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)

Two samples of street youth from the inner city area of Sydney, ranging in age from 13 to 20, with a mean of 17, were surveyed via a lengthy questionnaire. The first survey in 1989/90 (n = 92; 66 males, 26 females) revealed high levels of physical and sexual abuse; violence and negative relationships as major factors in leaving home; safe sexual practice not common (other than for those prostituting); polydrug use widespread and heavier for females; some needle sharing by injecting drug users (IDU). Second survey, 190/91 (n = 100; 70 males, 30 females), confirmed previous picture, but found changes in immunodeficiency virus (HIV) risk behaviours: needle sharing reduced; for those prostituting an increase in safe sexual practices with clients; reduction in regular safe sexual practices with non-paying partners. IDU was significantly linked to prostitution as was needle sharing. Some changes are in an encouraging direction, but more preventive work is needed focusing on safe behaviours with non-paying partners and how to initiate and negotiate these. More qualitative or ethnographic research could better inform such efforts and, indigenous strategies deserve recognition.
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PMID:Taking a chance on love: risk behaviour of Sydney street youth. 826 27

The only reportable exposure categories for human immunodeficiency virus (HIV) infection of children are vertical transmission from an HIV-infected mother or receipt of infected blood or blood products. Although sexual transmission of HIV among adults is the subject of intense concern, sexual transmission of HIV to children during child sexual abuse has received almost no investigative attention. This review discusses factors contributing to the exclusion of sexual transmission of HIV to children from studies of the epidemiology of HIV infection. Difficulties occur in screening and confirming abuse in nonselected populations of children, perceived and real barriers exist to the evaluation for HIV of sexually abused children, and problems occur in the assessment for child sexual abuse of HIV-infected children. Impediments to the understanding of the relationship between sexual abuse and HIV infection in sexually abused, HIV-infected children are considered, and measures that can allow these barriers to be overcome are discussed.
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PMID:Pediatric acquired immunodeficiency syndrome. Barriers to recognizing the role of child sexual abuse. 832 31

Sexually transmitted diseases pose a significant problem for children who have been sexually abused. The pattern of sexually transmitted diseases in this group reflects their changing pattern in the community at large. The prevalence of sexually transmitted diseases in sexual abuse victims is significant although it depends on a number of factors, including sexually transmitted disease prevalence in the community, the organism, and the type of abuse. The transmission route of most common sexually transmitted diseases beyond the neonatal period is accepted as sexual abuse, although the possibility of nonsexual transmission of some organisms, particularly those that can be transmitted at birth and have a long incubation and latency periods, is recognized. Mounting evidence for nonsexual transmission of human papillomavirus is generating continuing controversy. The significance of other organisms as indicators of abuse remains unclear. It is recommended that children suspected of being abused be screened for sexually transmitted diseases. There has been considerable discussion about the extent of screening. Screening should adhere to clear guidelines that address local epidemiologic issues. Screening for human immunodeficiency virus should be based on the extent of the virus in the community in which the child lives and on the nature of the abuse. Child sexual abuse must be recognized as an exposure category for human immunodeficiency virus. Test selection for evaluating sexually transmitted diseases in sexual abuse victims is a critical issue. Rapid screening methodologies should not be relied on, and if positive results are obtained, they should be confirmed using another method or even another laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sexually transmitted diseases and the sexually abused child. 839 42

