Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The impact of heterosexual transmission of the human immunodeficiency virus (HIV) on the United States blood supply was assessed, and deferral criteria that may exclude potential donors who are at high risk for heterosexually acquired HIV infection were evaluated. Interviews were conducted with 508 HIV-seropositive blood donors from May 1, 1988, to August 31, 1989 (Phase 1), and with 472 donors from January 1, 1990, to May 31, 1991 (Phase 2), at 20 blood centers. From Phase 1 to Phase 2, the overall HIV prevalence decreased from 0.021 to 0.018 percent (p < 0.001). HIV risk factors among HIV-1-seropositive donors were similar during both study phases. Eleven percent of the men and 56 percent of the women reported as their only risk that they had a heterosexual partner who was at increased risk for HIV or was known to have HIV. These percentages were similar during both study periods. During Phase 2, 13 percent of the men and 17 percent of the women with heterosexual transmission risk had a positive serologic test for syphilis, hepatitis B core antibody, or hepatitis C antibody. Among HIV-1-seropositive donors reporting heterosexual risk, the median numbers of previous-year and lifetime sex partners for men were 2 and 30, respectively; for women, those numbers were 1 and 7, respectively. Thirty-one percent of the men and 6 percent of the women reporting heterosexual transmission risk also reported having had syphilis or gonorrhea within 3 years of donation. It is concluded that the impact of heterosexual transmission of HIV infection on transfusion safety is not worsening at this time.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heterosexually acquired human immunodeficiency virus infection and the United States blood supply: considerations for screening of potential blood donors. HIV Blood Donor Study Group. 768 91

Gonorrhea and other infectious diseases were introduced to Ghana prior to the colonial period by European settlers. By the 1920s, both gonorrhea and syphilis were widespread in southern Ghana (3760 and 1503 cases, respectively, in 1925-26) and soon disseminated throughout the country. By 1946, there were 82,430 cases of gonorrhea and 9340 cases of syphilis--an increase exacerbated by the influx of laborers and troops during World War II. Although there was no government department responsible for the control of sexually transmitted diseases (STDs), sulpha drugs were widely utilized and distributed through the black market. It was not until 1986, when the first case of acquired immunodeficiency syndrome (AIDS) was diagnosed in Ghana, that government health officials gave serious attention to STDs. At that time, the most prevalent STDs were gonorrhea, chlamydia, and trichomonas. By 1992, 10,285 AIDS cases had been reported to the National AIDS Control Program and high rates of human immunodeficiency virus (HIV) infection existed in prostitutes and blood donors. Awareness of the role that STDs play as co-factors in HIV acquisition prompted in 1993 the decision to integrate AIDS and STD control programs. Campaigns to train health workers in AIDS/STD detection, treatment, and prevention were initiated. Women's subordinate socioeconomic status, which renders them unable to insist on condom use and denies them access to STD treatment, remains a major obstacle.
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PMID:STDs and AIDS in Ghana. 770 61

The purpose of this paper is to describe gender differences in risk behaviors--substance use and sexual behavior--in young adults with genital herpes. Two-hundred fifty-two young adults with genital herpes were recruited into the study via newspaper advertisements in a West Coast metropolitan area. As a part of a large randomized clinical trial, participants completed questionnaires measuring demographic characteristics and the risk behaviors of substance use and sexual behavior. Participants had a mean age of 27.1 years and were largely Caucasian, employed, college-educated, and heterosexual. Women were two years younger than men and had less income. Gender differences were found in both substance use and sexual behavior. Men were more likely to report current use of illicit drugs than were women. Men were also more likely to report a history of gonorrhea, and urethral discharge. Women reported initiating sex at an older age and having fewer sexual partners over their lifetimes than men. There were no gender differences in use of condoms or spermicides specifically to prevent transmission of genital herpes. Further study is needed of these young adults as they are at high risk for transmission of the disease and also for contracting other sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. Sensitive interventions are needed with this high-risk population.
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PMID:A description of the gender differences in risk behaviors in young adults with genital herpes. 773 90

