4, 1991, 12 cases of clinically active pulmonary tuberculosis (TB) were diagnosed at a residential facility for HIV-infected persons in San Francisco. This report summarizes results of the outbreak investigation.
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PMID:Tuberculosis outbreak among persons in a residential facility for HIV-infected persons--San Francisco. 189 Sep 84


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