This study assessed the situational and sociodemographic characteristics of children infected with human immunodeficiency virus (HIV) from pediatric sexual abuse. A letter of inquiry was sent to 2147 professionals across health and social service disciplines involved with child abuse assessment, treatment, and prevention. Respondents working in programs where HIV antibody testing of abuse victims occurs and who had identified HIV infection in one or more abused children were sent a survey to assess the demographics of victims, the family/living situation where abuse occurred, alternative risks for HIV infection, bases for diagnosis of sexual abuse and for HIV antibody testing, and profiles of the perpetrator and type of abuse. Of 5622 estimated HIV antibody tests conducted during 113,198 sex abuse assessments, 28 children were infected with HIV and lacked any alternative transmission route to that of sexual abuse. A total of 41 HIV-infected children with a history of sexual abuse were identified. Thirteen cases had alternative risk factors and were excluded from analysis. Sixty-four percent of the 28 victims with sexual abuse as the sole risk factor were female and 71% were African-American. The mean age was 9 years. Coinfection with another sexually transmitted disease (STD) occurred in 9 (33%) cases. Sexual abuse was diagnosed on the basis of a victim disclosure in 21 (75%) cases. The basis for HIV antibody testing was physical findings suggestive of HIV infection in 9 (32%) cases, HIV-seropositive or high-risk perpetrator in 6 (21%) and 2 (7%) cases, respectively, and the presence of another STD in the victim in 4 (14%) cases. Perpetrators were a child's parent in 10 (42%) cases and another relative in 6 (25%) cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Situational and sociodemographic characteristics of children infected with human immunodeficiency virus from pediatric sexual abuse. 841 4

Recent data suggest that the homeless and those with chronic mental illness may be at increased risk for HIV infection. A review of the recent literature reveals insufficient rigorously collected data to identify with confidence any particular subgroup of chronically mentally ill patients at increased risk. Nonetheless, it seems reasonable to suspect that those with acute psychosis, a history of substance abuse, or a history of sexual abuse may be at higher risk. Conversely, some data currently support the conclusion that homeless persons are at increased risk for infection due to human immunodeficiency virus (HIV). Clinicians of all disciplines should be aware of these findings and be particularly vigilant when patients are members of both aforementioned groups. Future research should focus upon improving service delivery to the homeless and mentally ill, particularly with regard to sex education and substance abuse intervention. Also, continued research into causal influences of homelessness will ultimately lead to more definitive intervention.
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PMID:Risk of HIV infection in the homeless and chronically mentally ill. 845 64

To address the unique manifestations of human immunodeficiency virus (HIV) among adolescents aged 13 through 21 years, a comprehensive evaluation and treatment program for high-risk and HIV-positive adolescents was developed in New York City in 1987. Among HIV-infected youth, mean age of testing was 18.2 years. One third of the HIV-positive patients were female and four fifths were African-American or Hispanic. No significant differences were found between HIV-positive (n = 50) and HIV-negative (n = 43) patients for age at first intercourse, injecting or other illicit drug use, history of sexually transmitted diseases, or survival sex (exchange of sex for money or drugs). HIV-positive males were more likely than HIV-negative males to have engaged in anal intercourse and to report a history of sexual abuse. Among infected females, 82% acquired HIV through heterosexual intercourse. Almost half (48%) of HIV-positive adolescents had significant immune dysfunction at the time of their initial visit (CD4 < 500/mm3) and were eligible for zidovudine. Many HIV-positive adolescents continued high-risk behaviors such as intercourse without condoms, particularly those with ongoing dependence on drugs or alcohol. With the epidemic of HIV infection increasing nationwide among adolescents, specialized, comprehensive programs are needed to counsel and treat HIV-infected adolescents and youth in high-risk situations.
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PMID:Human immunodeficiency virus-infected adolescents: the first 50 patients in a New York City program. 829 70