Early intervention for persons infected with human immunodeficiency virus (HIV) involves characterization of the stage of HIV disease, institution of therapy to prevent associated infections and postpone deterioration of immune function, and assistance in preventing transmission of the virus. This review examines the available data on the efficacy of current recommendations regarding the evaluation and management of persons with early HIV infection. Existing evidence supports the efficacy of physical examination, monitoring of the CD4+ cell count, tuberculin testing (with chemotherapy for persons who test positive), anergy testing, Papanicolaou testing and screening for gonorrhea and chlamydial infection (for high-risk women), screening for syphilis, antiretroviral therapy (for symptomatic patients), and guidance in reducing the transmission of HIV. Recommended measures for which evidence of clinical efficacy is less certain include immunization against infections due to influenza virus, Streptococcus pneumoniae, Haemophilus influenzae, and hepatitis B virus as well as antiretroviral therapy for asymptomatic persons. Quantitative measurement of viral titers appears promising for the monitoring of HIV disease and antiretroviral therapy; the correlations of these titers with clinical end points need to be confirmed.
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PMID:Early intervention for persons infected with human immunodeficiency virus. 779 7

The need to design acquired immunodeficiency syndrome (AIDS) prevention programs specifically tailored to the African-American community was underscored in a study that found substantial variability between Blacks and Whites in high-risk sexual behaviors. Included in the survey were 149 Black males, 155 Black females, 40 White males, and 64 White females attending the same college in the southern US. 71 (47%) Black males, 29 (19%) Black females, 20 (50%) White males, and 24 (38%) White females were currently involved with more than one sexual partner. 4.5% of Black students and no White subjects had tested positive for human immunodeficiency virus (HIV). Students with multiple sexual partners were significantly more likely than their monogamous counterparts to use illegal drugs, practice anal intercourse, have experience with prostitutes, have a history of gonorrhea and genital warts, and to believe condom use is not necessary if you love your partner. Blacks in the multiple partners subgroup were significantly more likely than their White counterparts to have experience with prostitutes, indicate an intense anger response to condom use, and perceive themselves as at high risk for HIV/AIDS; knowledge of AIDS scores did not differ. White students were significantly more likely than Blacks to engage in anal and oral sex. Discriminant function analyses revealed that having multiple partners was in large part (32%) determined for Whites by consistent condom use and having sex with women, while sex with women, oral sex, history of syphilis, and sex with prostitutes predicted 25% of the variance among Blacks. 41% of anal intercourse variance among Whites was contributed by having multiple sex partners, sex with males, sex with females, and marijuana use; 47% of the variation among Blacks was explained by previous treatment for gonorrhea, genital warts, and herpes; condom acceptance and the perception condoms are inconvenient; sex with males; being male; sex with a prostitute; and oral sex.
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PMID:What is the significance of black-white differences in risky sexual behavior? 780 59

The purpose of this study was to demonstrate the existence of sexually transmitted diseases secondary to sexual abuse inflicted on young infants in Black Africa. A total of 230 files involving infants presenting leucorrhea or urethral discharge were reviewed in Bujumbura (Burundi) to select only cases with bacteriologically documented gonorrhea. A total of 2 such cases were identified during the period from 1987 to 1992. There were 20 girls and 5 boys with a mean age of 6.4 years. In 4 cases, rape was proven. In 9 cases the contaminator could not be identified, but in 12 cases medical and legal evidence showed that the alleged authors of sexual abuse was a domestic employee at the child's home. These findings indicated that sexual abuse in children is not an uncommon occurrence in Black Africa and often leads to gonorrhea. The consequences of such abuse are aggravated by the epidemic of human immunodeficiency virus. The authors recommend a practical approach that should be taken whenever sexual abuse is suspected in these countries.
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PMID:[Aspects of sexually transmissible diseases in young children in Burundi: gonorrhea caused by sexual abuse]. 788 2

We analyzed data from a multisite study of 1,063 gay or bisexual men attending sexually transmitted disease clinics to evaluate factors predicting failure to disclose human immunodeficiency virus (HIV) risk behaviors to clinic staff and the extent of such failure. We compared data from a brief screening assessment on unprotected anal and oral sex with data on the same behaviors from a subsequent detailed interview. We also compared behavioral data from screening and the interview with data on diagnoses of rectal gonorrhea abstracted from medical charts. Of 523 men reporting unprotected anal sex at interview, 29% failed to report this behavior at screening. Men failing to disclose unprotected anal sex were also less likely to disclose engaging in unprotected oral sex. Among men reporting no unprotected anal sex, either at screening or interview, 1.6% were diagnosed with rectal gonorrhea. Logistic regression analyses comparing men who did and did not disclose at screening having engaged in unprotected anal sex showed that men who failed to disclose reported greater involvement in gay organizations, greater perceived peer support for condoms, fewer episodes of unprotected anal sex in the last four months, and lower rates of substance abuse treatment. Our data suggest that men who failed to disclose may have lower risk levels, and may be more integrated into the gay community. Brief interviews, as opposed to detailed ones, also may underestimate incidence of unsafe sex. Where feasible, HIV risk assessment and counseling and laboratory screening should be routinely provided to all clinic attendees, regardless of self-reports.
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PMID:Failure to disclose HIV risk among gay and bisexual men attending sexually transmitted disease clinics. 791 36

