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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey measuring acquired immunodeficiency syndrome (AIDS)-related behaviors and selected psychosocial factors was administered to 1091 tenth grade students residing in or near an AIDS epicenter. The purpose of the survey was to identify salient risk factors that could be targeted in AIDS prevention programs. By 15 years of age, one quarter of students reported engaging in behaviors that placed them at higher risk for acquiring infection with human immunodeficiency virus, and 3% of students reported engaging in very high-risk behaviors. Students exposed to certain psychosocial stressors (ie, adverse life circumstances and poor parental support), who engaged in other problem behaviors (ie, substance use and academic problems) and who had higher self-esteem, were more likely to engage in higher risk behaviors. Pediatricians and other clinicians, particularly those working in or near AIDS epicenters, who encounter adolescents with multiple psychosocial problems, should be alert to the possibility that these youths also are engaging in behaviors that place them at risk for AIDS. Comprehensive care for these teenagers must include an assessment of involvement in AIDS-risk behaviors and appropriate behavioral counseling.
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PMID:Psychosocial influences on acquired immunodeficiency syndrome-risk behaviors among high school students. 189 97

In a multicenter cohort study of homosexual men, the proportion of seropositives at enrollment who developed the acquired immunodeficiency syndrome (AIDS) during the following 18 months ranged from 5.5% to 8.2% in 1597 alcohol drinkers vs 9.2% in 109 nondrinkers with no clear trend according to use, and from 6.3% to 9.6% for 1662 users vs 7.2% for 83 nonusers of psychoactive drugs prior to enrollment. Among seropositive men with low initial T helper lymphocyte counts, those who continued to use drugs showed no significantly higher 18-month risk of AIDS than nonusers (13% vs 10%); the corresponding risks were 13% and 15%, respectively, for continued heavier vs continued lighter consumption of alcohol. No other manifestations of immunodeficiency were positively associated with substance use prior to enrollment. Prior use was not associated with low mean T helper cell counts at enrollment, and continued drug or alcohol use after enrollment was not associated with greater subsequent decline in counts. As used in a large cohort of homosexual men, psychoactive substances did not enhance the progression of human immunodeficiency virus infection.
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PMID:No evidence for a role of alcohol or other psychoactive drugs in accelerating immunodeficiency in HIV-1-positive individuals. A report from the Multicenter AIDS Cohort Study. 232 30

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

To examine the possible influence of obstetric factors, substance use during pregnancy, and other maternal factors on the relationship between a low maternal CD4+ level and vertical transmission of human immunodeficiency virus type 1 (HIV-1), data were analyzed from the Mothers and Infants Cohort Study, a prospective cohort followed for up to 4 years between 1986 and 1992 in Brooklyn and the Bronx, New York. The overall transmission rate for the cohort was 25.1% (95% confidence interval (CI) = 19.0-31.3). Prenatal CD4+ lymphocyte measurements were available for 162 HIV-seropositive mothers of infants with known infection outcomes. Among mothers who smoked cigarettes after the first trimester, those whose mean prenatal CD4+ level was < 20% had more than a threefold increased risk of transmitting their infection to their infants [relative risk (RR) = 3.30; 95% CI = 1.46-7.44; p = 0.004]. Among mothers who developed premature rupture of membranes, those with a low CD4+ level had a similarly increased risk of vertical transmission (RR = 4.33; 95% CI = 1.78-10.5; p = 0.003). These relative risks were much higher than those for mothers who did not smoke after the first trimester (RR = 1.14; 95% CI = 0.48-2.70; p = 0.76) or have premature rupture of membranes (RR = 1.29; 95% CI = 0.61-2.74; p = 0.50), indicating that these factors modified the effect of CD4+ level on transmission. Among all mothers without regard to CD4+ level, those who experienced preterm premature rupture of membranes were also at greater risk of transmission (RR = 2.24; 95% CI = 1.07-4.69; p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cigarette smoking, premature rupture of membranes, and vertical transmission of HIV-1 among women with low CD4+ levels. 791 27

This article focuses on the use of alcohol and marijuana in the context of sexual relationships and the impact of these substances on the consistency of condom use by urban, minority youth. Regression models are presented to test for the effects of alcohol and marijuana use with sexual partners while controlling for the effects of respondents' sexual history. The results indicated that when alcohol or marijuana was used with a partner, the consistency of condom use decreased even when other variables related to sexual history were controlled for. Alcohol use had a greater negative effect on condom use for Hispanic men and marijuana for African-American women than it did for Hispanic women and African-American men. These findings argue for the need for targeted safer-sex intervention programs for urban, low-income, minority youth, and suggest that such programs may need to emphasize the increased risk of human immunodeficiency virus exposure that may result from substance use, casual sex, and sex with multiple partners.
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PMID:Urban minority youth: alcohol and marijuana use and exposure to unprotected intercourse. 813 48