There is a growing awareness of the burden and implications of reproductive ill health as contributed by unsafe motherhood (during pregnancy, childbirth, abortion), reproductive tract infection (RTIs) and cancer, sexually transmitted infections (STIs) including the human immunodeficiency virus (HIV), poorly regulated fertility, infertility, unwanted pregnancy and adolescent/teenage sexuality and pregnancy. Sexual health further entails a state of well-being in expression of sexuality, prevention of unwanted pregnancies, prevention of STIs and AIDS and freedom from sexual abuse and violence. Reproductive health is increasingly being recognized as one of the corner stones of health and a major determinant and indicator of human social development. It is central to general health as it reflects health in childhood and adolescence and sets the stage for health and life expectancy beyond the reproductive years. It is affected by other health aspects such as nutrition and environment, low birth weight, neonatal and perinatal mortality and morbidity. According to the WHO, reproductive health problems account for more than one third of the total burden of disease in women and more than 10 pc of that in men. The challenges posed by the subordinate status of women, the exclusion of men in reproductive health programmes and the need for shaping adolescents' sexual knowledge and behaviour are viewed against today's poor reproductive and sexual health outcomes in the context of Africa. Education systems, employers and policy makers are challenged to provide adequate STI/HIV education and on-site (school, work, satellite, drop in) control services. Prevention interventions, disease and health trends and their outcome require systematic research in order to impact on policy. Reproductive health education should be universal, especially for adolescents, and its impact assessed against appropriate monitoring criteria such as reproductive morbidity, STI prevalence and abortion complications.
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PMID:Reproductive and sexual health: a research and developmental challenge. 865 76

Some effects of sexual abuse, for example, heightened sexual activity, are also risk factors for infection with the human immunodeficiency virus (HIV). Moreover, Social Cognitive theory suggests that the reduced self-esteem and increased sexual arousal that can result from abuse might alter self-efficacy for performing a behavior and expected outcomes of the behavior, making adoption of preventive behavior more difficult. Studies in the general population, adolescents, and male clients of sexually transmitted disease (STD) clinics, have found associations between childhood sexual abuse and HIV risk behaviors. This study was designed to measure: (a) whatever the association persists among female STD clinic clients; and (b) whether sexual abuse is associated with self-efficacy for condom use or condom use outcome expectations. Among the 83 female STD clinic clients studied, those sexually abused before age 18 had more sexual partners (p < .05), more positive hedonic outcome expectations for condom use (p < .01), and fewer positive partner-related outcome expectations for condom use (p < .05) than those never forced to have sex against their will. In summary, HIV risk behavior among female STD clients varies with childhood sexual abuse and Social Cognitive Theory suggests future directions for prevention.
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PMID:The relationship of sexual abuse and HIV risk behaviors among heterosexual adult female STD patients. 905 94

High rates of human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs) are seen in women prisoners. These high rates may be related to the nature of their lives, which may include violence, substance abuse, promiscuity, prostitution, and exchange of sex for drugs--all of which increase their risk for acquiring HIV. The purpose of this study was to examine the HIV-related risk behaviors and protective practices of women prisoners in a rural southern state and factors related to these behaviors. The sample included 57 women incarcerated in a medium-to-maximum security prison. Key findings included high rates of substance abuse, extensive past and current violent experiences including sexual abuse, high percentage of multiple partners, and low use of condoms. Additionally, women in this sample did not perceive themselves to be at risk for HIV infection. Practical suggestions for reducing the HIV risks of incarcerated women are offered.
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PMID:The lives of incarcerated women: violence, substance abuse, and at risk for HIV. 1054 75

Childhood mortality and morbidity patterns in the English-speaking Caribbean have changed significantly over the past 40 years. Acute respiratory illness, physical injury and conditions originating in the perinatal period have replaced malnutrition, gastroenteritis and other infectious diseases as major causes of illness and death in Caribbean children. Although population growth has slowed down, about one-third of the population of the English-speaking Caribbean remains under the age of 15 years. Infant mortality rates have also fallen but the major contributor to this decline has been a reduction in post-neonatal deaths. The decrease in mortality and morbidity from infectious diseases has led to a prominence of disorders originating in the perinatal period, psychosocial problems and chronic childhood disorders. Adverse economic conditions are held culpable for the re-emergence of protein energy malnutrition (PEM) and pulmonary tuberculosis in some territories. There is an urgent need to focus attention on the areas of perinatal and adolescent health, childhood disability, accidental and non-accidental injury, sexual abuse and human immunodeficiency virus (HIV) infection. Immunization programmes also require continuing support and expansion. These tasks cannot be accomplished without meaningful long term investment of financial and human resources in the health and educational services of the region.
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PMID:The changing face of paediatrics in the English-speaking Caribbean. 1063 56


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