Since infants who acquire sexually transmitted diseases from their mothers are rarely symptomatic at birth, many recommendations are based on the maternal history and results of serologic screening tests. Management of an infant born to a mother with syphilis is based primarily on the mother's history of the disease and treatment. With gonorrhea, a single dose of ceftriaxone should be given to the infant if the mother is infected. Infants born to mothers with chlamydial infection are at risk of conjunctivitis and pneumonitis within the first two to 12 weeks of life. These infants should receive erythromycin 24 hours after birth. With herpes simplex infection, conjunctival and nasopharyngeal cultures should be obtained 24 to 48 hours after birth. Intravenous acyclovir should be given in cases of neonatal infection. Hepatitis B immune globulin should be given as soon as possible to an infant whose mother is HBsAg-seropositive. Infants born to mothers who are seropositive for human immunodeficiency virus should be started on zidovudine within 24 hours after birth.
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PMID:Management of infants born to women with sexually transmitted diseases. 797 83

The most common spermicidal compound in use in North America is nonoxynol-9. Barrier methods of contraception used in combination with a spermicidal product help prevent a variety of sexually transmitted diseases. In 1991 the Centers for Disease Control reported a total of 620,478 cases of gonorrhea, 128,569 of syphilis, and 43,672 of acquired immunodeficiency syndrome (AIDS). The evidence for antimicrobial activity of spermicides against sexually transmitted disease pathogens has been accumulated during the last 20 years from in vitro and in vivo studies on Neisseria gonorrhea, Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, Herpes simplex viruses 1 and 2, and the human immunodeficiency virus. Uropathogenic bacteria, including E. coli, Proteus mirabilis, Enterococcus faecalis and Staphylococcus species, have been found to grow in concentrations of 25% or greater of nonoxynol-9. Less well known is the effect of nonoxynol-9 on the growth of lactobacilli, the predominant organisms colonizing the vagina of most healthy postpubertal and premenopausal women, which according to in vitro studies could inhibit the colonization and ascending infection of the bladder by E. coli and as E. faecalis. The organisms associated with bacterial vaginosis have been found to be inhibited by low concentrations of nonoxynol-9 (0.0019-0.5%). However, spermicide use does not appear to have any effect on the development of bacterial vaginosis. Clinical studies to date, with one exception, have shown no significant differences in bacterial vaginosis infection rates among users of diaphragms, contraceptive sponges and condoms and other contraceptive methods that do not involve exposure to spermicides. A history of nonoxynol-9 use as well as the use of antimicrobial agents should be considered in recurrent urogenital infections, since both can potentially disrupt the urogenital microbial flora. The physician must weigh the risk of exposure to sexually transmitted diseases or an unwanted pregnancy against the prevention of urinary tract infection or vaginal candidiasis before advising the patient to discontinue the use of nonoxynol-9-containing spermicides.
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PMID:The influence of nonoxynol-9-containing spermicides on urogenital infection. 805 30

To start an active sexual activity at an earlier age and with a larger number of partners, has arousen the frequency of sexually transmitted diseases (STS). The teenagers are a group particularly affected. The objective of this article is to report the etiology of STD in a group of teenagers, out-patients at the Instituto Nacional de Perinatologia (INPer). The study includes 1360 patients at the clinic of STD at the INPer, 8.5 percent were less than 20 years old; 18.9 percent of them had previously a STD. The most frequent pathology was cervicovaginitis and the most frequently isolated pathogens were Candida sp, Gardnerella vaginalis and Ureaplasma urealyticum. There were no cases of gonorrhea. Three patients had Immunodeficiency Syndrome.
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PMID:[Sexually transmitted diseases (STDs) in a group of adolescents attending a perinatal care institute]. 806 80


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