Use of alcohol and drugs is highly correlated with acquiring the human immunodeficiency virus (HIV), the precursor to developing an AIDS-related condition. Today the USA faces not one but two epidemics, the twin epidemics of substance use and HIV infection. A needs assessment in the state of Ohio of the 300 state-supported drug treatment facilities confirmed a need for HIV-related education and training of the 120 health care personnel, physicians and nurses. Unique train-the-trainer programming was planned and undertaken, including in the same training programme physician and nurse participants dealing both with substance use and HIV/AIDS issues. Significant differences were found in perceived levels of knowledge, and/or attitudes, before and after programme sessions, regarding substance use, HIV/AIDS, and related training issues. To reach all of Ohio's 120 drug treatment facility physicians and nurses required a 2.75 person-hour per trainee expenditure of professional resources.
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PMID:The twin epidemics of substance use and HIV: a state-level response using a train-the-trainer model. 816 76

Young people who engage in multiple health risk behaviors such as alcohol and other drug use, unprotected sexual activity, smoking, and violence, are a serious public health concern. To help identify potential strategies for influencing these behaviors, focus groups were conducted with 160 youth ages 10-18 years. For additional insights, focus groups also were held subsequently with 70 parents and grandparents of youth of similar ages. The youth participants were well-informed about most of the risky behaviors and their health consequences. Safe sex practices and the prevention of human immunodeficiency virus (HIV) infection were the exceptions. Despite this understanding, participants spoke of engaging in these behaviors as part of a lifestyle common to the high-risk environments where they live. The youth said that knowing why these practices were harmful was not enough to help them change the behavior. The need for skills building and support systems to reinforce their generally high level of awareness was evident. Love, home, family, and safety were cited as very important. Many participants said they wanted to talk to someone they could trust, who knew what they were going through. The groups of parents and grandparents were concerned about the physical dangers facing their adolescents and about peer influence. They also acknowledged their own mixed messages to their youth. The focus group findings suggest that health promotion strategies for high-risk youth should be comprehensive rather than categorical, with nonjudgmental, interpersonal communication integrated into community-based programs. To be relevant, program strategies must reach outside the usual channels and incorporate the high-risk environment where these youth live.
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PMID:Designing health promotion approaches to high-risk adolescents through formative research with youth and parents. 821 Feb 76

This paper explores differences in adolescents' attitudes, beliefs, and resistance skills regarding sexual behaviors and use of substances in the context of AIDS prevention. A total of 553 7th and 8th grade students completed a self-administered questionnaire as baseline data collection for a human immunodeficiency virus (HIV) prevention project. Students' attitudes about sexual behavior and substance use differed markedly. Teens in this sample reported feeling significantly more comfortable discussing substance use with their parents than discussing sex; they also reported that it is easier to say "no" to alcohol or marijuana than to resist pressures to have sex. Furthermore, these young adolescents believed that their parents would be less upset to discover that they were sexually active than to find out they were using drugs. Among students who had ever had sex and who had ever used alcohol, young adolescents indicated that their parents would be much less upset to find out they were having sex than to discover they were smoking, drinking alcohol, or using drugs. Implications of the findings for HIV/AIDS prevention efforts are discussed.
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PMID:Young adolescent attitudes toward sex and substance use: implications for AIDS prevention. 829 13

The present study determined lifetime and current psychiatric functioning in a sample of homosexual or bisexual men at various stages of human immunodeficiency virus (HIV) infection in order to address several questions regarding the relationship between psychopathology and HIV infection. HIV+ asymptomatic or symptomatic and HIV- homosexual or bisexual men completed self-report measures of psychological and health functioning and participated in structured diagnostic interviews. Additional information regarding HIV-related life events and their potential relationship to onset of disorder and family history of psychiatric disorder were obtained. A high lifetime prevalence of affective and substance use disorder was found, with almost one half of the sample meeting criteria for both disorders. Lifetime affective disorder diagnosis was associated with a positive family history of affective disorder. HIV-related events were most closely associated with onset or recurrence of affective disorder compared with other disorders. Low current rates of psychiatric disorder and levels of emotional distress were found, with no differences in degree of psychiatric adjustment across stage of infection. We conclude that the lifetime prevalence of certain categories of psychiatric disorder is high in both HIV+ and HIV- homosexual samples. Increased rates of psychiatric disorders do not appear to be a consequence of HIV infection. However, episodes of illness, particularly affective disorder, may develop following an HIV-related event such as confirmation of infection. Although symptomatic subjects have more somatic difficulties, there appears to be no relationship between stage of illness and level of emotional distress.
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PMID:Psychopathology in human immunodeficiency virus infection: lifetime and current assessment. 833 32

Curtailing the human immunodeficiency virus (HIV) epidemic requires the development of effective strategies for helping people reduce high-risk sexual behavior patterns. Because the objective of HIV prevention involves changing how people behave sexually, research findings in human sexuality are extremely pertinent to efforts to promote AIDS risk reduction. Unfortunately, most public health HIV prevention programs rarely reflect findings of human sexuality research. In this article, research is reviewed in the areas of the relationship contexts of sexuality, including variations in monogamy, condom use in affectionate versus casual relationships, sexual communication, and coercion; the modification of sexual behavior repertoires; substance use in relation to sexual intercourse; and sexual schema and scripts relevant to HIV risk. Policy and training issues related to human sexuality may have hindered efforts to incorporate sexuality research findings in HIV prevention programs. Advances and refinements in the success of HIV prevention efforts are likely if research on human sexuality is better integrated in AIDS prevention programs.
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PMID:Increased attention to human sexuality can improve HIV-AIDS prevention efforts: key research issues and directions. 854 13


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